Medicare-for-All Hearing: Doctor Says It's 'Impossible' to Care for Patients Afraid of 'Bankruptcy'

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A member of the audience holds up a placard as US Senator Bernie Sanders, Independent from Vermont, discusses Medicare for All legislation on Capitol Hill in Washington, DC, on September 13, 2017. The first congressional hearing on Medicare for All took place on April 30. JIM WATSON/AFP/Getty Images

Congress' first hearing on "Medicare for All" included confronting testimony from a New York doctor about making health care recommendations when "the patient is afraid of bankruptcy."

Senator Bernie Sanders popularized Medicare for All during his 2016 presidential campaign, and his bill has since gained widespread appeal in the Democratic Party. It has been supported by 2020 Democratic candidates Senator Kamala Harris, Senator Elizabeth Warren, Senator Cory Booker and Senator Kirsten Gillibrand. But Tuesday's hearing was called after a different Medicare-for-All bill was introduced by Representative Pramila Jayapal two months ago, and as health care returns to headlines before next year's presidential election.

During the hearing, Farzon Nahvi, an emergency physician at NYU Langone, said what attracted him to his job is that he "can help any person with any problem at any time."

"But over the years I've learnt that it becomes impossible to care for someone when our medical system forces them to fear things like bankruptcy and foreclosure when they come to decide to seek medical care," Nahvi said, adding that people often walk out of the hospital because of financial concerns.

"The reality for many people in this country is that seeking medical care means weighing one's health against one's wallet," he said.

Earlier this month, Gallup and the nonprofit West Health released the results of a 3,500-person survey which found 41 percent of Americans skipped an emergency room visit in the last year because of concerns about costs.

Nahvi shared several cases of patients deferring medical treatment because of high costs, only to require even more expensive care.

One patient had an easily treatable urinary tract infection and a routine prescription for antibiotics, but her insurer wouldn't pay. Unable to afford the drugs, within two days this patient ended up septic which cost thousands of dollars. Another patient had a "simple fever" and felt like she couldn't afford an emergency room visit so self-medicated by buying fish antibiotics, which she overdosed on. The antibiotics had affected her brain and central nervous system, causing her to fall down a staircase and be admitted to intensive care.

"All of that because she felt like she couldn't afford a simple visit to the ER for a simple fever," he said. "I never want to see another patient who thinks their best option for medical store is to go to to the local pet store."

The New York doctor urged lawmakers to consider health care "like any other public good" such as education and infrastructure, which are funded by the government.

The hearing was also attended by health care activist and lawyer Ady Barkan, who has the neurogenerative disease ALS, and spoke using a computer system that tracks his eye movements, converting text into speech. Despite having health coverage, Barkan said his insurer said his ventilator and medicine were not necessary and only recanted after he spoke out publicly, and later held a rally at their offices.

But if Barkan doesn't want to move to a nursing home, he and his family still need to pay $9,000 a month for home care.

"So we are cobbling together the money, from friends and family and supporters all over the country. But this is an absurd way to run a healthcare system, " he said. "GoFundMe is a terrible substitute for smart Congressional action."

For Nahvi the current system also places a burden on physicians, saying that the feeling of watching a sick person walk out hospital doors is "just as awful a feeling" as telling a loved one their family member has died.

"Even if I convince them [to get treatment], I don't feel terribly good about myself," he said. "Did I just sentence them to years of debt they can't afford?"