“Meg” was one of my favorite patients because she approached the impending delivery of her baby much like most men would; at the height of her pain and fear, with the baby about five good pushes from delivery, she told us she’d had enough of this “labor crap” and was leaving the hospital.
That’s how some of the American public appears to be approaching health care reform. It has turned out to be difficult, painful and scary stuff, and some of us want out of here. That fear has been the most powerful of those reasons to climb down off the health reform delivery table and head for home should not be a surprise; many opponents of health care reform have been going to great lengths to scare the bejeesus out of the public about reform proposals in Washington. They’ve said health reform will cause many of us to lose our insurance, lose our personal physicians, lose our elderly ill family members to “death panels,” or lose our country to socialism.
Most of that’s a crock, of course, but there is a reason opponents of true health care reform have used fear. Fear works, and has been used for almost a hundred years in American health care debates, according to political scientist Jonathan Oberlander of the University of North Carolina. In a story on National Public Radio recently, he reported that in the early 1900s, opponents of national health insurance said it was a plot by the German emperor to take over this country. Opponents in the 1940s said it was the first step to communism. Ronald Reagan opposed Medicare — yes, Medicare — in the early 1960s on the grounds it would lead to socialism, as did the American Medical Association. I, myself, am afraid health insurance for all will cause the rest of my hair to fall out, my dog to lose kibble money playing poker with the neighbors’ cats, and al-Qaida to take over this nation’s pizza parlors.
So what do we do when scary ideas about reform give us the health care heebie-jeebies? We should do what women in labor do; take a deep breath, focus on the work and not the fear, remember the chance something terrible is going to happen is tiny, and don’t fear things you have been told that sound too dumb to be likely.
Take “death panels,” the idea that some docs and government bureaucrats behind the green curtain are going to decide whether Grandma is worth saving next time she gets sick. This fearmongering started after some health reform bills before Congress proposed reimbursement to physicians for time-consuming discussions about end-of-life care with patients and families, discussions most patients want.
Death panels sound like a crackpot idea, are not part of Canadian or European health systems (or any other I know of), and no rational people in their right minds would ever propose such an idea. The idea that health reform proposals included death panels sounds like a crock and is a crock and was recently branded by the American Association of Retired Persons as a “flat-out lie.”
Let’s try another one: Health reform will result in government bureaucrats telling me I cannot keep my own primary care physician. Hmmm … every other Western country in the world has universal health insurance and not one tells people whom they must pick for their physician. Americans fight tooth and nail against any infringement of their personal choice, and generally love their doctors. If you add that all up, it’s clear the likelihood smart politicians would support health reform ideas that tell you who your personal physician must be is just about zero.
You get the idea. Stop reacting with fear to what you are hearing, start reacting with smarts, and this whole health care reform idea will be a lot less scary. At the end of all this debate and reform, we are going to have our personal physicians, nurse practitioners, physician assistants, nurses, enough hospitals, health insurance for all, and no death panels. Given that, there is little in health care reform that should truly scare us (unless, of course, it includes new rules that men have to give birth to every second child).
Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region. He is also the interim CEO at Blue Hill Memorial Hospital.