The Common Good

Affordable Care Act Is a Step in the Right Direction

“So what brings you in to the clinic tonight?” I ask, beginning a conversation with a middle-aged woman in typical fashion.

“I need some help with my medication,” she tells me, digging into her purse for the packaging from her last filled prescription.

“It’s for high blood pressure, but… I can’t afford it anymore.”

I take a look at her chart.

“Oh!” I say, pleased with my growing ability to recognize medications without aid from a reference text. “I think that’s on the Wal-Mart list. We should be able to give you a prescription for the generic which will be just four dollars per month at Wal-Mart.”

“I know,” she says. “That’s what I was prescribed. I can’t afford it.”

I don’t talk much about the Affordable Care Act in day-to-day conversation, even with the Supreme Court’s decision last week to uphold its constitutionality. In fact, I try to avoid it. It’s just not a conversation I’m poised to treat as small talk, simply because it’s a conversation that goes way deeper than I think most people realize.

One of the most meaningful experiences I’ve ever had has been volunteering with a group of free health clinics in Champaign-Urbana – nonprofit organizations funded on grants, donations and volunteer time – not patient fees – and specifically designed to serve the uninsured and underinsured in our community. When I was an undergraduate at the University of Illinois, these clinics taught me that the folks who come to the clinic – sometimes just one accident away from financial and medical disaster – were some of the same people I rode the bus with, passed in the grocery store, and even went to class with every day.

And frankly, I’m a little bit skeptical of the opinion of anyone who isn’t acquainted with the challenges these clinics and their clients face. Consider the Avicenna Community Health Center, for example, which has seen over 1200 patient visits in just two years of weekend clinics. Or the Champaign County Christian Health Center, which has been opened on weekday evenings for nine years and seen over 3500 unique patients through 7200 visits. Or Hope Community Health Center, which – before closing its doors in 2010 – faced a waiting list several pages long, documenting a need well beyond the ability of its volunteer medical staff to meet.

It was while volunteering at these latter two clinics that I met people like the woman I describe above. And it’s always been the same collection of stories: Unemployed and unable to afford insurance. Employed but without benefits. Barely able to put food on the table, much less think about seeing the doctor. Without insurance, most of them simply had nowhere else to go.

Often, folks show up with what should be relatively simple needs to meet. Hypertension, once under control, now through the roof since losing a job or changing employers and going un-medicated for months or even years. Or if it’s not an antihypertensive, it might be an antidepressant. I’ve lost count of how many patients I’ve met who could speak of a time when their depression was well-managed – until money ran out and the medication stopped.

Many exhibit conditions that can be managed with regular care, but are complicated by inattention – the result of inability to afford visits to a primary care provider. For many of these folks, the emergency room – from which they cannot be turned away – is a more accessible (and affordable) form of care than the doctor’s office. The cost of their visit, however, is distributed to the hospital’s other clients, exacerbating the problems surrounding the high costs of healthcare for everyone.

Martin Luther King, Jr. declared “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” His perspective was undoubtedly rooted in the ethos of Jesus, who demonstrated an even more radical ministry of caring for the sick than any Obamacare supporter could dream up. So in spite of the controversy over constitutionality, I think the question we must ask is: what is Christ-like?

I know a lot of people are upset about mandatory coverage and penalty taxes. Yet somehow it seems to me that those who are complaining are already insured – or at least able to access coverage. We need to place ourselves in a different pair of shoes before we declare that Obamacare represents some sort of liberal tyranny.

Imagine for a moment if every congressperson was forced to spend one night a month volunteering at their local version of the clinics I mention here. Imagine if they had to listen to stories of trying to make ends meet while chronic conditions unravel financial and physical security. What if our lawmakers were forced to sit down and counsel their low-income constituents through the red tape and paperwork involved in applying to pharmaceutical assistance programs? What if our politicians were to spend a day adding name after name to waiting lists to see an overwhelmed provider at an under-funded facility that will receive zero compensation for seeing that patient when their name reaches the top of that list roughly six months from now?

We all know that healthcare is a complex issue with no easy answer. But I’m concerned that as Christians we’re not asking ourselves the right question. The people who stand to benefit from the ACA have been forgotten, ignored and overlooked – pushed to the margins of society.

The ACA is one step toward giving these folks – and their struggles with healthcare – much needed attention. It may be uncertain and unsteady, but it’s a step nonetheless.

Isn’t it worth “giving to Caesar what is Caesar’s” to make that step a reality?

Greg Damhorst is an MD/PhD student at the University of Illinois at Urbana-Champaign, where he pursues a doctorate in Bioengineering developing a portable, low-cost, point-of-care device for HIV/AIDS diagnosis in resource-limited settings. Greg has been a leader with Interfaith in Action, the University of Illinois’ premier student interfaith organization, since early 2007.  Greg also co-directs Faith Line Protestants, a blog dedicated to encouraging Evangelical Christians toward relationships with people of other worldviews and faith traditions through social action.

Image: Russell Shively/Shutterstock

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