I once took an oath. It seems like just yesterday when I graduated from medical school and stood with my hand in the air, repeating the words to myself, “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.” After over a decade in healthcare, I still abide by the oath of my calling.
When a patient sits across from me, I can look at their chart and see that they may have any number of ailments, but first and foremost, I see them. I see their hopes for cure, their families hanging on my every word, and I hear the desperation in their voices when they ask if insurance is going to pay for that next test. I am well aware of the cost of healthcare. I have worked tirelessly over the past 10 years to provide the best possible care for my patients, at the least possible expense, while simultaneously keeping my patients among the healthiest. Do you want to know how I know that to be true?
I belong to an Affordable Care Organization, established by provisions in the Affordable Care Act (Obamacare) which relies on my adherence to Quality Bench Marks that establish standards by which patients should be treated.
If a patient is at high risk of hospitalization, they receive weekly calls from a nurse navigator to check on them. Pharmacists evaluate their prescription medications to determine risk of adverse side effects and polypharmacy (when too many docs prescribe too many medications with too many side effects). Home health care nurses visit them to check their vital signs, weight, and evaluate for fall risks in the home. We all communicate with each other and form a healthcare team that works in concert for the good of the patient. Even with all this attention and care, I am saving the system money by keeping the patient healthy and safe and decreasing readmissions to the hospital.
I am held accountable for the health and well-being of my patients. Everything I do is charted, analyzed, graphed, evaluated, graded, and compared to other doctors. I know when I’m not doing a good job because the numbers tell me. The patients can tell me, too, because they get to fill out questionnaires on their experiences.
Unfortunately for the American people, their representatives in Congress do not seem to be held to the same standard nor do they view patient care in quite the same way. They seek to take away those aspects of our healthcare that protect the sickest and poorest of us, giving breaks to those who are younger, healthier, and wealthier.
Do you have a pre-existing condition? Because I do and so do almost all of the patients that seek my care. The American Health Care Act (Trumpcare) does not allow for a person with a pre-existing condition to be denied healthcare, but it does allow them to be charged more. If they can’t afford the increased cost of their healthcare, well I suppose they weren’t technically denied access, but technically what is the difference?
Trumpcare would also allow states to decrease their Medicaid expansions, charge the elderly more money for premiums, repeal the employer mandate to provide healthcare to their employees or suffer penalties, and will likely dump 24 million Americans into an uninsured pool.
Trumpcare would hurt the sickest and poorest of us, many of them my patients, people that I care about. I once took an oath, I promised to do better than this for the people that seek my help.
None of this may scare you because you are healthy. Your pre-existing condition may not yet exist, but it will. Some day even the healthiest of us will have a moment of great fear and dread. Something will happen, an accident, a pain, a symptom, and everything will change. You will be one of us. You will wonder how you are going to pay for that next test. Who will help you, then? My hope is that help is there when you need it most because we had the foresight to protect those parts of Obamacare that allowed affordable quality healthcare for all Americans. My hope is that even if you don’t care about saving Obamacare for the sickest and poorest of us, that you will at least want to save it for yourself and your families.