screen-shot-2017-01-12-at-7-03-21-amUnder the cloak of night, when dirty deeds are often done, the Senate started the small cancer that if left unchecked will grow and metastasize and kill Obamacare.

One by one these brave lawmakers, oblivious to what might happen to others without the sterling health insurance that their jobs provide, gutted Obamacare. They even voted against an amendment from Sen. Bob Casey to preserve the protection for preexisting conditions.

I have never been so glad to have the job that I do.

Twelve years ago it became clear we needed to move. I was working at the University of Colorado in academic medicine and my job was just fine. My son Oliver’s lungs were not. Born at 26 weeks he developed bronchoplumonary dysplasia. He also had the bad luck of having a serious congenital heart defect. The combination was very bad and so he started getting pneumonia after pneumonia after pneumonia eventually scarring one his his lung lobes very badly. His bad lung condition became worse. His scarred lung lobe became a garbage trap for bacteria and viruses. We all inhale bad stuff and our healthy lungs and airways cough that stuff out. When you have unhealthy airways and a pokey heart it is entirely another matter. When you are living one mile up and the air is thinner it is harder still. Each pneumonia required oxygen and prolonged hospitalizations and then home oxygen.

There was a lot of bad medical stuff going on with his brother Victor who has cerebral palsy and congenital thyroid dysfunction and retinopathy of prematurity and was also on home oxygen, but we were in the ABC mode of triaging home life: airway, breathing, circulation. Oliver’s ABCs were not doing well. We were giving him the best medical care, but what about more oxygen in his daily life? Could that help?

And so I became obsessed with living at sea level. I am (I think) the only person board certified in both OB/GYN and in pain medicine by the American Board of Pain Medicine and the American Board of Physical Medicine and Rehabilitation. I did a fellowship in infectious diseases. I’m an expert in pain, vulvar skin conditions, and vaginitis and there are not very many of us. I put out feelers and was fortunate enough to have a lot of interest and many offers.

The first thing I looked at wasn’t the salary or the people it was the health insurance. I had a shitty HMO at the University of Colorado. It was so legendarily poor that our own department of Psychiatry didn’t accept the faculty’s (i.e. their own) insurance! I maxed out my children’s annual home oxygen benefits in May. Imagine running out of your oxygen allotment, kind of makes everything else you run out of moot.

I turned down all private practice offers, despite protestations that they had great plans, because I knew what would happen. Oliver needed more surgery and had many hospitalizations ahead of him and who knew what Victor would need? A year or so into the job my children would have driven up the premiums and they would have found a way to let me go before becoming partner. A small company cannot bear the burden of the health care costs of one child like mine, never mind two. If I were let go before finding a suitable job there would be no way I could purchase health insurance for my children on the open market.

I had a few job offers with good health insurance. I know that makes me incredibly privileged. In the end I was able to choose the one that I felt would allow me to provide the best care to my patients, but I wouldn’t have even looked at it if it had not offered great insurance.

When I took my job my children were guaranteed health insurance until they were 18. When Obamacare passed I heaved a sign of relief for my kids, myself and for other parents because now we had a breather to the age of 26. Enough time to help them cultivate careers that will provide them with health insurance.

Let than sink in. I’m not career planning for my kids so they can be rich or explore their artistic talents or be inventors or to help build this great country, I’m trying to guide them in ways so they will always have health care. Last night the Senate took the first crucial step to making that harder and I am doing my best trying to not cry out of worry.


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  1. Im in Canada, but my daughter has type 1 diabetes and I can relate to your situation. I actually left a very good job in my field with amazing benefits so that I could be close to her school since she was going in to Kindergarten at the time. It was so scary but I was able to do massage therapy from my husbands commercial building on our land. I am very blessed because I have needed to go to her school numerous times to cover for the ed assistants that monitor her through the day. I am so very glad, but I am obsessed with saving all the money I can for her and I fear I put far to much pressure on her to have a career like yours so she will have good health coverage πŸ™‚ We do the very best we can as Moms, don’t we? Great read, thanks for posting!

  2. My new job as a trauma ed nurse is in a state run hospital. They won’t give me health insurance until 56 days into the job. Cobra costs 750 dollars a month. And I’m healthy. So I’m crossing my fingers and paying for my retin a out of pocket. For someone of your caliber and training and qualifications to have to worry about health insurance/cost of care- just because you aren’t Tom price-or Paltrow- or some other rich moron who pays 75 dollars for a jade rock to shove up their vagainas so they can better serve their hedge fund rich husbands…is so unfair. Doesn’t it make you want to run away to Canada? I wish my parents immigrated to Germany. Or Denmark. Le sigh. Which country is ranked happiest? Yea- I wanna go there. Btw I love you. Your writing is so funny and smart. I’m a fan!

  3. Thank you for writing this . These are scary times for all of us but I am hoping that the collective wisdom of the American people will get us thru. You are an amazing physician and you should know that you have helped numerous patients across the region with your expertise that otherwise had no hope . Keep up the good work and thank you for all you do

  4. Hi Jen

    Just read this:

    “Lawmakers may not have control over what happens to insurance markets in the aftermath of the bill, but consumers are unlikely to see major changes to their health insurance this year because contracts are already signed and regulations are already in place for this plan year. Major disturbances could begin as soon as early next year.”

    So you all have some breathing space for a little while.

  5. Canada’s gain would be our loss, but your story does leave me wondering if you considered returning to Canada where the health insurance issue would be moot. I know a lot of Americans who would love to be able to emigrate, and will envy you the opportunity to do so without the immigrant hassle!

  6. We are the only developed country in the WORLD that hasn’t resolved this issue. It should be our ultimate shame and scandal. I used to be a researcher at both Presbyterian Hospital in NYC and Albert Einstein in the Bronx. For 15 years I interacted daily with physicians who were fellows from other countries. They were all horrified at the state of our medical system and were stunned that we put up with for-profit insurance. Some of these people were not from wealthy nations, but they all felt that the way care was rationed should be a national disgrace.

  7. At work I have been exposed to a narrow range of opinions about the president elect’s dismantling of the ACA. I would love to share your post if that’s alright with you? I believe a lot of people think high income earners are immune/sheltered from the disastrous impact of repealing the ACA.

    Trump is attacking it because it was working, not perfect, but working, and improving. What he is doing is unfortunately consistent with his character.

  8. Hi Jen. Thank you for writing this. Stories like these definitely need to be shared & told. I’m glad to have found it linked in this Forbes article (congrats!)

    I remember Oliver and Victor from churc while we were trying to hard to have our own children. They were so personable and full of life I had no idea at the time they were ill – obviously a benefit of having had the healthcare they needed. Having had our own preemie twins since with their slightly older sister, a pre-existing condition myself & subsequent hospital acquired superbug which has recurred, I really appreciate you using your expertise, experience and platform to give this issue the personal voice it needs. Thanks and best to you & yours.

  9. Jen – you know I’m there with you. I’m ‘mature’ now – and my husband is getting there. We both have several chronic diseases — he’s been in the hospital (for 2-4 days each time, with 5 procedures and 2 surgeries) 6 times in the last 12 months. I *think* he may better — but who knows? Thank heavens I have great insurance……and retiring? No way. We would be beyond broke – as in living in our car – without the insurance that my job gives us.
    And now? I worry about him if I die first — all these preexisting conditions!!!

  10. And I cry with you. “Sustain access to live-giving treatment” shouldn’t be the primary driver of life choices. It is appalling and evil. Like you I have the privilege to find opportunities that will ensure my family gets the healthcare they need but millions aren’t so lucky. And it’s exactly these millions of people the GOP is betraying. I am heartbroken and disgusted.

  11. I feel so lucky to live in Australia which has universal health care. I have a pre-existing condition that manifested itself in my 20s – and would have found life impossible in the US. Would you consider immigrating to Australia? I’m sure many hospitals (like the one I work in) would love to have you! Summers can be sometimes brutal though.

  12. I guess they were lying when they said they would keep some of the most important components like this and allowing kids to maintain their hold on the parents health insurance while in university. I am not surprised that this is moving so fast but I am shocked. And I am politically stupid. How can they do all this before the 20th? My mind is boggled.

    1. The Republican House and Senate are doing this. Their final legislation only needs to be signed by Trump after he takes office. The Republicans control 2 of the 3 branches of the federal government and will soon control the Supreme Court also.
      β€œThe accumulation of all powers, Legislative, Executive and Judiciary, in the same hands, whether hereditary, self-appointed, or elective, may justly be pronounced the very definition of tyranny.” – James Madison

  13. I’m right there with you sister. On this and so many other issues. I have nightmares every night now.

    Thank you so much for your columns. It is such a relief to read someone who still believes in science.

  14. I AM crying. No one should suffer or die because money keeps them from receiving the right medical care.
    Michael Moore’s comment about Hillary Clinton traveling as First Lady, investigating the care people received in other countries sticks in my mind. Because we didn’t get universal healthcare back then, a million people have died unnecessarily.
    A million people.
    I can only wonder what we all lost by losing them. The potential of the young. The wisdom of the older.
    It all breaks my heart that we have such horrible people running our country.

  15. The GOP is a group of slimey fuckers. Guess all those voters who elected them will be happy to see their health insurance go away.

  16. You are an amazing Physcian, Woman and Mother. I greatly admire your dedication to all aspects of your life. Now that we all live in Trumpland if I were you I would seriously consider New Zealand. Christchurch is wonderful. They would love you and I think you would love them. Keep on living.

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