Program Note: Tune in to hear more from Dr. Sanjay Gupta on the challenges facing President Obama tonight on an AC360° special, “Extreme Challenges: The Next 100 days,” at 10 p.m. ET.
Dr. Sanjay Gupta
CNN Chief Medical Correspondent
Tonight, we are talking about a topic that I have been thinking about for nearly two decades. Health reform. In the early 90’s, as a medical student, I attended grand rounds where the topic might be spine fusion, but the side discussions were on federal entitlements. Over the years, I learned the perfect technique of removing a brain tumor and clipping an aneurysm, and spent my odd hour reading and writing about our health care system and its ability to provide very good health care to many, but certainly to the exclusion of some. When I worked at the White House in the Clinton administration as a Fellow, I saw firsthand how massive health reform might happen. It didn’t. And, now as a neurosurgeon, who has chosen to work at a county hospital, I spend my days taking care of people who are uninsured and as a result are sicker and more desperate – it is sad and heartbreaking. I have wondered out loud again how it might all be fixed.
I think it’s safe to say that no one thinks our health care system works well. I haven’t thought so, almost from the moment I entered it. Simplifying a bit, for the purposes of this blog, the two issues on the table are cost and access – and probably in that order. Having sat down with President Obama, I know he believes we should build on the current system. That is, people who have health insurance they like should be able to keep the same coverage. People who can’t afford it would be eligible for subsidies to help defray the costs. I have not heard anyone from the administration talk about completely overhauling the system or having it completely run by the government.
Cost seems to be the driving force behind most of this health reform. Here’s why: many people believe we cannot possibly afford to provide health coverage for everyone unless healthcare itself is less expensive. I believe we pay too much for too little. Decreasing costs means increasing the value and possibly making health care insurance more affordable in the process. And that is how cost drives access. The President has talked about things like increasing prevention, investing in health IT and realigning the incentives for hospitals and doctors as strategies to lower the costs. The costs and the potential savings are not measured in the millions or even the billions, but instead the trillions.
Like I said, I have been thinking about this for nearly 20 years, but health reform has been on the table since the days of Truman, maybe even before. If you were to ask me, I am more optimistic now than ever, because of the support of organized medicine, industry and even the insurance industry. But, it won’t likely happen, even now, without the will of the people.
So, what do you think? Do you like the health care plans on the table and what would you change if you had the chance?
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