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    SB Physicians Sound Off on Health Policy

    ‘No one should become bankrupt because he is ill,’ said Dr. Patricia Coyle, Professor and Acting Chair in the Department of Neurology at Stony Brook. However, the Universal Health Care Action Network (UHCAN) claims that over 50% of bankruptcies that occur in the United States are related to medical bills. These bankruptcies occur because people who do not have health insurance must pay medical bills from their own pockets. According to a recent US Census Press Release, approximately 46.6 million people in the United States do not have health insurance coverage.

    Dr. Coyle, along with many other doctors at Stony Brook, stressed the importance of universal health care, the idea that health care should be available to everyone in the United States. Countries such as Canada, Great Britain, and Australia have universal health care systems. In the United States, publicly funded programs such as Medicare and Medicaid are available, and many employers also cover health insurance for their employees. Also, Americans are entitled to emergency care services by federal law. However, the government itself does not provide basic health care to everyone in the nation, leaving 15.9% of the total population without any heath insurance coverage.

    Doctors are unsatisfied with the present healthcare system for a variety of reasons. Dr. David Brown, Co-Director of Stony Brook Heart Center and Chief of the Division of Cardiovascular Medicine, discussed the ‘therapeutic fatality’ of some patients. As patients get sick, hospitals take care of them and give them the medication they need. Once the patients return home, however, they cannot afford their prescribed medicines because they do not have health insurance, and they get sicker and sicker until they return to the hospital again.

    Additionally, Dr. Patricia Coyle said he believes that the government’s health care policies have been extremely unsuccessful. Doctors are poorly reimbursed for medical care delivered, there is too much emphasis on procedures, and there is too much paperwork. When doctors do not receive appropriate reimbursements for their work, they are forced to see more patients and do not spend as much time as they can with each patient. Dr. Coyle explained how in her field, neurology, 80% of a diagnosis of a patient is determined by the patient’s history. However, doctors do not get properly reimbursed for just talking to patients, whereas if they perform different tests on the patient, they will get reimbursed. This may influence how doctors treat their patients.

    Several doctors also mentioned how the increasingly high costs of technology has increased the cost of healthcare in the nation. Dr. Raphael Davis, in the Department of Neurological Surgery at Stony Brook, said, ‘Interestingly, technology ultimately drives prices down in every field except in medicine.’ Higher costs make it harder for people to receive proper medical treatment without health insurance. Also, Dr. Steven Jonas, Professor of Preventive Medicine and of the Graduate Program in Public Health, whose first textbook on health policy was published in the 1970s, said ‘healthcare technology is the 800-pound gorilla in the room.’ Advanced procedures, such as MRI and CAT Scans are useful, but they are expensive and do not need to be performed on every patient. Nevertheless, doctors are better reimbursed for performing these tests, and this has an impact on their patient care.

    Stony Brook’s physicians suggested various reforms the government could enact to improve the healthcare system. Dr. Coyle argued that the government should spend more money on preventive care; patients could receive medical treatment before they become extremely sick and must get treated at a hospital. Also, she says that the government should encourage competition among pharmaceutical companies to drive the prices of medication down. Dr. Thomas Wilson, in the Department of Pediatric Endocrinology at Stony Brook, said, ‘It is deplorable when a country as advanced as ours cannot provide medical care to all of its population. Our priorities are off ‘hellip; we should stop our military efforts and spend money to better people in this country.’

    ‘Universal healthcare is an excellent concept in theory,’ said Dr. Davis. However, the government would have to develop a basic set of health care provisions, and, ‘it is hard to agree on what a ‘basic’ set of healthcare is in a country that is founded on individualism,” said Dr. Margaret Parker, Professor of Medicine, and Anesthesia, Interim Chair in the Department of Medicine, and’ Director of Pediatric Critical Care Medicine at Stony Brook.’ ‘Universal health care systems work well for other countries, but the United States is too big and too heterogeneous for a governmental universal health care policy.’ Instead, Dr. Parker suggested that we should introduce a single payer system in the United States, in which one private company or group of companies oversees health care coverage. This would decrease the amount of paperwork involved in health care coverage and would help make the system more efficient.

    In contrast to the United States, Canada, Great Britain, Australia, and other countries all have universal healthcare policies. Dr. Wilson said he believes that Canada is a good example of universal health care because people ‘pretty much get equal coverage.’ Other physicians pointed out that these countries have problems as well, such as long waiting lists for certain medical procedures. Because these governments provide health care coverage for everyone, they must prioritize who needs what care. In contrast to some countries, Australia has both a nationalized and private health care system. ‘All people in Australia receive basic health coverage, but they have the option of avoiding long waiting lists by getting help from private insurance companies. People are generally satisfied with healthcare,’ said Dr. Shaheen Rasheed, Chief Resident in the Department of Medicine at Stony Brook, who also went to medical school in Australia.

    Dr. Jonas discussed the state of America’s healthcare system in present times. ‘Ever since the failure of the Clinton Health Bill in 1994, the health system has come under the control of profit-making companies in the insurance, pharmaceutical, and technological industries.’ Stony Brook’s physicians advocate reform of the health care system in the United States. Nevertheless, Dr. Jonas admitted, ‘I do not know what the solution to this is. We are not in a crisis, because a crisis would be resolved in a short period of time. This system has declined over the last thirty years.’

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