Despite the Affordable Care Act’s undeniable success in extending health coverage to more people and in curbing some of the health insurance industry’s worst practices, recent reports show our nation still has 33 million people who are uninsured, a comparable number who are inadequately insured, sharply rising deductibles and copays, and skyrocketing pharmaceutical drug prices.
The 2010 health law clearly did not go far enough.
As a medical student without an MD and prescription pad, it can be easy to feel powerless. Asked if it felt like one were making a significant difference in the lives of patients on a day-to-day basis, the answer of almost any medical student would likely be “eh, sometimes.”
We study biochemistry and physiology, memorize treatment regimens for asthma and hypertension, and hold retractors in the operating room, amassing a fund of knowledge that will hopefully– maybe someday– help us care for our patients. We listen to stories, provide emotional support, and occasionally glean information that in some small way improves a patient’s physical condition. And though we learn from and are grateful for the small contributions we are able make on a day-to-day basis, we easily lose perspective at the bottom of the medical education totem pole, forgetting the power we possess when we use our voices collectively. In those moments when we feel we have so little to contribute to patient care, we can look to previous generations of students and trainees for strength and inspiration to affect significant change.
For one weekend in mid-August, comrades in health from around the world gathered in Seattle to discuss the work of Doctors for Global Health, liberation medicine, and social justice as it relates to health in the US and abroad. The theme was “Deconstructing the Status Quo: Building Global Health Justice” and topics ranged from the impact of the historical trauma and the boarding school injustice on breastfeeding for native communities in the state of Washington to the importance of alternative economies in community health promotion in Mexico, as well as tools and strategies for building social movements and creating social change.
Affordability and accessibility. These two words defined the health care reform movement in 2010, which culminated in the Affordable Care Act (ACA). Yet the effects of the legislation have fallen far short of expectations as a comprehensive cost-saving reform package. While the ACA has certainly reduced the rate of growth of health care costs, the per capita cost of healthcare has continued to increase; in 2012 the per capita cost was $8915, compared $8411 in 2010.
When I started on this journey to becoming a physician, I expected, in the end, to be rewarded. Not monetarily, though that is obviously part and parcel with any job, but with the privilege of building relationships with patients that lead to a level of trust and respect that remains rare among human interactions. The years of training and personal and financial sacrifice are all made worth it in the moments that I find myself making a true connection with a patient, especially in my home state of Tennessee where many patients presenting to the hospital have an ingrained distrust of “the system.”
On the afternoon of May 27, 2015, single-payer advocates including myself watched as the New York State Assembly voted overwhelmingly (89-47) in favor of the New York Health Act. This marked an important occasion, as this statewide universal healthcare bill had not been voted on in the Assembly since 1992. This event highlights the rare, intermittent successes that come from repeated lobbying and advocacy. However, the bill faces a significant uphill battle in passing the Republican-controlled State Senate.
I had the privilege of spending my last real summer break doing antibiotic resistance research and a mini-rotation at a hospital in Bogotá, the capital city of Colombia. This was actually my second stay in Colombia – I had spent 10 weeks studying Spanish there before my first year of medical school and fell in love with the culture, the food, and most of all, the amazingly kind and welcoming people. Despite this prior visit, I knew practically nothing about the country’s health care system when I arrived for a second time this May.
I feel like I need to start off this post with an apology: to all the wonderful teachers I had growing up: I’m sorry. I have done you a great disservice. It’s not because I was an insufferable know-it-all (although I definitely was), or because I often ignored your sage advice (also guilty).
Our goal can be easily guessed by our name: “Students for a National Health Program.” We are a group of students who believe the United States should implement a national, universal, single-payer health care system. Whatever you’d like to call it, such a system would entail that all citizens of the United States essentially pay into a national health insurance program for all other citizens. Everyone would chip in, nobody can opt out, and everyone gets covered for nonelective health care. Several other developed nations have successfully implemented such a health care system, Canada and the United Kingdom being perhaps the most representative countries. Our goal is simple, and we know based on the example of other countries, that our goal will also work.
In my faith tradition, we have a story about Jesus’ baptism. At this point in his life, Jesus has not started his ministry – no sick people have been healed, no one has walked on water, five thousand people have yet to be fed with loaves and fishes. Before any of his work challenging the brutal economic and military oppression of his people by the Roman Empire, Jesus goes to his cousin, John, and is baptized in the Jordan River. The heavens open up and the voice of God says: “This is my child, with whom I am well pleased.”