Sufficiently Indoctrinated

Rather than teaching physiology or immunology, our school devotes this entire month to population health, epidemiology, and health policy. The three subjects complement each other well: we learn statistics to analyze epidemiology papers and use such studies to devise policies that affect population health. The most eye-opening course for me so far has been health policy. I didn’t realize how little I knew about health care economic infrastructure and payment schemes until they were explained to us in great (and sometimes tedious) detail.

Health care coverage is relevant, nonintuitive, and downright confusing. Economics, policy, and politics are certainly not topics I have learned much about from sources other than the media. Every day, for four weeks, we learn about geographical variations in health spending, insurance, Medicare and Medicaid, cost growth, managed care, medical malpractice, health care quality, and health care reform.

If the purpose of a mandatory health policy course is to get future doctors to think about costs more frequently and intelligently, the short-term results seem pretty good. Now, during our population health lectures, it is not uncommon to hear a student ask the lecturer about the cost-effectiveness of an intervention–and then apologetically explain the fiscal interest as, “It’s just that we’re taking health policy now…”

I don’t remember these sheepish questions ever surfacing before.

Additionally, I have wondered if my classmates–and tomorrow’s doctors–know what it feels like to be without health insurance. About one in three Americans between the ages of 18 and 24 is currently uninsured, and about one in four of those ages 24-64 is. We are required to have insurance while we are in school. But have we ever experienced any time without it?

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