I'd like to offer a perspective of the healthcare system from a different point of view. I am a second year medical student and I believe in universal healthcare. In fact, the majority of physicians consider affordable healthcare a fundamental right. But I believe that so far we've overlooked a major problem in healthcare while formulating reform plans. If we granted every citizen in this country satisfactory healthcare coverage (primary, dental, vision, hospital stays and procedures, etc.) we would still have a crippled health care system. Why? Because of the SHORTAGE OF PHYSICIANS, especially primary care doctors. There are some areas of the country where there is already a dearth of physicians and reports are showing that fewer and fewer medical students are choosing primary care fields.

Why is that? Well, let's be honest. The personal financial situation and the bureaucracy is driving doctors away. When I graduate from medical school, my total student loan debt (before interest) will be $300,000. That amount of money could buy a house, a car, and support a family. When students finish medical school they enter residency, a period of additional training where they are paid $45,000/yr for 80hr work weeks. Eventually, doctors pay back their loans and can live comfortably off a good salary. But these staggering loans are driving many students not to choose the field that interests them the most, but the field that will help them pay off their debt.

Now coupled to that is the fact that malpractice premiums for physicians are growing ridiculous. Should people be able to sue a physician for negligence and legitimate mistakes? Absolutely. But the premiums doctors (esp. ob-gyns) pay are becoming prohibitive. Some doctors are closing their practices, some are going back to school to pursue a different career. This is happening at a time when we need physicians the most. The baby boomers are retiring, and they will need people to care for their medical needs. The new wave of people who will gain healthcare insurance with pending reform will need physicians.

Another reason why physicians are leaving is because of the massive paperwork, the cumbersome bureaucracy, and insurance companies telling physicians what treatments their patients are allowed to have. As much as 50% of their time is spent handling insurance forms, time that physicians would rather spend seeing you, the patient. As the aphorism goes, doctors want "To cure sometimes, to relieve often, and to comfort always." But the inefficient, bureaucratic mess is distracting healthcare providers from this goal. We entered this field full of empathy, and purpose, and we leave in disenchantment as we become more limited in our ability to practice humanized medicine.

So how can we draw medical students into primary care fields while improving conditions for current internists, pediatricians, and family medicine doctors? Expand and offer more generous loan-forgiveness to medical students who pursue these fields in exchange for service in communities where doctors are scarce. Capping malpractice premiums and malpractice settlements would also decrease the burden on professionals in the less well compensated primary care specialties. Also, standardizing and modernizing the billing system and electronic patient records would decrease healthcare costs all around. I feel very strongly that these proposals should be incorporated into any reform plan.

It is heartbreaking to hear the personal stories of people who have had to choose between chemotherapy for a family member vs. keeping their home. The points they and other members of the community raise are equally valid, and have no easy solutions. Piled on to their concerns is my fear that we will invite everyone over for dinner, only to find we don't have enough food to go around.

I hope I have clearly presented an additional facet of the healthcare crisis for your consideration.