I rarely tread into the political, but during this time of extreme political rhetoric bordering on insanity, I have seen two things in the last week that brought home what is such an important and ironic point. The first was this poster, which I happened across in the lobby of the American Heart Association’s national headquarters:
It’s a poster that I suspect was created during a time of debate about the ACA, focusing as it does on lifetime limits on benefits, which were eliminated with passage of the ACA. The focus of the poster, of course, is how important it is to write policy by starting with patient needs and putting politics aside.
The other item that got me to this particular blog post was a Huffington Post story today about candidate Rand Paul, who happens to be an opthamologist. The article talks about how, while other candidates were at the Iowa State Fair giving farm kids helicopter rides and eating meat on sticks, Dr. Paul was giving free cataract surgeries to Haitians. The quote that caught my attention was this, “In the operating room there are no politics,” according to the candidate. I’m sure his visit to Haiti was timed for political reasons, but the words still matter because they are right.
It is so pathetic to me to watch how the healthcare sausage is made through the political rhetoric machine. It’s such a basic human need, healthcare, and basically the same for all of us regardless of what flag we fly. Chronic illness, genetic conditions and the common cold really don’t give a damn if we are Republicans or Democrats or on this side of the border wall or the other (ps- my favorite quote of the election so far is Andy Borowitz’s observation that those in favor of Trump’s border wall are unable to find the border on a map). And yet, political parties use healthcare as a pawn in the discussion without regard for those it serves. You can’t turn on the radio or TV without hearing about all that is great or awful about the ACA, Planned Parenthood, Medicare, you name it. And rarely if ever do those public discussions take place in the context of the true impact on the patient. It makes no sense to me since patients = voters.
The ACA debate is cloaked in talk of cost and the subtext is whether or not we should make health insurance a right or a perk, especially when it comes to the poor. While I know that the wonks among us know the facts and figures correlating insurance with better health (high correlation fyi), it’s rarely mentioned on the evening news. For doctor reimbursement and bundled payments, it’s always about what the doctor’s do or don’t deserve and how we manage costs, but we rarely hear the arguments in the context of how the SGR decision might affect the actual people at the end of the checkbook: patients/consumers. For issues of birth control and women’s health, the subtext is either freedom from regulation or the role of religion and family values. Those who are for more freedom on this issue do cite the impact on women, but this seems to have no interest whatsoever to those on the other side of the political debate who haven’t done the math that 51% of voters are women.
But in the end, it’s real people who are affected by government policy decisions, not imaginary voting blocks. We in the healthcare field are now in a phase of “consumer empowerment,” recognizing and responding with business strategies to the coming of greater consumer/patient responsibility, financial, clinical and otherwise. You can’t attend a healthcare conference without hearing healthcare company CEOs talk about the importance of consumer-focus, patient engagement, personalized medicine, etc. And when they do, the personalization isn’t driven by party affiliation, thank goodness.
Population health is for the people with disease, not just the people lining up for Trump’s helicopter special or supporting Hilary’s right to secret email. I know that these healthcare CEOs have party affiliations, but they manage to leave those in their pin-striped pockets when making product strategy decisions, and thank goodness for that. The move to consumer-driven medicine is happening and there are no politics that will stop it. Economics are the driver, and especially the economics of consumer responsibility. Armed with their wallets, people with healthcare needs are beginning to draw a new picture of how the system must work. Yes, it’s slow but it’s real, and all of the savvy business people in healthcare understand it. Maybe they could take their favorite politician aside and explain how important it is to think about actual people when talking about healthcare.
Once upon a time there was a political activist who said, “Follow the money.” Considering that professional candidates whole job description is to follow the money into their campaign coffers, you would think they might heed this warning in their healthcare policy discussions. The money is in the pockets of patients and when they act as consumers, they are powerful and acting purely in their own self interest; that self-interest is to get the care they need in a way that satisfies them. I can assure you that there has never been a patient lying in a hospital waiting for a procedure thinking, “would the Republicans want me to have this surgery?” There is no cancer patient considering his/her treatment options who starts from, “what would Hilary think of this chemo regimen?” or “what would The Donald say?” (Answer: build a wall and throw the cancer patients over it).
In the operating room, there are no politics. So very true.