I am an emergency physician. Hospital emergency departments are rightly seen as the “safety net” of our health care system. However, we cannot close all the gaps in that system. The Affordable Care Act does go a long way in closing those gaps.
A recent example demonstrates the problems this Act helps to solve. I recently saw a patient who had been found to possibly have a tumor during a visit to another emergency department. She required further testing, not available through the ED to determine if this mass was benign or something more serious like a cancer. She had been referred to a specialist, but had been turned away because she had no insurance. She had called another specialist who told her she would need $100 cash before they would even talk with her. Fortunately, through the charitable services of Memorial Hospital where I work and through the compassion of a physician friend I was able to arrange for her to have the next test she needed. However, if this turns out to be something serious requiring surgery or major treatment her out-of-pocket costs could reach well into 5 or 6 figures and she would likely become one of the 500,000 individuals who file for bankruptcy every year due to medical costs. If she were to go out now to find insurance she would be excluded because this would be considered a pre-existing condition. Starting this year the affordable care act, ensures children will no longer be denied insurance due to pre-existing conditions and by 2014, discrimination against pre-existing conditions will be banned completely. In addition, the Affordable Care Act will prevent bankruptcies by capping annual out-of-pocket costs for families who receive insurance through the exchanges or a small business..
On a personal level, I have my own example of the folly of relying on the tender mercies of the insurance industry for our health care. Some years ago my wife and I struggled with infertility. This was an imminently treatable condition as shown by my two healthy children. However, when we applied for insurance for her at one point the insurance company attempted to exclude “all gynecologic conditions” as pre-existing conditions. This meant that, if my wife developed ovarian cancer 20 years later she would not be covered although clearly the two conditions would not be related.
The Affordable Care Act gives families the freedom from worrying about losing their insurance, or having it capped unexpectedly if someone is in an accident or becomes sick. It frees Americans from discrimination when insurance companies deny women health insurance because they are pregnant, or refuse to provide coverage to children who are born with disabilities.
The Affordable Care Act provides [Tennesseeans] with more freedom and control in their health care choices. I am here with my neighbors and colleagues to call on Congress to urge them to please side with my patients I see and not the insurance industry – and protect the Affordable Care Act and progress we’ve made.