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Harold Pollack

Harold Pollack

Posted: November 23, 2010 11:36 PM

I am an advisor to Doctors for America, a group of progressive physicians. DFA is circulating the below petition among physicians and medical students:

Dear Representatives John Boehner and Eric Cantor:

We are physicians and medical students who serve patients across America in all 50 states.

Every day, we see a broken health care system that is failing patients and health care providers.

That is why we stand behind the Affordable Care Act as an important first step in fixing our health care system.

We know that you have proposed to weaken or repeal the Affordable Care Act as one of your top priorities in the new Congress.

We believe repealing or weakening the Affordable Care Act will move our health care system backward - and we strongly urge against it. Instead, we ask you to work with us in building upon the Affordable Care Act, making it stronger, and ensuring that we can crate a health care system that works for all Americans.

The Affordable Care Act will cover 32 million more Americans that otherwise would fallen through the cracks of our health care system. It takes the biggest steps in history to improve the quality and reduce the cost of health care. It protects our children, our seniors and our sickest patients from the past abuses of the insurance industry. These are just a few of the reasons why so many doctors and patients support the Affordable Care Act.

(You can sign or contribute here.)

Alongside the hundreds of signatures, many physicians and medical students left short personal stories. These stories convey very well why people on the front lines of health care and primary care strongly favor health reform. I can't excerpt them all here, but the below caught my attention.

I have had breast cancer twice. I am a private practice physician. I see patients every day like me. I do not have health insurance (although I might have been approved for the PA health option that was offered to people with pre-existing conditions), because of my breast cancer history. I have paid into the system for 35 years.... I am appalled each time I hear some one with insurance saying they want to repeal the healthcare bill, especially those who enjoy the benefit of excellent healthcare as a result of our taxpayer dollars. I welcome Mr. Boehner and Mr. Cantor to go without healthcare for one year, then pray each and every day that they or one of their loved ones don't get sick.
I have seen patients avoid going to the emergency room or getting their prescriptions due to lack of insurance. They have died or gone into heart failure.
An adolescent female of our clinic was having heavy periods which had been controlled my medications. When her mother's insurance (and subsequently her insurance) interrupted due to cumbersome paperwork and provisions of her health insurance, they worked for two months to get insurance so they could afford the medication again. In that time, the patient bled enough that she had to be hospitalized for blood transfusions....
My niece, age 25, is likely to die in 6 months or less, of metastic adenocarcinoma of the esophagus despite heroic treatment at a major university hospital. Living alone, with a bare minimum wage income she ignored here symptom until she had almost complete esophgeal obstruction because she did not have health care insurance and made too much money to qualify for Medicaid. Without insurance, she could not get an appointment with a physician.
I am a pediatric oncologist. All of my patients have a catastrophic illness. Patients who are uninsured experience delays in diagnosis and gaps in care that jeopardize their chances of cure. Adolescents who have to leave school because of cancer and its treatment will lose their health coverage from their parents' insurance because they are not students. They too be at risk of delays in care that are potentially life-threatening.
Our clinic's population is primarily insured through Medicaid. Our patient population has grown significantly since the economic downturn. These are people whose lives are already difficult due to poverty and chronic stress. Please, before you dare assume what the American people truly want, come speak to the American people served at our clinic.
Representative Cantor- I look forward to driving up the Shenandoah Valley to be in Virginia once again in the house my mother and father have lived in for four decades... I am a doctor who takes care of children with cancer and with hemophilia, a bleeding disorder that costs on average $100,000-300,000/year for drug costs alone... I am deeply upset by the refusal to take part in the legislative process that so many in our government cynically display as a badge of honor. It is my request that you put your considerable energy and influence into moving the country forward.
All of my patients depend on health insurance to see me, from the disabled schizophrenic to the anxious architect. Since Massachusetts guaranteed health insurance for all, it has become possible for well-trained psychiatrists like myself to "do well by doing good" and forego cash-only practices.... One need only look at how Massachusetts has weathered the storm of the recession to see that our healthcare plan is both morally and economically the right thing to do.
I take care of college and university students at Yale. A recent graduate noticed a lump in his testicle about a month after he had graduated and his student health insurance had expired. He was working a menial job in NYC to pay his bills and had no health insurance. It was heartbreaking to see that I could only offer him my services and exam gratis, but could not do the Ultrasound or labs that he needed desperately to rule out a cancer.
I have a patient who can't get the medicine she needs and is now suicidal...
A Saturday morning free clinic where I work, even in a town full of doctors, has difficulty getting primary care providers or specialty services for patients and the demand grows every week.
I recently saw a young woman who was denied insurance coverage for her thyroid disease. She is a successful entrepreneur in Atlanta who has been creating new small businesses and hiring hundreds of Atlantans despite the economy. Yet insurance companies would not cover her only medical problem. This is a crime. The Affordable Care Act fixes gross immoral actions such as these for patients like mine....
Every time I have a patient who defers a screening test because of concerns over the cost of the copay, I can't wait for the ACA provision to take effect. Every time I get a call from a patient who is having trouble obtaining new insurance because of a pre-existing condition, I am thankful for the ACA....
Not only do patients struggle to get into the system, but as a provider, I had struggled to navigate the most vulnerable patients through the system once they are "in". It would be a shameful act to relinguish the government's duty to provide a standard of health care as stated in the Universal Declaration of Human Rights. I hope that politicians put politics and profits aside to ensure that lives are not jeopardized.
One of my patients who was admitted to the hospital with sepsis looked at me and my resident with utter desperation when we told her she was not yet stable for discharge home. She said, "I made $16,000 last year. I have no insurance. I can't stay in the hospital. I'm sorry, I have to be able to eat." We convinced her to stay, but we just spent her annual salary on a 2-day hospital stay.
I have had several student patients who were able to get coverage through their parents plan because of the expansion to age 26. This has been an enormous relief/benefit both to the parents and the students.
My patient is on dialysis waiting for a kidney transplant for many years. He was generously approached by a friend who expressed a willingness to donate her kidney... One of the potential "complications" of donation is the inability to get insurance subsequent to donating her kidney (she would have the "pre-existing condition" of a nephrectomy - one kidney removal). The potential donor was very concerned about the ramifications to her of this policy.
I am a physician, and the patient story I share is about myself. I have Common Variable Immune Deficiency and my IV's and meds cost more than $6000/month. I have a $200,000 lifetime maximum coverage which will soon run out. If that happens, I cannot possibly pay for the medication.... With the health reform, my lifetime maximum will be eliminated and I will be able to continue to work in a medically underserved community.
 

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09:54 AM on 11/30/2010
Just worry about the profits and business of health care and not worry about actually helping patients? Lame. If doctors wanted REAL change in health care, they'd embrace true and real remedies for their patients. Nutrients! No human being in history has ever been deficient in phamaceutical drugs. Food, real food heals and cures. Why does organized medicine violently oppose the natural order? Why do doctors who CURE patients with natural protocols go to jail?

The answer to all these questions is that people would pocket billions of dollars every year by using natural remedies. Billions that drug companies would lose.

The facts are irrefutable, incontrovertible, and unassailable. Foods heals. Drugs kill.
04:17 PM on 11/29/2010
The recurring theme in these stories is that “Health Care Insurance” is a PRIMAL NEED of the Human Beings in a Democratic Society. The Lawmakers often lose sight of the “Human” aspect of this issue until it hits home for them, whether that is sickness that affects them or their loved ones. Additionally, our Society somehow confused Business Perks of “Offers of Health Insurance” with a Person’s “Human Right” to Health Care Insurance. This misconception had minor consequences when our Economy was “functioning on all Eights” but our economic collapse has isolated the “Humanistic” necessity for Health Care Insurance FOR ALL.

This “confusion” has also affected the Medical Provider’s perspective, as this article so aptly points out, and, to that end, I recently recorded a short Video about the “Resurgence of The Family Physician” at http://youtu.be/aSDePjFTOX0. I think it adds even more perspective to Harold Pollack’s point about the pressing need for Health Care coverage FOR ALL.
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Pamela Grundy
Freelance writer & blogger.
06:34 PM on 11/28/2010
It's really not tons better even when you have insurance. Better, but not that much better. The last job I had that offered insurance gave us a choice of various HSAs combined with various high deductible 80/20 plans. I chose a fairly low deductible HSA (I think it was $2500), and yet a single ER visit in 2008 left me with out of pocket expenses equalling about 30% of my annual income.

I was referred to a cardiology practice after discharge from the ER for follow up tests and care, but needed $300 to walk in the cardiologist's door--just as a deposit, and that's WITH insurance--and I didn't have it, not after an ER visit that was the roughly the cost of a new economy compact car. So I never went. That happens a lot.

When I lost my job in 2008 I weaned myself off all medications, which went well as long as it went well--about eight months or so. And then it stopped going so well. So now I do have insurance again, and I've got a doctor's appointment in early January, but I dread it. We still haven't paid off the last family illness and don't know when we ever will--we keep chipping away but it feels hopeless.

The plain truth is that for MOST people, ongoing care is prohibitively expensive even with insurance. Don't go, you risk your heath or worse. Go, you risk your financial solvency.
02:00 PM on 11/28/2010
As an acedemic professor of medicine , you do not have the obligations private practice medicine does. Your academic salary is significantly buffered by direct government pay that does not reflect the efficiency of your work. And by statue you are buffered from torts.

A majority of doctors, in particular the ones that see the most patient and most of the everyday work, overwhelming reject Obamacare.
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LynneSpreen
Midlife Magic
01:16 PM on 11/28/2010
I've started to notice my doctors asking what kind of insurance I have before they write a prescription for me. I appreciate that they work with me to keep costs down, but it is a sign of the times, isn't it?
www.AnyShinyThing.com, A Blog for Smart Women of a Certain Age
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redstateblues69
11:51 PM on 11/27/2010
These stories made my eyes well up. Really moving.
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ajl1239
10:34 PM on 11/27/2010
These health insurance executives are absolute criminals - not because of their business, but because they lobby our government to prevent its citizens from having the high quality, government-controlled, single-payer system that they need and deserve.
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Vivian Alicia Evans
01:58 AM on 11/28/2010
Yes they are. Each and every one who works for this companies who denies a person coverage or lobbies the government should be sent to a special penitentiary built for them. At this penitentiary they would have to personally treat these patients who no longer have coverage.
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crom14
09:18 PM on 11/27/2010
I find it interesting that so few have commented on such a very important article on this site.
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alongst
too often denied to speak
12:34 PM on 11/27/2010
You say "Hundreds " signed this- but where are the tens of thousands of other doctors ?
As a doctor, I can tell you most of us do NOT like the government plan. Most of us trained in a VA or similar government run hospital and have seen the horrors of government run healthcare! The VA employess overwhelmingly refuse to use their own facilities- what does that tell you? Yes, we believe the system is a mess, but of the many reasons that it is a mess IS THE GOVERNMENT ! Why did our system work so well for so long- until the government got involved ?
The simple answer? Change our legal system, quit covering illegal aliens, limit the governments intrusion into healthcare itself ( but have them control the greedy insurance companies), rescind HIPAA, CLIA, Press-Gainey and all the other assanine programs they have forced on us that meant well but totally screwed up our system and have made things much worse and much more expensive.
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crom14
09:16 PM on 11/27/2010
What do I do when my husband retires and as a self employed person I could never afford the amount it will cost for coverage. When I first started my job over thirty years ago and was single, the premium was affordable. Now, I will have ten years with out insurance. The economy has hurt my income and my husband has worked forty five years as a teacher. Nobody addresses what we should do if we work hard and cannot afford insurance. Isn't Medicare government health care?
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redstateblues69
09:52 PM on 11/27/2010
With 700,000 going bankrupt a year and 45,000 dying each year I don't know why you think we did so well without govt. intrusion.
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crom14
11:22 PM on 11/27/2010
How did I imply that? I am all for the government solving this..... nobody else will.
10:48 AM on 11/27/2010
Thank you for this story. I ask myself if ALL those who voted for politicians that want to repeal the health care bill have full insurance and the security that they will always have the money to pay for it!!!! I want to know their secret.
It offends me that in a country who believes in equal rights the right to health care, which is ultimately the right to life, is only for those who can pay for it!!!
08:04 AM on 11/27/2010
If you really want to eliminate problems in the health care system and cover more people it really is time to weed out worthless ;nearly worthless and sometimes down right dangerous test and procedures. Cancer screening test are a prime example; both yearly mammograms and PSA test have been questioned as to efficiency but make no mistake the money generated by such test is huge,.... "Every time I have a patient who defers a screening test because of concerns over the cost of the copay, ."
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Vivian Alicia Evans
01:59 AM on 11/28/2010
That is illogical.
11:44 AM on 11/28/2010
Perfectly logical and true. The medical providers are at least as big a problem as the insurance companies.Every year huge sums are spent on cancer screening test but do they save lives. Lets look at a recent study . A recent study in Denmark found that mammograms in fact did not appear to save lives as reported here http://health.usnews.com/health-news/family-health/cancer/articles/2010/03/24/mammograms-may-not-boost-survival-danish-study-suggests.html as the lead author notes ...... "It is questionable if it saves women from dying from breast cancer, but we are certain that it has serious harms such as overdiagnosis and overtreatment of lesions that would otherwise never have caused problems, unnecessary recalls with long-term psychological consequences, and unnecessary biopsies and worries,"

If fact the rate of cancer death reduction appeared larger in the areas that did not screen than in those that did. Since providers rake in huge amounts from this procedure who really has an interest in suggesting 'The Emperor ....

After all medicine is a business
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crom14
08:14 PM on 11/26/2010
How do my post just evaporate?
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conal6
WINTER IS COMING
03:05 PM on 11/26/2010
well well well it is nice to here horrors stories from America and not Canada! I support health care reform. I am a Registered Nurse and I see some of the very same stories. I am particulary thinking of a man who walked into the hospital via the ER and never walked out because he didn't have insurance and waited way too long to get help. We shouldn't talk about Canada or England maybe we should say we're America and we can show not the world , but our citizens that we have a great medical system. Until we treat the least among our citizens with quality health care. America cannot call itself a "First World Country" . What will our legacy be that we made the most money on health care, or we helped our citizens be healthy and productive.
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Vivian Alicia Evans
02:10 AM on 11/28/2010
I find it interesting how many people who have dual citizenship (American and Canadian) who rush back to Canada when the first sign of medical problems appear. Could it be they can't afford the premiums in the States or that they preexisting conditions that makes them ineligible for coverage or they have reached their life time cap. What ever it is, they trust the Canadian system enough to cross the border.

Whose system is working better? I am Canadian and realize we have our problems but I would not exchange my coverage and our families monthy medical fees ($114.00 per month for 2 44 year old adults and a 5 year child.) I have a preexisting condition. Additionally the government keeps the price of medication in check.
10:25 AM on 11/26/2010
Well written article. My wife and I just donated to the National Association of Transplant fund for two people profiled on Countdown. One man needed a liver transplant, had a liver donation in place and they wouldn't do it because he did not have insurance and couldn't pay. And onother needs a heart transplant I believe, same thing. When Chuck Grassley talked about the"death panels" he had it all wrong. The insurance comapnies are the true death panels when they can tell people that sorry we won't insure you and deny them life saving operations. The only reason I didn't like the health care reform bill is I felt it did not go far enough.
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alongst
too often denied to speak
12:39 PM on 11/27/2010
I was shocked recently to see a man bring his child to the ER - neither spoke English and his story was that the boy had a heart problem and needed a transplant, but there was no way in Mexico he could get one so his doctor there told him to go to America and sign up there !!! He had been coached by family what to say and do to get into our system. If we cannot afford for our own people to get care , why are we taking care of other countries problems as well ?
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redstateblues69
11:08 PM on 11/27/2010
I agree. Due to costs, I had to birth my babies at home but illegals get free hospital births.
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Maggie Keavey Kozel
11:14 AM on 11/25/2010
Thank you for compiling these compelling stories. The issues facing us in healthcare today are urgent and complicated. This is no time for idealogical rhetoric or political football. One of the most important steps we all need to take is to decide who we trust on these issues. What better place to start than listening to dedicated doctors and their patients.