The Flexner Report from 1910 has had a huge influence on our current health care crisis. There were three main outcomes of the report. The first is that medical education in the U.S. and Canada is to become standardized. This had both positive and negatives outcomes. At the time there were a lot medical schools around that had no clear regulations. For instance medical students did not need to be college graduates. So there were most likely students in medical school who should not have been there. Also many of the schools themselves did not have laboratories to teach the students about dissection. While these positive changes ensured that our future doctors would be well trained, they also made is much more expensive to attend medical school which in turn decreased the number of doctors available to treat patients.
The second outcome from the Flexner Report is that it established medical care as a market commodity. Defining a market commodity, as an item to be bought and sold for profit. The result is soaring prices, and medical care is often only available to those who can afford it. If medical care had been established as a social good, then all citizens would be eligible for a basic level of care, rather than only the rich.
The third outcome from the Flexner Report is to grant sovereignty to the medical profession over the organization and financing of medical care. This meant doctors can order as many test as they want and charge as much as they want. While these powers were given to doctors with good intentions, the resulting adsorbent cost has crippled our health care system in America. (Barr, 2007)
Universal Health care in the U.S. can work because the long term benefits far outweigh the short term cost. Most Americans agree that out current system of health care is broken, the debate lies on how to fix it. Many citizens are concerned that Universal Health Care would be to expensive, but other prosperous nations have implemented it without breaking the bank. We can look at these successful nations as a model to structure our system in the most effective and fiscally reasonable way possible.
Not only have other nations found a way to protect their citizens at a reasonable cost, but so have small communities and cities within the U.S. In Grand Junction, CO, the physicians did not wait around for government reform. They took it upon themselves to ensure the health of their community while still controlling cost and make a profit. They were able to do this by creating a network of doctors who will accept any type of insurance including Medicare and Medicaid. They also pooled the payments to create a monoposy type payee system, where the private insurance made up for the smaller government payments.
Still other would argue that it would be unconstitutional to have universal heath care. A workaround for this would be to follow Canada’s lead. The healthcare would be provided by the individual states who would all want to participate in the program so they could receive federal funds to help subsidize some of the cost. This was those who strictly interpret the constitution could not say that he federal government is providing universal health care.
The main point being that our current healthcare system is broken, but there are numerous examples of successful universal healthcare coverage that we can model our system after. The US is the only industrialized country that does not have universal health care for all its citizens. Britain is a good example of a nation that has universal health coverage since the the 1940’s. Britain’s system is called National Health Service, or NHS. Similar to Canada’s system the national government provides a framework and guidelines while leaving specific decision making and accountability up to local regions. While the NHS has encountered its problems it is supported by even the more conservative political parties in Britain. They adjust their program as needed to control cost while still protecting their citizens.
The Flexner Report was useful at the time of its publication. During that time there were so many medical and scientific discoveries made. It was tough for the public to distinguish between genuine medical breakthroughs and the scam like quackery that was often fleecing people from their hard earned money, without providing any medical relief. Even today, with safeguards in place, it can be tough to tell the difference between real and fictional treatments. Back in the early 1900’s it must have been near impossible.
The consequences of the Flexner report have been very long lasting. There was so much power given to the A.M.A., American Medical Association, whether intended or not. Historically the A.M.A. has been the biggest opponent to universal health care. Physicians within the A.M.A. have a tremendous amount of power, especially in Washington D.C. The money and lobbying clout they wield dwarfs that of competing interest.
As a whole the A.M.A. still oppose Universal coverage, but there are groups of doctors who feel they have a moral obligation to treat everyone. Hopefully the A.M.A. position will change, but we do not have time to wait. The current health care system is in such dire straits, that postponing a complete overhaul will only make the change that much harder.
The AMA has come along way over the years. Many people believe that in the past the AMA has been a sexist and raciest organization, prohibiting woman and African Americans from joining. During the time of the Flexner report, it was much different time in this country. I hope that the AMA will continue to evolve.(Hunt, 2006)
Whether it was intended of not, the Flexner Report made it tougher for African Americans and women from becoming doctors. Opponents to universal coverage cite the myriad of other pressing concerns facing our nation. Everything from unemployment to terrorism threats has been suggested to take priority over universal health insurance. While those issues are no doubt important, we can not afford to use them as an excuse not to provide our citizens with a basic level of care, that they deserve.
According to the CDC, Increasing the number of persons with continuous health insurance coverage can reduce the number of occasions that persons forgo needed health care, which can reduce complications from illness and avoidable long-term expenditures.(www.cdc.gov). To put it simply it is much cheaper to keep society healthy as a whole rather than treat those who are already ill. No doubt people will still get sick, but by insuring everyone we can reduce the number of illnesses dramatically.
The obesity problem alone contributes to so many expensive chronic diseases. With an early intervention to prevent complications such as diabetes and hypertension, we can not only improve the quality of life but also save money. By spending a little for the initial cost of prevention, we will save on the long term cost of medication and doctors visits.
Doctors themselves can feel good about the impact they are having on their community, while still earning a comfortable living. The initial rush of those people seeking medical care can be prioritized by need. It should not take too long to see the critical patients first, and then the prevention and savings can begin.