Affordable and Accessible Healthcare: "Why We Need A Physician in Congress"

Two weeks ago, the Supreme Court rendered a decision in support of the Affordable Care Act, but to secure reliably accessible, high quality healthcare for all citizens, the devil is in the details. Fortunately, St. Louis voters from U.S. House Missouri District 2 have the unique opportunity to shape the future of American healthcare this election season. How? Dr. Randy Jotte, a St. Louis native and Emergency Physician is running for the congressional seat on a bipartisan platform of constructive and pragmatic healthcare reform.

Dr. Jotte’s perspectives and ideas are a reflection of his lifetime commitment to vulnerable patients in the constant challenge that is emergency medicine (www.randyjotte.com). One needs to walk a mile in another’s shoes to understand the struggles and opportunities that define our problem-solving approach. Dr. Jotte’s healthcare expertise was earned on the front lines of medical care. 

On the other hand, Dr. Jotte’s competitors are political insiders who will need to rely upon second-hand accounts and anecdotal experiences to define their approach to solving the issues confronted by modern medicine. By comparison, Dr. Jotte is an ally who understands the problems afflicting healthcare and who has the experiential knowledge to begin solving those problems.

I am also an emergency physician. My training included four years of medical school, four years as a Navy physician, and six years of residency training. I was a medical student in the early 1990s when life-threatening illnesses were the daily norm in emergency medicine. Twenty years later times have changed, but not for the better. I see increasing numbers of patients (medical, surgical, and psychiatric) struggling to access the healthcare “system.” The average patients too often wait for weeks or months to have concerning symptoms evaluated and treated. 

Many patients turn to the ED as a last resort. The symptoms are often not traditional emergencies, but to the emotionally-exhausted patient or caregiver who has spent hours trying to schedule appointments within a reasonable timeframe (days or weeks rather than months), these non-emergencies cross the threshold into a personal emergency. The ED becomes the most feasible alternative and the result is an ever-increasing volume of patients in the modern ED, increasing the waiting room times for everybody including those with truly time-dependent emergencies like pneumonia or trauma.

Can our access to high-quality, timely healthcare truly be challenged?  The United States of America has the best (I define “best” as the highest likelihood to benefit from scientifically advanced methods, be treated with modern equipment and infrastructure, and be treated by those who were intellectually educated in renowned training programs) healthcare that the world has to offer – if our citizens can access it.  A short-list of problems that led the United States to this point:

• An insufficient supply of primary care physicians (General Pediatrics, General Internal Medicine, Family Medicine);
• Increasingly burdensome administrative reimbursement requirements for services rendered causing the cost of business to increase just to maintain a medical practice;
• Ever increasing, more expensive medical advances in the form of imaging equipment, diagnostic tests, and pharmaceutical treatments;
• Shrinking health insurance and medication coverage juxtaposed against rising co-pays and stagnant paychecks.

Voters will consider many important issues this election season, including job growth, national defense, and affordable high-quality education for our children.  Many economists believe that medical costs transcend all of these issues. Currently, healthcare expenditures exceed 16 percent of the U.S. gross domestic product which is the largest proportion committed to medical expenses in the world. This is by far the greatest per person cost of healthcare of any country in the world, including countries like Canada and the United Kingdom who offer universal coverage to all of their citizens. for the United States to remain competitive with the rest of the global business world, our healthcare expenditures must be commensurate with theirs. 

In addition, without realistic constraints on healthcare costs, federal spending will need to be sacrificed elsewhere, which will eventually compromise national security and education. 

Other candidates’ physician consultants help them understand the realities of modern medicine as they contemplate healthcare reform. Dr. Jotte has lived medicine for over 20 years.  His perspectives will be indispensable for Missouri constituents as Congress debates medical care.  This landmark debate will affect all of us. Our children’s future medical and financial viability depends upon this generation’s response to the current fiscal challenges. 

Dr. Jotte offers us an insider’s view with ideas based on experience, not conjecture.  Let’s use every resource that we have to answer these challenges.

—Submitted by Christopher Carpenter, MD, MS, FACEP, FAAEM, Emergency Physician