When it comes to politics, it’s difficult to be a physician these days. There are many strong candidates in the presidential primaries this year. From the Republican side you’ve got a very ethical leader in John McCain. For the Democrats you’ve got a very charismatic and young Barack Obama and a very smart and battle-tested Hillary Clinton. All of them have very interesting ideas about the healthcare system and improving access to medical care.

Physicians as a voter demographic are a tough nut to crack. Surgeons and wealthier physicians usually align with republican principles of lower taxes, small business support, and separate public and private health systems. Public health and primary care physicians generally tend to align with democratic principles of improving access to care to all individuals and more socialized medicine. In general physicians tend to be altruistic individuals who entered medicine to help others. Yet medicine is a profit driven industry. Thus, there is a little democrat and republican in every physician.

Healthcare is and will continue to be a hot-button issue in presidential politics. Unfortunately, there is no easy solution to the healthcare mess. What is clear is that the government simply cannot afford to pay to take care of its aging population. Additionally, it cannot afford to take care of its young or immigrant population. It really cannot afford to take care of everyone who lives within its borders. Attempting to do so would bankrupt the country, significantly cut the wages of anybody who works in healthcare in any capacity, and would significantly drive down the discovery of new medicines and technological advances to help people.

We live in an economic system of “give and take.” There is no free ride for anyone anymore. To give to someone literally means taking from another in terms of budget allocation.

Unfortunately, the future of budget cuts and decreased reimbursement appear gloomy, regardless of whether you are Republican or Democrat. The end of the current healthcare system will come in this lifetime. The question is to we want the change to be slow and painful or fast and potentially more or less painful?

Any change within the healthcare system will be felt by all — physicians, patients, anybody and everyone who works in and utilizes the healthcare system. Regardless of who is president, we know change is coming soon. How are we going to deal with it?

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