On this Labor Day I sit in one of the richest countries of the world. I make more money than 98% of the American workers. My peer group (American physicians) makes that or above. Yet, when I watched a  physician on a Fox News clip talk about health reform today, I got the impresion he had just come in from panhandling. In addition, the blame-the-patient nature of his proposed solutions made me long for the days when we believed in demons and humors as causes of illness…at least then the individuals were not to be blamed. Rather than blather on, I refer you to the Health Affairs article from 2004 which identifies increases in cost per disease treated as the major contributor to health care cost increases for most diseases. For some diseases such as treatment of depression, that increase in cost leads to improved wellbeing and increased productivity. 

In short, let’s all agree to deliver high quality care and not milk the system as happens in some places. If we redirect the money currently spent, we can give better care to more people for less cost. No where are “tax breaks” mentioned in my medical texts as a treatment option. Regarding my overweight patients, my bet is that between good medical care and changes in the built environment and improved peer influence, people who need to lose weight will. Meanwhile, we physicians need remember (ironically) the “Fat Man’s laws” and stop blaming the patients for a flawed system that is much more our creation than theirs.

Also, physicians who are on television probably shouldn’t claim poverty.