In Case You Missed It: Guest Opinion: Medical providers write to Rep. Greg Walden

Guest Opinion: Medical providers write to Rep. Greg Walden

Sunday, Medford Tribune

Posted Mar 5, 2017 at 12:01 AM

Representative Walden:

We are writing to you as medical providers from Jackson County to express our strong concern about the possible repeal of the Affordable Care Act. Many of us have practiced medicine in the Rogue Valley for more than 10 years, and have seen first-hand the positive impact of increased insurance coverage for the residents of your district. From 2011 to 2014, following the passage of the ACA, Jackson County saw a surge in insurance coverage for its residents. In 2011, 27 percent of adults 18-64 were uninsured, a rate that dropped to 4 percent in 2014.

What has this increase in coverage meant in our daily medical practices? Over the past three years we have seen an influx of patients accessing preventative care (blood pressure checks, diabetes screening, etc.), mental health care and addictions treatment. Fewer people are foregoing important care. While in the short term this increases costs, in the long term it will improve the health of the population: controlling blood pressure and cholesterol prevents heart attacks — the science is clear. It is equally clear that the cost of prevention is far less than the cost of intervention.

Additionally, the ACA has allowed community health innovations on a scale we have not previously seen: health care navigators, wellness programs, “barrier buster” funds and several other programs. All of these were started because local CCOs felt empowered to pursue the Triple Aim (improving quality, improving health and lowering cost) because there was assurance of stable funding — stability allows risk-taking and innovation. What will happen to these innovations, which have only begun to show their promise, if funding stability is taken away? We fear they will disappear and we will return to a health care model we know was not meeting the needs of the population.

Another important ramification of repealing the ACA will be the impact on our local fight against the opiate epidemic. Representative Walden, this epidemic is having devastating impact in your district: In 2015 there were nine opiate addicted infants requiring NICU care at Rogue Regional Medical Center, in 2016 there were 30. Thirty infants requiring an average of 17 days in the NICU due to opiate withdrawal. This increase has prompted RRMC to recently form a task force around the issue, and it is only a small fraction of what we are seeing on a population level. What will happen if more young women lose health coverage and are not able to access contraception and addictions treatment? We know from national statistics that adults ages 19-35 are by far the most likely not to purchase health insurance, and this is precisely the demographic the mothers of these infants are in.

Regardless of the current political climate, we believe Americans fundamentally view health care as a right, not a privilege. This is codified in EMTALA: regardless of ability to pay, no hospital emergency room can turn away patients seeking care. As medical providers, we are bound to the code primum non nocere — first, do no harm. We ask that you, as our elected official, seriously consider whether your decisions can be held to this standard.


Justin Adams, M.D. family medicine; Patricia Andries, PMHNP psychiatry; Elizabeth Banowetz, M.D., family medicine; Cory Bergey, D.O., emergency medicine; Lori Braughton, FNP, family medicine; Linda Brouzes, CNM nurse midwife; Laurel Brown, PA-C, family medicine; Mimi Choate, M.D., family medicine; Victoria Cordy, M.D., family medicine; Julie Curl, FNP-C, family medicine; Mary Cutler, M.D., family medicine; Melissa Dever-Mount, PMHNP, psychiatry; Guadelupe Gabba, PMHNP, psychiatry; David Gilmour, M.D. family medicine; Linda Harris, M.D., OB-GYN; Lauri Hoagland, FNP, family medicine; Kerri Hecox, M.D., family medicine; Douglas Hecox, M.D., nephrology; Mary Hough, M.D., pediatrics; Matt Hough, M.D., pediatrics; Daniel Kahn, M.D., OB-GYN; Kelli LaFleur, FNP, family medicine; John Mahan, M.D., psychiatry; Lee Murdoch, M.D., pediatrics; William Palm, M.D., family medicine; Rachelle Roulier, PA-C, family medicine; Karen Sauer, M.D., family medicine; Dan Sengenberger, D.O., family medicine; Jim Shames, M.D. family medicine; Steve Wells, M.D., family medicine