Doctors Disappointed at Debate


A fitting metaphor from a Doc who was there

m-koriwchakThanks to some undeserved serendipity I had the good fortune of being invited to last week’s live broadcast town hall debate on CNN between Senator Bernie Sanders and Senator Ted Cruz regarding the future of Obamacare. I was offered the opportunity to appear in person to ask a question to the congressmen and spent many hours in communication with CNN producers to formulate a question acceptable to them.  Sadly the event ended in disappointment.  As the congressmen got long-winded and Senator Cruz had already spontaneously addressed the topic of my question, time ran out with my question unasked.  I have no ill feelings towards CNN over this.  Such is the nature of live events. 

Yet such an outcome is a fitting metaphor regarding the main problem with the narrative on health care reform.  My wife Amy said it first:  “This debate was no different from the ones we heard almost 10 years ago when Obamacare was first offered.”  She is absolutely right.  For decades we have heard – from both sides of the aisle – the same tired arguments from people who have never touched a patient and have no understanding of how health care should work.  There was nothing new offered Tuesday night.  On the Democratic side we heard that because health care is a right the government should provide “Medicare for all.”  On the Republican side we heard there is no way to finance such a big plan and that the government needs to get out of health care.  Familiar scapegoats – pharmaceutical companies and insurers – were dragged out with torches and pitchforks.  Both sides fight the war from the same trenches that were dug ages ago.  On Tuesday night no new hearts and minds were won for either side.

It is also fitting that the one opportunity to bring new life to the discussion – to bring physicians into the conversation – was turned away.  The one group who lives and breathes health care every day was ignored – as it has been for decades.  To be fair, some of the blame lies with us physicians – in the past we have as a general rule been averse to carrying our Hippocratic Oath beyond the clinic and the operating room.  But over the last several years that has changed.

Tuesday night’s debate may not have been the right time to engage.  We did not have as much time to prepare as we would have liked, and the exact rules of engagement were not clear.  But even with such apparent misfires we gain knowledge and wisdom.

The right moment to engage will come.  And we will be ready.



  1. What is lacking in delivery of health care is physician training in understanding the crucial role food holds in preventing, treating and reversing systemic chronic disease that is driven by our standard American diet. 80% of our leading chronic diseases can be treated and prevented with lifestyle modification: using the methodology of the institue of functional medicine. Responsibility begins with self care in life choices diet choices and habits, activity, sleep, social support. relationships stress and sleep. See the American College of Lifestyle medicine and the Institute of Functional Medicine Mission and directives. Our disease care system focus lacks direction is is unsustainable. Health is not a RIGHT but an individual responsibility. Our focus must be population based community lifestyle education and lifestyle choices. Our lifestyle choices are root causes of chronic illness that drive the major portion of Health care delivery Cost. More pharmaceutical intervention cannot drive major change in health out comes.What is needed is community education and reward incentives to our communities, that optimize individual responsibility in disease prevention that surpasses our efforts in high tech/cost procedural/Pharmacological solutions. Physicians education in population centered redesign of delivery must be included in this planning. More debate/dissent will never yield strategic planning and implementation. Health economists, physicians without specialty biased interest need to be at the planning table. Needed are our best minds not political partisanship. The root criteria for a successful planning: team focus and impeccable accountability. No room at the planning level should special/self interest interfere. Revamp the planning.

  2. Steve Messer

    Saw you on Twitter. I agree with your premise. Washington always applies Washington solutions. Obamacare has failed because of this. Hopefully Tom Price will bring some new faces to the table with fresh solutions. Not only does the discussion need to include Doctors, but also healthcare facilities, business CHRO’s, Insurance professionals (not necessarily CEO’s) and professionals involved in the delivery of healthcare and delivery of insurance. Too many healthcare dollars flow through too many hands before getting to providers. It is an incredibly inefficient system. Too much government involvement will only make it worse. Thank you for being a voice for change.

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