Sick in America: Health care reform will only come with public anger, says doctor-author

It's only a matter of time -- and not much time -- before the number of Americans without health insurance tops the entire populations of Canada and Australia.

The number (soon to reach 50 million) is "awful," said pediatric cardiologist Arthur (Tim) Garson Jr., executive vice president and provost of the University of Virginia and author of "Health Care Half Truths: Too Many Myths, Not Enough Reality" -- but it's not the whole story.

In many ways, he said, the issue comes down to the life of a single individual.

Garson spoke April 20 in Goldwin Smith Hall's Hollis E. Cornell Auditorium. The lecture was the keynote address and kickoff event for Cornell's first annual Sick in America series; it also was the inaugural event for the Cornell University Presidential Speakers Series on Current Affairs, a new series sponsored by President David Skorton.

Encouraging plenty of audience interaction, Garson laid out the topography of the health care debate, defining terms and dispelling a few myths along the way.

But first, Garson told a story from his first night of training in pediatric cardiology in a Texas hospital: During the night, the heart of a 5-year-old girl, who had just had surgery for congenital heart defects, stopped three times. "Each time she arrested I went down the hallway and discussed what was happening with her parents and grandparents," he said. "This was their only little girl."

She survived, and Garson attended her high school graduation 13 years later. But then halfway through her 19th year, the girl's mother called to say she had died.

"What it looks like happened is her Medicaid ran out at the age of 19," Garson said, "and she quit taking her medicine … a drug that was absolutely keeping her alive."

The story is a reminder, Garson said, that behind the statistics lie individual people, each with a story. And preventing similar tragedies in the future will require major reform to reduce waste, standardize treatments and increase coverage and access.

Electronic medical records will certainly help to reduce administrative costs and errors and provide the data needed to standardize care. And ultimately, a two-tiered system, which insures the public at a base level and allows for additional coverage through private companies, will be the best solution, he said. But it may not happen in the near future.

"It is going to take the American public saying 'this is absurd that we have anybody who does not have coverage,'" he said. "I don't think the anger is enough to carry the day. I hope we get there, But the public is going to have to want it."

The Sick in America series, which examines American health care from the perspectives of physicians, patients, economists and policymakers, continues through April 24 on Cornell's Ithaca campus. A symposium on business and medicine in New York City -- which will be simulcast to Sage Hall -- concludes the series April 30.

"The series links together the two campuses in a way that has been a very high priority for a number of years," said Skorton in his introduction to Monday's lecture.

Other events in the series include panel discussions, documentary presentations, a health fair and art installations. All seven undergraduate colleges are involved, along with the Johnson School and Weill Cornell Medical College.

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Blaine Friedlander