There are some who will tell you that the fate of America’s entire healthcare system hangs in the balance based on the outcome of tomorrow’s presidential election. To be sure, there are big differences between President Obama and Governor Romney. But the truth is that the pressures facing America’s healthcare system today are the same pressures it will face no matter who wins tomorrow.
I am talking about the pressure to deliver more effective, less costly care. I am talking of the pressure to reduce hospital re-admissions and the pressure to improve patient experience. The pressure to encourage preventative medicine, and to move certain types of care away from hospitals and toward outpatient services, among many, many others.
Oftentimes this election it has seemed that each side had not only their own opinions about our nation’s challenges, but their own facts. But the undisputed fact of America’s healthcare system is that its high cost makes it unsustainable in the long-run. Another undisputed fact is that the system does not produce the best possible results for the money for all Americans. We in emergency medicine are keenly aware of these pressures and have been working for years to meet those challenges.
We are the front line of healthcare delivery and pick up the pieces for a system which provides exceptional acute care but less than optimal primary care for all. We serve all members of society, including those who live on the “fringes” and are not welcomed in the majority of care settings. We were working before Congress passed the Affordable Care Act – “Obamacare” – and we will be working long into the future, regardless of whether all, parts, or none of that law remains, and regardless of who wins tomorrow.
The pressures on America’s healthcare system will survive tomorrow’s election. What is unclear, is whether President Obama’s signature legislative achievement will survive, either whole or in part. Many of us in healthcare are concerned about being midway through implementation of the far-reaching and still controversial healthcare law. We have already seen the enactment of several of the bill’s early features, and over the next few years, we will likely see both the law and the practice of medicine continue to evolve.
Just how that happens of course is somewhat up in the air. In case anyone hadn’t noticed, our government faces some incredibly tough challenges, and healthcare is only one of many. We stand at the threshold of the so-called “fiscal cliff” in the US, the worldwide economic outlook is less than upbeat, unrest is evident based on the challenges before us and extremist groups threaten nascent democracies in the Middle East.
At the same time, our own communities have their own challenges, whether it’s with fixing the economy, educating our children, or just filling in that pothole on the corner. All of us have a vote and it should never be wasted. It matters who is president, just as it matters who is mayor, who is governor, who sits on your local school board, or what ballot initiatives either pass or are defeated.
Finally, lest you fear that our times are the worst we have seen, remember that there were other times when even America’s very existence was in doubt. We have persevered and will persevere as long as we take heed of the lessons from those men who, through their courage and sacrifice, allow us to enjoy the freedoms we do today. I offer two nuggets from giants of our history:
“America will never be destroyed from the outside. If we falter and lose our freedoms, it will be because we destroyed ourselves.” – Abraham Lincoln “Always vote for principle, though you may vote alone, and you may cherish the sweetest reflection that your vote is never lost.” – John Quincy Adams
Your vote matters (in case you haven’t sickened of hearing people tell you that by now). This is your chance. So go vote!