Dear President Trump:
As a cardiologist, my top priority is the well-being of my patients. During the last eight years, out-of-touch politicians have imposed regulations that created more electronic paperwork and administrative tasks for health care providers, taking me away from what I do best — providing exceptional care for my patients.
Health care in the U.S. is broken. Smaller reimbursements, confusing Medicare filing requirements and adversarial relationships with insurers have limited my ability to connect with my patients. I now spend more time typing, doing clerical work, answering to hospital administrators and arguing with insurance company representatives about how to treat my patients than I do listening to my patients’ hearts.
The implementation of ObamaCare brought on “in-network” provider changes that dissolved many long-term doctor-patient relationships. Those relationships are sacred, and ObamaCare has poisoned them. There is no room for Washington in my exam room. There is no place for members of Congress or other regulators in my operating room. I implore you to make good on your promises and remove government from the health care equation.
There is no room for Washington in my exam room. There is no place for members of Congress or other regulators in my operating room. I implore you to make good on your promises and remove government from the health care equation.
Throughout your campaign, you were a vocal critic of the Affordable Care Act, and I am pleased that your first executive order, issued within hours of your inauguration, was aimed at dismantling ObamaCare. I am grateful that your order aggressively begins the process of repealing the ACA. I understand that your order itself cannot repeal the law, but it goes a long way toward eliminating key portions of President Obama’s signature legislation.
Change must come quickly. As a physician and as a patient advocate, I offer these suggestions.
1. Have an immediate replacement. We cannot repeal the ACA without replacing it immediately. Repeal-and-delay will destabilize the insurance market and likely result in even less access and choice for my patients.
2. Eliminate the individual mandate. Forcing Americans to purchase health insurance that is expensive and limited in scope is not freedom of choice. Every citizen should be allowed to choose.
3. Allow insurance plans to compete across state lines. Patients are far more likely to have more choices and be able to negotiate better premium prices in a competitive market. Competition will force insurance companies to provide better services for patients and doctors.
4. Cover pre-existing conditions. We cannot go back to the days when insurers could discriminate against or deny coverage to those with chronic medical conditions. People who have known medical conditions should be able to purchase insurance at the same rate as those who don’t.
5. Take on Big Pharma. We can no longer allow pharmaceutical and medical device companies to price-gouge, and we must hold their CEOs accountable for the pricing of new products. My patients want to get better, but excessive costs — the U.S. has the highest drug prices in the world — often prevent them from complying with their medication schedules. I encourage you to help drive prices down by allowing Americans to buy prescription drugs from reputable Canadian pharmacies.
6. Deregulate health care. Currently, doctors aren’t able to be doctors. We have become scribes. We spend hours in front of computer screens. A recent study in the Annals of Internal Medicine found that on a typical clinic day, physicians spent only 25 percent of their patient interaction making eye contact and connecting with their patients. The remaining 75 percent of the patient interaction was spent filling out government-mandated electronic medical records.
7. Require patient responsibility. Preventive health practices should be a cornerstone of health insurance coverage. When patients actively participate in their health care and treatment plans, their outcomes improve. Offer lower premiums to those who exercise, diet and quit smoking. Health care reform must require patients to “buy in.”
8. Limit malpractice claims. Tort reform on the federal level is essential to lowering health care costs. Many physicians order unnecessary tests in order to avoid “missing something” that could result in a lawsuit. “Defensive medicine” drives up costs and puts patients at risk of unnecessary complications.
As you begin your first 100 days, I hope you can motivate Congress to follow your lead. Your executive order is a first step, but House Speaker Ryan and Senate Majority Leader McConnell must follow through with a quick repeal and replacement plan that puts #PatientsFirst and allows medicine to return to its roots — doctors and patients working together to improve health outcomes and ensure long and happy lives.
The United States has the finest health care professionals in the world. We need to make sure that doctors are free to practice medicine and that patients — no matter who they are, where they live and what their economic status is — have access to care now.
Remember … patients and physicians like me are counting on you and your administration to save health care.
Dr. Kevin R. Campbell
Dr. Kevin Campbell is an assistant Professor of Medicine, Division of Cardiology, University of North Carolina and President, K-Roc Consulting LLC.