There is a tension between medicine and business: business demands cost efficiency, while medicine requires excellence at any cost. Now that healthcare is receiving a legislative overhaul, we are introducing a third player in the game, the government.
Most of us vote for whatever legislation benefits us personally. That is why the hospital and insurance lobbyists dislike the new bill, and folks that currently don’t make enough to afford insurance favor it. What we are seeing is the people deciding, via elected legislators, who will pay more and who will pay less.
Since I am a family physician, and a Fort Worth hospice agency owner, I am quite interested in the final bill. It will affect my clinic and hospice patients, and it will more than likely decrease my income.
The bill’s final version probably will not scale back the hospice benefit. That is good news for the hospice community. The bill will more than likely cut funding for medicare advantage plans. Bad news. Millions of seniors, and hundreds of my patients, receive care through these plans.
Details? We are not sure yet what will be cut. The bill will give power to a medicare oversight committee. That committee will experiment with cuts here and there, and expand those cuts that save the most money and disaffect the fewest people. At least, that is how it is supposed to work.
We can never forget the law of unintended consequences!
- Will we receive shoddy medical care if nurse and physician pay decreases?
- Will medication research stall out if generic manufacturers win their right to enter the market sooner?
- How will hospitals and doctor offices handle the millions of newly insured patients?
- What will happen to county hospitals when a portion of their patients acquire insurance and go elsewhere (i.e. how many people will lose their jobs there?)?
Whew! That is a lot to chew on, and too much to worry about. In ancient middle-eastern history, the prophet Jeremiah said to the Hebrew nation, then exiled in Bablylon, “seek the peace of the city where I have called you to be carried away captive.”
As followers of Jesus, we are under orders to work for peace here, where we are sojourning. Within health care reform, I think that means involving ourselves in the process, all the while, trying to civilize the dialogue, and avoid pushing just for what benefits us the most.
Regardless of what the elected humans distill from their final negotiation, I will hope in the One who is worthy. I like this Chuck Colson quote: “Where is the hope? Our hope is not in what laws are passed, or who governs us. Our hope is in the power of God working in the hearts of people.”
