Wow, is 2007 almost gone? I always find this time of year an important time to reflect on the year that is winding down and look forward to the upcoming year. This next year is especially important as we head into an election year. I usually shy away from discussing politics but there are hot topics that affect me and my patients.
Probably the most important political issue for me is health care costs. One of the hardest things for me to have to deal with is the cost of treating people. I often find myself being controlled by insurance companies telling what tests I can and can't order and what medicines I can and can't prescribe. I am torn between doing what is right for my patient from a medical standpoint, and what is best from a practical standpoint. I always try to take costs into account, but there is often a conflict of interest and I spend a lot of time writing letters to insurance companies explaining that their "approved" treatment will not work for my patient. I find it insulting that after all my years of training I am at the mercy of a pencil pusher. To be honest, I don't know the answer to the health care crisis in this country, but there needs to be an answer. Unfortunately, many of my favorite candidates have plans to help health care costs that I don't think are realistic or practical.
Along the same line is the cost of medications. Here is where I get on my soap box for a little bit. I often hear from patients about how the drug companies are wrong for charging so much for medications. I actually have to stand up for the drug companies and point out the root cause is bureaucracy. Granted, the pharmaceutical companies are out to make a profit, but at the same time they are trying to help people by controlling and curing their diseases. For every one drug that makes it to market there are between ten and twenty medications that don't make it. The amount of hoops that the companies have to jump through for the FDA is what is driving up the costs. I fully recognize that we need the FDA to monitor medications and keep us safe, but at some point we have to say enough is enough and allow the companies to cut some inconsequential corners. One of the most glaring examples is drugs in Europe. There are so many medications that have safely been on the market in Europe and when the companies bring it to the United States, they either have to pay the FDA an obscene amount of money to transfer the studies, or repeat the studies. Either way, it adds costs to the medications. Don't get me wrong, I strongly support the FDA, and know we need it, but there just has to be some other way that doesn't cost so much money.
I don't know the answer to these problems. If I did, I would be running for office myself. I do know that it is important to make sure that the candidate I vote for understands these issues in a practical way, and has a clear plan for the future.