Dr. Malia Reckons

I got a good laugh today, in an unlikely way. It was while reading a physician's take on the current national health care discussion. Consider the low probability of such a thing!

In the mail I received the October Forum, the monthly newsletter for the Rochester General Hospital Medical & Dental Staff. As usual, the President's Message led on the first page, and this month, the president, Richard Constantino, MD, offered a perspective about the national conversation couched in terms of Yogi Berra quotes. Never before had I considered that Yogi's sayings, utterly glib illogic mixed with a profound inherent truth, fit so well in our health care debate. I may not agree with every point Dr. Constantino makes, but I thought the essay was nicely done. And I appreciate the call for us all to remain in the discussion.

So, as a baseball fan, and a physician who cares about the national conversation for health care reform, I happily offer Dr. Constantino's President Message for October, 2009. Enjoy!  (Note that emphasis, with bolding, is my own for Yogi's sayings)

October, 2009

Forum, President's Message

Richard Constantino, MD

As we approach the height of the baseball season with the playoffs and World Series coming up quickly, and as we are approaching the height of the political season with debate over healthcare reform, I thought we should enlist the opinion of a well known philosopher and pragmatic thinker as we move ahead. Many have an opinion regarding who will win the World Series and even more have opinions on healthcare reform. Who better to advise us on both than Yogi Berra? Over the years he has uttered a variety of statements that I think have application to healthcare reform. See what you think.

Yogi has uttered many memorable things, but none more memorable than "I knew I was going to take the wrong train so I left early." Many feel that healthcare reform is moving too quickly and that although necessary, we aren't really at the point where we could make  final decisions and any artificial time deadlines or goals represent leaving early, but perhaps on the wrong train.

The application of this one of Yogi's quotes is remarkable: "If you don't know where you are going you will end up somewhere else." In healthcare reform we certainly don't know where we are going and many don't even recognize where we want to be. A good number of individuals are happy right where they are.

Yogi once said, "you better cut the pizza in four pieces because I am not hungry enough to eat six." Many people feel that the changes we are making in healthcare will reapportion the pieces of the pie, but not make it any smaller and may not make it any better. We all recognize that we cannot afford the rise in healthcare that we have experienced, but all want to be sure the changes we make will be meaningful in reducing costs, and along those same lines, Yogi's statement, "a nickel isn't worth a dime today," does raise the specter of how we'll pay for our current standard of healthcare in the future or costs under a new program.

I think all of us fear creating a new healthcare system that misses the mark and even those things that have "slam dunk success" written all over them, may not be. Who could have envisioned that the very "successful" "Cash for Clunkers" program would lead to a significant impact on the used car and automotive repair business? Along these lines Yogi warns "90% of putts that are short don't go in."

Yogi's quote, "this is like deja-vu all over again" seems made for healthcare reform when one considers what happened to the Clinton healthcare reform of the early to mid 90s. It certainly does seem that many of the occurrences of that decade are being experienced again. And lastly, with remarkable logic, Yogi states, "nobody goes there anymore, it's too crowded." Certainly the healthcare reform field is crowded with many opinions, biases, thoughts, proposals and agendas. Rather than following along like lemmings or withdrawing from the entire arena because of its complexity and emotionality, I hope we'll all remain involved in our thoughts, opinions and desire to influence healthcare reform to create the best healthcare system we can. I know most of us wish that political agendas were less evident in proposals and debate. I know most of us believe that all Americans should have basic health coverage and when it comes to our politicians I hope they will work together in a nonpolitical way. I almost hear Yogi exhorting our leaders, "Let's play ball."