The year before I started medical school, I canvassed in Rochester, New Hampshire for the Obama 2008 Primary campaign. One afternoon, the field directors assigned me the task of calling and inviting the citizens on my list to an event where then-Senator Obama was going to deliver his stump speech.
Rochester, New Hampshire is home to a robust working class, and through my phone conversations, I quickly learned that many of its citizens could not afford to be sick, to retire at age sixty-five, or even to give an evening to slog through the New Hampshire wintry mix to the local American Legion to hear upstart Presidential candidate Obama speak.
One house-ridden elderly woman explained to me that she would be unable to attend because the snow was now piled two feet above her front step. Over the phone, I could hear her heavy breathing. “HELLO?!” The elderly have a tendency to speak loudly into telephones and the gingerbread-and-kindness senior citizen population of Rochester, New Hampshire was no exception.
“HONEY, HOW OLD ARE YOU AND… WHAT ARE YOU DOING CALLING STRANGERS ON THE TELEPHONE?”
I politely explained that I would be entering medical school in the fall, and that I was thrilled to be campaigning for health care during the presidential election in the meantime. After another extended pause filled with heavy breathing, she responded, “WELL, HONEY, THAT IS JUST MARVELOUS.”
She then began to outline a tableau of health-related complications that had arisen because of an aching hip fracture that required surgery she could not afford. The anticipation that I might be able to help hung in the air as she spoke, but my heart sank to my stomach as I listened. None of these complications had been covered in any of my premedical chemistry and physics courses, where I had learned how to balance complex chemical equations and how to calculate the velocity at which a ball would hit the ground. Nothing I had done to prepare for medical school allowed me to hold a meaningful conversation about where to find money to pay for medical expenses. I greeted her with silence when she finished, too embarrassed at my impotence to do anything but respond that my advice be that she pledge her vote to Senator Obama. Disappointment dripped from her voice as she reminded me that she could not leave her house, “ALL RIGHT, THEN… DEAR. BYE-BYE NOW.” The phone clicked as she hung up.
It is now almost three years later to the day since I called that elderly woman, and I wish I could call her up again and tell her about the wonderful things for senior citizens that started happening this year.
Beginning on January 1, 2011, seniors struggling to pay for brand-name drugs will find an automatic discount at their pharmacy. Medicare Part D recipients who are in the donut hole will receive a 50% discount on covered brand-name drugs and a 7% discount on covered generic drugs if Part D is the primary payer.
I’ve learned a little more about aching hips during my time in medical school, and I know that hip fractures are often linked to osteoporosis. Osteoporosis is the thinning of bone tissue and the loss of bone density, and is a disease that is most common in women after menopause. Moreover, it easily can be prevented with lifestyle changes and medication in certain cases. If I were to talk to that lady again, I would tell her that Medicare now covers osteoporosis screening with no copay or deductibles for women over 60, depending on risk factors.
These new provisions signal a wonderful turning point for seniors worried about access to health care that they need. However, our work is far from finished. As new measures are implemented, providers need to empower their patients with the knowledge of how to access the benefits of these new provisions. The medical students of Doctors for America will kick off their year with an initiative that calls on medical students to give presentations to senior citizens in order to make sure they understand what the new law means for them.
As health care providers, one of our roles is to be a voice for our patients. We have a duty to report the challenges of implementation that only we are privy to and to identify the problems in health care delivery that still need to be confronted. Sound policy means nobody is left behind. So does sound medicine. Let’s make it work this year!