Twenty-four million people — a number greater than that of the populations of Florida or New York — 24 million people live in your neighborhood, worship with you, attend school with your children, sit next to you at the cafe. Some of them sit alongside you in the waiting room of your doctor or dentist. These are the 24 million people who stand to lose their health care if the Affordable Care Act (ACA) is repealed and replaced by the Republican health plan proposal, as estimated by the Congressional Budget Office.
They daily shoulder important functions within your community and at your workplace. As a physician, I know many of these 24 million men, women and children; I care for them; I laugh and cry with them; I partner with them to ensure that they are healthier than before we met.
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I am able to provide care for some of these 24 million people because the ACA gave physicians and other health care providers access to them, offering them a route into the health care system that had previously been closed. If that access disappears, I know quite well that most of these people are likely to become sicker, and to die prematurely. If the effort to repeal the ACA is realized and 24 million people lose their health insurance, we will be doing harm. Great harm.
Regardless of your politics, providing people with health insurance is a good for them and for our country.
I became a doctor above all to be able to care for patients, to promote health and to alleviate suffering. And then, above all, I pledged an oath: to do no harm. I do not pretend that the ACA is perfect; we have borne witness to the fact that it is not. The fervent voices urging one point or another on every side have left us all-too-familiar with the range of deeply-held positions that animate supporters and detractors.
What can be lost in this debate, however, is the voice of the 24 million people who would be largely excluded from health care in our country without the ACA. Some things can develop in parallel while waiting for redress; the benefits that accrue with timely health care are not among them. Health is too important, America is too important, and healthy Americans are too important for any of them to be figured into political football.
Providing healthcare for all Americans will continue to require a course that integrates moral and ethical practices and beliefs. We remain the only major, industrialized nation that treats health care as a commodity, rather than as a basic human right. As a commodity, health care — and health itself — can be reduced to a budget byline, or seen as a staple, rather than as a matter of justice.
I choose to believe in the solidarity and resiliency of Americans. I choose to believe that empathy can be apolitical. I choose to believe that our country, including our lawmakers, will not allow 24 million human beings of all ages to be stripped of their health care coverage. I am calling for a compassionate approach to health care legislation, one that keeps the needs of 24 million Americans front and center, one that expedites and extends health care benefits for them and for others.
If, instead, we allow politics and rhetoric to siphon the nation’s health care efforts through a political spigot of half-truths and innuendo, 24 million American friends, neighbors, and loved ones will suffer. You will still see them everywhere — except in our waiting rooms — and that one single exception will affect our nation’s development, reach and productivity across every aspect of life. As with all new legislation pointing toward a higher standard of life for our citizens, we do need eyes and minds focused on ways to improve the ACA; we do not need to repeal it and wait for some future opportunity to start the ball rolling toward better access to care all over again.
As a physician, I cannot allow this harm to transpire — not to the 24 million, not to the fabric of American life — because I took an oath.
Michele David is an adult primary care physician with MIT Medical.
