Will Dr. Price ‘do no harm?’
Editor’s note: The following blog post is authored by Kenan Heise, a Chicago journalist who has for decades illuminated the lives of poor people in his morally powerful writings. He has written for the Chicago Tribune and other major daily papers; he founded the “The Neediest Children’s Christmas Fund” in 1969 with the help of other reporters. Now run as the WGN Neediest Kids’ Fund, it has raised more than $60 million over the years. His work is all about justice as well as charity, showing the human truths underlying the need for a government role to alleviate poverty. Heise is the author of several books, including The Book of the Poor (2012) and his autobiography, He Writes About Us (2015), both published by Marion Street Press.)
If he is confirmed, Dr. Price—President-elect Donald Trump’s choice for heading up the Department of Health and Human Services—will confront several medical questions that can tragically affect the lives of millions of people in the United States.
The actions and policies that will impact his fellow citizens the most are life and death issues. These will include his participation in determining what changes will be made to the Affordable Care Act (Obamacare) as the Trump administration and Congress try to repeal and replace it with a Republican alternative.
The effect he will have on the life and death of Americans that is more certain, however, concerns Medicaid.
One of the most important provisions of the Affordable Care Act is the expansion of health care coverage to low-income families through the Medicaid program. Even though the federal government covered all the costs of the expansion for the first three years and will cover 90 percent of it after the year 2020, nineteen states opted not to participate.
Dr. Price supports drastic cuts in Medicaid’s capacity to serve low-income people. According to a Washington Post November 29, 2016 article about Dr. Price, describing his positions on Medicare and Medicaid:
“Under his vision, both programs would cease to be entitlements that require them to provide coverage to every person who qualifies. Instead, like many House Republicans, he wants to convert Medicaid into block grants to states — which would give them more latitude from federal requirements about eligibility rules and the medical services that must be covered for low-income Americans. This plan would also require “able-bodied” applicants to meet work requirements to receive health-care benefits — an idea that the Obama administration has consistently rebuffed.”
There can be little question that his thinking emphasizes cutting people off Medicaid. Furthermore, the low-income families and individuals—even if they passed an “able-bodied” test—could be denied benefits even if an extensive search for work has still left them jobless.
Clearly, his intentions represent a commitment to dramatically restructure Medicaid, (i.e. cut it back) whether or not it remains a part of any national health care program.
This is personal with me. Two friends and a relative have been kept alive because of Medicaid. Through it, they received not only life-saving medical attention but also hospitalization and necessary life-extending equipment. The relative, who had suffered a severe stroke, survived 10 years in a decent nursing home on Medicaid after his savings ran out.
Still, does Dr. Price know what would be the overall impact of his personally desired cuts? As a medical doctor, his reason and experience should take seriously the conclusion reached in the following Harvard study.
The New York Times on July 25, 2012 reported on “…a new study by Harvard researchers who found that when states expanded their Medicaid programs and gave more poor people health insurance, fewer people died…When researchers adjusted the data for economic factors like income and unemployment rates and population characteristics like age, sex and race, and then compared those numbers with neighboring states, they estimated that the Medicaid expansions were associated with a decline of 6.1 percent in deaths, or about 2,840 per year for every 500,000 adults added.”
The study establishes that he would absolutely fail the intent of the Hippocratic Oath. Reversing the expansions of Medicaid and restricting it even more would do harm. It means death.
In 2005, Florida CHAIN, a nonprofit consumer health care advocacy organization, asked this writer to interview 16 Medicaid recipients to determine the impact of proposed major cuts in the program that Florida was considering at the time.
The stories were tragic. The idea of being cut off was causing immense and dominant anxiety and fear in their lives.
I will quote one of them, and wish that Dr. Price could listen to the voices of all 16. These represent the kind of problems that recipients regularly encounter when Medicaid programs start making cuts.
I am 52 years old and for many years I was an elementary school teacher.
In 1999, I was diagnosed with MS [multiple sclerosis]. My life changed from then on. It is an illness that has many hidden symptoms. The most disabling of them is fatigue, total exhaustion. It can last a whole day, a whole week, a whole month.
I needed my job so I kept going after the MS hit me. My only mission every day was to go to work. I would get up in the morning, eat breakfast, go back to bed to get strength to go to my car, and be exhausted by the time I reached my desk.
There were other hidden problems, especially at the beginning. I had blurred vision and could not drive. My hearing was bad, and I had a lot of pain, and my right side was partially paralyzed. The drugs I take have helped immeasurably with these symptoms.
Four times I applied for Medicaid and disability status with the Florida Office of Disability Determination, but was denied three times before I was finally listed as eligible.
Since then, I have been knocked off several times when the Florida Legislature cut back on Medicaid benefits, targeting the particular program under which I was getting help. Early on, I sold my suits, dresses, and other work clothes. My family gave me groceries, and I got bags of them from the Halifax Urban Ministries, a Methodist organization.
You stay home otherwise. You have no money to do anything. I begged and borrowed but I did not steal.
Stress also causes problems for people with MS, and if you do not have an income or health insurance and Medicaid does not find you eligible, you have a lot of stress. That time is foggy to me.
I take an injectable prescription drug, Copaxone. It costs $1,200 a month. Every year, the state legislature reevaluates the list of drugs covered by Medicaid. They took mine off. My doctor was able to get it restored under what is called “prior authorization approval,” but time lapses before you get something like that straightened out.
I held up my end of the bargain, I worked, paid taxes and mistakenly believed I would be protected by a safety net should the need arise, but every year the Florida Legislature believes that net should be opened up.
As I read Dr. Price’s grand plans for saving money, I see no room for dealing with the many complexities that sick people are forced to live with. It is nearly impossible to imagine a physician with so little care and concern for the sick and dying as Dr. Price has demonstrated.
People like Monty get no chance to testify or reach the Senators who will be approving or disapproving a doctor willing to do harm.
Maybe you can do something. Call your senators.