In the aftermath of the midterm elections, political commentators are saying that Democrats paid a heavy price for overreaching, particularly with healthcare. That is probably true. In our preoccupation with the political fallout, however, let us not lose sight of the real people who will benefit from the new health-reform law. As a physician, I am witness to the struggles of such people. David is one of them.
Several years ago, David went to an emergency room for a minor accident. His X-rays did not show any fractures, and he was cleared to go home. As he was leaving, a doctor informed him that he had high blood pressure. He told David not to worry. All he needed to do was make an appointment with a primary care doctor to get treatment.
David soon realized that there were no primary care doctors willing to see him without health insurance. Although his job as a taxi driver provided enough money to maintain a small apartment and pay the bills, it did not provide health insurance. So he had to forgo treatment as his high blood pressure silently damaged his kidneys.
Five years passed. David began to tire easily. He could not make it across a parking lot without having to stop to catch his breath. A few months later, he would wake up from sleep gasping for air. His breathing was getting worse by the day. One night his sister finally brought him into the emergency room, where I first met him.
I could tell that years of high blood pressure had damaged David's kidneys beyond repair, causing fluid to accumulate inside his lungs and compromise his breathing. After a few days of treatment, David began to feel better. That is when I broke the news to him. To stay alive, he would need to go on dialysis.
David was stunned. "Doctor, will I be able to work?" was his first question. Then he asked me if he could ever visit his parents again. They lived abroad and were too frail to travel. That evening, it became clear that his life would never be the same.
David's life will have to revolve around dialysis. For three days every week, he will make his way to a dialysis center and wait for four hours as his blood is cycled through a large machine. Since missing a single session can be dangerous -- leading to sudden cardiac arrest, for example -- his ability to leave town will be curtailed. It is unlikely that he will ever see his parents again.
Working will also be difficult. In addition to the demands of thrice weekly dialysis, David will have to put up with the weakness, nausea, and cramping that accompanies his condition. There will be the fear of complications. His risk of having a heart attack, for example, has increased by ten fold because of kidney disease.
This could have been prevented. The emergency room doctor who saw him six years ago was right. All David needed was a primary care doctor to regularly check his blood pressure and write a prescription for pills that cost as little as a nickel a day. Yet, he was denied that access because his line of work did not come with health insurance.
Americans are understandably skeptical about the new health reform law. Some fear a larger government role in healthcare. Others wanted the law to go further and include a public insurance option. Many were disturbed by the politics that played out on their television screens, such as the raucous town halls and Senate backroom deals.
Yet, no one can deny that the new law will address a fundamental issue in healthcare -- the unacceptably high number of Americans, like David, who are uninsured.
Politically, it would have made sense for Democrats to put off health reform, at least until the economy had improved. Those without insurance, however, suffer the consequences of waiting. Had this law been enacted five years ago, David would have had a chance at saving his kidneys. Now, it is too late.
The new law will provide coverage for more than thirty million uninsured Americans. Those with insurance will have the peace of mind that they will be protected if they lose their job or fall ill. This matters for a mother unable to obtain a mammogram because she is uninsured or a diabetic who lost his insurance because he was laid off. With all the focus on the political fallout, now is a good time to remind ourselves that their stories matter. Because of them, health reform was worth it.