Advocacy in Action: Affordable Care Act Op-Ed

Ben Hoffman, MD, is professor of pediatrics at the OHSU School of Medicine and is medical director of the Tom Sargent Safety Center at OHSU Doernbecher Children’s Hospital.

20 million people—more than the populations of Florida or New York. 20 million people who are your neighbors, worship with you, go to school with your children, sit next to you at the cafe. 20 million people in the waiting room of your doctor or your dentist. 20 million people who stand to lose their health care if the Affordable Care Act (ACA) is repealed.

As physicians, we know these 20 million people. We care for them; we laugh and cry with them. We partner with them to ensure they are healthier than before we met. This, indeed, is exactly why we became physicians: to care for human beings, to promote health, and to alleviate suffering. Above all, we all pledged an oath to do no harm.

We care for these 20 million because the ACA finally allowed them to walk through our doors, providing a route into the health care system for many that was previously closed. We know that if these 20 million people lose this access, they are likely to become sicker and more likely to die. It is no coincidence that the word “care” is used to describe the role of physicians, nurses and other health care practitioners, in the lives of our patients. Those of us who provide that care have literally listened to the hearts—and more importantly—to the stories, of those 20 million. Every single day, we care with every fiber of our beings. We know how deeply these 20 million human beings care as well.

If the promise to repeal the ACA is realized, and these 20 million men, women and children lose their health insurance, we will be doing harm. Great harm.  Regardless of your politics, providing every one of these people with health insurance is good for them and for our country.

We do not pretend that the ACA is perfect; we have borne witness to the fact that it is, in fact, very imperfect. As a tremendously contentious issue with fervent disciples on both sides, we are familiar with the deeply felt arguments from both supporters and detractors.

What is often lost in the debate, however, is the voice of the 20 million, and the stark reality of their plight. As doctors, we know the value of looking into the eyes of our patients, listening to their stories, and building authentic partnerships to cure illness, alleviate pain, and preserve health. America cannot allow the health of her citizens to be used as a political football. As an ethical and moral issue, the lives of 20 million Americans cannot be sacrificed on the altar of partisanship. The United States remains the only major industrialized nation that treats health care as a commodity and not a basic human right. We debate budgets and ignore justice.

We choose to believe in the solidarity and resilience of Americans. We choose to believe that empathy can be apolitical. We choose to believe that Americans want to help one another, independent of politics.  We choose to believe that our policymakers want to look us in the eye and say that they will make sure that everyone has meaningful health coverage.  We choose to believe that our country and our lawmakers will not allow the 20 million to lose their health care coverage. We join five major professional organizations in calling for a compassionate approach that keeps the needs of Americans front and center.

This is not about Republicans or Democrats, about Trump or Obama. It is about 20 million real Americans with friends and loved ones who want to be healthy. We physicians cannot ignore them, for they are our patients. You will still see them everywhere, except in our waiting rooms; to us, they will become invisible.

We cannot allow this to happen, we cannot allow this harm to come to them.  Because we took an oath.

I represent the 48 Physician Advocacy Fellows of the Institute for Medicine as a profession who collectively launched the national 20 Million Lives Campaign at our annual meeting in January. Please join us at

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