To @morganjane, see the HRSA community health centers as a possible source of care (https://bphc.hrsa.gov/about-health-centers).

To @cekkk, I do not think that it is an accurate statement that government has a goal to destroy medicine. I am fairly old myself (mid-60s) and that is not what I have seen. For an even longer historical perspective I can recommend a book called "The Book of Charlie: Wisdom from the Remarkable American Life of a 109-Year-Old-Man," by David Von Drehle. He was a doctor in the 1920s and beyond. (Your public library may have it.) Among other things, he saw how medicine had changed since then.

It is also helpful to have a global perspective to see how other countries handle medical care. The British, for example, have the National Health Service.

I can assure you that no one in the civil service gets up in the morning and thinks about anything other than how to do a good job for the American people. What the political appointees are thinking, I can't say.

I am a civil servant myself. My specialty is IT (computers). There is a lot of IT in government, and my job is basically to do oversight of IT contractors to make sure that they do what they are supposed to do, and to make sure that the American people get good value for their tax money.

That value includes benefits for recipients of Medicare, Medicaid, and Social Security. It also includes the health research done by the National Institutes of Health, a couple of dozen NCI-funded Cancer Centers that do both research and treatment, and the HRSA community health centers.

I have AML, and I recently had a relapse. I am getting chemotherapy for it. I am working part-time because that is all I have the energy for right now. I considered retiring because, quite frankly, my expected lifespan is so short that having enough money to live for the rest of my life may not be a problem. I talked about this with a coworker because I was looking for meaning in my remaining life . She said "Tim, what do we do here? It's healthcare." That reminded me that although I don't see patients, my IT work does contribute to getting people healthcare. My work provides meaning to my life now, and that is why I continue it.

My coworkers and I are serious about our jobs. It's intense. For example, I have a conference call set up with people next Friday (the Friday before New Year's) in which we will be talking about some particulars of an IT contract coming up. The contract is about software testing of an IT system. The system is needed to provide health care to millions of people.

To add to my already considerable experience in the IT field, and to prepare myself to deal with the software testing contractors, in the past few weeks I marshalled my energy and read about 150 pages of difficult, technical papers about testing a large-scale System of Systems. What is possible? How do you do it? What is the best methodology to use? Now I'll be able to judge which testing contractor can do the job and provide the best value for the American people.

Here I am with a very bad cancer, receiving treatment, and I'm putting my energy into keeping IT systems running so that a major part of the American healthcare system can continue to function. That's the kind of intensity and devotion that I see among my coworkers every day. If I died tomorrow, they would continue, but I very much want to do my part, and so do they.

If you want to better understand the American healthcare system I can recommend a source that my boss three levels above me recommended, which is the research reports by the Kaiser Family Foundation. If you want to know what efforts are underway to improve the American healthcare system, you can take a look at the new models produced by the CMS/CMMI innovation center.