What Health Insurance

Sharp, stabbing chest pains, stomach ulcers, cancer have been my lot in life. As well, I have been unable to avoid severe clinical depression, erectile dysfunction and, on occasion, bloody ejaculate. But I am a survivor.

For the past 18 years I've been a Standardized Patient in the Greater Kansas City area, having been involved in the training of hundreds of medical students. I play the role of a patient with some real or imaginary concerns.

Patient-centered medical care is today the overarching mantra in the majority of medical schools throughout the country. Medical schools are training students to make the patient a participant in his or her medical care. The patient needs to feel in charge. It is the patient's decision. It's so obvious isn't it?

Well the not so good news is that health care in the United States has more to do with revenue streams, bottom lines and marketing, rather than something seemingly as abstract as actual patient care. Just possibly it's not about the patient making any decision.

Elizabeth Rosenthal, physician and editor in chief of Kaiser Health News, has stated that, "There is no free choice. Patients are stuck, and they're stuck buying American." And Atul Gawande, surgeon and writer, has said that, "It's not that we make all the money. It's that we order all the money."

I have worked in several health care institutions, from large teaching hospitals to junior colleges with nursing programs. Among other things, in addition to having played numerous standardized patient roles from first year medical students to residents, I have taught exam skills to medical students and trained standardized patients.

Health care, if divided into its broad components, would include insurance, hospitals, physicians, pharmaceuticals and medical devises. If you wander into the weeds you can learn about billing, coding and collections. Then of course there is research and consolidations. Finally there is the Affordable Care Act or ACC, or simply Obamacare.

While the Democrats have tried their best not to upset powerful vested interests, the Republican health plan has been a constant attempt to destroy the ACA from the very beginning, but with seemingly no idea what to replace it with. Last but not least is Medicare and Medicaid, subjects unto themselves.

I've often told medical students to go to the main foyer and watch who comes in the door. Those are your patients. You'll be greeted, for example, by obesity, diabetes, hypertension and those who have no insurance or what they have is inadequate. You will also notice how young some of these people are.

Self-help websites are exploding on the internet. I recently came across one offering 20 tips on how to prevent or slow down the onset of dementia: Don't smoke, control blood pressure, watch your weight, healthy diet, exercise and so forth. It's essentially preventive medicine, what a healthcare professional ought to be speaking to a patient about, and which every American should have access to ... but doesn't, unlike most of the developed countries.

The problem  is that health care is not the same as selling cereal or deciding which deodorant works the best.

I don't even play a doctor on television but i have worked in the healthcare field for close to 20 years, training those future doctors whom we patients sincerely want to put our trust in, rely upon and feel confident that our needs will be met. Hoping for the best is not a health care system nor is "I got mine."