The Denver Post
May 16, 2004
Tough lessons for a med student
By Patrick Kneeland
Medical school admission interviews are predictable. Stressful, but predictable. The interviewer offers some questions: Why do you want to go into medicine? What would make you a good doctor? What would you do if you didn’t go into medicine? The potential student has probably considered these questions before and rattles off more-or-less rehearsed answers.
Once in a while, an unexpected question arises. It was such a question that
caught me off guard at one interview. “Is health care a right or a privilege?” a doctor asked me. “A right,” I answered.
The answer seemed straightforward. It stemmed so easily from my answer to
why I wanted to be a doctor: “To blend an interest in science with an interest in the well-being of people,” and “to use medical knowledge to improve the quality of life of patients.” Quality of life, I thought, depends on the ability to overcome the burden of illness.
In the two years since entering medical school, I have often thought about
my answer. I have turned the issue over in my head, revised my justifications and considered the ways I could have justified answering “a privilege.” My instinctual answer has proven to be infinitely complicated.
In those two years, a romanticized view of doctoring has given way to a reality of negotiating more than disease and patients: the skyrocketing costs of drugs, burdensome malpractice insurance and the numerous bottom-line interests that supercede interests in the patient’s well-being.
Despite the complexities inherent in health care, I am equally confident in my answer today as I was two years ago. If asked the question again now, I would say this:
All people deserve access to health care, and I believe that we have the opportunity to make the right to health care a reality.
We face an unnerving paradox. Every year we spend twice as much per capita
on health care as the average of other developed countries. At the same time, we rank an abysmal 37th among developed nations when outcomes such as life expectancy and infant mortality are compared. Moreover, all nations that rank above us provide health coverage for all of their citizens – a far cry from the U.S., where around 44 million people (including 8.5 million children) are uninsured. We lead the world in medical training, facilities and spending, yet we fail to provide many citizens with even basic care.
The good news is this: As we look for ways to improve health care, we do not
need necessarily to demand more financial sacrifice from the average (citizen). Instead, we can search creatively for ways to better use the resources that exist.
One proposed solution to the problem lies in a national health insurance program. Proponents cite studies that such a system would create enough savings in administrative overhead (currently one-third of health care spending) to cover everyone. Such insurance wouldn’t increase costs for most American families and would free employers from extravagant insurance costs.
There are innumerable excuses given as to why we cannot provide health insurance to all. Change is frightening. Yet the status quo is even scarier.
Let’s commit to asking not if we can, but how can we provide health insurance to everyone in this country. By putting our energy into “how,” we just might be able to get there.
(Patrick Kneeland is a second-year medical student at the University of Colorado Medical School.)
http://www.denverpost.com/Stories/0,1413,36~158~2146834,00.html
Comment: Most of us who participate in various forums on reform have heard
repeatedly the debate over whether health care is a right. Those of us who
believe that everyone should have access to affordable health care cringe
when we hear the all too common invective of the opponents of reform, “Is
food a right!?” The food fight that follows is never productive. It is sad that the discussion of the right to health care is such a highly polarized, divisive issue.
Fortunately, informed, dedicated individuals, such as medical student Patrick Kneeland, are able to look beyond this ideological debate on the right to health care, and move on to an analysis of the problems with our system and solutions that would work.
We can learn much by listening to the fresh wisdom of the Patrick Kneelands
of our nation. We need to discard this “’tis so, ’tis not” broken record, and get on with reform.
