If I may, a blogpost about something other than the book. Last week I went to a happy hour at a Baltimore watering hole* organized by the National Physicians Alliance. The NPA is an organization that I have felt warmly towards ever since they started the ball rolling on the Choosing Wisely movement. It is a group that wears its ideology and advocacy proudly on its white-coate sleeve and hanging from its stethoscope. (I talk more about the Choosing Wisely campaign in the book, which means this post is actually related. Whew!)
The people I met there were wonderful and of that ideology: primary-care centric, against the blandishments of Big Pharma, for evidence and for the patient at the same time. I don't remember their names, but many of them were in preventive residency programs (most at Hopkins) and a number were specialists in family medicine.
It was with a family medicine doctor that I had the conversation that sticks with me most, more even than the beers I had. I told him I thought a single-payer health care system would never be a reality, and he pointed out that it could, on a state-by-state basis. While all such state-level single-payer proposals have failed (except in Vermont), it wasn't too long ago that gay marriage was illegal in all states - and that too has made its way to legal acceptance through piecemeal, state by state progress.
Which is not to say that these issues are entirely comparable, of course. The permissibility of gay marriage is to my mind a moral cause, and not a hard call at all, while incrementalists have made powerful arguments that single-payer health care is not the only way to go. The long-term question, I suppose, is what comes next after the Affordable Care Act (i.e. Obamacare). Will access, quality, and (hopefully) cost continue to be improved under our employee-based model? Or will we make that leap that I more and more think is necessary, to care for all, indepdendent of employment?
The get-together with the NPA folk was inspiring. And, since most of them were a fair bit younger than I am, it bodes well for at least a corner of the future of healthcare.
*The Brewer's Art, where I was excited to see an artisanal beer called Migdal Bavel [the Tower of Babel, in Hebrew]. How often do you see a Hebrew-named beer in the US? So I asked for it from the bartender. Who couldn't understand what I was saying until I pointed it out on the list. I guess my beer-Hebrew pronunciation is off.
The people I met there were wonderful and of that ideology: primary-care centric, against the blandishments of Big Pharma, for evidence and for the patient at the same time. I don't remember their names, but many of them were in preventive residency programs (most at Hopkins) and a number were specialists in family medicine.
It was with a family medicine doctor that I had the conversation that sticks with me most, more even than the beers I had. I told him I thought a single-payer health care system would never be a reality, and he pointed out that it could, on a state-by-state basis. While all such state-level single-payer proposals have failed (except in Vermont), it wasn't too long ago that gay marriage was illegal in all states - and that too has made its way to legal acceptance through piecemeal, state by state progress.
Which is not to say that these issues are entirely comparable, of course. The permissibility of gay marriage is to my mind a moral cause, and not a hard call at all, while incrementalists have made powerful arguments that single-payer health care is not the only way to go. The long-term question, I suppose, is what comes next after the Affordable Care Act (i.e. Obamacare). Will access, quality, and (hopefully) cost continue to be improved under our employee-based model? Or will we make that leap that I more and more think is necessary, to care for all, indepdendent of employment?
The get-together with the NPA folk was inspiring. And, since most of them were a fair bit younger than I am, it bodes well for at least a corner of the future of healthcare.
*The Brewer's Art, where I was excited to see an artisanal beer called Migdal Bavel [the Tower of Babel, in Hebrew]. How often do you see a Hebrew-named beer in the US? So I asked for it from the bartender. Who couldn't understand what I was saying until I pointed it out on the list. I guess my beer-Hebrew pronunciation is off.
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