Health Care

An angry doctor's plea: Stop bickering and fix the ObamaCare mess

FILE -- House Speaker Paul Ryan of Wis. speaks during a news conference on Capitol Hill in Washington.

FILE -- House Speaker Paul Ryan of Wis. speaks during a news conference on Capitol Hill in Washington.  (AP Photo/Manuel Balce Ceneta)

One of the biggest issues of the 2016 election was the state of health care in the U.S. 

Republicans ran on a platform of repealing and replacing a failing ObamaCare system. 

Democrats touted ObamaCare as an overwhelming success.  Neither party has really addressed the issues surrounding the law—patients are experiencing higher costs, diminished access and poorer quality care.

I waited to see what the first days of the new Congress would bring—would our lawmakers actually deliver on their campaign promises?

I have seen my patients go without medicines, miss important preventative care milestones and struggle to find access to high quality care. Copayments continue to increase—deductibles are rising (more than $12,000 in some cases) to the point where an average family simply cannot utilize insurance except in catastrophic circumstances.

I have seen my patients go without medicines, miss important preventative care milestones and struggle to find access to high quality care. ... I am tired of watching and waiting for the Washington elite to do their jobs.

Now I am angry.  I am tired of watching and waiting for the Washington elite to do their jobs—So far its just more of the same with a different group in charge.

Rather than advocating for patients and putting patients first we are seeing just the opposite.

Lawmakers on both sides are putting their OWN interests ahead of the health of the American people. 

Money, special interest groups and concerns over re-election (as well as power moves within Congress) dominate the thinking in Washington. 

We have seen press conferences and heard promises. Instead of acting quickly, lawmakers took a week long vacation.

Currently, we see each party circling the wagons and digging in without any interest in compromise—leaving millions of Americans without any type of legitimate health care.

The status quo is no longer acceptable

As a physician, I am fed up and angry.  My job is to heal and to PREVENT disease.  I can no longer do my job with the government sticking its large (and quite ignorant) nose into my exam room or operating suite.

Most of our current health care regulations were crafted by non-physicians--by those who have the financial resources to obtain health care anywhere and anytime they want it.

Interestingly, while the ACA was touted by Democrats as a great success, Congress voted to exempt themselves from purchasing ObamaCare.

It’s now time to act. Congress would be wise to listen to both doctors and patients as they move to fix our broken system.

Doctors as well as patients must work to get their health care back—government intrusion has increased paperwork, increased cost, diminished efficiency and limited quality.  The escalating costs of ObamaCare have resulted in the exit of numerous major insurance companies and the uncertainty surrounding the ACA has served to significantly destabilize the insurance market.

So, Where Do We Stand?

The Republicans:

While Republican lawmakers produced legislation during Obama’s presidency they have done little since that time.  A 2015 repeal bill was vetoed by then President Obama in early 2016 during his second term.  Remarkably, even though they have had eight years to construct a viable replacement, few solid details on a new health care plan have been made available—even though the Republicans control both houses of Congress as well as the White House.  Within the Party, there are also fractures—more conservative groups within the Republican Party are pushing back on the replacement plans put forward by Speaker Paul Ryan and other leaders.  These groups are opposed to the continuance of Medicaid as well as refundable tax credits to help consumers pay for health care.

In addition, many factions within the party are refusing to back any legislation that fails to defund Planned Parenthood.  Special interest groups, including Americans for Prosperity, are exerting significant influence in the process—including running a television ad campaign opposing the Ryan backed repeal and replace health care plan.

The dissent within the Party will create a situation where the Republicans will not only be fighting against Democratic lawmakers they will also be fighting among themselves—and ultimately putting the health of the American people at risk

 

The Democrats:

Democrats have long believed that government regulation of health care will be the answer for increased accessibility and improved care for all Americans.  ObamaCare—while expanding coverage for millions of Americans ON PAPER—has, in reality, done next to nothing to improve health care in the United States.

Insurers have pulled out in many counties across the country leaving many areas with only ONE choice for a health care plan.

Back in the 1920s, this was called a monopoly.

Democratic Party leaders in Congress have made it clear that they will not compromise on health care and that they are unwilling to work to address the mounting problems with the ACA.

When the ACA was initially crafted and passed in Congress, it was done without a single Republican voice.  In fact, Republicans were unable to even see the thousands of pages of legislation until 30 days before the vote.

Congressional leaders such as Harry Reid and Nancy Pelosi would not allow debate or discussion.

Ultimately the law was passed and signed by the president and thus began the destruction of modern medicine.

Today, Democrats complain that they are not being included in the discussions surrounding a health care law overhaul but have made it clear that they will not work to craft a compromise bill.

Democrats contend that we must continue to provide health care subsidies and costly programs such as Medicaid without addressing issues of access and cost.

In addition, Democrats such as Nancy Pelosi continue to believe that ObamaCare actually works—which demonstrates the profound disconnect between the Washington elite and the average American.

 

What about the Patients?

Patients are caught in the middle of the ObamaCare debate.  Many are losing insurance due to high costs and others are finding little continuity of care as more physicians are no longer found “in network.”

In my practice, I have seen patients who have to choose whether or not they will attend a visit with their specialist or their family doctor due to the inability to afford multiple copayments.

Patients are not getting the time and attention that they need when they do come to the office for a visit.  Increasing non-clinical demands have been placed on doctors and, according to one study from the Annals of Internal Medicine from 2016, only 27 percent of an office visit is spent actually talking to a patient (i.e.: direct face to face communication and care)—the rest of the time is consumed with government mandated electronic paperwork.

Health care systems now put an emphasis on billing and charge capture rather than on the health of their patients.

While physician numbers are static, the rise of hospital and practice administrators has risen nearly 3,000 percent.

The sanctity of the doctor patient relationship is now at risk.  The long-term bond between doctor and patient has been shown to improve health outcomes but is no longer the centerpiece of care.

Patients are frustrated—as are health care providers—and we continue to tread water without advancing care.

What MUST happen NOW?

We must demand action in Washington.  It is no longer acceptable to allow lawmakers to behave like toddlers fighting over a toy when it comes to our health care.

It is time for those in Washington to be held accountable for their campaign promises.

It’s time to end political positioning and inter (as well as intra) party squabbling and PUT PATIENTS FIRST.

We can no longer tolerate the childish behavior of those in Congress.

As a physician I believe it is critical that Congress involve physicians (not groups like the American Medical Association or AMA who CLAIM to represent us) as well as actual patients in the development of a new health care law that will provide  effective care for all Americans.

WE must change the focus of American medicine to PREVENTION of disease on the front end rather than spend trillions of dollars on the TREATMENT of disease on the back end.

I encourage all Americans to reach out to their representatives in Congress and demand actual action on health care.  Use social media to and help advocate for change by using the new hashtag #PutPatientsFirst when posting.  Through individual action we can bring about global change!

Dr. Kevin Campbell is an assistant Professor of Medicine, Division of Cardiology, University of North Carolina and  President, K-Roc Consulting LLC.