My Health Care Reform Letter

I haven't posted in a while, but if anyone's interested, this is the letter I recently sent to my U.S. Representative and 2 Senators. It by no means encompasses everything I think, hope, or believe about health care and health care reform, but at the current stage of the health care debate, I tried to select the things I thought most relevant without re-hashing too many things that have already been beaten to death or are likely to end up in a final health care bill no matter what. So without further ado, here it is:

Dear (Insert Elected Official's Name Here),

I am a medical student at Georgetown University. As a future health care professional, I write to express my feelings about health care reform. As one of your constituents, I voted for you because I believe you have the best interests of Virginia and of all Americans at heart, and that that concern for our welfare will inform your decisions in the current health care debate. Most importantly, I believe in the power of good people to make a difference, if they are willing to stand up for what’s important.

As most agree, our health care system is broken. Health care costs rise at twice the rate of inflation. As premiums continue to outstrip people’s incomes, more and more fall into the ranks of the uninsured and underinsured. As the father of a young family, the prospect of a medical catastrophe is terrifying, despite our being insured. In addition to the emotional toll of illness, the financial toll can drive good hardworking people into the ground, derailing future hopes and aspirations, and saddling them with a load of debt that leaves the shame and difficulty of bankruptcy as the only option. Our modern medical knowledge has unparalleled power to improve the life and health of our people – is that a right we wish to reserve only for those with the money to purchase it?

I believe everyone has a right to live, and has a right to access to affordable healthcare. Everyone has a right to live free of the fear that lifesaving interventions will be beyond their reach because they don’t earn enough. I hope this principle also guides your thinking as we approach this crucial time in our nation’s healthcare debate.

That being said, simply paying to provide healthcare to all Americans will only perpetuate the grave problems in our system. American healthcare is exorbitantly expensive. Real healthcare reform must take bold – and perhaps unpopular – steps to control healthcare costs, and while some of these reforms will require an investment up front, over time we can bring our healthcare system into a more sustainable balance.

Fixing our American healthcare system is, to me, the most pressing issue facing our nation today. It affects our prosperity and happiness as much today as it will in the future. For that reason, I urge you to vote for any healthcare reform bill that includes provisions for the following:

· Shift the focus of our medical system to prevention and primary care. Research has consistently shown that healthcare based on primary care delivers better quality at lower cost. Some ways to effect this shift include:

o Providing incentives for medical students to enter primary care. This can be done by bolstering existing scholarship and loan-repayment programs, such as the National Health Service Corps.

o Narrowing the income gap between primary care physicians and their specialist counterparts. This will require changing the way Medicare reimburses physicians. Implement a pay-for-performance system rather than a fee-for-service system that disproportionately compensates specialists for the higher number of procedures they perform, whether those procedures are necessary or not. Also invest in Patient Centered Medical Homes, that focus on prevention, holistic care, and long-term benefit to the patient.

o Delay or eliminate altogether the scheduled 21% reduction in Medicare payments to physicians. While this saves money, it does nothing to change the income gap between primary care physicians and specialists. This makes primary care even less attractive to future doctors and will only exacerbate the current shortage of primary care physicians. It will also discourage physicians from accepting Medicare patients, which isn’t good for anyone.

· Support a large-scale transition to electronic medical records. This will eliminate much of the waste of unnecessarily repeated medical tests, and help avoid the tragic medical errors that cause so much unnecessary suffering and death. Ways to aid this transition include:

o Subsidizing start-up costs for hospitals and physicians offices.

o Standardizing the language of electronic medical record systems, so that any system can interface with any other.

· Supporting a group or agency to look into comparative effectiveness of different medical treatments and interventions. Much of what physicians do is not backed by good research. Having a group that examines the research and makes recommendations, as well as commissioning research to be done in areas where the research is weak, will go a long way to improving the quality and decreasing the cost of medical care.

· Better oversight of Medicare/Medicaid and harsher punishments for fraud. No one should be getting rich at the taxpayer’s expense.

We as a society are now presented with an opportunity to right past mistakes and put our health care system back onto an affordable, sustainable track. Many of the issues I have raised here are already included in health care bills currently under discussion, but others will require a courageous voice to take them up and make them a part of the discussion. As a future physician I know this is crucial to the continued health and prosperity of our people and urge you to support meaningful health care reform along the lines I have outlined here. Thank you for your time and for your service to our country.

Sincerely,

Me (OK, that's not how I ended it in my letter)