Clinic Notes on the ACA
In this season of college graduations, it has been gratifying to watch the first cohort of young adults graduate without having to worry about how to keep their health insurance. For many this means the chance to look for a dream job or try out an internship that could lead to exciting opportunities without risking their health. At the same time, I am truly enjoying being able to tell my patients who do have health insurance that their insurance covers preventive screenings without a co-pay thanks to the ACA. For many of the women I take care of, it has meant the difference between skipping their yearly mammogram to save a few dollars and getting a potentially life-saving screening test.
Yet, three times in the past 2 weeks my clinic staff have struggled through layers of bureaucracy to help a woman with a new diagnosis of breast cancer to get insurance coverage. Each of these women has had to face this diagnosis with a double burden of fear, first from her disease and second because she was uninsured and fears she will be denied treatment. Last week, I sat face to face with one of these women, trying to explain that we will do everything we can to help, but that we need to process paperwork before she will be able to have her needed surgery. I know that our insurance counselor is smart and savvy, and that she will somehow manage to get this woman the help she needs. Yet as I look into her eyes and explain the process for the fourth and fifth time, I can only think that 2014 cannot come soon enough. I can only wish that all those calling for the new law to be defunded and repealed could look into her eyes as well and explain themselves, not to a television camera, but to a frightened woman with a potentially lethal diagnosis. We have taken some big steps forward, but much of the work is just beginning as the battle over funding and implementation of the exchanges takes shape. In 2014, I hope that the diagnosis of cancer will be the most frightening thing that I have to tell a patient. If all of us insist on it, we can make it our future.