Several months ago, I was working a night shift, admitting sick patients to the hospital. I was called to see a relatively young person, who was there with a pretty simple complaint. However, she had kidney failure and was receiving dialysis which made things more complicated so the Emergency Room had asked me to take a look.
As I spoke with her and collected her health information, I learned her story. She had developed juvenile diabetes at an early age. This meant that she absolutely needed insulin and close monitoring to avoid severe complications. When she was young she was able to do this on her parents insurance. However, once she finished school she no longer qualified and was unable to afford the very high premiums she was being charged due to her pre-existing condition. For awhile, she went to free clinics, bought some insulin over the counter and tried to manage things herself. However, without consistent access to a provider and only spotty ability to afford better medications, her diabetes became uncontrolled. This was toxic to her body and in her early 30s her kidneys failed. She now requires life-long dialysis.
I listened to her history with a sense of overwhelming sadness. This is a disease that we know how to treat. This is a disease with serious complications but with good care, can be well controlled. The human cost is immeasurable. The economic cost is irrational. We traded a cost of ~$8000 a year for a cost of ~$100,000 a year for an outcome that is much worse for this young woman.
As I was so discouraged and empathizing with my patient, her husband interjected ‘We are so grateful. Obamacare saved her life. Without that law she would be dead’. And I knew he was right.
With this statement, this gentleman highlighted just how crucial it is for healthcare providers to be a part of the conversation on health policies. In practice we can help one patient at a time. In policy, we can help the population.