Last night, I attended the 18th Annual National Institute of Health Care Management Awards, where my feature story, “Tragic Tale,” won an honorable mention for Print Journalism in the Trade Publications category. This was a huge honor, since our entry was accompanied by some incredible journalism from noteworthy publications.
When I accepted the award, I was given a chance to share a few words at the podium. Being as long-winded as I am, I suddenly grew nervous – not about speaking in public (I love speaking in public) but that I would yammer on for so long they would have to break out the shepherd’s crook for me. I don’t recall exactly what I said, since I did not prepare remarks in advance, but they went something like this:
In today’s publishing world, especially in the business-to-business or trade publication space, there can be great friction between the editorial desire to create compelling and uncompromising content, and the need to make sure the bills get paid. With this story, one of our advertisers looked fairly bad, and that was a concern for me. (Enough so that I reached out to that advertiser while writing the story to offer them as much room in the story as they wanted to tell their side of it. They appreciated the offer but declined.) When I brought this concern to my executive editor, I was told to proceed. This is why we are here; to not be afraid to tell stories with uncomfortable truths in them. It is alright if we are hard, so long as we are fair. That is so important to keep in mind: be fair.
Our modern health care system is a Gordian knot of conflicting priorities, and the sad story of Bill Mantlo illustrates that in grim detail. At some level, most people feel that in a country as rich and as advanced and as developed as ours, anybody should have access to the health care they need to fix the problems with their body. Everybody gets sick or injured in this country. Everybody knows where the medical help is. Nobody refrains from going because they can’t afford it. Meanwhile, there is a private health insurance mechanism in place that is only there because it manages to turn a profit. This mechanism funds health care, but it is not actually delivering health care. That is what doctors and nurses do. So insurers have no Hippocratic oath to uphold. Rather, they have shareholders to appease. And with that pressure on them, is it any wonder that they must pursue claims aggressively to keep costs down? Somewhere along the line, we have developed starkly mismatched expectations of our health care infrastructure, and that, more than anything, is helping to keep people from getting the care they need, and from making the system operate at its peak efficiency. Because right now, not everybody is getting what they need, and both before and after PPACA, the system is not even close to operating at peak efficiency.
Many people see health care reform in terms of black and white, us versus them, right and wrong, socialism and capitalism. It is not that simple. It has never been that simple. I appreciate the passage of health care reform – despite the legislation’s gargantuan structure and many flaws – because it has forced a practical discussion of how to overhaul health care itself. Surely, it went about this in a heavy-handed manner, and it has precipitated the discussion of fundamental political issues that will shape our nation for generations to come. I have heard health care reform referred to as this generation’s civil rights movement. I’ll let the historians decide on that one, but surely it appears that the first could easily change our daily lives as much as the second did. No wonder why folks are so eager to argue over it. But in so doing, we must not lose sight of the fact that making our health care system better is an incredibly complicated problem with no single solution in sight,and if we are to craft an outcome that does the most good for the most people, we need to reconcile ourselves to the facts that nobody is going to get everything they want from this process, and that resorting to alpha-and-omega characterizations of health care reform isn’t being part of the solution. It’s being part of the problem.