Archives for posts with tag: patient advocacy

We’re all sick of the health care debate. But those who are sick, trying not to get sick, or taking care of others who are sick don’t have the luxury of absenting themselves from this debate.

They (we) are looking on in horrified fascination as the GOP makes its plan known: dismantling Obamacare and leaving millions without insurance — replacing it with stopgap subpar underfunded skimpycare.

The so-called “skinny plan” is chockfull of real harm. 15 million more uninsured. 20% premium increases. And that’s before the skinny bill is stuffed even more full with add-ons designed to pacify the elements in the GOP who take moral exception to Medicaid. (The poor should refrain from getting sick, you see. Government should not be involved in healthcare. We should go back to the good old days, whenever and wherever those were.)

It’s as if the check-engine light was blinking on your dashboard, and in response your mechanic doused the car with gasoline and set it on fire.

If you have a Republican senator, call them and tell them your healthcare story. Ask them if they came to Washington to harm the sick. If you have a Democratic senator (or if your senator is Collins or Murkowski!) call and thank them for standing up for what’s right. You can also go to the Indivisible website to be patched through to those in red states, whom you can connect directly with their senators. (I’ve done it. It’s addictive.)

Yes, life is full of complications. Things are hard. There’s plenty to do besides this sort of advocacy. You have work to go to, kids to raise, doorknobs and toilets to fix. If you are involved in whatever else you have to do, no one should criticize. But if you can just take a moment to speak up, you’ll feel good, and we’ll all thank you.

Cross-posted as usual to the blog at Talking To Your Doctor.

The last chapters of my book propose remaking our health care system on the basis of good communication and positive relationships with our doctors (and nurses, and physician assistants). How do we get to a changed system on the basis of individual behavior? Isn’t that unrealistic, even naive?

Remaking our system is a noble, grand struggle, one of the most important tasks for this century. Remaking is already going on in different ways. Obviously, there is health care reform, by which is meant legislation and executive action. This is, mostly, top down. I am not a libertarian: there is nothing I find philosophically inimical about top-down change. Health care is huge and someone has to flip the master switches.

At the same time, however, change has to come from the bottom. Patients are their own people with adequate decision-making capacity: can you believe that some doctors are only just coming around to this truth? But how do we get the system to embody this truth? We can not legislate shared decision making and patient-centeredness; nor can we merely, by fiat (as some e-patients are doing), say that patients are now the owners of the store.

Patients should be the owners of the store, together with their doctors, but just proclaiming that in a loud voice won’t get you anywhere. Some of us live out in the woods, where Internet calls-to-action don’t carry, and some others of us are too disempowered or intimidated to take charge in our doctors’ offices even if we are given permission to by those well-spoken advocates.

I like to make the comparison to the struggle for civil rights, which I am no historical expert in (so correct me if I am wrong). That struggle’s success was dependent on both legislative action and bottom-up activism, each of which informed the other. The exercise of the right to vote would not have been possible without the Voting Rights Act. The Voting Rights Act would not have worked without protests.

There is a place for health care reform to encourage primary care providers to establish a relationship with patients, and vice versa. But the importance of communication to such an endeavor, I can’t help but think, is not something that will come out from Washington. That will have to bubble up out of each exam room individually.

Tomorrow’s the big day! Please – if you have read the book already – review it on Amazon or Goodreads. If you haven’t read it, you are warmly invited to do so. Even more important than buying the book is letting me and others know what you think about it.