There is an old folk tale about the peasant wife and how she solved a problem. Every night, she and her husband found that their feet were cold while they slept, because their blanket was not long enough to tuck in.

To solve the problem, she cut off a wide strip from the top of the blanket and sewed it on the bottom. That way, she reasoned, there should be enough blanket at the bottom to tuck it in at night.

This kind of thinking seems to be what is going on in "health care reform."

Solving the whole health-care conundrum all at once would be too much to ask, but what about starting with one significant change?

Continue reading Health care reform could start with one significant change


Guest column
Angela Heider, M.D.

I recently retired from the practice of obstetrics and gynecology at the young age of 32 and after only two years in practice. My reasons are, of course, complex, but they boil down to the impossible logistical, financial, and familial implications of practicing medicine within the confines of the current system. Alarmingly, four of my young female partners have also elected to hang up their stethoscopes – a growing trend. If we are to reverse this trend, we need to reform our health care system.

Some health policy experts believe comprehensive reform is impossible in the absence of a national disaster. I believe we can make a difference but a really important first step is to make insured people understand the necessity of such an endeavor.

True enough, there are millions of uninsured and underinsured Americans who are clearly suffering under our current system. However, there are many more happily insured Americans who are completely unaware of the horrific state of a system they trust whole-heartedly. The fact is, even wealthy Americans are impacted by the looming health care crisis. They just don’t know it yet.

Continue reading The Rise and Fall of Dr. Mom


Guest column
Dr. Donald D. Trunkey, OHSU Professor of Surgery

Dr. Trunkey presented his ideas on health care reform at the City Club of Portland on June 9, 2006.

Access to US healthcare is a lottery, and what used to be a “not-for-
profit” system has become a “for-profit” system.

I would like to begin this dissertation with two relatively recent quotes. “We live in a great country that has got the best healthcare system in the world, and we need to keep it that way.” (George Bush, June 2003) “We do have the best healthcare system in the world.” (Bill Clinton February 2000)

Unfortunately, the evidence does not support the two presidents. One barometer of measuring effectiveness of a healthcare system is the average lifespan and the per capita cost. In the United States, we have an average lifespan of 77.8 years, at a cost per capita per year of $4887. In Spain, the lifespan is 79.6 years, at a cost of $1100. In Canada, the average lifespan is 80.2 years, at a cost of $2792, and in Japan, they live an average of four years longer than we do in the United States, at a cost of $2003 per year. Another measure of healthcare system effectiveness is the infant mortality. In the United States, it is 6.9 deaths per 1000 live births. In Denmark, it is 5.3, France 4.6, Sweden 3.4, and Japan 3.2. In fact, in the WHO Global Ranking of Healthcare, the United States is number 37, between Costa Rica and Slovenia, both developing countries.

Continue reading Dysfunctional Care in a Dysfunctional Healthcare System



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