The stakeholders in the Obamacare rollout aren’t just in Washington, D.C. Across the United States, health care providers, small-business owners, patients, and others are all affected by the law. In a new msnbc series, we send an Obamacare questionnaire to people all over the country – places where health care exchanges have been set up, those where they have not been set up, and those where the debate continues. Through it all we hope to understand one thing: How Obamacare is affecting the lives of Americans.
Dr. Donna L. Hamilton is the vice president of communications for the Artemis Medical Society, a group dedicated to supporting women physicians of color. While African-Americans make up 13% of the U.S. population, only 1.9% of the nation's doctors are black women -- a number Artemis Medical Society hopes to change. Recently, clips showing three of the society's 2,500 members at their jobs were featured in the popular Disney Junior show Doc McStuffins.
Dr. Hamilton practices in Pennsylvania, where Republican Governor Tom Corbett has chosen not to expand Medicaid under the Affordable Care Act.
Q: What were the biggest problems with our health care system before the ACA?
DH: Much of the debate regarding health care reform addresses some of the obvious problems plaguing the health care system. In particular, much attention has been given to the lack of access to affordable, quality health care, the exorbitant cost associated with receiving health care, and disparities in receiving health care.
Three equally important issues, however, have not received as much attention: We have a health care system that focuses on treating illness rather than promoting health; we have a looming physician shortage stemming from an aging workforce along with a decrease in workplace satisfaction; and we have a lack of physician diversity.
Q: In your experience, is the health care law adequately addressing those problems?
DH: We are already seeing the numbers of uninsured patients decrease with the implementation of the Patient Protection and Affordable Care Act. In my experience, gaining access to health insurance combined with the ACA directed creation of Patient Centered Medical Homes will have a significantly positive effect on patients’ health. The medical literature also supports this.
In addition to making health insurance accessible to millions who previously could not obtain it, the ACA also has provisions making it easier for insured people to receive preventive care. It requires all insurance companies to provide preventive care, such as mammograms, wellness visits, and prenatal care, without charging a co-pay. It also has provisions expanding employers' ability to reward employees who meet health status goals by participating in a wellness program.
The ACA also has some provisions attempting to increase the number of health care professionals, particularly in the public health arena. This does not necessarily mean, however, it will increase diversity in the health care workforce. For decades, the medical literature has shown that physicians of color provide a disproportionate amount of medical care to traditionally underserved communities. Increasing diversity among physicians is essential for decreasing economic and racial health disparities, and for helping to improve the health and well-being of our entire nation.
Q: In what ways has Obamacare affected you?
DH: Professionally and personally, I’ve had a significant increase in questions asked and conversations about health insurance, pre-existing conditions, medical expenses, and wellness care. The overwhelming majority of these conversations arise because people are looking for the truth about the ACA and identify me and my peers as respected and trusted sources on this issue. In addition to seeking out my professional opinion about how ACA can help them and their loved ones live the healthy lives we’re all meant to live, they also personally trust me and value my opinion. This again points to the importance of physician diversity. We must understand that there is still a high level of distrust of the health care delivery system in our nation by communities who have been hurt and ignored by it. Physicians of color not only provide care to our patients, but we also serve as a trusted source of important information and education in our communities. We need to have an honest discussion about how the lack of physician diversity is a serious problem in our health care system.
Q: What is the one thing that people should understand about the ACA based on your experience?
DH: Everyone should understand that, though many people have politicized the ACA, it is a health issue not political issue. The law has not only made it easier for millions of people to receive health insurance, it also has improved the type of insurance that people will receive, including those who had insurance prior to the law. By requiring new rights and protections, like ending lifetime coverage limits and requiring free wellness care visits, even previously insured people can benefit from this law. These changes in the law are good for the health of all Americans and we should all be supportive of them.
Q: What are you most concerned or excited about ahead of the March 31st deadline?
DH: I’m most excited that millions of people who previously could not receive health care will now have access to it. As millions of Americans begin receiving necessary care, not only when they become ill but also when they want wellness care to stay healthy, I hope to see a decrease in health disparities.
I am concerned though that we are not doing enough to increase the number of, and diversity in, America’s physician workforce. African American women are only 2% of the physician workforce and we need to understand those numbers hurt the delivery of health care and raise health care costs. Physician diversity and cultural awareness must be addressed if we are truly going to provide quality health care for all Americans.