A health commissioner’s perspective: The ACA safeguards life

The start of the 115th Congress has focused on the Affordable Care Act (ACA). Legislators speak about repealing a policy, about political strategies.

For me, as a doctor, as Baltimore City’s doctor, it’s about my patients and their lives.

Eight years ago, before the ACA, I treated a 36-year old man, a father of two toddlers. He stopped taking his seizure medications because insurance companies wouldn’t cover him. He had a choice: pay thousands of dollars a month, out of pocket, or ensure that his family had rent and food. As many others would have done, he chose his family, and let his medications lapse.

By the time he was brought to the ER, he had suffered a grand mal seizure. He was unconscious and continually seizing. We gave him medications. We put a breathing tube in. We did everything we could, but he never came out of the coma, and he died.

I think about him and his family when I hear discussions of the ACA. I think about the 40,000 people in my city who would be uninsured if not for the ACA. My patients tell me that they’re scared.

They are getting their diabetes and heart disease treated for the first time. They have mental health concerns finally being addressed. One of my patients told me that for her, health insurance has been her rock that helped to get her life back on track. She is terrified that it will all be taken away from her.

The ACA has provided funding for hundreds of other programs that ensure health and well-being. I think about the thousands of uninsured children who are receiving vaccines for the first time. I think about the millions of women who depend on the ACA for basic, preventive services like pap smears and mammograms.

I think about the hundreds, even thousands of heart attacks and strokes averted every year because of prevention programs in obesity, tobacco cessation, and blood pressure control. I think about the opioid epidemic devastating the nation and how only one in ten people with the disease of addiction are able to get the help that they need.

By identifying gaps in coverage, previously unmet needs such as mental health and substance use disorders are finally being addressed. By paying for preventive services, medical problems are identified early, saving lives and reducing costly interventions later. By incentivizing high quality care, the ACA has also paved the way to shift the goal from volume-based care to value-based care.

Another component of the ACA is the Prevention and Public Health Fund, which is nearly one-seventh of the Centers for Disease Control and Prevention’s (CDC) budget. In addition to supporting the prevention efforts above, this critical funding also helps to ensure that our nation is prepared against emerging threats such as bioterrorism and Ebola and other infectious diseases.

Last week, in the Journal of the American Medical Association, the editor-in-chief, Dr. Howard Bauchner wrote an editorial about healthcare access. For him, as a physician: “Healthcare is a basic right for every person, and not a privilege to be available and affordable only for a majority.”

This is a message that speaks to me. On the frontlines of medical care, I don’t see a policy, but its impact on people’s lives. I have seen my patients’ suffering as they strive for healthcare access. The ACA has provided a safety net for millions and the mechanism to ensure a healthier, more secure, and financially stable future for America.

No matter our disagreements about policy, I hope that all of us — policymakers, providers, and patients — can commit to one fundamental principle: that access to health is access to life, and it is up to all of us to safeguard life.

Dr. Leana Wen is the commissioner of health in Baltimore City. Twitter: @DrLeanaWen and @BMore_Healthy.

The views expressed by contributors are their own and not the views of The Hill.


Originally published at thehill.com on January 11, 2017.