Alright, so generally I try to stay away from politics. I find value in pondering "The Issues" but I struggle when it comes to talking about them. I've never voted for a president--in 2008 I was too young by 9 days and in 2012 Kalamazoo County and the West Virginia postal services failed me and I received my absentee ballot the day after the election. While I really cherish the right to be a part of the nation's future, I don't really mind that I haven't been able to vote since I'm kind of a commit-o-phobe towards political ideals and thus do not feel qualified to take a multiple choice test about them every November. Living in West Virginia especially has led me to believe that what might seem like perfect answers to big problems in the nation/world are usually not perfect for everyone. Walking the political line between being an "enlightened" college graduate and being someone living in a real world of American poverty is an eyeopening, but frustrating, experience. For now, understanding all of my own political beliefs seems like a far off dream but I'm enjoying working on it one issue at a time.
So naturally, like any selfish American, I'm first drawn to the parts of politics that will affect me the most. Most recently, ObamaCare, since this is something that will affect me and my family as consumers of healthcare as well as my own future as a provider of it. I spent another day shadowing at the clinic and learned a lot of interesting insights about how this new policy will affect rural health and rural physicians. My initial thoughts on the Affordable Healthcare Act were ones of excitement. It was hard to have spent so much time with people I care so much about, knowing they don't have access to healthcare. But talking with Kelli at the clinic has brought some changes. Currently, the clinic runs on a policy where people who don't qualify for medicare but can't afford their own policy can still have office visits and pay on a sliding scale carefully calculated based on income and household size. This will no longer be the case once things begin to set in place, resulting in unaffordable co-pays and more visits to emergency rooms. Physicians will be reimbursed by insurance companies based on a patient-per-day salary, removing any incentive for those providers to stay a full day once that quota has been met. This results in a lack of availability of care for patients who need help, and eventually will create a classist system of medicine where those who can afford better healthcare will go to better health institutions paid for by their private insurance companies. These private locations will eventually draw all of the best doctors (because they will be the highest paid positions) and the poor in America will lose out on quality of care. Further, there will be a Meaningful Use clause, which my dad aptly pointed out to me, seems to be changing the healthcare system to mirror the public education system...and I think we all know how well that is working out. This clause says that insurance companies can access patient logs and use objective "progress" markers in cases to award bonuses to physicians. Seems like a great system, right?--Doctors who are doing right by their patients and helping them get better get paid more than ones who aren't. So what if, like a teacher in a district where the kids and parents don't care about education, you practice medicine in, say, southwest West Virginia where the majority of people are fat, smoke, and believe too much in the magic of Mountain Dew? Well, that would probably mean that no matter how many antibiotics you prescribe, tumors you help remove or conditions you treat, people won't change their lifestyles and you'll never see any extra money. So good luck recruiting physicians to work in rural areas where this will be the issue, but sadly where the most help is needed.
Although I'm pretty sure that no one really understands how things in medicine will really change, I find these new insights to be really distressing. While I mourn for the possible impending downfall of quality healthcare, I also feel even more called towards this vocation to try to fight it.
There is beauty in clarity and understanding, I'm sure, but I also find it in the process of seeking answers and that's what I have today.
Thursday, February 7th:
Today was busy--I spent it making arrangements for my time at home and making sure everything I need for the volunteers, who will arrive when I get back, is all done. Although I don't feel like I've been stressed this whole winter and so am in need of a break, it is nice to know that I'm going to have some time to relax at home before things get really crazy. Late in the day I helped Stan and Larry with some yardwork. This resulted in my first experience with poison ivy. So itchy. Any assistance in finding the beauty in life's curveballs is appreciated. For now, I'll use my calamine lotion to cheers to karma. Apologies to my staff in WV for deserting them this week, but they should know that it's not all roses here in MI.
Friday, February 8th-Saturday February 16th:
I'M AT HOME!!! And I have this lovely companion to keep me company when the folks here have to stop entertaining me and go back to their real lives.
"A new commandment I give to you, that you love one another: just as I have loved you, you also are to love one another. By this all people will know that you are my disciples, if you have love for one another." John 13:34-35
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