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Once again, the Boston Globe declines, and this community receives.

Share this as far and wide as you think might help, as we still have to defend the ACA.

And watch for the Doctors for America "Patients Not Profits" bus tour this summer in a town or Internet near you!

As a psychiatrist, I try to hear out my patients before I jump in.  It’s a method I’ve used while waiting to hear the Supreme Court’s decision on the Affordable Care Act (ACA).  Fortunately, reason prevailed and the Supreme Court confirmed the ACA was constitutional.

The ACA works.  Take it from me, a doctor in Massachusetts.  The nation is now on the cusp of a system basically identical to the one we have had in the Commonwealth for years.  I'm proud of it, and as a dad of an "Obamacare" baby, I'm grateful for it.

But unbelievably, we still have to fight for it.

Follow me below the squiggle for more.


I’ve focused my career on treating people in “emerging adulthood,” ages 18 to 35, and the ACA has been invaluable to them.  During this stage of life, individuals make attempts to set professional and personal goals.  This is also the phase when many chronic psychiatric conditions manifest, re-challenging the sense of self and derailing first forays into adult endeavors.  Keeping a job that comes with insurance can be one task too many as the cloud descends.  Catastrophic care for an uninsured young person comes with a heavy personal toll and a high price for the rest of us who pay for it through our taxes.

For the last two years, thanks to the ACA, all young Americans can stay on their parents’ coverage until age 26.  My patients have often used their parent’s insurance to begin with me; if by age 26 they don’t have a job with coverage, the MassConnector exchange helps them purchase a private plan.  Moreover, insurance companies cannot exclude my patients due to psychiatric “pre-existing conditions.”

My profession prevents me from speaking specifically about any of my patients, but I can share a story of my own.  Our daughter is a healthy and happy “Obamacare” baby.  In the 32nd week, my wife presented to the hospital with excruciating pain.  After repeated workup she was diagnosed with a pregnancy-related liver condition.  Immediate delivery would restore my wife’s health but result in potentially life-long complications of prematurity for our child.  Watchful care over five weeks would provide the best shot for both of them.  In the end, my wife required more than one hospitalization before being induced at term.  During delivery our baby aspirated fluids and we held our breath as she spent hours under further care.  But she made it, now beaming joy with every new person she meets.  Without the ACA, which limits deductibles and co-pays for perinatal care, we might have spent our entire savings on this crisis.  And we are two young physicians who have employer-based insurance.  Before the ACA, neither of us would qualify for individual insurance because of “pre-existing” diagnoses.  What would other parents do given such a terrible choice?  How many babies have been tracked to a life of disability by the pre-ACA system, at great cost to all of us?

Unfortunately, these benefits are still at risk due to misinformation.  Even after the Supreme Court ruling, many stories incorrectly stated the ACA mandates insurance.  Just like “Romneycare,” the ACA asks the uninsured to “bond” at tax time against the shared cost of their potential catastrophic care.  Greater than 99% of Commonwealth residents, now insured, have this “bonding” tax waived.  This confusion is endangering the progress made by the ACA by causing many politicians to call for repeal, including our junior U.S. Senator and former Governor who created the same exact system in Massachusetts.

I joined Doctors for America to fight for access to high-quality affordable health care for all Americans.  Our advocacy, along with those of millions of other citizens, helped bring the ACA into being.  At the time, I did it for the young people I might see.  I had no idea it would prove central to the life of my own child.  But that’s how life works.  Disease doesn’t email years in advance of the first signs or symptoms.  It’s why the ACA makes sense.

When I can encourage my patients not to jump to conclusions, they are often surprised how reasonable other people turn out to be.  The Court's ruling has been a pleasant surprise.  They deserve everyone’s thanks for their reason, prudence and judiciousness.  Let’s not let it go to waste.

Originally posted to Ptolemy on Fri Jun 29, 2012 at 03:12 PM PDT.

Also republished by Invisible People and Community Spotlight.

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