I must not be living right. My wife called Congresswoman Niki Tsongas and left a message with one of the staff. This was about my wife's views on the proposed Health Care Reform bill in the US House of Representatives. Within a week she had a nice letter back from the Congresswoman.
I, on the other hand, was listening to a Tsongas call-in and at the end left a message, as I was invited to. That was a week before my wife called the Congressional Office. I have yet to hear back. I did stop by the Lowell office about a week ago and was told that it was being worked down in the DC office.
So, what was my comment?
I am concerned about the economics of it all. If we have about 260 million people in this nation with health insurance and about 47 million without health insurance, how are we going to provide the actual medical care for those without insurance? Or, are those 47 million getting medical care now, but the payment process will change? It is a simple economic question.
If the medical industry is producing 260 million units of care a year and there is some degree of market stability, then when there is an additional demand for 47 million units, per economic theory, if there are not sufficient doctors, nurses and other health care specialists ready to move into the market, the only thing that can happen is the price goes up or there is rationing.♠ I haven't yet figured out how we are going to get more coverage without opening the spigot of health care training.
And, there is a need for more health care out there. For one thing, out across broad spaces across the fruited plain the people are spread out and the health coverage is thin. My buddy Neal has a cousin who is a doctor and he flies to his patients. It would appear we need health care extenders (relatively quickly trained Physician Assistants (PAs) and Nurse Practitioners (NPs) in my concept) to provide more and better coverage.
Then there are the inner cities where there is insufficient health coverage, aside from Emergency Rooms, which are sometimes overwhelmed by people with medical issues that would be better treated if the patient had a primary care physician. This is another place where Physician Assistants and Nurse Practitioners could make a difference.
So, what do I propose? I propose that the US Congress expand the US Public Health Service♥ to include a greatly expanded uniformed corps of Physician Assistants and Nurse Practitioners, who would pay back their education by serving in a location selected by the USPHS. The Surgeon General sends you off to school for a year or two for qualification and then for a "pay back" you are sent to Montana or Detroit, Michigan for three years to work with certified MDs to provide quality care to the people in your area.
With this process people get a change to have issues resolved more quickly and those people can then be passed on to specialists if there are serious problems. Further, the USPHS healthcare provider can move into the neighborhood and advocate for things like childhood shots and dealing with identifiable health hazards.
Is this a solution with a lot of problems? For sure. However, it addresses the economic side of the issue. If we are going to provide more health care we are going to have to provide more providers. The time to start is right now.
Where is the response from Representative Tsongas' staffers?
Regards — Cliff
♠ Let us be honest, there is rationing today. My buddy "X" has Parkinson's Disease and he is on an experimental regimen of treatment. My non-medical judgement is that the treatments work well. A while back I helped him reformat his Excel Spreadsheet where he tracks the costs, which are currently not covered by either Medicare or TRICARE. Frankly, we don't have the extra money that would be needed if either my wife or I needed such experiment treatments. He gets the treatment and I wouldn't be so lucky. Rationing.
♥ One of the seven uniformed services in the Federal Government.