Guest writer

Memo to Trump

Don’t take away private option

Tuesday, Nov. 8, 2016, was a dramatic victory for Donald Trump, who went from the Republican nominee for president to our actual president-elect. It seems like a striking and dramatic mandate by the people for a fundamental change in the way politics is done in Washington, and for the sake of the country, I hope these fundamental changes are implemented in the way we all hope will improve the country.

But for all their rapid change, I ask this on the part of 330,000 Arkansans who benefited from health-care reform: President-elect Trump, please don't take away our private option.

As a physician in our community and resident of Arkansas from birth, I have seen firsthand how having access to health care through the Affordable Care Act (ACA, or "Obamacare") has changed our community for the better. My patients went from decades of coming to the ER to treat their heart attacks and strokes to being able to go to a primary-care doctor who could treat their chronic illnesses and prevent these life-threatening events.

These people have in turn been able to continue working, providing for their families, and generally contributing to our economy instead of draining it.

Yet I will be the first to acknowledge that paying for health care has come at a high cost. Whether it's due to taxpayer spending or increasing premiums or unchecked drug prices, we have all felt the squeeze in our pockets.

As Arkansans, we were the only state in the union to have adopted a hybrid version of the ACA, called the "private option," where rather than expanding traditional Medicaid, we used the government's money to allow our citizens to buy insurance off the exchange. The health-care marketplace in Arkansas has linked so many of our citizens with affordable plans, and we have managed to be one of the few states in the country to keep our premium costs down as a result. This has strategically allowed us to keep our people healthy while encouraging private enterprise.

Furthermore, the economic benefits of increasing health care in our communities are clear. Prior to 2014, a majority of Arkansas' hospitals were on the verge of bankruptcy due to seeing a high volume of uninsured patients and providing uncompensated care, whereas now our hospitals are growing and thriving due to increasing compensation, attracting more medical talent to the state, and increasing the number of jobs for Arkansans as these hospitals expand their services.

Our president-elect has stated he does not want to abandon all the points of the ACA, including keeping the ban on insurance companies dropping patients for having pre-existing conditions, and allowing children to remain on their parent's insurance until they are 26. This is an encouraging first step.

Furthermore, he stressed on the campaign trail a desire to curtail increasing prescription-drug prices, which would also be a boon to millions. Yet the individual mandate of requiring people to obtain health insurance is threatened by his administration, but unfortunately is essential to keeping the cost of premiums low as healthy people will obtain insurance to balance out our chronically ill.

This is reflected best in Arkansas, where we have cut the rate of our uninsured population by half since 2013 (27.5 percent to 15.6 percent) by also covering a significant percentage of our younger population, and our premiums have remained stable during that time due to a large percentage of our population remaining insured via the ACA.

If it is not clear already, the abrupt repeal of the ACA would have devastating consequences for those of us in Arkansas. Therefore, on behalf of all of my patients and fellow Arkansans, I plead with our new government to consider making policy changes and investing in policy research that enable the program to become more feasible long-term, including evaluating Arkansas' own innovative private option as a template for other states.

As a physician, I cannot support betraying those who need us most at this critical hour. And President-elect Trump, I hope you won't either.

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Nisha Viswanathan is a hospitalist physician in Batesville.

Editorial on 12/01/2016

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