Dear Patient, great things are happening in health care

Dear Ms. Patient,

I hope this letter finds you well.

Let me begin by saying that it is such a privilege to care for your family. It has been a joy to watch your children grow and your family thrive. I’m sure you will agree that we have been through a lot together.

As you know, I am devoted to help in keeping your family healthy, despite the many obstacles that have arisen. Remember the time when your husband lost his job? You not only lost your family’s main source of income, but everyone lost their health insurance. It was a dark time. We were both surprised to learn that insurance premiums were so expensive. We thought that those prices were crazy until we factored in your diabetes (a preexisting condition) and then realized it was worse than we thought . So you and your husband made the hard decision to go without insurance for a while. Even without insurance premiums, you ended up paying so much for your health care during that time. Minor aches and pains were ignored. I recall that your daughter had a difficult winter with asthma attacks, where you reluctantly agreed to expensive trips to the emergency room.

Having worked your entire life, you never imagined that you could be in this situation. I remember you spoke about the frustration — and enormous parental guilt — you felt for leaving your family so vulnerable. There were sleepless nights, filled with worrying. We both held our breaths in fear every time your son went out to play a football game, praying that he not get injured. The stress of that alone was enough to warrant a doctor’s visit. It was not fair.

There were glimmers of hope. We talked excitedly about a health reform law when it passed a few years ago — though it was unclear exactly how it would help your family at the time. As it turns out, your mother did get some money back for her Medicare prescriptions and she was pleasantly surprised to be offered a free annual wellness visit newly given to all Medicare beneficiaries.

The Supreme Court upheld the Affordable Care Act and I breathed an enormous sigh of relief. At that moment I could visualize the faces in your family and many others in similar situations who will qualify for affordable health insurance. I am thrilled to tell you that soon you will no longer have to feel embarrassed or guilty. It will be different. If your partner were to lose his job again, you and your family could still access affordable health insurance. Preexisting medical problems will no longer factor into the cost of health insurance premiums. If you or any family member gets sick, there will be no caps on insurance coverage. It is hard to believe that a decision by only nine people so removed from us can make such a tremendous impact on our daily lives. But this decision does. This law will allow me to be a better doctor for your family. It will give you peace of mind and security that your family members can get the health care they deserve.

Great things are happening. Have a fun and safe summer. I look forward to seeing you at a future visit.

In health,

Dr. Ricky Y. Choi, MD, MPH

Ricky Y. Choi is a pediatrician who blogs at SFGate and the Huffington Post San Francisco.  It reprinted with the author’s permission.

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  • Michael Mank

    I hope this patient does not live in a state that will be opting out of the Medicaid expansion.

  • AuthenticBioethics

    Yeah, Obamacare will certainly help some people out. And those people, politicians will appear with them at campaign events, saying that their political opponents want to take away their healthcare and make them choose between taking their kid to the ER and paying the rent. This, to me, is what Obamacare is all about, and what making the government a dispenser of money and benefits generally is all about. Use tax money to buy votes with entitlements, and threaten people with loss of entitlements if they vote the other way. Social security, welfare, medicare, just look the rhetoric when one candidate says of these budgetary behemoths, “Hey, we gotta fix this” — the opponent accuses him of wanting to turn old folks out on the street, or making poor people starve, or something. How will it be any different with Obamacare?

  • Lisa Gilbert

    and who exactly is going to pay for those preexisting conditions that are caused by poor lifestyle choices? Say a lung cancer that stems from years of tobacco use, or Type 2 diabetes caused by obesity and lack of exercise? All of our premiums will go up. And who is to say that people will choose to forgo insurance anyway, and pay the small annual fine in lieu of insurnace premiums…these people will be the ones that will purchase insurance on the way to the hospital after Jonny breaks an arm at the football game, or after Mary has renal failure because she refused to comply with her doctors orders for her diabetes. PPACA sounds good. But in reality it is a disaster.

    • W Joseph Ketcherside, MD

      I agree, I don’t want to pay for the choices others make. I also don’t want to pay for people who have higher risks because of their particular genetic make-up. Should we require genetic testing for everyone and rate their insurance premium accordingly? And not just smoking or obesity, I want a wireless pedometer on everyone so I know who sits more than 3 hours per day. Those people get a higher premium. And I want a GPS on everyone so I know who walks and who drives. The more you walk, the lower your premium. Can we put a camera on everyone and monitor their diet?

      It’s easy to pick one thing you don’t like and say we should penalize that person. But for every one you pick, I will add another and my science will be just as good. When we are done. we have an entire nation of risk pools of 1. The concept of insurance is that you pool large numbers of people, each pitches in a little, and the few who lose the bet get their benefit paid. Once you start carving up the pools the concept breaks down.

      Fat, lazy smokers have other issues besides the size of their insurance premium. They smell like smoke, can’t do things they want, get sick, die – plenty of incentive to change their lifestyle. If those things don’t change behavior then why do you think a little bump in their premium will

    • politigal12

      How fortunate for you and your family that you have perfect genetics, exercise daily, can affort to eat lots of fresh vegies and maintain perfect weight. Yet even with all that at some point in time you or someone you love will need medical care. PPACA is far from perfect but given the lack tolerance or generosity of spirit hidden in your post, I’ll take it any day.

    • kullervo

      Just checking… was my dad’s prostate cancer his fault? I’m afraid it killed him last August, so I can’t upbraid him for his moral failure. How about my being born with bilateral hip dysplasia? Is that something I did wrong, or should I blame my mother? In any event, I’ve never mentioned it to a doctor since I moved out of my parents’ home and off their insurance. Couldn’t have been insured all these years otherwise. Do two decades of pain alleviate any of the sin involved?

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