National Healthcare

National Healthcare

Michael Moore's Sicko is a treatise for a National Health Service Program. It sounds good on the surface, to use tax dollars as a means to improve the health of the country. However, if you are an otherwise healthy individual, why should you participate? Granted, as a physician, you applaud the implementation of a plan that would allow everyone the access to health care. However, maybe you feel, as a new graduate at the age of 27, that you shouldn't be paying for a new defibrillator for Dick Cheney or for Bob Dole's erectile dysfunction. Also, with an eye towards history, maybe you think by paying for a health benefit now, you will be paying for a program that will be phased out by the time you really may benefit. But, in a civilized society, what is the option? Do we move towards a nationalized health care system or not? So often these topics are infused with special interest groups and millions of dollars, but as a purely ethical question, is health care a right?

Case 3

This patient comes to your ER complaining of joint pain. On further questioning, you also find the patient complains of pain on urination and matting in her eyes in the morning. What is the diagnosis?


A geographic tongue is a loss of pappillae in the tongue that often changes with time. In general, the patient is asymptomatic, and the patient has spontaneous resolution. The georgrapic tongue may be due to psoriasis, Reiter syndrome, lichen planus, herpes simplex virus. systemic lupus erythematosus, drug reaction and leukoplakia. In this case, the other symptoms of arthritis, urethritis and conjunctivitis comprise the triad known as Reiter syndrome. In a related note, the medical establishment is moving away from the term Reiter syndrome as it is named after Nazi physician who described it after experimenting on unwilling patients during World War II.