Wednesday, March 9, 2011

Medicine at Crossroads

Human knowledge, understanding and behavior evolve due to experiential references. Our time and its consequential references has foreshadowed the eloquence of one of the greatest nobilities of human endeavors; Medicine.

Medicine lies bleeding at the doorstep of a world caught up in the weight, value and cost. Medicine that once redeemed the health of a human being is now relegated to the swamps of fatigue, walls of worry and opaque windows of haze from where the future is not visible. The restlessness that permeates this once noble and generous profession is gathered and proffered by none other than those that lined it up as the road paved with the best of intentions.

The safety net that was to catch those elderly with fixed incomes has now become the Holy Grail for the politicians and the retirees. No one wants to let go of the rope. No one seems willing to understand the consequences. No one seems to see the crumbling pixels of the image of the future. Is it that we have come so far away from the premise of self-reliance to the desire of dependence that we don’t see the thorns that line the paths to our own future?

What will happen to that water-colored painting when the drenching doubt of solvency rears its ugly head? Would the officers in charge continue to kick the ball down the road and use patchwork of band-aids to cover the abraded wounds of their diseased and dying concept? What will they do? How will they solve this calamity that they keep putting off on some one else’s shoulders? When will “It is not my problem,” end? When will giving “more” to seek a polling-booth advantage give way to a reasoned thought, concerned with the debt on our progeny?

These are serious questions that require a few courageous tough-minded souls to take on and answer. The resolution will not come easy. There will be a lot of crying, criminalizing, vilifying that will go on, because those that are on the ride will be left wanting and those that expected to get on the train will find the doors shut.
If courage is to take hold and determination is to provide a consensus of strength to proceed with the tough road ahead the simplest solution is to make the break now.

Some simple solutions involve, raising premiums for those wealthy seniors who are able to afford, stop enforcing assignments on the physicians and allow fee-for service to find the balance between good care and affordability, stop chastising the physicians and allow the “market-place” to determine the difference between need and want. Somewhere in our citizenry there is a “self,” wanting to have a go at being reliant.

Medicine is at the crossroads between excellence and mediocrity. Choose the right path and generations will prosper and benefit. Choose the wrong path and the whole house of cards will fall upon us all.

The moment of reckoning closes in upon us. Choose wisely.

The following graphs and charts are obtained from the Office of Management and Budget (OMB) and rendered for information.

If it be now, 'tis not to come; if it be not to
come, it will be now; if it be not now, yet it will come—the
readiness is all. --Hamlet

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