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I’m Glad Economists Aren’t Practicing Medicine

I was invited to speak at the National Library of Medicine’s 2010 Annual Conference. Today I heard fellow speaker Uwe Reinhardt, Ph.D., discuss healthcare economics, and although his presentation was entertaining, as a physician I found it to be rather disturbing.

On the one hand I understand Reinhardt’s desire to engage Americans in a rational conversation about limited healthcare resources. My friend Dr. Rich Fogoros has been calling for this for many years. Yet, I was disappointed by his enthusiastic reductionism — that peoples’ lives should be reduced to a mere societal cost equation. He also said that, “When America grows up, it will look a lot more like Europe,” and cited a conversation with Dr. Phil Gingrey as an example of the congressman’s over-valuing human life.

“Economists see people as a collective statistic… physicians see them as individuals” said Reinhardt. And I thought to myself – “Well thank goodness Reinhardt’s not my doctor.” The depersonalization of suffering individuals is the first step to denying care with a clear conscience. Broad-stroke solutions can result in a march towards mediocrity… and Reinhardt’s attitude worries me.

Reinhardt seems to believe that the United States would provide better medical care for its citizens if it adopted a European-style socialized medicine approach. I’ve heard this argument from many Democrats and friends – and I wonder if we’re in the midst of a cultural revolution. Is America losing its fierce individualism, thirst for innovation, drive to be the global leader in science and a primary economic engine for the world at large? Do we really believe that we need to “grow up and become like Europe?”

There is no doubt that some people are falling through the cracks in the US healthcare system, and that there is waste and inefficiency in the system that needs to be addressed. However, I’m not convinced that the solution is to reduce people to statistics, offer a one-size-fits-some national healthcare plan, and begin to move away from personalized medicine and high tech research. In copying Europe, we may lose the essence of who we are as Americans. What makes us unique is our frontier spirit, creative problem-solving, and drive towards the American dream – where anyone who is prepared to work hard can reap benefits.

The question is whether or not we’re still prepared to work hard, turn our economy around, and use that wealth to care for those who are sick and disabled. America is the most generous nation on the planet – and that generosity should be used to drive improvements in healthcare services for all. But if we don’t address our economic decline – and make its reversal our top priority – what wealth will we have to increase access to healthcare?

As a physician, I’ll continue to do the very best I can for each individual patient who comes to me in need – and I hope that economists will turn their attention to helping America stoke its financial engine so we can afford to provide as much evidence-based care as we can to as many people as possible.

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