Three weeks and 1 hour ago, I ruptured my quadriceps tendon (tendon above the kneecap (patella)) while playing tennis. Five hours later, my quadriceps tendon was surgically re-attached to my patella using three drill holes and wire sutures. The surgeon said, upon opening my knee, that it looked like a “bomb” had exploded. I can sympathize with that statement because, for two weeks after surgery, every step with crutches felt like an explosion had occurred again in my knee.
No work for one week and reduced hours for the next two weeks has led to a lot of news watching (CNN and CBS) and news reading (The New York Times and other sites). Nearly every day recently and for months prior, my intellect and my ethical sensibility have been subjected to explosion after explosion regarding the actions of the Trump Administration.
This blog has been centered on health reform in Iowa, so I am sorry to digress, but both situations — my knee and the actions of the Trump Administration — have drowned out my ability to address health-reform efforts in the last several weeks.
Let us start over again.
Before my accident, I toured the Republic of Ireland for eight days. Our tour guide Katie, a native in her 30s, talked about health care in her home country. Her father, a sheep farmer, was having abdominal surgery in Dublin. He was at the public St. Vincent’s University Hospital but, at the time of surgery, was wheeled in a “trolley” (hospital bed on wheels) via an underground corridor to the adjoining and similarly named St. Vincent’s Private Hospital, where he had surgery. Afterward, he returned to his bed at the public St. Vincent’s hospital.
Along the same lines, the papers in Ireland while we were there discussed the findings of the government-commissioned de Buitléir Report, which sought the removal of private work from public hospitals. The report recommended that the government mandate through legislation that “no private activity in public hospitals will be permitted.”
As I said two blog posts ago, I believe that any system devised for universal health-care coverage will always include a public system of health-care financing living side-by-side with a private, for-pay system. Such a private, for-pay system will allow for wealthy patients and tertiary centers such as the Mayo Clinic to connect.
Similarly, on my Ireland trip, a fellow traveler from Australia told me she had a choice of knee replacement from her public system or from her private insurance’s system. She chose her private system because it was so much faster to have surgery.
I still want universal coverage and believe a public alternative to private insurance is necessary for universal coverage. But I am realistic enough to know that the financial restraints inherent in a public-financed public option will undoubtedly mean that the parallel private system will in some ways be either more timely or more comfortable for patients.
After traveling the world and being a family physician in the United States for 35 years, I do not see a different way things play out.
In the meantime, my knee will continue to improve, and the explosions with every step have subsided.
My top three Democratic candidates as of now:
1. Pete Buttigieg
2. Joe Biden
3. Elizabeth Warren