If I could go back into time I would tell myself not to stress or worry that I’m going to have to go through college all alone. Ending my first year at college, this was a time of growth. Looking back I have realized how much I have changed as a person mentally and physically(dropped a few pounds from all the walking). The most important thing I would tell my past self is that I am going to meet amazing people and friends and that when ever I need help I’ll have someone to lean on. I would also tell myself that life at Michigan is not going to be easy, but that I will get through it and it will be fun. Looking back I realize that sometimes you have to with the flow and life won’t always go the way you plan-it rarely does for me- and that’s okay because from these experiences we are able to learn and grow. I would also tell my future self to not skip meals, eat, and take care of my body.
Brian Zikmund Fisher is a Public Health Faculty member and researcher. He uses his knowledge to understand all the factors that lead to decisions one makes about their health. In lecture we discussed about the desire to have individual autonomy versus the decision you make affects others around you. We discussed times when the patient does not have control, for example when medication is being prescribed. We coerce patients to do what the doctor wants. For example, Jacobi vs. Massachusetts was the first time the state punished people for not following medical advice. In 1905 the Supreme Court ruled that individual right is overturned when keeping the greater society healthy and safe. There are also times when health care providers are informing, but not motivating a patient. For example, abortion or chemotherapy. There are certain cases as well when the patient has all the control. For example, during organ donations or resuscitation. But most often we see the second, where we are shaping our information in order to maximize that individuals outcomes. This surprised me because even though doctors and physicians have the best in mind, they do forget that they do know the implications, but not what is right for that particular person and the patient has the right/choice to steps to take for their health. As Mr. Fisher said, we have to be aware of moments when we say something factual and not relaying something you value through facts. We have to make decisions based on the information we are provide and not let those facts dictate what we do. Another concept that surprised me in this lecture is that the FDA is doing something similar to what was done in the 1900’s when health propaganda was used. It was not the content but the intent. It was not their intent to help individuals make better decisions but to make the right decision. To inform you, to make you do what the experts wanted, not what you wanted. Change your attitude, compliance without coercion. As a future doctor, what I will keep in mind is that in order to help my patients we both have to work together to provide a solution. I have to remember that what I may think is right, may not be right for that particular person. Its very important to be a good communicator because there could be multiple factors that may affect a patient, but you wont know unless you are able to communicate. We have to always keep the boundary between fact and valued fact.
It is hard to believe that my first semester of college is almost over. It feels like just yesterday that I came in wide eyed ready for the adventure. During this semester I can reflect on everything I have learned, all the experiences, new friends made, and more lovely moments yet to come.
When I read the letter I wrote to myself, I realized that my fears were not doing well academically but also not being able to find my niche. I also worried that I would not be able to manage everything coming my way, but I am proud to say that I was able to manage time for my courses, but also make time for friends and family. I stayed organized and was not completely stressed out this semester. Also being apart of the Health Science Scholars program helped me find great friends that I cannot imagine being without, but HSSP opened my mind to all the possibilities outing the health care system and the impact I can have within it. It made me more knowledgeable about public health and that this is my niche. This is what I am passionate about. This is why I like to thank Adam, Molly, and Micalah for all of their hard work, love and support.
Professionally, I really enjoyed shadowing Ruth Halben the Cardiologist Social worker and Dr. Laule who works in pediatrics. Both observations were very insightful by which I realized I can incorporate social work in my medicine career. This was the first time I was able to understand the major role social workers play in the healthcare system, but they do not receive much recognition. This semester made me realize the power of knowledge and I want to continue to learn and expand my horizons during my undergrad and graduate career at the University of Michigan.
The Journal of American Medical Association recently published an article with President Barack Obama as the author. In the Article, President Barack Obama discusses and reflects on his health care laws. Obama points out an interesting fact that since the Affordable Care Act the amount of non-insured people have declined by 43%, from 16.0% in 2010 to 9.1% in 2015. He also goes on to say that elderly men and women have gained access to health insurance through the expansion of Medicaid and this in turn reduced the debt by $600 to $1000. Obama states that there is still work to be done-which is true-and we should increase the competition in the marketplace and provide Medicare where there aren’t as many insurance providers to keep the costs low. Even though there is much debate on whether it was appropriate to let Obama publish his article on a medical journal, I thought it was very interesting and gave regular citizens like me a deeper look into the progress and impact of the Affordable Care Act.
Seventy years later we have seen such a huge amount of progress in Healthcare. What worries me is that if Donald Trump becomes president, he wants to take Obamacare and replace it with a Health Savings Account (HSA). What worries me with Donald Trump’s approach is that since it took us 70 years to progress in Healthcare, taking away Obamacare all together could push the country in the opposite direction. Right now we are still working on Healthcare, but if Donald Trump becomes President then we will be starting from square one. The country would have to start from the beginning and it might take another 70 years to get to where we are today. In my opinion we should keep working with Obamacare and except for repealing it all together, find solutions to the problems it has and improve it.
Two improvements that can be made in the healthcare system is first finding an easier way to access all the information on different insurance companies and finding a plan that fits best and second, find a way to keep people healthy rather than just treating them when sick. First we need to change our mind from seeing healthcare as a business, and looking at it as a basic human right that should be given to anyone. I believe that all political members need to put pride aside and find out the best plan for the good of the people and not their pockets.
The biggest challenge as the U.S. has tried to improve our health care system is the strong opposition against it. President Truman believed healthcare was a basic right, and he was the one who shaped the healthcare system. John F. Kennedy came after Truman stating the healthcare is for American seniors medicine insurance should be provided for the elderly. Kennedy appealed to Americans to urge the legislature but met strong opposition from the Medical Association who did not agree with John F. Kennedy. President Johnson continued JFK’s work and formed an alliance with Wilbur Mills-who cut the deal with John F. Kennedy-and passed his bill establishing Medicare and Medicaid. From 1968-1980 Nixon, Ford, and Carter were trying to expand healthcare to low income families and had the idea that healthcare should emphasize keeping people well, not just making people well. Opposition and change in leaders caused the healthcare reform to take 70 years. These factors made it challenging to improve our healthcare system.
The biggest failure is the inability to compromise on the issue. There is so much strong opposition that no change can be made. If legislature could get together and put aside their differences, then we would be able to make some progress. Not only do we have to agree on these changes, but we have to make it accessible to the citizens. Obtaining Medicare or Medicaid should not be difficult. The process should be easy and quick.
One of the successes in healthcare was President Johnson being able to pass his bill and establish Medicare and Medicaid. Another success was the establishment of the Affordable Care Act which expanded healthcare insurance to the poor. Because of this billions were able to access affordable insurance and this saved countless lives.