Health Insurance
From Atul Gawande's editorial in the NYT today, in which he discusses the possibility of a major overhaul of the healthcare system:
"There is a second option, a fallback: we could guarantee coverage for today’s children — for their lifetime. It could be through private insurance or through a Medicare plan that families must enroll them in. Either way, the subsidies required are very much within our means.
We might even pass the fallback plan first. Then, while we are stymied fighting about how to fix the rest, there’d be at least one generation that could count on something more."
I've gotten to the point where I'm counting on that fallback plan; over the past six months it's started to heavily influence my interest in pediatrics. I don't want to get stuck treating only patients who have money, but I also don't want to spend my career trying to plug holes in a broken system by having a career where I'm treating only underserved communities.
I realize that sounds harsh, but I'm saying it because I know myself and I know that after a while I would become demoralized and bitter because in a way I would essentially be an enabler. If you work on behalf of the underserved as a politician or a civil rights lawyer you're working towards a goal of some kind of justice for that group. Towards a day when the fight will be won. I find it hard to think that way about medicine, because treating individual uninsured patients doesn't really have the larger effect of one day creating a system where everyone is covered. Again, I know it sounds harsh and maybe I'm wrong there (factually and morally). I guess what it boils down to is that given a choice, I'd rather work within a system that's fair and includes everyone. If that's not possible, then yes, I'd rather work the broken system in a way that allows me to treat the underserved populations. In third place is working as a dermatologist for upper middle class people with PPO's and driving a BMW; that option is tied with returning to Hollywood and working as a personal assistant.
I want to work with a diverse population in a practice that's accessible to anyone, and I'm betting that policymakers can convince voters that every child in the U.S. should be able to see a doctor regardless of their family's income. I've got three years to make that decision, and I'm guessing that the midterm elections in Clinton's first term in office will pretty much tell us if reform is possible. Hehe.
"There is a second option, a fallback: we could guarantee coverage for today’s children — for their lifetime. It could be through private insurance or through a Medicare plan that families must enroll them in. Either way, the subsidies required are very much within our means.
We might even pass the fallback plan first. Then, while we are stymied fighting about how to fix the rest, there’d be at least one generation that could count on something more."
I've gotten to the point where I'm counting on that fallback plan; over the past six months it's started to heavily influence my interest in pediatrics. I don't want to get stuck treating only patients who have money, but I also don't want to spend my career trying to plug holes in a broken system by having a career where I'm treating only underserved communities.
I realize that sounds harsh, but I'm saying it because I know myself and I know that after a while I would become demoralized and bitter because in a way I would essentially be an enabler. If you work on behalf of the underserved as a politician or a civil rights lawyer you're working towards a goal of some kind of justice for that group. Towards a day when the fight will be won. I find it hard to think that way about medicine, because treating individual uninsured patients doesn't really have the larger effect of one day creating a system where everyone is covered. Again, I know it sounds harsh and maybe I'm wrong there (factually and morally). I guess what it boils down to is that given a choice, I'd rather work within a system that's fair and includes everyone. If that's not possible, then yes, I'd rather work the broken system in a way that allows me to treat the underserved populations. In third place is working as a dermatologist for upper middle class people with PPO's and driving a BMW; that option is tied with returning to Hollywood and working as a personal assistant.
I want to work with a diverse population in a practice that's accessible to anyone, and I'm betting that policymakers can convince voters that every child in the U.S. should be able to see a doctor regardless of their family's income. I've got three years to make that decision, and I'm guessing that the midterm elections in Clinton's first term in office will pretty much tell us if reform is possible. Hehe.
Labels: Healthcare
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