AAMC Reporter: May 2006

Viewpoint: "Steering the Ship Toward Reform: A Medical Student's View on American Health Care"

Erick Cheung, B.S., third-year medical student, Albany Medical College; National Chair, AAMC Organization of Student Representatives

We sail aboard a fine ship with two words printed neatly in gold letters across the stern: American Medicine. It is a cutting-edge vessel loaded with the newest technology and commissioned to serve the country with pride. Its operators are highly skilled and capable of swiftly ushering our sick and endangered to safer waters. An unprecedented amount of investment has been made in American Medicine. But for all its worth ($1.9 trillion annually, at last count), only the privileged have been granted boarding passes. It appears our compass has wandered and our ship has sailed far out to sea, with no regard for millions left treading water.

For the fourth year, the Robert Wood Johnson Foundation and more than 1,000 national and local sponsors are calling attention to this injustice in America's health care system with Cover The Uninsured Week. The AAMC is once again leading the effort to raise public awareness of this issue, and is unique in its ability to represent the mightiest medical education facilities in the world and the future physicians of American medicine. It is an ability that carries an extraordinary responsibility.

Stop and consider the incredible irony of having nearly 46 million people uninsured in the United States. How has providing care for some, but not all, become an accepted truth in our system? Evidence continually demonstrates that the uninsured suffer greater morbidity and mortality from chronic illness and lack of preventive care, and are at greater risk of bankruptcy due to high medical bills. I firmly reject the notion that this should be tacitly accepted. Our professional and ethical duties call upon us to care for the nation's people, regardless of race, gender, age, social class, and, least of all, economic means.

As medical students, we have chosen to pursue a fulfilling and influential career that is dedicated to relieving suffering and improving humanity's health and well-being. We certainly have a vested interest in the search for a better way. On the floors of our mighty and charitable academic health centers, in the emergency departments and free clinics, we see the uninsured and the under-insured. We listen to their tragic histories. We also hear complaints about the costs and constraints of the health care system from not only the patients and media, but the providers as well.

One day we will inherit American Medicine. Many of us worry it will be too far out to sea for us to navigate safely back to shore. The challenges facing the next generation of physicians are absolutely immense: more uninsured, more racial and socioeconomic injustice, a physician workforce shortage, a ballooning elderly population, eroding public trust in medicine, and uncontrollable costs of financing health care and medical education. How long can we, as a country and as a profession, sustain these trends? More importantly: Who will make decisions about our health care system for the future? Steering a health care system without the input of the best minds in medicine is as perilous as sailing a ship without a captain. We have reached a time when all the leaders of medicine, especially academic medicine, must come together and put forth a comprehensive solution to fix American Medicine.

Not long ago, I stood at the dock, bright-eyed, fresh, and eager to embark on the course of medical education, looking toward the day that I would heal the sick as if they were my own brother or sister. But, navigating the sea to become a doctor is arduous and unrelenting. Inspirational and idealistic beginnings are unconsciously submerged beneath the weight of examinations and residency, and eventually fall victim to the turbulent "business" aspects of medicine in this country. We must continuously find ways to rekindle the idealism that should be the foundation for all that we do in medicine. Whether student or physician, let us periodically re-focus our lenses and widen the angle to view the care of the nation, once again, as if it were the care of our own family.

Cover The Uninsured Week reminds us that there is still tremendous work to be done. It is no longer good enough to recognize that someone needs help (46 million people); something needs to be done. It is no longer good enough to bring these individuals into our emergency departments as the backdoor to our elite (or elitist) health care system. The uninsured must be our herald for reform; a fundamental and comprehensive transformation in the financing and delivery of health care in our country. American Medicine must chart a new course, and we must stand up and be a part of the change.

Editor's note: This year, the AAMC will award 10 grants of up to $500 each to support medical student events during Cover The Uninsured Week 2006, May 1-7.

For more information about the CTUW campaign, visit www.covertheuninsured.org.

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