A Transparent Moment

Public Policy Contributor Brad Flansbaum writes…

My dad recently asked me why I liked politics, health policy, and in particular, why I read so much.

Years ago, I used to like plunking myself on the couch Sunday afternoons and watching six hours of football. I enjoyed Grisham novels and pointless comedy shows. Those days are long gone. Yes, I actually watch C-SPAN and enjoy Health Affairs.

Living life in the hospital listening to patients, friends, and residents wrongly attribute the root causes of our nation’s ills bothered me. I was never a studied wonk, and civics in high school did not activate my passions for government. I suppose though, getting older and having a front porch view of health disparities in my community, reading contradictions in the newspaper or listening to a local official tell the masses (us) what we want to hear stirred my intellect.

I began to explore, learn a bit more, and listen to my colleagues from around the country who shared different views than me. My committee work with SHM is instrumental in this regard, and folks from Texas, California, Michigan, Missouri, etc., have taught me a great deal and opened my mind to new ideas.

It has taken me a long time to get to this place.

I find it challenging to wake up each morning and educate our residents on the workings of healthcare and debunk the myths that are so prevalent, even amongst health professionals. Ask a resident why health care costs are so high, and invariably they will say defensive medicine or greedy insurance companies. Even Obama knows better, and on the latter point, he himself continues to push, driving a penny wise, dollar poor agenda that will not pay dividends for the remainder of his administration. Eventually, he will have to sell the country on the real reasons why our hospitals are so inefficient and wasteful.

The insipid press does a lousy job of schooling the public as well, and politics and policy is merely a tabloid exercise. Read Politico sometime and you might confuse it with the National Enquirer, only Sarah Palin will be on the cover instead of Mel Gibson.

Conversely, we the people consume negative ads, love them, and are ever so gullible, overcome by their easily digestible messages. We want low taxes, minimal government interference in our lives, yet want the social programs that benefit our families and communities. What is a public official to do, actually tell the truth? If you do not believe me, watch this politician commit Hari-kari on live television.

Winston Churchill said it best: “The best argument against democracy is a five-minute conversation with the average voter.”

I imagine congressional representatives behind closed doors on one hand, repentantly having to spend half their time raising money and working the phones to raise cash to feed us the daily pablum. On the other, betraying their conscience and lying to their constituents about how troubled this country really is today. This is not a partisan issue, and if you are reading this, you know it too. Shame on them, and shame on us.

Anyway, having read these two exposes this weekend, one okay, the other outstanding (a must read if you work in a public institution), I am energized to preach the gospel for one more week.

Some docs like to commit to memory the differential diagnosis of a macular rash; others, like me, feel the need to explain to trainees why Medicare will not pay for custodial care and why a $50K/year biologic is a potentially inefficient use of our scarce resources.

Boring maybe (my mom thinks so), but it gets me out of bed every day with a bounce in my step. That is my daily bread.

Brad Flansbaum

Bradley Flansbaum, DO, MPH, MHM works for Geisinger Health System in Danville, PA in both the divisions of hospital medicine and population health. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education.

Currently, he serves on the SHM Public Policy Committee and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates.

Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University.

He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a resident of Danville, PA.

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