The push toward healthcare reform in this country has been framed from the aspect of the infamously greedy third parties. Big, large scale foci of enmity are, by nature, easy political targets to stir emotion and get votes. Lawmakers, particularly the Democrats (and some Republican moderates) have boilerplated to death the “control” these entities have on healthcare delivery. Certainly, there’s no denying the impact Pharma and Insurance, for example, have had on the heatlhcare economy as drivers for it, but to blame the trajectory of this economic sector solely on such entities is both lazy and irresponsible. From the WaPo:

The question came from a Colorado neurologist. “Mr. President,” he said at a recent forum, “what can you do to convince the American public that there actually are limits to what we can pay for with our American health-care system? And if there are going to be limits, who . . . is going to enforce the rules for a system like that?”

The question is so simple, yet entirely profound. Up till now, the mainstream media have been characterizing the debate on healthcare in terms of all major issues, with the notable exception of the main cog in the wheel: the physician. Healthcare decision making, for example — ordering the most appropriate test and treatments for patients in a cost effective manner, has all but been ignored in the coverage on this issue. For many physicians on the Right and Left of health policy, the loss of autonomy is, perhaps, their greatest fear. And now seems to be the right time to examine how this issue will be influenced in the scope of healthcare reform.

For President Obama, who seems to have an answer for everything on the issue of healthcare reform (including his interest in “comparative effectiveness” of medical decision making), the answer on this particular one is probably best reserved for physicians on the front lines who make these decisions daily. Remember, just as all politics is local, so is the crux of medical practice and healthcare delivery: the physician, the patient, and whatever sound plan of care results. We have to trust that those decisions are just as economically feasible as any major large scale reform. | LINK

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