As an executive who works in healthcare, I am tired of the low-grade chronic anxiety that our President and the Republican Congress has caused not only to me but to those on the frontlines of healthcare provision and patients.
Years before President Trump thought about becoming the leader of the free world I was a student of public health, and I saw then, as did most who were there, many aspects of healthcare costs that were alarming. And most, if not all of us in my class also knew that that with the increasing life span and baby boomers aging into Medicare, we would face a financial crisis, but this was mitigated by another driving force – a moral imperative to help people.
Yes, healthcare is a business. Yes, I want to get my paycheck every other Friday, but I also actually believe that helping people is the driving force of medicine.
It seems there is a great amnesia affecting the nation about where we were six years ago as the ACA slowly crept into our lives.
For many of us working in healthcare, we started to see people with such advanced disease we would scratch our heads and ask, “Why did this guy wait so long to see a doctor?” The answer was, of course, they could not afford to. Working in a surgical subspecialty, these were the patients who were sent for medical clearance, and it was then that they learned that they had Type 2 diabetes, heart disease, CPOD and a growing list of preventable and never diagnosed conditions.
And, while there was indeed a host of disasters with the roll out of the ACA, there is no question that in New York State, many people are seeing physicians and getting help in numbers that they did not before.
There is another concern all of us should consider who work in healthcare if we simply scrap the ACA.
The opioid addiction epidemic, it is not a simple issue to explain, either its cause or advent.
The start of this problem was “Big Pharma” or the drug companies. With aggressive lobbyist, “pain” became a “vital” sign. Yes, to the same degree blood pressure was considered. And in our modern world where every ailment has a solution with medication, “pain” had a pill. However, the problem was that the pills we had did little to address the increasing tolerance that patients had for them. The solution was to create stronger opioids and marketing them to physicians with “alternative” data.
So to keep it brief, we trained doctors under threat of discipline to treat pain aggressively with medications that were addictive and also said these drugs when used for pain did not cause dependence.
At the same time, we had millions of people seeking care in emergency rooms for many non-life threatening conditions, albeit painful ones. The solution was to treat the pain and not the underlying condition. Millions, who had no coverage chose to seek expensive care in ERs because few specialists accept Medicaid or provide charity care.
Pile on to this, the cheapest food in the US is the worst food, filled with sugar, salt, and fats.
It is the chronic preventable diseases (and addiction is one of them) that is crushing this nation. On the backs of the poor, weak and the sick “big money” made billions and now we want to rob them of healthcare coverage so that we can build a wall, buy a few more jets and bombs and provide tax breaks and health care benefits to the wealthy.
Scrapping the ACA is not good medicine. It is wrong. It is political, ideological and immoral.
Healthcare professionals need to rise up be counted and remember the basics, which starts with the Hippocratic oath. What this president and Congress is proposing with the “American Healthcare Act” will do harm.
Fix the problems, yes. But, deny people coverage as this new bill will do is simply perverse.
Author’s PostScript: I had written this article before I learned the Congress had postponed the vote. Sadly, what slowed and then caused the pause in the House of Representivies was not the harm the bill might have caused, but rather a block of men who wanted the bill to be more painful.
We are skating close to the edge where women’s healthcare is solely about pregnancy; where prevention is no longer valued and those in need will face a closed door.
12 Angry Men. (Times 2 if you do the math)
Josh Powell is the Chief Executive Officer at Capital Region Special Surgery, a medical practice in New York with Neurosurgery, Ear, Nose and Throat, Ear Institute, Neurology, Pain Management, Sleep Wake, Physical Therapy and Diagnostic Imaging practices. Previously Mr. Powell was the Chief Executive Officer at Northeast Neurosurgery. Josh earned a Bachelor’s and a Master’s Degree from the State University of New York (SUNY). Follow him on Twitter.