I am a physician who has cared for uninsured and underinsured patients for my entire 31 years of practice. In the past I have written editorials in support of the Affordable Care Act and with the likelihood of its repeal without a viable replacement I feel that I need to provide a voice for my patients who will be adversely affected by this change.
People need to understand that not having insurance kills people. I have seen this in my own practice prior to the ACA. I cared for a patient who refused to come to the doctor in spite of an obvious cancer until it was so advanced that there was little we could offer her but comfort care. She was too young for medicare, had to quit her job to care for an ailing husband and was concerned that they might lose their house if she incurred medical bills. She may have lost her house but sadly she did lose her life.
My personal experience with the implementation of the ACA is that patients can now afford their medications and their preventive care. This has resulted in many of my patients now having their chronic illnesses such as diabetes and hypertension under control. This has significant economic benefits to our communities in that the cost of catastrophic care for the consequences of these diseases left unchecked are much more expensive, not only in dollars spent but in suffering. My experience has been verified by a study published in JAMA Internal Medicine where a comparison of health care in Kentucky, Arkansas and Texas was completed. Kentucky and Arkansas both expanded medicaid while Texas did not. The results indicate that in Kentucky and Arkansas the number of emergency room visits decreased, the visits to primary care physicians increased as did compliance with medications. This was in contrast to Texas where patients are still obtaining their health care through the emergency department. This is what the law was intended to do.
This is not a perfect law – some folks did not benefit from the expansion of Medicaid or the subsidies and now have higher deductibles and limited options for plans. The law could be improved but the Republicans have focused so much on the repeal that nothing has been accomplished. It is interesting that now that they have the votes to actually repeal the law, no viable replacement has been discussed. They have had seven years to develop their own plan. My own personal opinion is that a single-payer system – Medicare for all would be the best possible replacement.
A recent poll indicated that only 20 percent of the public is in support of the repeal of the ACA. For me, this is NOT a political issue – it is an issue of caring for my patients. I have had many discussions with patients in my office recently who are concerned about losing their insurance and I have difficulty reassuring them. I will continue to care for them – it seems to me that our elected officials do not.
Barbara R. Casper MD, is a professor of medicine at the University of Louisville.
On Saturday, December 10, 2016, at the Unity Dinner, Tom Moffett was honored by the Kentucky Alliance against Racist and Political Repression with the 2016 Carl and Anne Braden Lifetime Achievement Award. Tom is an ardent single payer advocate in addition to his constant struggle against racism, for peace, and for economic justice. Congratulations, Tom.
L to R: Christie Swan Kelly, Tom Moffett, and Barbara Boyd, Chair of the Kentucky Alliance.
On Friday, Nov. 18, 2016, about 200 people picketed and rallied outside the headquarters of PHARMA in Washington, DC, to protest astronomically high prices for drugs and to demand improved Medicare for All. The demonstration was called by Physicians for a National Health Program (PNHP), the national organization of over 20,000 doctors who support single payer health care.
Dr. Robert Zarr, a Washington, DC, pediatrician and President of PNHP chaired the rally.
Lane Adams (red scarf) and Dr. Garrett Adams (blue coat) of Louisville, Kentucky, were among the protesters. Behind them is Richard Master, the producer of “Fix It–Health Care at the Tipping Point,” the movie that explains the economic advantages of a single payer system.
Mark Dimondstein, President of the American Postal Workers Union (APWU), addressed the rally. “The people of this country are ready for a Medicare for All, single payer system,” he said. “Big Pharma is criminal cause people die on the altar of profit,” he stated.
Members of the APWU joined in the protest. The APWU represents more than 200,000 USPS employees and retirees, and nearly 2,000 private-sector mail workers
Medical students who were attending the PNHP training and annual meeting kept the picket lively with songs and chants.
Click here to watch the 27 minute video of Louisville medical students and physicians speaking for national single payer health care. Students for a National Health Program organized the event which took place on the medical school campus on October 31, 2016.
UofL SNaHP president Mallika Sabharwal speaking to Courier-Journal reporter Deborah Yetter.
On Wednesday, November, 9, 2016, at the UofL University Club, Dr. Syed Quadri of Elizabethtown spoke at a luncheon of the Institute for Sustainable Health and Optimal Aging. He presented a detailed explanation of the problems of our current health care system comparing the costs and outcomes to those countries that have universal health care systems. He made a compelling case, both moral and financial, for moving to a single payer plan.
The program was organized by Dr. Edgar Lopez, Board Member of Kentuckians for Single Payer Health Care. Both doctors are members of Physicians for a National Health Program.
Single Payer presentations are available to any Kentucky class, organization or group. Call Kay at 502 636 1551 to make arrangements.
On Monday, October 31, 2016, University of Louisville Medical Students hosted a single payer event on the Health Science Campus Quad. Mallika Sabharwal, President of Students for a National Health Program, SNaHP, chaired and introduced the four medical students and four physicians who spoke.
The event was a part of a national #TreatNotTrick action that took place at medical schools across the country to highlight the need to remove private insurance companies from the system to guarantee that everyone receives needed care.
The Courier-Journal covered the story. The link is here. Press coverage was organized by KSPH PR Director, Charlie Casper.
L to R WAVE-TV reporter interviews medical students Mallika Sabharwal and Lyn Jones. Jones spoke of going without coverage and care. Her untreated infection led to serious and lasting consequences for her health. She urged that everyone be covered through single payer.
Med student Rina Perlin speaks with Dr. Garrett Adams, past president of Physicians for a National Health Program. Rina said she dressed as a ladybug because “Private insurance bugs me.”
Med student Michael Gasser addressed the crowd.
L to R Dr. Garrett Adams with medical students Justin Watkins, Mallika Sabharwal, and Rina Perlin. Watkins spoke of the great advantage to his family when his first two children were born in Canada. When his third was born in the US, the drug essential for his wife’s care cost $1,000 instead of the $200 they paid under Canada’s single payer system.
Medical student Sarah Van Gaasbeek spoke to the group.
Barbara Casper, MD, Internal Medicine, spoke of her concern for those who cannot afford their care. Peter Esch, MD, is an advisor to the UofL SNaHP.
Mallika with Charles Kodner, MD, Family Medicine, who also spoke.
Edgar Lopez, MD, pictured with Tom Moffett, Louisville legendary social activist. Dr. Lopez practices at a free clinic in Butchertown. He told of ear drops needed by a patient who could not afford them because the cost was over $200. He said that the same drug is available in Ecuador for $10. He called for an end to the gouging by the pharmaceutical companies.
Christian Davis Furman, MD, Geriatric and Palliative Care, spoke of the efficiency of the VA and Medicare. She is pictured here speaking with Peter Esch, MD.
On October 25, 2016, Kentuckians for Single Payer Health Care presented a program for the Social Justice Committee at Epiphany Church. Dr. Barbara Casper spoke of the crisis she sees daily as too many patients are unable to afford care or delay care because of the cost.
Charlie Casper, Public Relations Director of KSPH, narrated a showing of a single payer power point that shows US standing in outcomes and the advantages that would result from a single payer system of health care financing.
The group participated in animated discussion with particular concerns for the costs of premiums, drugs, and deductibles for their families and neighbors.
More than half of the group signed up to stay in touch with KSPH.
The power point presentation or the movie “Fix It” is available to any group that is interested. Just contact KSPH at firstname.lastname@example.org or 502 636 1551.
Medical Student Mallika Sabharwal, President of the University of Louisville Chapter of Students for a National Health Program (SNaHP), has announced that the group is planning an event for 12 noon on Monday, October 31, 2016, as a part of #TreatnotTrick actions for single payer at medical schools across the country.
Monday, Oct. 31 at 12 noon, U of L Health Science Campus Quad 500 South Preston, between Muhammad Ali Blvd and East Chestnut St, U of L Medical School, downtown Louisville