Newt Gingrich's recent post on the National Review Online's "The Corner" is a mixture of good intention, fundamental ignorance, and conservative dogma. Gringrich, founder of the Center for Health Transformation, reminds his readers that "bureaucrats have tried health-care reform before without much success," and continues with a vapid, uninspired litany of what our health care system should be: mainly, one in which individuals don't get sick, doctors don't make mistakes, and the government does as little as possible. "Our goal," Gingrich writes, "should be to take back our money from the crooks who defraud the system, rather than taking it from the American taxpayers." Of course preventive and predictive medicine should be maximized, medical errors minimized, and fraud eliminated. Of course health care should be universally accessible, of the highest quality, and free for American citizens. But suggesting that these goals can be accomplished by individuals alone, without government support, demonstrates fundamental lack of understanding of the problem's magnitude and complexity, and an unabashed political dishonesty.
To his credit, Gingrich acknowledges that health information technology is an important part of the health system improvement process. Also admirable is his emphasis on the patient's role in the systemic health care process, an often over-looked component of intervention efficiency assessment and prediction/prevention measures that are crucial to sustainable reform. I suppose Gingrich's Center for Health Transformation is an effort to address these needs without involving "bureaucrats" and "big government." The Center's website lists ambitious "metrics" of success, including "prevention of all medical errors" and "elimination of all preventable diabetes." How such sweeping change of this magnitude is achieved without nation-wide determination of and adherence to data-collection and intervention protocols or guidelines is, I guess, left to individuals and their will power. How individuals without medical educations are expected to make informed decisions about their care, without standardized data that attempt to compare available interventions, isn't addressed by the Center's efforts to "cut out the middle man." How the practice of medicine itself is supposed to progress from an intuitive process, in which error is inevitable, to a more precise, data-driven process, in which error is minimized, is ignored. To sum up Newt's message: it's not realistic for government to play a positive role in health care reform, but the Center for Health Transformation can "prevent all medical errors." Obviously, because politicians are human beings but doctors are gods. Right.
As much as I'm frustrated by the off-hand dismissal of any possibility that government can play a positive role in improving America's health care system, I do appreciate the Center for Health Transformation's emphasis on individual action. While I don't agree that "personal responsibility" to live healthier is the solution to any of the most problematic aspects of the broken U.S. health system (see Atul Gawande's recent New Yorker piece), I do believe that it is only by the united action of citizens that any significant social change can happen.
More on the connections between social activism/disobedience and technological innovation coming soon...
No comments:
Post a Comment