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Doctors On Effects Of Supreme Court Decision


This is TELL ME MORE from NPR News. I'm Michel Martin. We're continuing our conversation with a roundtable of doctors, checking in with them about their thoughts about the Affordable Care Act in the wake of the Supreme Court decision to uphold most of the provisions of the act.

With us, Dr. David Ellington, a family physician in Virginia; Dr. Lawrence Johnson, a pathologist practicing in Oklahoma; and Congresswoman Donna Christensen. She is a Democrat representing the U.S. Virgin Islands in Congress. She's also a board certified family physician.

Dr. David Ellington, you were raising questions, some sort of global issues about just the overall state of health care in this country. Could I get you to sort of tie a bow on your thought and just tell us, overall, as complicated as it is, in the end do you think that it will lead to better health outcomes in this country or...

DR. DAVID ELLINGTON: Absolutely, Michel. As I said, this is the first step of the long process, and what we need to do, as Americans, is we need to stop arguing about the need for universal insurance coverage and start working together to figure out what is the best model we can come up with.

Dr. Johnson had some excellent points and we need to take his points and the points of other people and meld them when they write the rules on this thing, which will be the real - where the real nitty-gritty happens, so that this works. We have to do this as a country for our citizens.

MARTIN: Dr. Johnson, your final thought?


MARTIN: What do you think?

JOHNSON: Well, in terms of optimism, I'm very optimistic because the issues have been raised and we've been ignoring them for years and decades, frankly, to our peril. What I'm concerned about is making a bad situation worse, and to the point that Dr. Ellington raised about our ranking in the health system, this is important in understanding statistics and how they can be misleading.

The WHO, which is a similar ranking system, ranks us 37 out of 191 in overall systems, but a quarter of that ranking is based upon life expectancy. The problem with using that ranking is our life expectancy is not as good as other Western nations. But when you factor out homicides and car accidents, our life expectancy is equal or greater than all other Western nations. And in terms of infant mortality, again, depending on how you rank them and what you use as your standard - and not all of the countries do use the same, and I'm concerned because people are not comparing apples to oranges - we do very well. So I don't want to make a bad system worse and I'm concerned about the government taking its hand in a situation where I don't think they always do the best job. And as an example I will give you this. If you want to send a package and get it somewhere reliably, you usually send it - some other company other than the U.S. postal system. I won't name other names, but most people prefer to use a private provider.

And I think relying on the U.S. government to do a better job is not necessarily the best solution. I give them full points and credit for raising the issues. I am just worried we're going to take this situation and make it far worse and hurt more people.

MARTIN: I appreciate that. I appreciate your thoughts about this, Dr. Johnson. And Congresswoman Donna Christensen, a final thought from you. At the end of the day, I know that you are a Democrat and you supported this initiative. I mean, I assume that you think will - it'll make things better, because you are a supporter of the law. Perhaps you could lead us in a different direction about what you're most concerned about in the near term as the law gets implemented.

REPRESENTATIVE DONNA CHRISTENSEN: I'm most pessimistic about the Medicaid - 17 million people living in this country would be covered, by our projections, by the Medicaid expansion, and so it is really critical that we do everything that we can to encourage the states to accept the Medicaid expansion and cover those 17 million people. That would be my biggest concern.

MARTIN: That's Congresswoman Donna Christensen. She is the delegate for the U.S. Virgin Islands serving in the U.S. Congress. She's also a family physician and was with us from the Virgin Islands. Dr. Lawrence Johnson is a pathologist who joined us from Tulsa, Oklahoma, and Dr. David Ellington was with us by phone from one of his offices in Lexington, Virginia.

I thank you all so much for speaking with us.


JOHNSON: Thank you for having us.

ELLINGTON: Thank you very much. Transcript provided by NPR, Copyright NPR.