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The architecture and philosophical
underpinnings of the Better Care Reconciliation Act (BCRA), the proposed
replacement of the Affordable Care
Act, conflict with common sense and
our basic hardwiring for compassion.
On June 28, the Academy joined the
American Academy of Family Physicians, American Congress of Obstetricians and Gynecologists, American College of Physicians,
American Psychiatric Association and the American Osteopathic Association in visiting key senators and their
staff from both sides of the aisle to express our strongest
opposition to BCRA. We represented 560,000 physicians, about 60% of the practicing physicians in the U.S.,
as well as medical students.
Our organizations represent the nation’s frontline physicians who provide the over whelming majority of care to
our nation’s children, pregnant women, adults and elderly
for a full-range of physical, mental and behavioral health
conditions. Every day, we guide our patients through the
best and worst moments of their lives.
It takes more than two voices to make a choir. We were
not alone. We were accompanied by the largest choir of
our constituents who simultaneously were writing and
calling their representatives to voice our united opposition to the health care bill in its current form. Other
colleagues around the nation were publishing editorials.
It was reported that an academic medical institution in
the southwestern part of the country had a live session of
questions and answers during the daily morning report
between the residents and the staff of a prominent senator
who opposes this bill.
The house of medicine is a harmonious choir singing
the hymn of objections based on facts. If enacted, this
legislation would cause millions of people to lose their
health care coverage, including people with employ-
er-sponsored insurance. It would permanently undercut
the Medicaid program, negatively impacting health care
coverage and access to care for 37 million children of
low-income families and children with special health care
needs as well as pregnant women and seniors in nursing
homes. It would allow states to opt out of vital market
reforms and consumer protections such as essential health
benefits, prohibitions on annual and lifetime caps, and
meaningful protections for people with pre-existing con-
ditions. And, most troubling, it would financially punish
older, sicker, low-income adults – the very people who
need the security of health insurance the most.
In 1965, at the signing ceremony for the Medicare and
Medicaid programs, President Lyndon Johnson stated:
“Many men can draft many laws. But few have the pierc-
ing and humane eye which can see beyond the words to
the people that they touch. Few can see past the speeches
and the political battles to the doctor over there that is
tending the infirm, and to the hospital that is receiving
those in anguish, or feel in their heart painful wrath at the
injustice which denies the miracle of healing to the old
and to the poor… But it is just such men who illuminate
the life and the history of a nation.”
The bill that is being considered by the Senate fails to
meet this standard. Our health care system is not perfect,
and there are reforms that should be pursued, especially
those that reduce health care costs for individuals and
families. We should all recommit ourselves to pursuing
public policy that improves people’s lives or in the words
of President Johnson, policies that “see beyond the words
to the people that they touch.”
Our organizations stand ready to work with the Trump
administration, the U.S. Congress, governors and state
legislatures to identify and implement such policies. We
must abandon the bill that is before us. This bill is de-
void of compassion – one of the pillars in the practice of
medicine and implementation of public health.
A vote for the BCRA is a vote to knowingly and deliberately harm millions of people. We implore the Senate
to Do No Harm.
The discussion of the nation’s financing and implementation of health care is not theoretical or based on
ideology or economic philosophies. It touches the lives
of real people and if implemented as is, there will be a
measurable body count.
House of medicine a harmonious choir
singing hymn of objection to BCRA
Fernando Stein, M.D., FAAP
President, American Academy of Pediatrics
Top stories on Gateway,
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affects child’s body fat later, http://bit.
• CDC: 1 in 4 youth-rated movies shows
smoking, http://bit.ly/2v3k Y4Q
• Gunfire kills or injures more than
7,000 children per year, http://bit.
• Lead found in 20% of baby food samples, http://bit.ly/2tA1Dup
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