There's no question that healthcare in America is in trouble. However, most of the time we hear about it from the patient's perceived perspective of not being able to afford healthcare coverage, high insurance costs, physicians not treating them with courtesy, etc.

Well, there are two other perspectives that aren't heard from all that often that came out this week. One was the fact that, with the economy running the way it is lately, fewer people are having elective surgeries than ever before. Elective surgery is usually considered things such as breast implants, liposuction, and the like, but elective surgery is really any surgery that's not considered as life threatening, such as hernias, knee repairs, and the like.

This is putting a strain on an already tough healthcare market that saw a misleading news story pop up just a few days before this one. That story indicated that hospitals on average in 2006 made record profits with over a 7% increase. That sounds pretty good until you read the rest of the story, which said hospital expenses on average increased 6%. Thus, a 1% average increase overall, which means that possibly half the hospitals in the country lost money. Yet, when I read some of the commentary on that particular story, all one saw were people saying how greedy hospitals and physicians were; no one seemed able to equate the expense portion at all with how tough the healthcare environment is.

Next comes the latest story, where a survey of physicians was taken, and about 50% of them said they were either going to reduce services they provide or quit altogether. Over 60% said they wouldn't recommend medicine as a career for anyone. This at a time when the United States has a shortage of internal or family doctors, as well as a major shortage of OB/GYN specialists, although other specialties seem to be doing fairly well. That is, for those physicians who aren't feeling the pressure of too many patients and too many lawsuits. One finding was that 76% of the physicians said they are working at "full capacity" or "overextended and overworked".

Healthcare reform of some kind is definitely needed, but it can't be short sided or one sided. It not only has to take into account finding health coverage for as many people as possible. It has to also: make sure that reimbursements to hospitals and physicians are fair; put a cap on the amount that can be paid out for malpractice when it's accidental (grading system for physicians is key here); reduce malpractice insurance; and encourage more people to get into healthcare by offering rebates or tax breaks for them to go to school, and maybe having a staggered rate depending on the types of vocations a physician is going into.

It's not going to happen, of course, but if President-elect Obama needs some ideas, someone pass him my phone number.