Personalities: Accessible for All

After a gunshot wound patient failed to show up for surgery for the third time, L.D. Britt, MD, MPH, FACS, decided to do something he had never done before: Fire the patient. Still, Britt, the department of surgery chairman at Eastern Virginia Medical School, is an advocate for making healthcare accessible to all Americans, regardless of race or socioeconomic background. He became the first black chair of the Board of Regents for the American College of Surgeons in October 2008 and has some strong opinions.

On U.S. healthcare inequality: There's no reason for the wealthiest nation of all time to have one-third of its population either uninsured or underinsured. That's an embarrassment. And add on top of that for people who do have insurance it's sometimes hard to access. And add on top of that in some areas of the country we have a high infant mortality rate, higher than some underdeveloped countries. You put all that together and there's a disconnect.

To me this is one of the worst problems we have, one of the greatest challenges. At the end of the day we're going to solve the economy, the war will end, but what I find to be the most chronic and the most problematic is the access problem—it's crippling. Martin Luther King Jr. said a long time ago of all the inequalities in America the one that's most inhumane is inequalities in healthcare access, and we still have that today.

On the need for universal healthcare: At the end of the day we need global coverage. We can't have people who don't have access to care and insurance. When you end up carving out the innocent, meaning they're not part of the system, then by definition you have two tiers: You have people who can get care and people who cannot get care.

On educating the public: What our public has to realize is we cannot do everything. They cannot have all the bells and whistles. I'm not saying we need to deny care, but there's a lot of people who want 24-hours-a-day, seven-days-a-week, the top-notch care all the time, even when they might have a disease process that's irreversible. There needs to be public education. No one wants to say that, but that's going to be part of the solution.

On what the Obama administration needs to do to fix healthcare: They need to bring everyone to the table. They need to have a clean slate.

—Marianne Aiello