All I Want for Christmas Is a Better Health Care System

There's Christmas music wherever I go this time of year. I recently heard "My Grown-up Christmas List" -- a great song written by Linda Thompson and David Foster -- and it got me thinking about what I would put on my own wish list.

With only a few shopping days left before the holiday, here are some things I would like:

• Respect -- Let's start with respect for one another. We should all look inside ourselves and out to our neighbors so we can respect each other's point of view. There does not seem to be enough of that these days. I would also like to see family medicine respected more by our peers, payers and employers. I firmly believe that family medicine is the answer to this country's health care issues. A little respect for our profession would be welcome.
  
• Fair evaluations -- When we talk about metrics by which we are evaluated, let's get a few in our stockings that make sense. Metrics that actually make an impact on patient care would be a welcome present for any family physician.
  
• Less red tape -- How about some nice scissors to cut through the red tape we all complain about? How about doing away with prior authorizations for things like generic meds? In addition, how about some simple common sense? If our patient is diabetic today, he or she will be diabetic in a month -- or a year. Reduce the administrative complexity in our practice. It is time for us to be allowed to take care of our patients! If we could spend more time with the patient and less time with the computer, that would help.
  
• Affordable health care -- Health care costs are eating up the budget. Whose budget? All of them! The federal government's budget grows because of increasing health care costs. Sure, the rate of increase has slowed,(www.reuters.com) but it continues to grow, nonetheless. How about our patients' budgets? The minimal pay increases many individuals have gotten in recent years have been more than overshadowed by the growing costs of health insurance premiums.(www.washingtonpost.com) It seems our patients get one step ahead but wind up two steps back because of rising costs.
  
• Health care for all -- Wouldn't it be a great present if everyone could afford to go to the doctor when they need to? Families should be able to prevent illness through checkups, coverage for pre-existing conditions and emergencies. We have millions of people who are uninsured, and millions more are underinsured. Catastrophic coverage is only hospital insurance, it is not health insurance. It is intended to cover major expenses, not the things that are needed to keep someone healthy and on the job.
  
• Partnership -- For our country to continue to grow and thrive, we have to have a well-educated and healthy workforce. A partnership between the medical community and the educational community is needed to help our towns and communities grow in the future.

I'm not sure if Santa's sack can hold all that. Maybe we need to make some New Year's resolutions to work on it. I am willing to try if you are.

Happy holidays.

Leonard Reeves, M.D., is a member of the AAFP Board of Directors.