A Doctor’s Take on Obamacare: Are Patients Really Ready for This?

I’m a physician, and I, like many others in my profession, are keenly watching the rolling-out of Obamacare. I understand the mixed emotion around the program, as the pros and cons have been debated widely by citizens, healthcare stakeholders, insurers and employers. As a primary-care provider who has worked with uninsured patients, I am thrilled to know that patients may have an opportunity to seek the care they need, without the worries of not being covered. As a Canadian primary care physician, I’m pleased to see the U.S. move toward a more equitable approach to meet the healthcare needs of the greater good.

The other day, however, I was confronted with an issue—one very basic to the healthcare debate itself—that I think needs to be addressed. A woman—not my patient, but someone conversing with some people I was with at the time—was complaining about not being able to afford an MRI and other tests she needed, because she was part-time at her job and not eligible for benefits. She complained of aches and pains, of joint stiffness and other ailments, and of the costs of seeing a doctor and the lines at the free clinics in Philadelphia. Someone I was with joked that she should move to Canada to get “free health care.” I didn’t comment, as I have spent much of my career here in the U.S. explaining how Canada’s healthcare system, albeit universal, is extremely costly and relies on the heavy taxes of Canadian citizens—so it’s not “free” at all.

But the woman, realizing I was from Canada, turned to me and said she had just taken a cruise in Alaska that stopped in Canada, and she thought it was a beautiful country. After she left, someone in the group said, “Did she just say she went on a cruise?” Of course, it’s not fair to judge, as we don’t know all the facts, but I found myself shaking my head. Here’s why: Physicians need to understand that patients may not align their healthcare priorities in a way that we would hope or like. Spending money on things like vacations, expensive data plans and fancy cell phones are a personal choice—but those things are a luxury, in my opinion, especially when one’s health needs to be addressed. This woman could have a systemic illness and may be in need of screening which could ultimately save her life, but instead appears to be choosing to spend her money on other things.

Although the healthcare system is looking to fix the issues around rising costs and increased privatization, if patients are not valuing their health now, what’s to say that when we pour money into Obamacare, patients will value their health then? We take an oath as physicians to do no harm, but we cannot prevent the economic harm patients are causing themselves when they decide that the costs of their health is less important than taking a vacation. So maybe it’s not just the current system that needs fixing. Maybe the values of the population need to be examined before we celebrate or mourn the rolling out of Obamacare.


Bindu Kumar, M.D., is a Philadelphia-area physician with expertise in primary care and occupational medicine. She maintains her family medicine board certification in both the United States and Canada.

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