The health care system's Yom Kippur confessional, from A to Z

I don't talk too much in the pages of Talking To Your Doctor about my own personal religious or cultural allegiances. Good health care, as I mention in the book, is the application of universal principles to infinitely variable patients. Doctors' characteristics are inherently less interesting (to my mind) than those of the multifarious people they try and help. Still and all, we are now in the days leading up to the High Holidays of the Jewish calendar, when - as Jewish myths have it - the world was created. In that tradition, this is the month where we try to surprise ourselves into realizations of how imperfect we have been. It is the time not to take any flaw for granted anymore.

Since much of this blog has to do with our system's flaws, I thought I would present an attempt at secular liturgy. The Yom Kippur prayers involve many acrostics meant to catalog our imperfections. Why not do the same thing with our health care system? If sometimes it gets awkward making problems fit into the alphabet, it's no more awkward than being a patient that has to go through such a system.

We should not ask forgiveness, but change our health care system that
accepts inequality as a matter of course;
breaks hearts callously;
computerizes without deliberation;
deliberately popularizes without evidence;
ever specializes;
familiarizes us with inefficiency;
grabs the most expensive thing off the shelf;
hates difference;
innovates technologically but not ideologically;
jeers at the addict;
kills;
lies;
medicalizes personality differences;
never says sorry;
often dissembles;
pays whatever is asked without question;
questions patients more than providers;
rashly introduces new treatments;
shies away from community engagement;
treats the poor with disdain;
understands little;
very little;
wears the mantle of science without justification;
excels in profligacy
yet cannot manage equity.

Zack Berger

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