Viewpoint

Hunger Games and health care

FROM THE CHIEF MEDICAL EDITOR Larry E. Patterson, MD

I shall stick to my resolution of writing always what I think no matter whom it offends.

—American abolitionist Julia Ward Howe

Earlier this year I found myself stuck at Chicago O’Hare Airport on a layover that extended hours beyond what was originally scheduled. Unusually, I had no reading material to keep me occupied, so I entered a concourse bookstore looking for something to pass the time. I spied a novel that my 21-year-old daughter had urged me to read, The Hunger Games, by Suzanne Collins. The story had not seemed that interesting to me, but remembering my daughter’s fascination, I purchased the book, and finished it the next day.

The Hunger Games is set in a post-apocalyptic dystopian future, where the vast majority of the populace is controlled and impoverished by a self-serving totalitarian government. The story centers around an annual event where young people are chosen in a lottery to compete in the ultimate reality TV show, a battle to the death, where only one can emerge victorious, and alive.

Then I rented the movie and was fascinated by it as much as the book. And just last night I emerged from the theater having seen the second movie of the trilogy, The Hunger Games: Catching Fire. I’m a bit slow, but I started putting pieces together. (To better understand the visceral impact of this short opinion piece, you may need to read the books, or see the movies; otherwise just ask your children to explain it to you.)

The first novel appeared in 2008. The author stated that a major inspiration for the series was the Iraq war. But so much has happened since then. We’ve learned a bit about the extent of NSA domestic spying. The middle class continues a slow financial decline. And most recently we’ve watched as our patients and practices are feeling the efforts of the government’s attempts to control even more of our country’s health-care system.

I wrote a few months back about being opposed to central governmental control. This is not meant to be political, but, in my opinion, with Obamacare we are witnessing the biggest mess out of Washington in my lifetime. I’ve never had so many patients both frightened and angry at the government as I do now. Millions are losing their insurance plans. Many of us have been inexplicably kicked off insurance panels. The government health-care website may get straightened out yet, but then what?

Large hospitals across the nation have been rejecting many of the new plans. Some insurers are suggesting new payment rates could be lower than current Medicare rates, and some even lower than Medicaid. In addition, the proposed SGR fix freezes our fees for 10 years, regardless of inflation.

Look, we aren’t anywhere near the horrific mess portrayed by The Hunger Games, but it makes you think. Is it 1984 all over again? OM