Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Wanting better health care shouldn’t be conservative or liberal

Aaron E. Carroll, MD
Policy
September 25, 2010
Share
Tweet
Share

I remember this one moment back in the midst of health care reform when I was sitting in a radio studio, feeling pretty glum about the whole ordeal, and I mused aloud, “I wonder if anyone is enjoying this at all.”

For some of us, improving the health care system is more than a passing fancy.  I’m a health services researcher.  It’s my job.  Those people on the TV pay attention to it when it gets ratings, and those people in Washington get into it every other decade or so, but it’s what I do every day.

I really with I could make you believe that I couldn’t care less about the politics of it all.  Seriously.  Yes, like everyone else I care about who is in the White House of Congress, and I do lean different ways on different issues, but – on this I swear – I just want a better health care system.  That’s all.  I don’t care if it’s labeled conservative or liberal.  I don’t care what names you call it.  I just want it to be better.

Specifically, I want it to have phenomenal outcomes, I want everyone to have access to it, and I want it to be cost-effective.

I hope you notice I didn’t say cheap.  I think good things do cost money.  I just wouldn’t like to spend any more than we have to.

People may think I’m closed minded, but I swear I’m not.  I am persuaded by good research.  That’s all.  Evidence.  Data.  Science.  I really don’t have a stake in who “wins” this.  It’s only the final product that matters.

Which brings me back to the title of this post.  I’m heartened by some recent activity I’ve seen.  I watched a debate occur between Austin Frakt and Avik Roy without it degenerating into partisan hackery.  I somehow managed to say a few words on the topic without resorting to sarcasm.  And I believe (maybe I’m delusional) that someone following the whole thread may have seen that it is possible to discuss good, unbiased research in a civil manner.  I stand by this:

I don’t think there is necessarily a right or wrong here.  Research is, more often than not, baby steps.  Each study adds a small amount to our understanding; each study is only so generalizable.

And I’d add that by talking about the body of work that exists, and discussing what from it we can agree on, we could find a starting point for moving forward.  Wouldn’t it be nice if we could devise pilot programs in health care reform in different ways, and then study them?  Agree to the methodology beforehand and then see what happens?  How great would it be if we all agreed to stand by the results, no matter what they might be, no matter what our ideology?

For instance, Avik cites the Medicaid program in Indiana which set up health savings accounts for Medicaid recipients and then coupled them with high deductible health care plans.  Why oh why did they not agree to allow an independent third body to set up a study to see how it worked?  Maybe good research would have shown that reform to be a spectacular success, vindicating the consumer-driven approach.  Maybe good research would have shown that reform to be a spectacular failure, suggesting that such an approach cannot succeed in a high-risk population.

It sure would have been nice to find out.  Instead, too many are driven by a desire to see their pre-chosen method of reform succeed, and so prevent any chance of it being seen in a bad light.  These types of people deny any flaws in a single-payer approach, no matter if such flaws exist.  They refuse to examine the downside of increasing out-of-pocket costs because it might hurt their “side”. They are more interested in the ideology than the goal of improving the health care system.

No good can come of that.

Anyone who reads this blog knows I think highly of Austin.  And, I opened by email this weekend to receive a very nice note from Avik concerning my recent posts.  Those personal contacts really do matter.  They remind me that some of us do have a shared goal – a better health care system.  We may disagree on how best to get there, but we can at least discuss our differences, and – perhaps – look for similarities. This kind of post gives me hope.

I hope this type of debate continues.  For my part, I’m going to keep an eye out for the study that started this all.  When I can finally read the whole thing, I will make sure I tell you what I think.  I’ll tell you if I think it’s a good study (or not), and how I think it adds to our body of knowledge about Medicaid.  And maybe, if more people keep on doing that, we can shift the discussion of health care reform away from politics and back to what really matters.

ADVERTISEMENT

Aaron E. Carroll is an associate professor of Pediatrics at Indiana University School of Medicine who blogs at The Incidental Economist.

Submit a guest post and be heard.

Prev

Medical blog posts of the week, ending September, 24, 2010

September 25, 2010 Kevin 0
…
Next

Many doctors order tests rather than do a history and physical

September 25, 2010 Kevin 10
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Medical blog posts of the week, ending September, 24, 2010
Next Post >
Many doctors order tests rather than do a history and physical

ADVERTISEMENT

More by Aaron E. Carroll, MD

  • a desk with keyboard and ipad with the kevinmd logo

    We have the potential to have the best health care system in the world

    Aaron E. Carroll, MD
  • I will never be the physician that my father was

    Aaron E. Carroll, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Health reform and the iron triangle of health care

    Aaron E. Carroll, MD

More in Policy

  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • The hidden health risks in the One Big Beautiful Bill Act

    Trevor Lyford, MPH
  • The CDC’s restructuring: Where is the voice of health care in the room?

    Tarek Khrisat, MD
  • Choosing between care and country: a dual citizen’s Independence Day reflection

    Kathleen Muldoon, PhD
  • How fragmented records and poor tracking degrade patient outcomes

    Michael R. McGuire
  • U.S. health care leadership must prepare for policy-driven change

    Lee Scheinbart, MD
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • A world without vaccines: What history teaches us about public health

      Drew Remignanti, MD, MPH | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Recent Posts

    • From Founding Fathers to modern battles: physician activism in a politicized era [PODCAST]

      The Podcast by KevinMD | Podcast
    • From stigma to science: Rethinking the U.S. drug scheduling system

      Artin Asadipooya | Meds
    • The gift we keep giving: How medicine demands everything—even our holidays

      Tomi Mitchell, MD | Physician
    • The promise and perils of AI in health care: Why we need better testing standards

      Max Rollwage, PhD | Tech
    • From burnout to balance: a neurosurgeon’s bold career redesign

      Jessie Mahoney, MD | Physician
    • Healing the doctor-patient relationship by attacking administrative inefficiencies

      Allen Fredrickson | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 8 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • A world without vaccines: What history teaches us about public health

      Drew Remignanti, MD, MPH | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Recent Posts

    • From Founding Fathers to modern battles: physician activism in a politicized era [PODCAST]

      The Podcast by KevinMD | Podcast
    • From stigma to science: Rethinking the U.S. drug scheduling system

      Artin Asadipooya | Meds
    • The gift we keep giving: How medicine demands everything—even our holidays

      Tomi Mitchell, MD | Physician
    • The promise and perils of AI in health care: Why we need better testing standards

      Max Rollwage, PhD | Tech
    • From burnout to balance: a neurosurgeon’s bold career redesign

      Jessie Mahoney, MD | Physician
    • Healing the doctor-patient relationship by attacking administrative inefficiencies

      Allen Fredrickson | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Wanting better health care shouldn’t be conservative or liberal
8 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...