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The midterm elections have come and gone, and there soon will be a lot of new voices reverberating through the halls of the Capitol -- which has to be great news for health care reformists. Who better to find a saner and fiscally more responsible way to deliver health care to our citizenry than those who have pledged to save us from wasteful spending and ineffective policies?

Welcome back, fiscal conservatives! We need you!

We need you because in 2009, US healthcare expenditures rose to 2.5 trillion dollars, representing almost 18% of the nations' spending that year, and marking the largest yearly increase in health care spending this nation has ever seen. We have witnessed your passion in all those campaign ads where you spoke about bringing runaway spending under control. Certainly, when our current way of operating the business end of health care is driving us both individually and as a nation towards bankruptcy, your consciences will not rest until you have made the kind of profound changes to our healthcare system that such wasteful spending calls for.

And we need you, fiscal conservatives, because if we can believe all your campaign ads -- and how could we not -- you have a proven track record of cutting through red tape and solving problems. The US has, by almost all measures, some of the poorest health on the planet despite the fact that our health care is also, by far, the most expensive. Now that's a problem. A big, embarrassing, shameful problem. If ever there was a time for tough, honest, no nonsense leaders who will fight for us in Washington, this would be it.

And talk about taxes! Transparent taxation is part of the bedrock of democracy. Yet most Americans have no idea of the hidden costs of our privately insured health care -- the approximately $1500 of a new car cost that covers autoworkers health benefits, for instance. Carry that same kind of calculation over to college tuition or any other typical big-ticket item, and we get a startling picture of just who it is that is not allowing us to hold on to our hard-earned money. It ain't big government. Compound that to the effect that employer-paid health insurance premiums have on our paycheck, our job security, and even our ability to change jobs, and we realize the toll our privately run system has taken not only on our pockets, but also on our individual liberty. We welcome your representation on this insidious taxation.

Now we may have the tiniest disagreement on the role of the free market in our society. We all understand that free market principles are part of the American DNA; in fact some of you folks talk about the free market the way you would talk about your sainted mother. But lets be honest. No matter how much we all love our mothers, there are some places we don't want to take her -- to college to be our roommate, for instance. There are some places where the free market needs to be kept at arm's length as well. It doesn't mean we don't love her.

At the hand of the free market, our healthcare system has devolved into a health-industrial complex where health policy is decided by executives in the boardrooms of insurance companies while pharmaceutical companies spend hundreds of millions of dollars annually to successfully market expensive drugs of questionable efficacy. To watch the commercials featured on the evening news, one would think that the biggest medical problem facing our nation is erections lasting more than four hours. Even many of the medical tests and procedures we undergo are driven primarily by the people who will make money if the tests are "positive." We don't need to be communists. We just need to be smarter. Healthcare for profit has not been good to us and we can't afford it.

We know you fiscal conservatives are a patriotic bunch -- to the point where you almost imply at times that the rest of us are unpatriotic, but I am willing to overlook that in a spirit of cooperation. Those of you who have served in the military, like I did for eight years as a medical officer in the US Navy, are quite familiar with a little concept we call single-payer, universal health coverage. So you see, it really was not invented by the Canadians, which means you can safely consider the medical and economic benefits of this system without feeling you are betraying the homeland.

So, new guys, you're smart, your patriotic and you know how to manage money and solve problems. Can you see why you are bringing hope (dare I say change?) to a liberal-leaning pediatrician who has seen, firsthand, the best that medicine has to offer in the form of our own military's universal single-payer health care system -- one whose policies were guided by medical science rather than profit? If you indeed mean what you have been saying about bringing spending under control, then profound, meaningful health care reform will be a top priority, and you really will be just what the doctor ordered.

Maggie Kozel, M.D. is the author of "The Color of Atmosphere: One Doctor's Journey In and Out of Medicine," forthcoming from Chelsea Green Publishing. Follow her blog at barkingdoc.com

 
 
 

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