Kevin R. Campbell, MD, FACC
In the past month, I made yet another trip to Washington DC in order to make the case for meaningful healthcare reform. While Congress continues to play partisan politics, patients and doctors continue to suffer. According to the Mayo Clinic, physician burnout is at an all-time high with nearly 50% of all US physicians reporting experiencing the symptoms of burnout in the last 3 years. The Journal of the American Medical Association (JAMA) reported in 2015 that 30% of young physicians had symptoms of depression or suicidal ideations. In fact, Suicide accounts for 26% of deaths in physicians ages 25-39 as compared to 11% of deaths in individuals of the same age in the general population. Physicians are leaving practice at an alarming rate, with a shortage of over 100K physicians expected in the next decade. For patients, frustrations continue to mount. Rising premiums, diminished choice (only one choice in nearly 23% of counties in the US and only 1 or 2 choices in 41%), and limited access have patients scrambling for their basic healthcare needs. Medicaid expansion has not happened in over 1/3 of the States and many are left uninsured—millions more are underinsured. Medicine continues to focus on the treatment of disease rather than on prevention. Patients are not getting proven screening therapies and many cannot afford necessary medication due to rising costs. Clearly, something MUST be done. Healthcare in the US is on the verge of a major collapse—poor care, poor access and likely physician shortages are looming.
Dr. Campbell Goes to Washington
I began making phone calls about a month before my visit in order to set up meetings with key Congressional influencers and leaders. I was able to secure a few meetings and set off for DC. On arrival on Capitol Hill, I was amazed by the general lack of interest in the healthcare debate (other than when cameras are rolling for the mainstream media). On the day I entered the Rayburn Building (which houses most of the House of Representatives offices), there was a long line of people and politicians were buzzing around in the hallways—all due to more hearings on Russia and our election as well as President Trump’s tax proposal announcement—almost no one was interested in discussing healthcare. I was able to secure meetings with a few Congressional offices and staff, including the Deputy Whip, Patrick McHenry from North Carolina. I was able to meet with Congressman McHenry’s team and spent nearly an hour going over issues with healthcare. They listened, took notes, and promised to follow up in the coming weeks. They seemed truly interested and empathized with the plight of patients throughout the United States. I also met with staff from Vern Buchanan’s (R-Florida) office and shared more of my concerns. Mr Buchannan sits on the Ways and Means Committee and is influential in discussions concerning healthcare expenditures and funding of healthcare related programs. Interestingly, both of the Congressional staffs that I met with seemed genuinely surprised about my report of the “real” state of healthcare, particularly when I discussed issues of billing, reimbursement for physicians and the cost of drugs and medical devices. I really think that many of our Congressmen and women are not adequately informed about healthcare related issues because they do not have to deal with the system in the same way that doctors and the average American patient have to on a daily basis.
Healthcare and Congress, On Life Support
I really believe that there is little hope for saving the US healthcare system during the next 4 years. After more than 7 years of criticizing the ACA and campaigning on promises to repeal and replace, the Republicans have little to offer. One would think that during the two Obama terms, the Republicans could have been working on a viable replacement plan—but clearly they have not. In Medicine, we are always taught to be prepared, to be able to be flexible, and respond to unforeseen circumstances. We meticulously plan our treatment, or surgical approach and our next steps. Congress, after winning majorities in both Houses and also taking the White House, has shown a lack of preparation to actually govern—particularly when it comes to healthcare. The Democrats, always simply satisfied with the status quo, refuse to admit that Obamacare is not viable in the long term and have not put forward ANY plans to address its failings. Most of their energy has been put in to thwarting any legislation put forward by the opposition. The Republicans, due to bitter infighting within the party, have crafted piecemeal replacement plans that are likely to show no real improvement—in short, these plans simply “rearrange deck chairs on the Titanic”.
What MUST Happen Now?
In the hospital, when a CODE BLUE is called, all available staff rush to the bedside of a patient who is in distress. In most cases this means the initiation of CPR of cardio pulmonary resuscitation and any necessary heroic measures are employed in order to save the patient’s life. Any indecision or any delay in treatment can result in death for the patient. However, if the CODE team works in concert, with a single goal (of saving the patient’s life), comes together quickly and effectively, a positive outcome is far more likely. It is now time to call a CODE BLUE on healthcare in Washington DC. We must demand that both Houses of Congress focus on real, meaningful healthcare reform. Any delay, much like with a patient who is in distress, will lead to disaster and ultimately, death. Not only for healthcare as we know it, but ultiamtely for doctors and patients as well.