(Fade up on college dorm room, future college student, around maybe age 19:)

A young man (or lady) sitting in his (her) dorm room at college, it's sophomore year for this student, and there are some decisions to be made. Freshman year has been about taking general courses, getting that math, social sciences, English, and maybe hard science coursework behind him (her). Now it's time to decide which direction his (her) life will take.

He (she) has always been a pretty smart kid. Pretty high sense of ethics. Whatever he (she) chooses, he (she) stands a pretty good shot of being successful and doing well. Perhaps he (she) has always thought about going into medicine. But now, with an end in sight, he's (she's) having second thoughts. See, in this world, health care reform has occurred. And one of the key components to "control costs" was to lower reimbursement rates to physicians and other health care providers. So physicians had to respond by doing one of two things: Accepting a lower yearly salary, or cut the time they spend with each patient further in order to produce the same amount per hour. The second option seems to erode quality, the first is hard to do because overhead expenses and insurance premiums have not dropped significantly.

Our college student sees all this. He (she) maybe talks it over with the family doctor, and knows that good people are leaving their fields for jobs with maybe less stress and the same or higher reimbursement.

And then there is the business school beckoning. These guys and girls are having trouble getting their foot in the doors, but once they do, either by getting an MBA or a law degree, look out! The sky appears to be the limit for them.

Our student has a tough decision to make. Go for the bucks or go for the career that perhaps he (she) has always dreamed of, which appears to be so useful to society, and which had appeared, up until this moment, to be an excellent way of doing something of value and being highly compensated for it. Which was will he (she) go? Tune in next year to see: College course choices 101, at the school of business...

(fade to black on end credits...)

****

I know. Silly scenario. I'm so far removed from college that I don't really know how this stuff works anymore. But I do know this: When I was coming out of school, the health care field (dentistry in my case) appealed to me because I could do something I saw as valuable and useful, allowing me to serve others, and would afford me the lifestyle I hoped to achieve. I never had illusions of being rich beyond all belief, but I did have the desire to live comfortably.

There are lots of ways to be useful to society, but how's the compensation? Will they allow you to get to be economically free (meaning, your choices aren't dictated by money but instead by your enjoyment, your values, etc.)? If that advantage is taken away from being a health care provider, then we all will get what we deserve: care that is inferior but still expensive.

President Obama has placed tort reform on the table. That's a good first step. But as I listen to the "debate" (and I use the term loosely), I hear a lot of stuff about cutting providers' reimbursement levels to rein in costs.

Won't work. We'll end up with less providers, inferior care, and a lot of rich businesspeople with interests in keeping things the same and having others bear the brunt of the "cost-cutting".

Just my humble opinion.