Map of life expectancy at birth from Global Education Project.

Wednesday, September 30, 2009

Well Jesus H. Christ

today is International Blasphemy Day. I kind of see this as being like National Brotherhood Week -- you mean I can't blaspheme the other 364 days? My proposal is to combine it with Talk Like a Pirate Day -- imagine the possibilities.

Anyway, of more urgent concern is this finding that fewer than half of graduating medical students say they understand the system in which they are about to begin practicing. Tell me about it. I used to teach a course for med students called Patient, Doctor and Society, in which we tried to explain it all. They eliminated the course because the students complained they didn't have time for that shit, they had a licensing exam to pass.

And it was a whole lot of shit, to be sure. Just explaining Medicare was a week. I tried to create a diagram showing the organization and financing of health care in the U.S. and it ended up looking like a wiring diagram for a jet fighter. I couldn't get a readable version onto a legal-sized page. For each patient, the doctor has to figure out what is covered and what isn't -- including which drugs are in this person's formulary -- and how and where to send them for specialty services and how much the doctor is going to get paid and by whom and when. Here's the answer:

Universal, comprehensive, single payer national health care.

Very easy to understand. Everybody's covered for everything that's actually good for them. The doctor gets paid by the same payer, in the same way, for every patient. Everybody has the same formulary. No problem. Don't worry about it. Go ahead and study for the licensing exam.

Now that's blasphemy.


Bix said...

"they didn't have time for that shit,"


I can relate to aircraft wiring diagrams.

Anonymous said...

Yeah I tried a diagram or something like it once and gave up after two hours.

Impossible to understand unless one is an expert, on the spot, is paid for it, etc.