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In the age of Trump, a single-payer healthcare system is needed

hands-699486_1920This article originally appeared in the Winston-Salem Journal. You can read the article here.

Ten years ago, I began transporting sick patients at Forsyth Medical Center. Transporters are some of the hardest working and least recognized workers in the hospital. My job was to transfer patients as smoothly and comfortably as possible onto a clean gurney and transport them to the radiology department. Deceptively simple, transporting turned out to be a crash course in humanity. I decided to pitch in as best as I could.

The very first patient I went to transport by myself died in front of me. My astonishment about the patient’s death amused my seasoned co-workers, who helped me understand that the hospital is a place where sometimes people come to die.

“Why is this happening to me?” asked another patient, terminally ill with cancer. Her words hung in the air as I settled her back into bed. I had no answer for her then, and I still don’t.

Transporting overdose victims, some of them younger than me, underscored the fragility of life. And watching stroke patients relearn basic skills like feeding themselves or walking taught me about the resilience of the human body and spirit. Hope Jahren, the celebrated geobiologist and author, echoed my response when she wrote, “Working in the hospital teaches you that there are only two kinds of people in the world: the sick and the not sick. If you are not sick, shut up and help.”

Medicine has changed a lot even in the short time since I began transporting patients. Despite the much-vaunted health-care reform of 2010, the Affordable Care Act, medicine is still driven by profit, not progress.

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The 2017 SNaHP Summit: Coming together to make universal healthcare a reality

snahp_2017_Cropped“Hello Ms. Jimenez!”

She grimaced when I flipped the light switch but quickly smiled, a sign she just woke up from much needed slumber. This was no ordinary day for Ms. Jimenez; she had delivered her second child the night before, a healthy baby boy born at full term. I congratulated Ms. Jimenez and asked her the standard postpartum questions about breastfeeding, contraception plans, and follow-up appointments. Yes, she had an appointment for her son. But she would not be scheduling any for herself.

Ms. Jimenez did not have health insurance.

She made enough in wages to not qualify for Medicaid but was unable to afford the Affordable Care Act’s marketplace insurance plans. New Mexico has state funding for medical care for pregnant women, but after delivery, people are kicked off. This was especially concerning as her last pap smear suggested a pre-cancerous growth that would require follow up care.

The Affordable Care Act has improved the lives of over 750,000 New Mexicans by expanding the Medicaid program. But it still leaves 26 million adults uninsured in the United States. While the ACA may have been a step in the right direction, the plan still leaves too many without any insurance, has permitted skyrocketing deductibles and premiums, and ignores outrageous drug prices. Ultimately, it falls short of providing affordable, comprehensive, universal health insurance.

Republicans just released the American Health Care Act, the “wonderful new Healthcare Bill” as tweeted by the President early Tuesday morning. But the AHCA will further disrupt America’s  already tenuous health care by downsizing Medicaid benefits for millions of low-income families, reducing premium and out-of-pocket subsidies for poor and middle income Americans and giving tax breaks to only the wealthiest individuals. Ultimately, hurting accessible and affordable healthcare access for the low and middle classes.

The ACA is not doing enough for Americans. And the AHCA is a clear assertion by Republicans that affordable health care is not a priority.

We need a real solution that provides affordable, comprehensive health care for all Americans from birth until death. And we need those on the front-line of the health care system to stand up and demand it.

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Appalachia needs a single-payer healthcare system

An edited version of this article was originally published in the Johnson City Press. You can read the article here.

linn-cove-viaduct-curveDuring a rural medical outreach visit in East Tennessee, I met a woman who had become alarmed after she found a lump in her breast. She was 44 years old, only a year younger than her mother was when she died of breast cancer at 45. The patient had not seen a physician in many years because she could not afford the copay and she had to drive 45 minutes to reach her appointment that day. She was working as a waitress and had no health insurance, which further delayed her seeking care. She had a history COPD and methamphetamine abuse, but had been clean for five years. During my exam, I felt a mass in her left breast. My alarm bells were sounding.

Unfortunately, stories like this patient abound in Appalachia and reveal the need for rethinking our healthcare system.

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Action Alert: Calling Southern medical students to march for universal healthcare

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Physicians and medical students march for healthcare access at the 10th Annual HKonJ/Moral March on Raleigh.

Southern supporters of universal healthcare, including members of Health Care Justice and Health Care for All NC, are calling for all health professionals and health professions students/trainees to join N.C. White Coats Supporting Healthcare for All in a massive white coat action
at the HKonJ (Historic Thousands on Jones Street) People’s Assembly on Saturday, Feb 11, 2017 in Raleigh, North Carolina.

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Single Payer: The long-term treatment of our ailing healthcare system

14925708_3498108215536_4449164534997249699_nLike thousands of other medical students, I train at a safety-net hospital, Boston Medical Center, where patients can be treated no matter what their income or insurance status. The majority of our patients come from underserved, low-income populations. Medicaid, the public insurance program for the poor and disabled, helps so many of our patients obtain life-saving medical care.

At the primary care clinic, I helped care for a resilient young woman named Stephanie (name changed for privacy) who was diagnosed with both HIV and opioid use disorder. Because of Medicaid, Stephanie was able to see an expert on HIV and addictions. This doctor prescribed her antiretroviral medications and buprenorphine maintenance therapy, and helped her through recovery. Now Stephanie appears healthy; both her HIV and opioid use disorder are in full remission. Medicaid helped her regain health, which in turn enabled her to obtain full-time employment while simultaneously working toward a college degree. Without Medicaid, Stephanie would not have been able to afford treatment, which would have left her at high risk to die from AIDS or overdose.

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Kentucky should move forward, not backward, on healthcare access

kynectThis op-ed was originally published with Scalawag Magazine on January 12, 2017. This version includes a section on how single payer healthcare can help end health disparities in Kentucky and across the country. You can read the original article here.

By Brandi Jones and Mallika Sabharwal, University of Louisville School of Medicine

The patient reached for his bedpan and vomited. He clutched the right side of his abdomen and groaned.

His appendix was inflamed and had to be removed. As the surgeon explained the upcoming procedure, the patient, despite being in obvious pain questioned the necessity of the impending surgery. His concerns became evident when he alluded to having a new job and “waiting for his benefits to kick in.”

While the surgeon gently reassured him of the need for the appendectomy, the patient simply responded, “Now I’m missing work, and I still don’t know how I’m gonna pay for this.”

The unfortunate reality was that although his was the first such experience I encountered on my 8-week surgery rotation, it would not be the last. More than a dozen patients relayed their concerns about the price tag associated with their necessary interventions, their regrets over not being able to get the issues addressed before they became more emergent, and the mounting costs they would face after they were discharged, when they had to get medications and schedule follow up appointments. While I listened to each person’s problems, I couldn’t help but feel that the vast majority of their distress was preventable—if only our system was better suited to truly address the healthcare needs of its people.

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SNaHP Call-In Day to Stop Health Cuts and Support Single Payer – Jan. 13

pnhp_1TO PARTICIPATE, FOLLOW THE LINK OR SEE BELOW!: https://docs.google.com/forms/d/e/1FAIpQLSc-g_sQHevc39ke-AZ1BBZ9E7s1ayeoinV1TpT9rWG_bS1o-A/viewform

~~SHARE WITH OTHER PROGRESSIVE GROUPS TO ELEVATE OUR COLLECTIVE VOICE~

There has been an incredible amount of momentum around protecting the Affordable Care Act and the millions who would lose health insurance should the law be repealed as promised by the incoming administration.

Students and Physicians for a National Health Program is asking you to help us demand even more!

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#ProtectOurPatients: Defending Health Care Access in the Wake of Donald Trump

15541959_10208411538867006_6986356909354642239_nAs members of Students for a National Health Program (SNaHP) and future health professionals, we endorse the #ProtectOurPatients Campaign and stand with them on January 9th in their efforts to prevent the repeal of the Affordable Care Act (ACA). While we believe that nothing short of a single payer system will provide adequate access to healthcare for all people, the ACA has expanded it significantly. As a result of the ACA, more than 20 million people gained insurance coverage, insurers are no longer allowed to deny coverage due to pre-existing conditions and children are allowed to remain under their parents insurance for a longer period of time. We acknowledge that the ACA has significant shortcomings: it leaves nearly 27 million people uninsured and additional people underinsured and it strengthens the grip that private insurance companies hold on our healthcare system. Nevertheless, the incoming Trump administration’s threats to repeal the ACA would lead to a situation far worse for our patients – and much further from a single-payer system – than the status quo.

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The Top Ten Moments of 2016 in the Fight for Universal Healthcare

This article was originally published by In-Training. You can read the original article here.

bernie_memeDebate about some of the most pressing issues facing our country were lost in the horse race of the 2016 presidential campaign. Among those issues was healthcare. While millions of Americans received health coverage under the Affordable Care Act, an estimated 30 million remain uninsured and medical bills continue to be the leading cause of bankruptcy in the United States. Despite assertions that universal healthcare in the United States is merely a liberal “pipe dream”, a Medicare-for-All health program remains the best option for ensuring that all Americans have access to quality healthcare. In addition, 58% of the population – regardless of political affiliation – support the idea of universal health coverage. Although you might not have heard about it, the campaign to expand health coverage for all Americans gained new momentum during 2016. Here are some of the highlights.

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“We Condemn the AMA and AAMC Endorsements of Tom Price for HHS Secretary”

SNAHP IconEarly Tuesday morning, President-elect Donald Trump announced his selection of Representative Tom Price (R-Ga.) for Secretary of Health and Human Services (HHS), to succeed Secretary Sylvia Mathews Burwell. Almost immediately, the American Medical Association (AMA) and Association of American Medical Colleges (AAMC) expressed strong support for this nomination.

As students and future health care professionals, we are deeply troubled by the AMA and AAMC endorsements of Rep. Price. The policies he has endorsed not only stand in stark contrast to our ideals, but also threaten the well-being of our patients. We question why these organizations—established to protect the interests of all physicians, students, patients, and communities—would ignore the priorities of those they represent. As HHS secretary, Dr. Price will endanger medical institutions and policies, as well as jeopardize our medical education and the very practice of evidence-based medicine.

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SNaHP Statement of Solidarity

Students for a National Health Program (SNaHP) will continue to advocate for universal, comprehensive health care reform in the United States. With the results of the presidential election, however, our focus on health care reform must be part of a broader effort for justice.

Discrimination, on both the individual and systemic level, has extensively-studied, irrefutable negative health impacts. SNaHP has traditionally operated in the arena of health care reform, but we realize that providing universal access to health care will not be the silver bullet that ends inequality.

SNaHP stands in solidarity with other student and community organizations that promote peace and justice. And SNaHP is prepared to take action with these groups in the name of preserving the human rights to peace, liberty, and justice.

Trump’s proposal to repeal components of the Affordable Care Act (ACA) would leave 20 million people uninsured. Donald Trump’s hateful rhetoric and regressive policies threaten the well-being of women, Muslim communities, the LGBTQ community, low- and middle-income families, immigrants, and others among the most vulnerable Americans.

Together, our voices can be louder than Donald Trump’s. The results of this election do not change our core values and shared vision. This moment will be remembered in history as the catalyst of a new, unified movement for social justice and progressive action.

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NATIONAL DAY OF ACTION: This Halloween, let’s treat, not trick, our patients!

Despite living in an era of great potential in the fight against disease and death, Americans continue to be haunted by health care profiteers. This Halloween, hundreds of medical and health professional students around the country will call on candidates and elected officials to abolish private health insurance, and to replace the health insurance industry with an expanded and improved Medicare-for-all.

Our message: “Private health insurance is a trick – we just want to treat our patients.”

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Nov. 3 Follow-Up to #TreatNotTrick in Philadelphia

philadelphia_snahp

For SNaHP’s #TreatNotTrick Philadelphia action, a group of ten people gathered at City Hall. They were mostly medical students with SNaHP, joined by two members of Put People First! PA (PPF-PA) and another local activist.

This Thursday, November 3rd, PPF-PA will be at IBX headquarters to fight back against the outrageous ACA premium increases recently approved for IBX and other insurance companies by the PA Insurance Department. I think the stories shared there will give us some clarity as to who “we” are, and what we are up against in the fight to abolish insurance profiteering and install single payer.

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“Let’s treat our patients, not trick them with private insurance”

Jack-o'-lanterns carved from pumpkins and lit with tea lights
Photo courtesy of William Warby.

A few days ago, I was studying a medical diagram in a coffee shop when a man in his mid-forties walked in. His face was red, he was sweating, he looked upset.

“Please, can anyone help me?” he asked. “My daughter is at Children’s Hospital for seizures and she needs medicine. My credit card is maxed out. I need $16.50.”

A few weeks ago, I was listening to a friend describe a Pennsylvania Insurance Department hearing on proposed rate hikes for marketplace health insurance premiums.

“One insurance company representative actually asked the department to consider the health of the company,” he said. After this hearing, all six insurance firms received rate increases, often more than the rate increases they had requested.

A few months ago, I was standing in the operating room. The attending surgeon was instructing the resident about how to deal with a patient who had insurance difficulties.

“Well, the patient is going to say, ‘My insurance says they won’t pay for it,’” he said. “You say, ‘That’s not my problem. I gave you my advice.’”

Before you dismiss the coffee shop encounter as a panhandler pestering customers, consider that we live in a country where some medications have unaffordable copays, that many people go without needed medicines, and that people often have to make a choice between seeing the doctor and paying their utility bill.

Before you dismiss the big premium increases by pointing to Obamacare’s subsidies, consider that we live in a country where insurance firms helped write the Affordable Care Act, that millions of people remain uninsured despite the ACA, and that copays and deductibles are sharply rising.

Incidentally, the “health of the company” is not the kind of health I give a damn about.

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Webinar: Intersecting struggles in the movement for health justice

Students for a National Health Program (SNaHP) explores the impact of race, gender, religion, sexual orientation, socioeconomic status, age, ability, and immigration status on access to health care. This webinar was originally broadcast on October 19, 2016. For more information on medical student advocacy, please visit http://student.pnhp.org.

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Single payer and the struggle to end LGBT health disparities

27364526070_42d73e094b_o “I’m going to a drag show tonight.”

My third year resident asked what I was doing with my day off, and my reply, the gayest of weekend plans, gave her pause.

I felt the same awkward beat in our otherwise amiable conversation, saw the same uneasy shift in her seat, just the day before when I told her about a date I had been on. I’m not exactly inconspicuous about my sexuality in the first place, so I wasn’t prepared for her to be surprised that I’m beyond-a-shadow-of-a-doubt-gay. I had felt uncomfortable for making her uncomfortable, and wasn’t exactly sure why. I wondered if I was allowing some sort of personal insecurity or professional courtesy insinuate discord in a completely innocuous conversational pause. So I could have said “I’m going out” or to a bar, or something similarly vague, but I wanted to test the waters. I wanted to confirm a suspicion that it wasn’t just me, and it wasn’t just once.

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“Healthcare is a human right”: Single-payer testimonials

Members of Students for a National Health Program (SNaHP) and medical students from across the United States are joining together to voice their support for the Physicians’ Proposal for Single-Payer Health Care Reform. To learn more about this important proposal, and to learn how you can advocate for meaningful health care reform, please visit www.pnhp.org/nhi.

 

SNaHP Summit 2016

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Medical School: An invitation for activism towards single-payer

I’ve been a part of SNaHP since the beginning, watching our annual gathering grow from a few dozen people in a small conference room in 2012, to the massive turnout we had this spring with representatives from around the country.

Each year, I’m impressed with the reality that many of our most enthusiastic and active members are students early in their medical school journeys, many of whom haven’t had much contact with patients yet. When I first began medical school, it was easy to get caught up in the praise and aggrandizement that was heaped upon us – the constant congratulations for joining a profession as well-respected and impactful as medicine. It is true that physicians can have a profound impact on the lives of our patients, curing terrible diseases and lessening the suffering caused by chronic ailments. In looking at the nature of the health care system as a whole, however, I have seen clear examples of how access is rationed based on a patient’s financial resources, and how seeking health care can leave patients vulnerable to harm that affects their livelihoods and economic security.

 

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Future MDs: Americans want single payer healthcare – and yes, it can work!

In light of the media’s recent attention to single payer healthcare and the release of Bernie Sanders’ proposed plan, Students for a National Health Program (SNaHP) would like to rectify public misconceptions of and clarify our stance on Medicare-for-All.

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