Some of you may remember me as the emergency physician who strongly supported John Edwards for president until he dropped out.
That was painful-- not just for me, but for the 37 million people in the United States without health insurance. John Edwards had the plan and the passion to finally bring about universal health coverage in this country, but you all (and by that I mean in the generic sense of primary voters) chose otherwise.
Now that he's no longer an option, I felt it was my duty to weigh in on the two remaining Democratic candidates.
In this world of rising malpractice premiums and shrinking insurance reimbursements, doctors are forced every day to make difficult decisions. Should they agree to care for the uninsured sick person who can't afford the upfront payment, and will likely default on their bill, or should they turn them away?
More often than you care to realize, the decision comes down to profit or perish, and the patient is out of luck. If the doctor wants his practice to stay open, he/she must be a healthcare grinch and instruct the scheduler to say no.
I chose emergency medicine for several reasons, but the biggest one was the federal mandate that EVERY person is entitled to an emergency evaluation, and the treatment necessary to stabilize their condition.
I simply did not want to ever be in a position where I had to say "no" to someone in need.
But there was a downside to my decision too. Yes, I can take care of everyone with a clean conscience, but I'm also stuck seeing the end result of the broken system:
The migraine headache with vomiting that should have cost $150 for a clinic visit and prescription, but has now turned into dehydration and will require IV fluids and a $2600 emergency room bill.
The minor skin infection that should have cost $150 for a clinic visit and prescription, but has now spread to the entire leg and will require a prolonged admission and surgical debridement for $26,000 instead.
It is so painfully obvious to me and every other physician I know that the SYSTEM IS BROKEN.
We need a system that covers everyone. Not just the sick, but the healthy as well-- because even the healthy are at risk for catastrophic injury or illness.
Barack Obama's plan may appeal to healthy young people, most of whom don't see a doctor very often, but it is shortsighted. Allowing some people to not be insured raises the rates for everyone else, and sets those people up for disaster.
All it takes is one car accident. One severe allergic reaction. One infection gone bad. One rare disease-- and your whole world will come crumbling down around you.
We have a moral obligation to take care of our neighbors.
We have a moral duty to make sure nobody is EVER turned away.
We have a moral responsibility to insist that every American shares the burden of universal health coverage.
For that reason, I cannot support Barack Obama for president. He does not have the vision or the moral clarity to make universal coverage a priority.
By letting people choose to "opt out" of the system, he is continuing the situation where doctors must sometimes say "no". He is tolerating the game of Russian Healthcare Roulette, where the unsuspecting person suddenly finds themselves in need, with no options.
Most Obama supporters seem to be okay with that. Either you're in that "healthy" group yourselves, or you let the word "mandate" scare you away from the right decision.
Let me tell you about mandates.
We mandate seatbelts in America, to help protect people on the off chance they should get in a serious accident.
We mandate Social Security tax in America, to help protect people on the off chance they should hit financial disaster before retirement.
And we should mandate health insurance in America, to protect those without the foresight to protect themselves, on the off chance that they will need serious medical attention.
To encourage them to take advantage of preventative care, instead of suffering the results of disease neglect.
Hillary Clinton's universal health insurance plan is the closest to the one John Edwards offered. It provides coverage for free to those who can't afford it, and subsidizes coverage to those on the edge.
But most importantly, Hillary Clinton's health care plan elevates the level of humanity in America. It allows us to finally make good on the ideal of loving our neighbors, and caring for strangers as we would for family.
Because we're all brothers and sisters in this country, and on this planet.
We're all in this together.