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Protecting the Vulnerable and Fighting For Evidence-Based Health Care Reform


In March 2019, the Trump administration revived the Republican assault on the Affordable Care Act (ACA), reiterating its desire to repeal the law in its entirety. Once again, we future doctors find ourselves at odds with our elected officials.

Two years ago, we stood alongside fellow medical students in defense of the ACA. In Manhattan, sprawled on a sidewalk in our white coats, we staged a die-in to protest its attempted repeal. In Chicago, along with hundreds of our peers and faculty, we placed our white coats on the ground and promised not to “pull the rug” out from under our vulnerable patients. In Denver, we protested at the state capitol, urging our representatives in Congress to defend the ACA. Over twenty medical student demonstrations took place across the country to support this law that has dramatically reduced the number of uninsured Americans and improved our patients’ access to healthcare.

These protests were not anomalies. Recently, in the most comprehensive study of future doctors’ opinions of the ACA since the 2016 election, nine in ten medical students supported the law. We are in agreement on this issue. Our politicians ought to step in line.

Republican repeal efforts are against the wishes of us future physicians. They are against the wishes of angry citizens concerned for their loved ones at town hall meetings. They are surely against the wishes of the 19.3 million people who gained coverage under the ACA. Still, under the pretext of reducing costs, Republicans have endeavored to rob Americans of the health insurance expansions provided by the ACA.

They approach this mission zealously. After over seventy failed attempts at repeal, Republicans were gleeful in the final days of 2018 when a Texas judge struck down the Affordable Care Act as “unconstitutional” in its entirety. Just weeks ago, the Trump Administration affirmed this ruling in a two sentence letter to the 5th Circuit Court. So much for protecting Americans with pre-existing conditions. Although the Senate Majority Leader flatly refused to entertain President’s Trump’s early-April call for another “repeal and replace” effort prior to the 2020 elections, the Administration’s recently approved request to expedite oral arguments on the legality of the ACA should put Americans on guard—this campaign is certainly not over.

We know that our health care system is imperfect. Calls for containing costs are not unfounded. The United States spends substantially more on healthcare per capita than any other modern democracy. Despite this fact, we stand alone amongst our peers in failing to provide health care access to all. Republicans would curtail expenditures by further decreasing access, as they proposed in 2017 with the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA). As future doctors who would bear witness to the human costs of such legislation, this bargain is unacceptable. People should not die simply because they cannot afford care.

Fortunately, research does not support the need for such a trade-off. Study after study has shown that we could expand access, improve coverage, and curb costs with reforms such as an improved Medicare-for-All, single payer healthcare system. Hence, future health care reform must carry on the spirit of the ACA and focus on securing comprehensive coverage for the nearly 28 million still uninsured. Such reform must be affordable and actually protect us from bankrupting medical bills.

Republican policy proposals continue to neglect such priorities, even as they attempt to brand themselves – in the words of their standard-bearer – as the “Party of Healthcare!”. Rather, repeal efforts past and present reveal that party and rhetoric take precedence over data-driven solutions and American lives.

In response, we current and future healthcare providers will continue to protect our patients: we will protest against crusades to dismantle the ACA and advocate for the universal coverage and additional reforms that are so desperately needed in this country.

We will uphold this commitment. Nearly unanimously, medical students agree that we have duties beyond the clinics and operating rooms. We have a professional responsibility to address the policies that impact healthcare coverage and those inequities that land patients in our care in the first place. We will advocate for evidence-based reforms of our health care system, just as we prescribe evidence-based treatments for our patients. We will defend the gains made under the ACA and fervently call for the reforms still needed. We implore lawmakers – charged with the health of the public as we are – to heed our voice.

Alec Feuerbach, Jake Fox, and Jordan Rook, are Colorado Springs natives and 4th year medical students in New York City, Denver, and Chicago. They are co-authors of the study recently published in Academic Medicine, “Looking to the Future: Medical Students’ Views on Healthcare Reform and Professional Responsibility”. The opinions expressed in this essay are their own and not necessarily representative of those of their institutions or other co-authors of the referenced publication. They have no conflicts of interest to report.

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