After 14 months of debate, town halls, protests, and fear mongering, the nation finally has a bill to provide health insurance to over 32 million Americans and new laws to protect those who all ready have it. It only took over 60 years to successfully fight for it. This issue has polarized the nation for decades--perhaps because so many fundamental issues are at stake including constitutional rights, states rights, abortion rights, and the right to pursue happiness. Some have even said that it is through good health that true happiness can be found. 

As a doctor, I always found it frustrating to have to argue with insurance company reps to get the appropriate tests or medications for my patients. I was the physician, but the person on the other end of the phone line had the power to make the decision which would impact the well being of my patient. As a consumer, I was frustrated and angry that my own private insurance went up each year. In fact, it increased this year by over 30%, and yet I was healthy and rarely used it except for preventive screenings. As a daughter, I was devastated when my mother was shipped out of an university hospital emergency room in the middle of the night because she had "maxed" out her insurance. The next day she "crashed and burned" in medical jargon and thus begun her 3 weeks of torture and suffering in a futile attempt to fix horrific medical missteps.

Initially, I strongly supported health care reform. I worked on the presidential campaign with the hope that we would achieve this goal --believing that health care was not a privilege but a right for all Americans. As the bill developed and it appeared that individuals with more income as well as device companies would have to pay extra taxes, I became less enthusiastic. Perhaps it is human behavior to not want to pay for others' bad behavior such as for the diseases associated with obesity, smoking and drinking. I also provided scientific policy advice to a device company that is so fully committed to ensuring the promotion of good health that it directs many of its profits into research and development as well as providing Americans with stable, good jobs. I became concerned that these new taxes would impinge on these opportunities which have helped the public tremendously.

But, I became a believer again that we needed reform and we needed it now. We all learn from our experiences if we are just open to receiving the messages. Sometimes they have to hit you on the head and even in your heart. I began to remember the last week of my mother's life when I had to meet with the Chief Financial Officer of the hospital that she was in to discuss her medical bills and to remind him why she was there. I would have rather met with the Chief Resident to discuss medical therapies to save her life. The sod was not even placed on my mother's grave when the hospital began sending menacing letters to my father. His fear of losing his home compounded his grief over his loss of his beloved wife of 56 years. 

I finally remembered a lesson that I received at Columbia University. I had taken an anthropology course taught by Professor Rose Solecki. Her husband had excavated a cave in Shanidar, Iraq and unearthed skeletons of Neanderthals. They found one man who had been clearly infirmed with injuries to his limbs -some of which could have been congenital or from childhood. This demonstrated that his clan had taken care of him which allowed him to live a relatively long life. Dr. Solecki stated that this was one of the first examples of compassion and care for others indicative of civilization. Prior to this, it was assumed that those who were ill or injured would be left behind because it would negatively impact the clan.

So, perhaps we can look at the passage of health care reform legislation in a brighter light--that it is not indicative of socialism or communism or the fall of democracy, but rather as a milestone of a civilized society. It may have taken us a long time to get here, but we have finally evolved.