The world of health care – its delivery, administration, financing, and reform – is complex. My hope is that this site will help to make it less so for its readers, whether they are my fellow MDs, patients, or members of the general public.
During my medical training, I have made two observations that were my prime motivators in creating Wonkologist.com.
First, while health care policy may seem complex, it is understandable. Its complexity arises mainly from its size and the sheer number of moving parts – the innumerable cast of physicians, patients, insurers, technology companies, and many others, who compose it. However, the motivations, choices, and products of each of these actors, on the individual level, are largely comprehensible and rational once one understands the underlying incentives that our system has in place. A little bit of Economics 101 – supply and demand, business models, etc. – combined with a few basic facts about the laws and regulations that these actors work within goes a long way towards answering any number of questions about the health care system.
Such as: Why are new drugs so expensive? Why is my home-town hospital now part of a large network? Why do so few young American doctors go into primary care? How come different doctors are always repeating the same tests on me? The behavior of doctors, hospitals, insurance companies, become much clearer with just a basic understanding of the underlying infrastructure.
Second, there is, sadly, a large amount of misinformation floating around, obscuring the picture for anyone who lacks the background or first-hand knowledge in health policy to see through the smoke. Health care is political. And as often happens with political topics, facts can fall by the wayside in favor of strategy, spin, and rhetoric.
My goal is to help people see past some of that.
Fortunately, outside of the sphere of punditry and partisan bickering, I have been encouraged by the level of discourse – and even the level of agreement – present within serious policy circles. There is some disagreement, of course. The ideal systems imagined by health care experts on the left and right would probably look vastly different. But my overall impression is that there is a much greater ability to at least agree on the problems, and maybe even to hammer out workable solutions, among health policy experts of varying ideological backgrounds than one might expect. They just aren’t always the people you see on TV.
That serious discussion going on behind the scenes is, as they say, a bit “wonky.” It is conducted in long, sometimes complex research studies, not quick sound bites. And its conclusions can be detailed and nuanced, often not fitting into a clear red or blue shade, or into an easily-deliverable quick fix.
But why “Wonkologist?”
Wonkologist = wonk + oncologist
But what, then, is a “wonk”? According to Wiktionary, a wonk is “a person who studies or develops strategies and policies, especially one who has a keen interest in and aptitude for technical details.” I hope to serve in that role – interpreting the “technical details” of health care policy, to reveal for you how simple the underlying ideas actually are.
The “oncologist” refers to the kind of doctor I will be in the near future. I currently practice internal medicine, but am pursing training in oncology, or cancer medicine. I hope that this perspective, as both an “insider” with first-hand knowledge of how hospitals operate and doctors think, as well as a specialist in one of the largest and perhaps most misunderstood branches of medicine, will also be illuminating for readers.
At the heart of this site is the health care spending “crash course,” including my map of the major causes of high health care prices in this country. The overall cost of health care in the USA is one of the biggest, if not the biggest, single problems facing our health care system, if not our society as a whole. Uncle Sam may have trouble affording Medicare in the near future, and millions of patients are already having trouble affording the care they need NOW. Herein, I do my best to demystify the reasons why care is so expensive, and increasingly more so.
This part of the site will also serve as a reference, since most of the things I will be blogging about will relate to one of these issues. As for the blogging itself, I hope to cover a range of topics and types of content – everything from explanations of new research findings, to health policy news updates, to observations stemming from my own experience in caring for cancer patients.
I would of course welcome any feed back on the site, or questions on the material. I would love a healthy discussion and debate as well – let’s please remember to always keep it a civil one.
Welcome to Wonkologist, and thanks for reading!