You can count Dr. Robert Wachter as one of the people taken aback at the vehement ongoing ruminations in favor of maintaining health care's status quo.
"What they're missing," said U.C. San Francisco's chief of hospital medicine and medical service
, "is that the present system is terribly broken and unsustainable. An argument for the status quo is pretty scary. The status quo has Medicare going bankrupt in seven years. It has levels of quality and safety I think most people would find unacceptable. And it has nearly 50 million people without insurance."
So you can count Wachter as one of the people applauding yesterday's signing of comprehensive health care reform
into law. But he's not just supporting this bill because it's better than nothing. In his learned medical opinion, "it ain't that bad."
"To me, what this policy does is it tackles these problems about as well as anything I think they could have, given the political constraints," said the doctor. "It makes a significant dent in the number of people who are uninsured -- and if you've ever spoken with them they live in great fear of getting sick. And hospitals have to absorb the cost of care when they come to the ER or get hospitalized -- and that gets passed on to everybody else."
While a free-market economy is a great thing, continues Wachter, it hasn't worked so far for the national health care system. Primary care physicians earn a fraction of specialists' wages -- setting up a system in which more doctors go the lucrative route, charge more, and more patients aren't initially diagnosed. Naturally, this leads to massive costs.
Care is "completely fragmented" between large hospitals and small doctors' offices -- so "the most information-intensive business we have is less computerized than Safeway." The government needed to step in and try to put health care right, maintains Wachter -- because it wasn't happening on its own.
In the short-term, Wachter said he's thrilled to see the ostensible demise of "the most heinous aspects of the present system." These include the possibility of losing one's insurance when diagnosed with a major medical condition, being unable to leave a job solely for insurance reasons, or being unable to buy insurance because of preexisting conditions.
But what if you've got good insurance and no complaints What's in it for you? Wachter answers,"it makes us a better society. And if you thought this was someone else's problem, you may lose your job or get really sick or hit your 'lifetime cap
'. People say 'How is it possible I'd spend $1 million on health care?' Believe me, come to my ICU, these people did not expect to be on mechanical ventilators, ringing up a bill of $1 million in fairly short order.
"You may not have thought this [bill] would help you. But it does."