Jay's Anatomy

It's also not uncommon for the Jay Docs to send their patients to the emergency room. Co-director Claire Zeigler remembers when a volunteer at the clinic sent a patient with a possible intestinal abscess to the hospital. The doctor called ahead, suggested that the patient needed a CT scan, maybe even a procedure to have the abscess drained. Instead, the patient was dismissed.

No matter how many grants the students get to expand their services, no matter how many phone calls they make trying to coax a specialist to see one of their referrals at a reduced rate, the moneyed system always seems to block their efforts. edical school doesn't just turn kids into doctors. It makes businessmen out of them, too.

"Most of our students went into medicine because they want to make the world a better place," says Joshua Freeman, chairman of the KU Department of Family Medicine and a faculty advisor to the Jay Docs. But, he admits, "The system does tend to beat it [that idealism] out of them as they go through the four years into residency."

Classes focusing on the business aspects of becoming a doctor are vital preparation for the next generation of physicians anchoring private practices and staffing major hospitals. Rigorous study schedules keep them busy in the evenings as they cram to make the grades and secure an impressive residency that will launch their careers.

During his first year, Ben Hall assumed that he was just studying himself sick. After all, the workload was enough to give anyone an ulcer.

But just after spring break last year, Hall's stomach pains gave way to bloody diarrhea. His roommate rushed him to the emergency room. Three days later, while lying in a hospital bed in his hometown of Topeka, Hall was diagnosed with ulcerative colitis, a chronic digestive disease characterized by bleeding, pussing sores in the colon and rectum.

"The nurses there on the floor compared it to the pain of childbirth," he says. "I wanted as much Demerol as I could."

He was stabilized after six days in the hospital, but Hall's symptoms returned before the end the semester. This time he was vomiting. By the time he checked back into the hospital, he'd lost 20 pounds and the physicians recommended the Mayo Clinic in Minnesota. Doctors there told him he had two options: surgery to remove his entire colon or a drug called Remicade that would cost $3,000 for each of the infusions he would need indefinitely every six to eight weeks.

Twenty-three years old and living away from home, Hall wasn't sure he would be covered by his parents' insurance. Hall panicked, dreading what might happen if he were forced to pay $45,000 in medical bills. Luckily, his father's insurance plan at the The Topeka Capital-Journal covered Hall's costs.

"But if I was a student without insurance, who knows what would have happened?" he says. Suddenly, the kid who had run cross-country and never come down with much more than an ear infection was feeling a lot like the patients he saw when he volunteered at the Jay Doc clinic.

Now all the theoretical talk he'd heard in lecture halls and the articles he'd read in The Economist, about how the U.S. model of health care is "unsustainable," made sense.

Nationwide, more than 46 million Americans lack health insurance, a number that swelled by more than 1.3 million in 2004 alone, according to the U.S. Census Bureau. According to the Institute of Medicine at the National Academy of Science in Washington, D.C., that lack of coverage kills 18,000 citizens each year, or 50 Americans every day.

In Kansas, where 300,000 residents are uninsured, a July report from the Kansas Hospital Association found that 58 percent of residents called the widespread lack of insurance a major concern.

In Missouri, 700,000 people lack health coverage. An April survey from the Missouri Association for Social Welfare indicated that 90 percent of consumers were concerned about health care for themselves. Among doctors, 76 percent cited "too many uninsured patients" as their top health concern.

Doctors worrying about uninsured patients isn't news. What isn't part of the public discussion is how many of those doctors favor a single-payer national health care program, one in which the government bankrolls medical coverage for all citizens.

Though conservatives scorn universal health care as "socialized medicine," 49 percent of U.S. physicians supported legislation to establish national healthcare insurance, according to a widely cited national study by researchers at the University of Washington and the Indiana School of Medicine in 2003.

Concerned health care professionals organized Physicians for a National Health Program and published an article proposing a single-payer national health care program in The New England Journal of Medicine in 1989. In 2002, KU joined the ranks of a half-dozen universities where students have organized into an offshoot of PNHP called Students for a National Healthcare Plan. Research published last month in Academic Medicine found that two-thirds of first- and fourth-year medical students support a universal health care system.