I am so glad 2017 is coming to an end.  I hit the big 60 this year and that was a high point.  However, the low points cannot be overlooked.

Socially and politically, we witnessed outrage and disgust. Women marched on Washington.  The blatant assault on our rights was too much and women of all cultures and faiths banded together across the world to demonstrate in record numbers.  Black women in Alabama stood together and drowned out the overt racist, sexist and vulgar representation from one man and sent a powerful message across the world.  I had the pleasure of celebrating that victory with two friends  and my husband with dinner and  a bottle of the best champagne I have ever had.  But once again, I was appalled by the number of people who voted for this person.  It mirrored the horror of the presidential election but with poetic justice.  So, I do admit I am having a hard time talking with and listening to people who say they voted the way did to protect “Christian values”. Because, there was nothing Christian displayed.

On the right to vote, Dr. Martin Luther King said:

“Voting is the foundation stone for political action.”

The unspeakable acts committed against women in the workplace was especially upsetting.  This behavior highlighted the lack of diversity, the abuse of power and the ineffectiveness of the present training.   However, despite what we have heard,  there are still so many other stories out there to be told. So many of these incidents happen daily in workplaces in small towns and in immigrant communities.  Women forced to survive and care for themselves and their children are victims.  In doctors’ exams rooms, women tell horrific stories, we listen and offer support.  We can’t force them to file complaints with Human resources or the police.  Many are scared because of their undocumented status.

Dr. King on silence:

” Our lives begin to end the day we become silent about things that matter.”

In healthcare, the defeat of the whatever that awful bill was to overturn the Affordable Care Act was a step but the erosion to that law is going to have major consequences. Many aspects are not being funded.   I am a medical educator. That means I am paid to mentor the next generation of primary care providers. Very few Americans understand how we pay for medical education in this country. Well, it is paid for by first the student who decided to go to medical school.  The average student completes medical school with over $200,000 worth of educational loans.  They enter residency training and then out to practice or into fellowships.  The need for primary care physicians is great and the number is growing too slowly.  The Graham Center has projected that in order to maintain current rates of utilization, New Jersey will need an additional 1,116 primary care physicians by 2030, a 17% increase compared to the state’s current (as of 2010) 6,236 PCP workforce.  Compared to the Kentucky, which will need an additional 624 primary care physicians by 2030, a 24% increase compared to the state’s current (as of 2010) 2,520 PCP workforce.  To achieve this, we will need an increase in dollars directed toward Graduate Medical Education and medical education debt relief. So, I hope you see why I am not cheering my tax savings because I and all of you are losing a whole lot.  The tax cuts will be “disastrous”.

The blatant attack on the Children’s Health Insurance Plan shows the lack of insight and compassion to understand the implications of not insuring children and protecting their families.  Many parents are forced to leave their jobs to care for children with chronic medical conditions or acute illnesses that require extended hospitalizations.  Parents need their children to be covered because they forfeit the insurance once provided by their employers.  If the other parent picks up the cost of providing that benefit, then the cost is much higher.  In our office, we see daily the benefit of children getting Medicaid.  Newborns are covered from the moment they are born. Both inpatient and outpatient care is provided.  The immunizations are covered.  The other assault is on Federally Qualified Community Health Centers.  They provide the care in communities across the country that are underserved by primary care physicians.  Care is based on income and they provide care to Medicaid and underinsured patients.  The number of these FQHC’s were expanded under George Bush’s administration. Physicians in these FQHC’s are often recipients of loan assistance through the National Health Service Scholarship program.  The funds for this program are included in the Affordable Care Act.

Despite all of this, I do remain hopeful.  If the success of the vote in Alabama teaches us anything, it does show the power of voting and we should never sit home again and feel that our one vote does not count.  It does and it can change the world.

Martin Luther King quotes for the New Year:

“The whirlwinds of revolt will continue to shake the foundations of our nation until the bright day of justice emerges.”

 “With patient and firm determination we will press on until every valley of despair is exalted to new peaks of hope, until every mountain of pride and irrationality is made low by the leveling process of humility and compassion; until the rough places of injustice are transformed into a smooth plane of equality of opportunity; and until the crooked places of prejudice are transformed by the straightening process of bright-eyed wisdom.”