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The Stakeholders: The Rhode Island medical student

Stanford Tran, a 26-year-old medical student, weighs in on Obamacare.

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 the Obamacare questionnaire to people all over the country--places where healthcare exchanges have been set up, those where they have not been set up, and also ones where the debate continues. Through it all we hope to understand one thing: How Obamacare is affecting the lives of Americans.

Stanford Tran is a 26-year-old in his third year of medical school at Brown University and a candidate for Congress in Rhode Island's First District. Rhode Island will be expanding Medicaid in 2014 and has set up its own health care exchange under the ACA.

Q: What were the biggest problems with our health care system before the ACA?

Stanford Tran: Rising health care cost. If health care weren't expensive, we wouldn't be having this discussion right now.

Q: In your experience, is the health care law adequately addressing those problems?

ST: Not at all. Requiring everyone to have health insurance is a good thing, but it doesn't address the issue of rising cost. The ACA passed because it gave a lot of concessions to Big Pharma and the insurance industry. They stand to profit from this, at people's expense. Medicare cannot negotiate with drug companies and must pay whatever they charge. On the other hand, the Department of Veterans Affairs can negotiate drug prices and pay about half of what Medicare pays. If Medicare could negotiate the same rates as the [Department of] Veterans Affairs, we would save $100 billion annually. Americans pay the most for prescription drugs because it is illegal to import cheaper drugs from Canada and Mexico. We won't be able to keep health care costs down until we can get the Big Pharma lobbyists out of Congress.

Q: In what ways has Obamacare affected you?

ST: As a student wrapping up with my medical training, I have taken care of patients on Medicare, Medicaid, private insurance, and Veterans in the VA Hospitals. I have seen how the ACA is beginning to affect procedural specialties like surgery and non-procedural specialties like internal medicine. I will be the first generation of doctors to practice in this new environment, the specifics of which are still yet to be determined.

Q: What is the one thing that people should understand about the ACA based on your experience?

ST: It's very complicated with many pieces. There's a good reason why most members of Congress who voted on this bill haven't even read it. The individual mandate is the most controversial piece but actually it is just one minor piece. Most people, in fact, won't even be affected by this because they will keep their current coverage through their employer.

Q: What are you most concerned or excited about ahead of the March 31 deadline?

ST: I am both concerned and excited about getting uninsured people covered. I have seen a surge of patients who recently got coverage through the expansion of Medicaid and is now seeing a doctor for the first time in years. I saw a diabetic the other day whose blood sugar is twice the normal value because he didn't have insurance and couldn't afford insulin. It will take a lot of hard work and many follow up visits to reverse the years of damage done to his body.