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Senator Toomey, Welcome to our World!

By Dr. Christopher Hughes

I recently received  an email from Senator Pat Toomey, describing his fight to have federal rules waived in order to facilitate the receipt of a lung transplant by a young girl in Philadelphia. He makes an emotional case for the federal government to intervene, to change the rules, to allow for just the opportunity for this girl’s life to be saved, “a young girl fighting for her life as she awaits a life-saving lung transplant.”

Every day, physicians and nurses everywhere in this country face this problem. We have patients that cannot get access to the life-saving treatments that they need. Every day, we see the tragedies of omission of millions from access. We see patients with diabetes, asthma, high blood pressure and other chronic illnesses become gravely ill due to lack of care, we see deaths and amputations and strokes heart attacks, needless hospitalizations and on and on, day in and day out. If you are in health care and reading this, you can tell us stories that would stun the uninitiated (“We do that to people?”).

If you are not in health care, as nearly every state legislator, governor, US Congressman and US Senator is not, then you probably do not understand the spectacular cruelty of our system.  You may look at the tragic case of a girl in Philadelphia and think, “This is intolerable, I must do something for this girl, this family!” Welcome to our world, Senator!

There is a reason that every major physician and nursing organization in the country has endorsed the Charter on Medical Professionalism, which specifically calls on the medical profession to ”promote justice in the health care system, including the fair distribution of health care resources. Physicians should work actively to eliminate discrimination in health care, whether based on race, gender, socioeconomic status, ethnicity, religion, or any other social category.” The reason for the unanimity is that it is clearly the right thing to do. Every nation in the world has made the decision that we have not yet made in the US: everyone deserves access to health care, regardless of their situation.

 In Pennsylvania alone, Medicaid expansion would provide access to health care for as many as a million patients. That’s a million people whose lives would be changed for the better. Hundreds of thousands of people who would have access to a primary care provider, to a clinic, to x-rays, to blood tests, to a hospital, to things most of us take for granted.  Hundreds of thousands would be protected from the financial catastrophe that an illness can bring down upon a family.

I have noted elsewhere that expanding access to health care was a non-partisan issue just in 2007, with conservatives like Jim DeMint and  Trent Lott calling on George W Bush to do something!

I have purposely not dwelled on the economics of this issue, though I teach health policy, and I would be happy to do so with unlimited space, but at some point, we have to first agree that expanding access to health care for millions of people across the nation is the right thing to do. As health care economist Uwe Reinhardt has said, “Go explain to God why you cannot do this. He will laugh at you!”

I hope that Senator Toomey will make the commitment to advocate to our Governor and Legislature for access to health care for nearly a million Pennsylvanians via Medicaid expansion, in addition to his sincere advocacy for one tragic case in Philadelphia.

Dr. Hughes  practices critical care medicine and hospice medicine in Pittsburgh, and is a Lecturer in Health Care Policy at the Thomas Jefferson University Graduate School of Population Health.

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