Don’t we always take something for granted until
it’s taken away? But the truth is that we can’t put a
price tag on health. Many of us are willing to go that extra mile,
or make certain sacrifices, to maintain it. Unfortunately, health
care remains unobtainable for many Americans.
The problem extends from patient to provider. Medical school
students face astronomical tuition costs, typically graduating
years later, saddled with serious debt. Clearly, a major dilemma
exists within the framework of the medical establishment.
That’s why Robert Brook, a UCLA professor of health
services and medicine, and director of Rand’s health sciences
program, said we need to consider putting specialized technicians
““ not just over-trained doctors and surgeons ““ in the
field.
Generally, these technicians would be cheaper to train, charge
their patients less, and still get the job done. The concept is
surely appealing, albeit different. There’s no doubt that
Americans remain desperate for health care alternatives, and while
some patients may not trust technicians as much as traditional
doctors, the fact remains that the medical establishment requires
serious revision.
Health care is an elephant of an issue. In the 2004 presidential
race, President Bush and Sen. John Kerry soared with big promises
““ more accessible health care, greater insurance coverage, a
stronger, healthier America.
Their claims flaunted an encouraging, if not idealistic, agenda.
But many Americans, including UCLA students, fail to acquire proper
insurance coverage.
Health care remains as controversial as ever, and Brook, after
spending years in the medical establishment himself, developed
ideas of his own. He argues that most physicians are usually
over-trained for what we actually require of them. We typically
only need one specialized, repetitive procedure to be done.
For example, let’s say I require some sort of joint
procedure. In that case, why not seek a technician who specializes
in joints, as opposed to a physician who spent years studying skin,
organs and virtually every other part of the body prior to learning
about joint procedures?
The proposed technicians would be highly trained in specialized
fields. They would be certified in whatever is their specialty.
Brook is definitely on to something. For one, technician
certification requires significantly less time and money than that
of a doctorate degree.
In the past 20 years, medical school costs have shot up 165
percent in private schools and 312 percent in public schools. The
average medical student graduates with a hefty $100,000 of debt,
according to a recent study by the Association of American Medical
Colleges.
Meanwhile, everyday patients ““ not just medical students
““ require the opportunity to receive much cheaper options. As
of 2003, 45 million Americans were uninsured. Medicare and Medicaid
programs are rife with problems, and HMOs aren’t entirely
supportive. We’re dealing with a dire situation.
But what would be lost? The problem with taking Brook’s
claims at face value is that technicians don’t know
everything about the body. Therefore, some argue, technicians would
be ill-equipped.
In the case of complex, critical procedures such as heart
surgery, complications could potentially arise. In these instances,
a greater understanding of the body as a whole is absolutely
required. That’s when a doctor is essential, despite
financial constraints.
“Who would you like to perform this sensitive surgery on
you? A 55-year-old doc who’s done it all? Or a 23-year-old
who grew up playing Nintendo, is a wizard at controlling a device
via a video screen, and has just been through two years of
intensive training on this technique?” said journalist Daniel
Weintraub in his recent article concerning Brooks’ research
in the Sacramento Bee.
I was interested in contacting Professor Brook, particularly in
regard to these criticisms, but he was unavailable.
But like any decent service, technician-based assistance should
be available ““ but never required. Simply put, it should be
another option that has the potential of increasing the patient
base and addressing the needs of the uninsured who were previously
denied access to any procedures at all.
While doctors are well-trained and available, technicians would
offer low-cost alternatives. So, in instances like specialized and
fairly routine procedures, technicians could well prove
beneficial.
But keen judgment must be in order. There are times when a
doctor’s expertise is necessary. Hopefully, patients,
insurance companies and the medical establishment alike will
understand this difference.
Today, the health care bureaucracy appears so massive that most
of us cannot fathom challenging it. The institution, however, needs
bold revision.
That’s why Brook offers an alternative. Though it may not
be perfect, I commend Brook for his willingness to suggest creative
strategies to repair a seriously ailing system.
Certainly, it is no final or complete answer. But it’s a
firm jumping-off point, and that’s exactly what we need.
Fried is a second-year history student. E-mail her at
ifried@media.ucla.edu. Send general comments to
viewpoint@media.ucla.edu.