P. Gordon is professor, University of Arizona College of Medicine-Tucson, Tucson, Arizona; ORCID: http://orcid.org/0000-0002-3366-1054. E. Shapiro is clinical professor emeritus, University of Arizona College of Medicine-Tucson, Tucson, Arizona.
Acad Med. 2019 Jul;94(7):931-933. doi: 10.1097/ACM.0000000000002669.
Reflecting on the 2018 U.S. midterm elections, it is clear that health care coverage once again played an important role. This prompted the authors to look back on their 2016 bike listening tour across the country when they asked people about their views on the Affordable Care Act. Through those conversations, the authors observed that a common thread was the rampant misunderstanding of health insurance coverage and the central role that politicians had in the creation of policy. In this Invited Commentary, the authors explore the results of the 2018 election, particularly in the rural northern areas where they toured in 2016, and the contradictions between what people say they want, what the candidates say they support, and what the facts actually show. They offer suggestions for the role physicians might play with patients in correcting misunderstandings about the health care system and the policies that shape it. Patients do not always make decisions as physicians do. As opposed to evidence and data, they might rely on personal experiences and stories. The authors suggest that physicians might be able to help patients use these stories to inform their decisions, and to help them understand the connection between their personal health care experiences and the votes they cast in elections.
反思 2018 年美国中期选举，很明显，医疗保健再次发挥了重要作用。这促使作者回顾他们 2016 年在全国范围内进行的自行车听力巡回赛，当时他们询问人们对《平价医疗法案》的看法。通过这些对话，作者观察到一个共同的主线是对医疗保险覆盖范围的普遍误解，以及政客在制定政策方面的核心作用。在这篇特邀评论中，作者探讨了 2018 年选举的结果，特别是在他们 2016 年巡回的农村北部地区，以及人们所说的他们想要的、候选人所说的他们支持的和实际情况显示的之间的矛盾。作者为医生在纠正人们对医疗保健系统及其政策的误解方面与患者合作提出了建议。患者并不总是像医生那样做出决策。与证据和数据相比，他们可能依赖个人经历和故事。作者建议医生可以帮助患者利用这些故事来告知他们的决策，并帮助他们理解个人医疗保健经历与他们在选举中的投票之间的联系。
