Every election is said to be the most important election, but this time it feels different.
The COVID-19 pandemic has put a spotlight on the U.S. Not only have the undercurrents of racism become tidal waves, but the fragility of our healthcare system and its glaring inequities have moved to center stage.
The past 4 years have highlighted exactly how much separates us. I have found myself, at times, wondering how we can call ourselves the “United States” when divisive rhetoric and actions have seeped into everything from football to public health.
I am hoping that the silver lining of this pandemic will be a true uniting around the idea that high-quality healthcare is a right for all.
I have seen many types of patients during my 10 years as an outpatient internal medicine and sports medicine physician in Illinois. This has been the most enriching part of my job.
Building relationships with people who are rural, urban, young, geriatric, upper-middle-class, or poor, people who have immigrated, and people of almost every ethnicity has been a privilege. I have worked in a large public healthcare system as well as a private practice and have experienced the challenges of both.
The benefit of working in a public healthcare system was that it was a protected bubble with access to specialists, shared electronic health records, access to affordable medication, and the ability to treat uninsured patients.
Some downsides were longer wait times for appointments and tests, and although medications were affordable, we were limited in the medications we could prescribe. Also, the bureaucracy seemed to turn a cold shoulder to innovation that may have improved the most frustrating parts about public healthcare.
The Affordable Care Act was passed while I was working in a public healthcare system, and it did address some of these issues. I was able to get people screening tests like colonoscopies without the year-long wait that had become commonplace.
The expanded coverage allowed patients to get timely imaging studies, like MRIs, and surgeries for conditions that had originally been deemed elective and not covered but that severely impacted the quality of life.
I saw many new, young patients and was able to introduce them to preventive medicine, which saves lives and reduces future healthcare costs.
I also made many diagnoses early in the course of disease, which was a welcomed change. In a public healthcare system, we often see patients at the later stages of disease, which is more detrimental for the patient and more costly for the system.
A big highlight of the Affordable Care Act was access to mental health therapists. In many underserved communities, it is challenging for patients to accept a diagnosis of depression or anxiety — and even more challenging to get them the therapy they need. For once, there were a plethora of options. I was excited about the direction of healthcare.