New effort puts reform’s focus on patient impact

Andis Robeznieks
Senior Staff Writer
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The nonpartisan Congressional Budget Office projected that 23 million people would lose their health insurance coverage if the version of the American Health Care Act (AHCA) that approved by the House of Representatives becomes law.

“While Washington talks about people in aggregate—23 million people—the physicians of the AMA understand that those numbers represent the lives of real individual people, my patients: moms, dads, children, those who are sick, those who are hurting, those who need our help,” said AMA President David O. Barbe, MD, MHA (@DBarbe_MD).

The event was the first of four that will be organized under the “Protect Patients First” umbrella, which is a joint effort between the AMA and organizations representing hospitals, patients and consumers. The cross-organizational effort is urging people to call 844-259-9355 to be connected with their home-state  senators. The message for callers to send: “Scrap the ACHA.”

A second event took place today in Reno, Nevada, and others are scheduled for Colorado and West Virginia. A Senate working group is reportedly set to release a "discussion draft" of its version of the AHCA on Thursday, and Senate Majority Leader Mitch McConnell hopes to schedule a vote on the bill next week.

Understanding what is at stake

Dr. Barbe served as moderator for the Cleveland event that included speakers and patients representing the American Cancer Society Cancer Action Network, AARP, March of Dimes, Center for Community Solutions (a Cleveland-based health-issues think tank), American Diabetes Association and MetroHealth System, the public system for Cleveland and Cuyahoga County.

Their collective message was that the AHCA, as it currently stands, threatens affordability of insurance and access to essential care, and lacks protections for those on Medicaid as well as those with employer-sponsored health insurance.

“We’re here to let people know what is at stake in this health care debate,” Dr. Barbe said. “Senators need to fully understand the impact of the policy proposals that they’re considering.”

He mentioned that, in Ohio, 1.9 million have a pre-existing condition and 75 percent of the state’s Medicaid enrollees are from working families, which includes 1.1 million children. And, Dr. Barbe added, since Ohio approved Medicaid expansion in 2013 its uninsured rate has dropped from 12 percent to 7 percent.

Dr. Barbe added that “no one is here is to protect the status quo,” but loss of health insurance coverage for millions of Americans “is the wrong direction.”

Among those who told their stories at the event was Laurie Merges-Jett, a Cleveland resident who was laid off in October 2015 and was diagnosed with Stage 3 breast cancer two months later. She credits Medicaid with getting her access to all the treatment she needed.

“This saved my life,” Merges-Jett said.

Della Powell, also a breast cancer survivor, is enrolled in MyCare Ohio, a managed care plan for people who receive both Medicare and Medicaid benefits. She credits the program with allowing her to stay in her home by helping to cover costly prescriptions. The program also helps her afford the food she needs and essential services such as transportation to see her physician.

“If they cap Medicaid, a lot of those things will be cut off,” Powell said.

Finding a human face

In closing, Dr. Barbe urged attendees to form constructive relationships with legislators and to “look for areas of commonality” even if there is disagreement over a particular bill. He also encouraged patients to tell their stories, which lawmakers can then borrow in their own speeches.

Those were messages that were also delivered to physicians at the recent 2017 AMA Annual Meeting in Chicago by Andrew Gurman, MD, the AMA’s immediate past president, and Richard Deem, the AMA’s senior vice president of advocacy.

“We need to develop relationships with legislators,” Dr. Gurman (@AndyGurmanMD) said. “You can’t just walk in and tell them what to do.”

The discussion can be cold if all you talk about is statistics, Deem added.  

“You have to put a human face on this,” he said.

Deem cited as an example the news media stories that are generated at an annual free clinic in Southwest Virginia where the turnout is so great that many people are turned away.

“It’ll make you cry,” Deem said. “It should make you cry.”

Dr. Gurman, an orthopaedic hand surgeon, cited the story of one of his patients which he has retold on “ PBS NewsHour” and elsewhere.

The patient is a self-employed carpenter who has carpal tunnel syndrome and needed surgery. Dr. Gurman described how the man “earned $20,000 to $30,000 in a good year” and was enrolled in an insurance plan with a $6,000 deductible.

Even if he worked with him to lower his fee, Dr. Gurman wondered how his patient could afford the procedure as well as time off from work to undergo rehabilitation. Such high deductibles are a problem, he said. The AMA has been advocating that Congress and the administration bolster cost-sharing reductions that help lower the out-of-pocket costs of exchange marketplace plans for low- and moderate-income patients.

Read more about the AMA's comprehensive vision for health-system reform, refined over more than two decades by the AMA House of Delegates, which is composed of representatives of more than 190 state and national specialty medical associations.

You can further explore the AMA’s health reform objectives at Patientsbeforepolitics.org, an online platform designed to educate and engage patients and physicians on the current debate. The site makes it easy for patients and physicians to write their elected Congressional representatives and urge them to protect Americans’ access to quality care.

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