Asian Americans Advancing Justice - LA

Building upon the legacy of the Asian Pacific American Legal Center

What It Means to Have Health Care For All

Friday, July 28th 2017

By Heng Lam Foong, Senior Policy Manager, Health Access Project, Advancing Justice-LA

Overnight, the Senate rejected Republican legislation to repeal and replace the ACA after a week of debate and unprecedented fast-track procedures that reduced transparency. While the Republicans’ attempts to repeal ACA are over for now, we cannot let our guards down. We came too close to stripping millions of Americans of health care and putting their lives in jeopardy.

In June, during my first week at Asian Americans Advancing Justice - Los Angeles, I learned about an elderly immigrant who had to undergo a craniectomy because of an aneurysm. A craniectomy[1] requires that a portion of the skull is removed but the skull bone is not replaced immediately, usually to allow for swelling to subside.

Senator John McCain had a blood clot surgically removed behind his left eye on July 14. The surgery, called a craniotomy[2], is like a craniectomy and involves partially removing bone from the patient’s skull to expose the brain. But, after the surgery is completed, the bone flap is replaced. Despite the fact that the Senator broke the tie last night, effectively destroying the repeal and replace efforts, he was privileged enough to have access to the gold standard of care and used this privilege to begin the process to deny over 20 million Americans access to the same care.

Unlike Senator John McCain, this patient was receiving her care at a county medical facility, paid for by California’s Medicaid Program,  Medi-Cal. Unlike Senator McCain, she had to wait for months to have her skull replaced. You see, restricted scope Medi-Cal considers a craniectomy as an emergency procedure but a cranioplasty isn’t. Medi-Cal might have saved her life but it has not been able to complete her care. Can you imagine going through life wearing a helmet to cover a hole in your skull?

Obamacare did not level the health playing field for everybody but it is a step in the right direction and has provided access to over 20 million Americans who were previously uninsured. However, our health care system is largely dominated by profit-driven managed care; it excludes 11 million men, women, and children who are deemed unauthorized to be in this country but are nevertheless residing, working and going to school -- like the elderly immigrant still fighting for her cranioplasty, like you and me -- and the list goes on.[3] But the Patient Protection and Affordable Care Act (ACA or Obamacare) provided a necessary foundation to improve access to health care and allocated much needed dollars to prevention. Obamacare requires that we all have skin in the game -- everyone chips in to buy insurance whether you need it or not. It assumes (correctly) that we all will need health care at some point in our lives, so you pay into a pool now to help cover care for someone who needs it and you can draw from it later when you need it. Simple, isn’t it?

Senator McCain broke the tie and he received a lot of praise and press for this vote, overshadowing the consistent courage shown by Republican Senators Susan Collins and Lisa Murkowski who have openly expressed opposition to any repeal bill without a proper replacement this entire week and Senator Mazie Hirono who, despite being diagnosed with stage 4 cancer, flew from Hawaii to vote to keep health care for Americans.

Health care should not be about party politics; it should be a right for every human being.


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