The News Herald (Willoughby, OH)

Trump pledge is facing a reality check

- By Ricardo Alonso-Zaldivar

President Donald Trump has often said he doesn’t want people “dying in the streets” for lack of health care.

WASHINGTON » President Donald Trump has often said he doesn’t want people “dying in the streets” for lack of health care.

But in the United States, where chronic conditions are the major diseases, people decline slowly. Preventive care and routine screening can make a big difference for those at risk for things such as heart problems and cancer, especially over time.

That edge is what doctors and patients fear will be compromise­d if Republican efforts to repeal the Obama-era health law lead to more uninsured people. The uninsured tend to postpone care until problems break through.

It’s a message that lawmakers are hearing from doctors’ groups and constituen­ts, in letters and emails, and at town hall meetings.

About 10 years ago, Cathy Cooper of Ocala, Florida, was battling a blood cancer. Against doctor’s advice, she continued to work full time as a paralegal, through chemothera­py and radiation, just to preserve her health insurance. Cooper said she would schedule chemo on Fridays, spend the weekend sick from side effects and report back to work Monday.

Now in her early 30s, Cooper is healthy. She has her own business as a photograph­er specializi­ng in maternity, newborns, families and seniors, and a family of her own. Her health insurance is through HealthCare.gov. With her cancer history, Cooper is worried about changes under debate that may reduce options for people with medical conditions. She said she voted for Hillary Clinton in the presidenti­al election.

“The ‘dying in the streets’ thing — it’s an over-time process,” said Cooper. “If I didn’t have insurance, it (cancer) could just keep forming inside me and I wouldn’t know. Then I’d go into the hospital, and there’s nothing they could do. And then, yeah, I could die in the street. But that’s because I wouldn’t have had insurance to get things checked out prior to that point.”

In Charlotte, North Carolina, Dr. Octavia Cannon said that’s basically what happened to one of her patients several years ago. The patient, a working mother with three young children and more than one job, was uninsured after losing previous Medicaid coverage. She went to Cannon, an osteopathi­c ob-gyn, because of abnormal bleeding. Cannon said she knew something was horribly wrong on the basis of her initial physical examinatio­n. The pathology lab confirmed advanced cervical cancer.

“In six months, she was dead,” Cannon recalled. “All I could think was ‘Who is going to take care of these babies?’ If she had only come in for a Pap smear.”

Such stories are swirling around the Senate debate as Majority Leader Mitch McConnell, R-Ky., pushes toward a vote on legislatio­n rolling back much of former President Barack Obama’s Affordable Care Act. The GOP bill has been facing headwinds since the Congressio­nal Budget Office estimated it would lead to 22 million more uninsured people by 2026.

Administra­tion officials say the nonpartisa­n budget office has been wrong before about health coverage, and its analytical methods may give too much weight to the current requiremen­t that most people carry health insurance or risk fines. (Republican­s would repeal that immediatel­y.) Health and Human Services Secretary Tom Price said Trump’s goal is more people with health insurance, not fewer.

“Nobody is looking at it in its totality,” Price said recently on NBC. “We will bring down premiums, we will increase coverage, we’ll increase choices. And I believe we’ll increase the quality of care provided in this nation.”

There’s not much debate about the negative consequenc­es of being uninsured.

Studies by the National Academies have found that the uninsured are more likely to receive too little care, and too late; be sicker and die sooner; and receive poorer care in the hospital.

 ?? JOHN RAOUX — THE ASSOCIATED PRESS ?? In this photo taken Cathy Cooper leaves her photo studio in Ocala, Fla. Cooper, a cancer survivor, is concerned that if the GOP health bill goes through, she may not have access to the kind of health insurance she needs to make sure she stays cancer...
JOHN RAOUX — THE ASSOCIATED PRESS In this photo taken Cathy Cooper leaves her photo studio in Ocala, Fla. Cooper, a cancer survivor, is concerned that if the GOP health bill goes through, she may not have access to the kind of health insurance she needs to make sure she stays cancer...

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