As elections approach, major health care concerns remain unresolved

As Election Day approaches, clinicians are anticipating the impact the election results will have on health care. While the primary responsibility for healthcare delivery lies with clinical teams such as doctors, nurses, and pharmacists, the financial structure, policies, and regulations of this sector are primarily controlled by non-medical elected officials with no medical background. is controlled by.

Despite the risks, “physician voter turnout was nearly 20% lower than the general population, which is alarming given our unique role in influencing health care policy,” says Emergency Medicine. says Dr. Alistair Martin, a physician and CEO of Healthy Democracy.

Although some argue that health care and politics should be separated, health-related issues consistently appear on ballots. Therefore, clinicians expect many of their medical concerns to be addressed by the next elected official. “My biggest concern is that medical care doesn't seem to be among candidates' top priorities right now,” says Dr. Scott Weiner, an emergency medicine physician and health services researcher. . The lack of focus on health care this election cycle is alarming to clinicians who have witnessed numerous struggles in the health care system.

With these concerns in mind, here are the key health care issues that clinicians are urging elected officials to prioritize and address.

major medical issues

Equitable access to health care

A fundamental priority of any health system is ensuring access to quality care. “More than 7% of Americans are uninsured, and more than 100 million people face challenges accessing primary care,” said Dr. Regan Marsh, an emergency medicine physician and health equity researcher. says. Marsh wants to eliminate generational inequities in the health care system. “Black, Latino, and other communities of color face worse health outcomes in a variety of settings.”

Although the United States spends the most on health care compared to other wealthy countries, “its health impacts are among the worst,” Marsh added.

Expansion of children's health insurance

Similarly, a significant problem is the lack of universal health insurance for children. “This is partly due to health policy and economics,” says neonatologist and author Dr. Rachel Fleischman. According to research, Medicaid and the Children's Health Insurance Program provide coverage to more than half of all children in the United States. Fleischman added that the state agency was “again called upon to implement federal Medicaid” to ensure both the delivery of care and adequate coverage of services. She said that because of the large number of children receiving Medicaid and the disparity in remuneration for pediatric services compared to similar services for adults, children's hospital services are closing and doctors who become pediatricians are They warn that it is decreasing.

prior permission

Prior authorization is the process by which your doctor seeks approval from your insurance company for a specific drug, diagnosis, or procedure. Although the goal is to ensure responsible care, “the process is very burdensome,” said Dr. Steven Saltzbrenner, a psychiatrist who studies this area. For example, we often have to provide evidence of past failed trials of preferred alternatives, which may not be accessible. As a result, he feels clinicians may be reluctant to use new, more expensive drugs or change diagnoses to meet approval criteria. “This inefficient system hinders treatment and harms public health,” Salzbrenner said, calling on lawmakers to increase transparency in insurance prescribing and limit the influence of big pharmaceutical companies. There is.

Private equity reform in healthcare

Private equity investors spent more than $200 billion acquiring healthcare companies in 2021. Many believe this change will compromise quality of care and patient outcomes. The biggest fear is that hospitals will suddenly close due to failed investments, leaving marginalized people without access to treatment. For small business owners, selling their sole proprietorship to private equity may seem like the only solution to staying afloat. But critics feel the private equity-owned practices force clinicians to rush treatments and prioritize profits over the health of patients and employees. Dr. Marietta Angelotti points out that “increased speed leads to diagnostic errors, over-referrals to specialists, and over-treatment with antibiotics.” Private equity reform in healthcare faces challenges, with investors largely unregulated and unaccountable.

food access and nutrition

Many health problems are related to the food we consume. “Access to healthy, fresh food is essential to improving health outcomes, especially in marginalized communities that face significant barriers,” says Dr. One Dr. Fatima Cody Stanford explains. Her research has shown that targeted advertising of sugary drinks and processed foods to black and Hispanic youth is linked to higher rates of obesity and related diseases. She argues that limited access to nutritious foods and an abundance of fast food options are the result of structural racism and are exacerbating the problem. do. “To address these challenges, it is important to develop effective obesity policies that focus on reducing consumption of unhealthy foods and increasing access to affordable and healthy options.

women's health rights

“Studies show that states with abortion bans have higher maternal and infant mortality rates,” says Dr. Karen Tan, a board-certified gynecologist and women's health advocate. Tan is concerned that states with strict abortion bans are driving clinicians out of the region “in part due to fear of prosecution and physical safety.” She makes clear that these “maternity deserts” reduce access for all women, even for issues unrelated to pregnancy, such as pap smears and managing uterine fibroids and endometriosis. Who is elected president is critical, he added, because “the next president could appoint two Supreme Court justices who will decide reproductive health and other laws for generations.” .

LGBTQIA+ health rights

Leading health organizations such as the American Medical Association and the American Academy of Pediatrics advocate for more accessible care for LGBTQIA+ individuals. Dr. Alex S. Kuroglian, a psychiatrist and advocate for LGBTQIA+ people, believes the federal government has been successful in defending LGBTQIA+ health rights. But they find that some state governments are “violating the biomedical ethical principle of respect for autonomy.”

“More than half of state governments in the U.S. have proposed or promoted legislation that would restrict the health rights and freedoms of LGBTQIA+ people, particularly with regard to access for transgender and gender diverse individuals,” said Kuelorian. states. Political decisions regarding LGBTQIA+ rights must begin with an evidence-based discussion that includes the voices of doctors, patients, and relevant healthcare organizations.

gun safety policy

Dr. Cedric Dark, an emergency medicine physician and author, emphasizes the urgent need for effective gun safety measures to combat the gun violence epidemic. He called for “background checks on all firearm sales, a national security law to prevent minors from accessing firearms, raising the legal purchase age to 21, and law enforcement prohibiting domestic violence access.” It advocates for the removal of firearms from individuals upon orders and a ban on high-capacity ammunition magazines. and prohibits concealed carry without a state permit. ” Dirk, a doctor and gun owner, calls for political leadership that prioritizes safety and public health and makes these measures evidence-based.

Boarding to the emergency department

In emergency departments across the country, patients are designated as “borders.” This is the status of an inpatient who is physically placed in the emergency department for an extended stay. “Boarding can lead to delays in care, patient safety concerns, and negatively impact the experience for both patients and staff,” says Dr. Marcus Baymon, emergency medicine physician and medical director. Research shows that patients who stay in acute care hospitals for longer often face more discrimination, especially among historically marginalized groups, and report increased dissatisfaction with care. Baymon urged elected officials to “educate patients about capacity challenges, invest in health care workers, fund alternatives to hospitalization, expand virtual care options, and improve patient flow.” “We want to focus on encouraging hospitals to improve their

climate change and medicine

“Healthcare in the United States is responsible for 8.5% of total greenhouse gas emissions,” says Dr. Sheetal Khedkar Rao, a physician and climate and health expert. She shared that medical pollution occurs, for example, from single-use plastics and excessive surgical waste. There is a movement to reduce the impact through voluntary efforts with the Joint Commission and Centers for Medicaid and Medicare Services. However, “many in the health care industry are calling for immediate and concrete action, including mandatory industry-wide greenhouse gas reporting standards,” Rohr added.

Another way climate change is impacting health is through “extreme weather events such as heat, floods, and hurricanes,” Rao said. Natural disasters have revealed how climate change can impact supply changes in our sector.

“It is important for both candidates to consider directing preparedness resources in a more intentional way to avoid critical shortages during disasters. IV fluids are the latest example post-hurricane.”Massachusetts says Brian Hayes, a clinical pharmacist at General Hospital. He added that shortages of critical medicines, such as intravenous fluids, remain a large and persistent problem, exacerbated by the unexpected closure of production plants and distribution centers. “Several efforts have been made at the national level to encourage early reporting if companies anticipate shortages,” he added. However, challenges remain to be addressed both in the prevention and management of shortages.

burnout and exhaustion

As with any scenario where employees feel unheard, unsupported, and unable to deliver quality work, burnout and turnover increase. “Over the past five years, I have seen so many great physicians, often the most caring and dedicated physicians, leave clinical practice,” said Michelle P. Lin, an internist and researcher. says the doctor. While COVID-19 has caused some layoffs, she also feels that the pandemic has “revealed systemic causes of burnout and dissatisfaction that have yet to be addressed.” Her list of stressors that need to be addressed speaks to the many causes of increased administrative demands, declining reimbursements, labor shortages, and gender inequality.

“Communities with higher rates of civic engagement are healthier,” Martin said. Considering this connection, it is concerning that only 162 million Americans are registered to vote. Now is the time for physicians, patients, hospital administrators, private equity investors, and elected officials to vote and come together to create evidence-based solutions that benefit patients, the workforce, and the field.