Sunday, November 15, 2009

Health Care Reform and Restoring Dignity to Medicine

With so much talk about health care reform it's easy to lose track of the individual stories of people across the country who live, get sick, need care and "consume" health care. There is probably no better way to appreciate these stories than to hear Anna Deveare Smith tell them. The actress, interviewer and playwright is currently in performance in New York with her "Let Me Down Easy" show which is a distillation of interviews conducted with over 300 patients and people across the country over the past eight years. From this vast trove, Smith has developed 20 roles that she plays on stage in her one woman show.

Her project started as an assignment from a Yale medical school professor who asked Smith to show doctors how to gain understanding and insight from really listening to patients' stories. But she goes way beyond her original assignment to show us how the likes of Lance Armstrong, Ann Richardson, a rodeo rider and a New Orleans Charity Hospital physician look at illness and suffering in the broadest sense. We learn from Smith about our health care system, about the ways folks struggle with life and death and the life cycle, and about how to rescue "grace and kindness" in a world of suffering, disappointment, and broken hearts.

One of the best segments is about the notion of charging one price for whatever ails you. It makes complete moral sense that the cost of whatever problem a patient has should not be based on its threat to his or her life. In an interview on public television with Bill Moyers
Smith says that when people are charged a "flat rate" for care, "that's when you'll get your good doctors," when money doesn't matter any more.

Now that Wall Street can no longer necessarily pull the best and the brightest, we can hope that the helping professions will attract some of those best and brightest for the right reasons--namely to engage with people. Prospective doctors will see that they can treat themselves to the joy of medicine through patients' marvelous stories, not merely because of a dearth of money-making jobs elsewhere.

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