If it is done right, the Affordable Care Act (a.k.a. Obamacare) may well promise uninsured Americans a lot more than cheap, reliable medical care. It can also open the door to the democratic empowerment of millions of poor people, who are often alienated from much of the nation’s civic life, by strengthening the organizations that give them a voice.
This year more than 30 million uninsured Americans are to begin signing up for Obamacare, but the vast majority of those eligible for either the expanded Medicaid program, or for subsidized private health insurance through state health exchanges, have no idea how to enroll. Surveys and focus groups have found that up to three-quarters of Americans who might directly benefit from the program are skeptical that the law can provide high-quality insurance coverage at a price they can afford.
As a physician who works at Grady Memorial Hospital, I am regularly reminded of the implications of poor access to health care.
One of my regular patients had been suffering from diabetes and hypertension for five years. She was a single, dedicated mother who had been working long hours at a local grocery store to provide for her 15-year-old daughter. She understood that good health meant that she could perform better at work, and the earnings she received from her work would help her provide a stable home for her daughter. Therefore, she did whatever it took to keep herself healthy — monitored her diet, took her medicines diligently and visited the physician regularly.
Things changed one day when during one of her visits to my clinic she said, “Doc, I just lost my job. I don’t have insurance anymore. Medicaid denied me coverage even though they said it was OK for my daughter to have insurance. I can’t pay my co-pays to see you anymore. I may not see you next time.” I was horrified.
A mother who wanted nothing more than to be as healthy as possible for her child should be able to receive care. The health care system in our country that should be serving patients exactly like this one is preventing patients from receiving the care they need and deserve.
In many cases, access to health care coverage is not within the control of patients nor their physicians, resulting in significant consequences. That is, if they don’t obtain coverage, many of our patients will succumb to their (many preventable) illnesses if they don’t have access to their physicians or cannot pay for their medications. My patient’s future could be a testimony to this.
What further confounded me was that Medicaid denied my patient.