Obamantibiotics
As you probably already know by now, Donald J. Trump will be the 45th President of the United States of America. The reason why I’m 100% sure that you are already aware of this is because the U.S. has never seen a political campaign or election of this magnitude. In the days following Donald Trump’s election, our country has seen everything from riots to burning cars to a woman being choked by her hijab to protestors in California occupying the 101 freeway. Our nation is more divided than ever before. That being said, you might be wondering what exactly does all of this have to do with antibiotics?
If you take a closer look, this election, and the impact of it, may have a stronger connection with antibiotics than you may originally realize. As was the case with the previous three elections, one of the mostly hotly contested issues of the 2016 presidential race was United States healthcare. Under President Barack Obama, the Affordable Care Act aimed to increase health care quality and affordability, while also expanding coverage and reducing costs. I could write 10 pages on all the different aspects of Obamacare, but I specifically want to speak on one area as it directly relates to antibiotic treatment.
One of the primary focuses of Medicare under Obama was to reduce hospital readmissions. This was a response to the fact that hospitals around the country were generally so frequently overcrowded because the same people keep getting sick and occupying hospital resources, so anytime a new patient or citizen got sick, the process of being treated was so backlogged that it created drastic inefficiencies. To address this, Obamacare implemented a 3% fine on Medicare payments for every instance in which a Medicare patient returned to the hospital within 30 days. This tax shifted the focus towards helping patients and keeping them out of the hospital to avoid the fines. As my 10 weeks of blogging has pointed out, one of the quickest ways of fixing the problems is resorting to antibiotics. In response, hospitals started treating patients with more and more antibiotics to help cure them. To make sure those patients didn’t return, many hospitals were giving patients a week’s worth of antibiotics to take at home as well. In some cases, hospitals were urged to prescribe the patients antibiotics within 4 hours if they were suspected of having pneumonia. While these policies may have kept patients out of the hospitals longer, it wasn’t long before medical professionals realized that these same policies were also leading to overuse and misuse of antibiotics, which we know of course leads to antibiotic resistance.
To address this flaw, Obama created an executive order in September 2014 detailing antibiotic stewardship programs where the government started determining exactly when antibiotics should and should not be given out. Essentially, the government took the decision out of the doctors’ hands. Doctors could only prescribe antibiotics according to protocols handed down by the federal government. In many cases, the protocol called for the doctor and patient to wait a few weeks before issuing antibiotics to ensure that an antibiotic was the only legitimate option. Like it or not, this policy does and will, over time, decrease the growing rate of antibiotic resistance. The less often antibiotics are prescribed and used, the less often bacteria can build resistance to them.
The only problem is that with Obama leaving the office, no one is sure of the status of Obamacare. President Obama and President-elect Trump disagree on many issues, especially healthcare. When Donald Trump takes over, he very well may repeal Obamacare, and if that happens, who knows where our healthcare system will be? Will we reenter the world of unregulated antibiotic prescriptions? Will we maintain certain aspects of that executive order we have now? Should the government even be involved in healthcare to begin with? It remains to be seen how things will change, but if you are concerned with antibiotic resistance, it is certainly something worth looking into.
