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    Posted November 3, 2012 by
    This iReport is part of an assignment:
    Your vision for America

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    A Future Physician's Perspective on The Affordable Care Act


    CNN PRODUCER NOTE     DrRodgerArdo said he was 'compelled to write about my vision because I don't think it is unique to me. Many medical professionals are likely in the same boat - pro universal health care but very strongly against the way Washington is trying to pay for it.'
    - lila, CNN iReport producer

    Now in the first week of November, Fall is in full swing. For many Americans, the Autumn season means their favorite football team in the red zone, pumpkin spiced lattes worthy of Instagram glory, topical Halloween costumes that will reap Reddit gold, and leaves changing color faster than you can tweet about 'em. But to some of the US population, specifically the 45,000 pre-med students across the nation, Fall is the stressful climax of the medical school application process.

    We travel, we interview, we sweat, and we wait for that thick envelope to come in the mail. With most of my interviews finished, I recall some of the most difficult interview questions I was asked. Questions that would make anyone feel like they're in the hot seat of Who Wants to be a Millionaire in 1998 (because, let's be honest. It was just better back then). By far, the question I dreaded the most sounded something like this "What do you think about the direction of healthcare in America". Any other year, this would seem like a logical and simple discussion to have with a future health care provider but every 4 years, med school interviews coincide with a general election. And it just so happens that this year's candidates differ on healthcare more than Philly natives in between Geno's and Pat's.

    Interview day. I'm in the hot seat. There I sat, already nervous but then asked to discuss a highly polarized topic to a stranger who will make a decision on whether or not I am worthy of pursuing my dream career. What do I say?! *Zack Morris Time-Out* Do you really think I got through the strenuous pre-med process without developing some skills in foresight and preparation?! I knew this conversation was coming so I took time to think. And I mean really think hard about how the Affordable Care Act will affect me and my generation of physicians. What comes next is a telling of my conclusions.

    At the risk of dividing my reading audience, I am confident in saying that I am a registered Republican. The GOP was founded on individual liberties and free market capitalism. I will always stand behind those ideals by which the Republican party was rooted. What surprises my friends and colleagues is that after learning of my party affiliation, I then explain that I want to go into primary care. Strange combination and it is this internal conflict that has shaped my views on Obamacare.

    As a future primary care provider, I strongly believe that prevention should be central to medical care. By preventing the development of diseases (metabolic, infectious, or otherwise), patients will be healthier. Is that not the bottom-line in medicine? Is patient wellness not the ultimate goal of all practitioners? Sounds pretty liberal and idealistic, if you ask me. How can America provide healthcare to 30 million more citizens without punching them right in the wallet? The answer is pretty simple, it's not possible. Health care reform is going to cost money. Period. Ask Romney, his revolutionary legislation in Massachusetts cost the state a pretty penny. But the benefit was clear, greater access to health care. Pure and simple . . . and expensive.

    That's about when my Republican fiscal conservatism kicks in. How do we cut the costs without limiting access to care? The unique complexities of healthcare are convoluted. Would you take such a heavy question to your local law office? A private investing firm? Of course not. Well, guess what. Business men and lawyers are a dime a dozen in Washington.

    Granted, these legislators are intelligent, successful people but very few of them are or were health care providers. That's why I don't expect all of them to understand the issues in healthcare. For many, it's easier to say "Cut costs? Sure, let's give less people coverage. Let's change requirements for this government assistance program." What a great way to condemn US citizens to illness - please tell me sarcasm does not escape you.

    We need a much broader conversation about health care. We need tort reform, we need to reduce medical errors, we need to move toward prevention and primary care to reduce the incidence of diseases. What we don't need is cuts to Social Security programs. Millions of citizens living in poverty depend on these programs and gutting their funding has dangerous implications.

    A more complete answer would be to get former health care professionals together in Washington and allowing them to assist representatives in creating comprehensive legislation. This group of expert health care providers, administrative personel, and financial professionals is a real possibility and it's known as the Independent Payment Advisory Board (IPAB). If the Affordable Care Act moves forward, this panel will aide in making decisions on how to reduce health care spending.

    Just think, I'm a student. I'm just beginning my career in medicine and I already have some basic ideas about how America can reduce health care spending. Imagine the ideas your primary care physician of 20 years has. Or the OB/GYN who delivered your son. Or the Chief of Medicine at your local area's hospital. Or the surgical team who performed your complicated procedure (you know the one). And then think about your lawyer and personal investment manager. Who do you think has a more well-rounded solution to saving you money at the doctor's office?

    My vision for America is prosperity through comprehensive health care regulated at the federal level. Because every US citizen, no matter which state you live in, deserves quality care.
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