Getting back to health care for at least one more entry:

At the end of my last post I talked about a shift in the focus of those entering the health care fields, away from the business-minded and entrepreneurial-minded, and toward a type of person who is driven by altruism. I said that any health care solution to provide coverage for all Americans had better take into consideration the people providing that care, as well as those needing access to it.

I was thinking about just that, as I saw a survey asking what was most important to someone in choosing a job. I was surprised that "making money" (or however it was phrased) was only fourth, after "making a difference in the world" and a couple others. I did not note who was being surveyed (I think I got interrupted while reading it and put it down without taking the mental notes on it I would normally have taken) but I think in the end, making a comfortable living comes in first, especially for those with a family. (Sounds like one of those pro athletes who, upon turning down 10 million a year to sign with a different team for 12 million a year, says, I gotta think about my family, doesn't it?)

Seriously, many people choose jobs that don't provide much financial security, perhaps over others that do. (Granted, many people don't have such a choice to make.) I've met some people who decided to work for starving artist wages in order to make things better for humanity, or to help people, or to do something they really believe is important. (You choose the reason...) They seem to burn out quickly, with feelings of being unappreciated, of struggling economically, of making too large a sacrifice... The reality is, if you can't be "economically free" to do what you love, it will be hard to do it.

Medicine is a hard profession. There isn't much downtime. Even when you're off, you're on. Maybe you're "on call", maybe you're just going over the problems mentally. There's a ton of risk that you deal with every day. There's the threat of lawsuits. There's the problems of running a business, if that's where you go, professionally.

Financial rewards can be great. Not pro athlete great, or entertainer great, or CEO great, but great in the sense that if you can stick with it long enough and not burn out, you can attain "economic freedom". And with that, you can do what you really want to do. In many cases, I'd guess, that would be to continue practicing medicine. I know several older MD's in my community who spend most of their time these days donating their time to the local free medical clinic. I know others that get out of the field as soon as they possibly can, and go on to other business ventures.

The point of all this is that whatever health care system ends up being implemented in the United States had better address these issues. If there is going to be a tradeoff in that perhaps an MD can't attain the really high salaries that some aspire to now, there had better be less risk associated with the work. (No human is perfect, and doctors are only humans trying to do their best.) And it still better be a pretty comfortable living. If that means raising reimbursement rates or changing the thought process on how physicians are paid, so be it.

If lawmakers decide to put into force a real universal health care plan, they need to consider the type of person they want caring for their constituents, indeed, for their own family members. And they better design a plan that makes the profession an attractive goal for those types of persons.