Affordable Care Act - It's Personal

Congress and the new President appear poised to do away with the Affordable Care Act. That would be a terrible misstep in the progress of healthcare in this country.

Millions of Americans have been provided affordable health insurance since the Affordable Care Act was enacted. It has done just that - provided affordable care for millions who would otherwise be without insurance.

This is personal. A dear older friend of mine many years ago was ill. She had heart trouble. She was in and out of the hospital. Her husband was underemployed and they lived paycheck to paycheck. One day I stopped by to take my friend to lunch and she was in tears. When I was finally able to get the story out of her, it turned out that she was being hounded by bill collectors who were making horrible threats in order to collect on medical bills she had absolutely no way of paying. She was already on a payment plan sending $10 a week to some collection agency for a $10,000 medical bill she would never be able to pay off. In the ensuing weeks, I did what I could to get the collectors to stop with threatening phone calls at all hours of the day and night.

Ultimately, she had to file for bankruptcy. It was that single act that broke her.

She was proud.

She was self-sufficient.

Her family had escaped the Nazis in Europe and had made it safely to America.

They had become productive, hard-working, proud Americans.

But they had fallen on hard times and there was no safety net.

She was ashamed beyond words of having to file bankruptcy. She mulled it over and waited and prayed to find an alternative, but there was none. Finally, after much heartache and delay, she filed. She was never the same. It had truly broken her. She died not long after that, I imagine the added stress and shame were too much for an already fragile heart.

Belatedly, I found out that she and her husband had been eating just one meal a day, conserving whatever money they did have so they could afford to send their $10 a week off toward paying down an impossible debt. She had hidden that from me, from her doctor, from everyone because she was ashamed she could not pay her own way. No one should have to go through that in this country.

The Affordable Care Act provides insurance for those who have no other options. If it is repealed without a new provision in its place, millions of Americans will go without insurance and therefore, without care.

What happens next? Sick people don't get primary care, they end up very sick and in our emergency rooms. The cost of care skyrockets. Hospitals, especially community and not-for-profit hospitals, bear the financial burden of caring for those who cannot pay. It is their mission and they carry it out faithfully, but they cannot provide free care to the detriment of paying their bills and remaining viable businesses.

Rural areas will suffer the most - rural hospitals are running on fumes right now as it is. Remove insurance coverage for a large segment of their population and these small hospitals and community clinics will fold. There is no stop gap measure, no safety net, for millions in these rural areas. That creates a serious risk for all those locations - if the nearest emergency department or hospital is a two or three hour drive away, what will happen?

Our mission in healthcare is to provide care, regardless of whether the organization providing it is for-profit or not-for-profit. Without the safeguards of the Affordable Care Act, or some reasonable alternative, in place, millions of Americans will slide backwards. More will become sick, more will become impoverished, more will suffer. This is not the way forward for this great nation.

The ACA is not without flaws, but to repeal it wholesale without an alternative in place will put millions in jeopardy.

If you know anyone who relies on ACA health insurance, as I do, you'll know that as flawed as it is, it IS far better than nothing.

Also, consider these facts:

FACT: People who receive healthcare earlier in the disease cycle have better outcomes.

FACT: People who receive healthcare earlier in the disease cycle spend less overall on healthcare.

FACT: People who receive healthcare earlier in the disease cycle have better quality of life.

So, as a nation, do we want to continue to spend less and provide a higher quality of life for our citizens?

Or do we want to see health decline while costs increase?

Is that really a choice?