By Jeanne M. Hoban

The Affordable Care Act was enacted in March 2010 to reform health care and make health insurance accessible and affordable to more Americans. Yet 14 years later, nearly 26 million Americans remain uninsured and nearly one-third of working age Americans have some form of medical debt.

In fall 2021, a group of students from the College of Medicine at Northeast Ohio Medical University decided to become part of the solution to this ongoing challenge. The students worked with faculty advisor Joseph Zarconi, M.D., to form a student organization focused on advocacy to make health care affordable for all.

During its first year, SNaHP – Students for a National Health Program – attracted 40 members, mostly students in the College of Medicine. Since then, NEOMED’s student chapter of Physicians for a National Health Program has grown to more than 160 members from across the Colleges of Medicine, Pharmacy and Graduate Studies.

“We work on educating, advocating and coalition building, with the goal to improve health care in all its forms and functions throughout our local community and the country,” said rising third-year medicine student Saaleha Shamsi, who served as SNaHP president for the 2023-2024 academic year.

The group has actively engaged in talking to legislators, writing op-ed articles for community newspapers, testifying before city councils in Akron and Kent, Ohio, and other advocacy activities. Much of their work has centered on affordability of care and the idea of single-payer health insurance.

“A national health program allows for universal coverage and can be affordably achieved even as benefits are expanded and cost sharing all but eliminated,” Shamsi contended. “Improving Medicare ensures that all medically necessary care is achieved without copays, deductibles or premiums or a need for supplemental insurance. This could be achieved and equitably funded through progressive taxation. This model includes everyone residing in the U.S.A. regardless of age, income, employment or immigration status and ensures that they are reliably covered for entire life.”

Many advocates from a multitude of organizations over many, many years have lobbied for Medicare for All or similar restructuring of the U.S. health insurance system. What possible difference can some medical students from Northeast Ohio make?

“You’re so right — there are so many groups that care about improving the way health care is managed in this country,” Shamsi agreed. “The biggest reason that SNaHP is different is our student involvement. SNaHP is the student branch of PNHP and this gives us the unique advantage of being mentored and coached by seasoned physicians, who are familiar with the system, while also allowing us a space for collaboration and a voice to enable change in whatever ways we can. It is so empowering to know that our advocacy efforts are supported by physicians across the country who are confident in our abilities but simultaneously ready to help at every step.”

The NEOMED SNaHP group has grown so successfully that it has become a hub for statewide activity.

“We’ve got one of the largest chapters in the country and have affectionately been referred to as the model chapter!” Shamsi shared. “We feel that our responsibility as such a prominent group has been to provide the resources and avenues to support other students across the state, regardless of the size of their home institution’s chapter.”

The group helped create a coalition with other medical schools across Ohio to form the Ohio chapter of SNaHP, which meets regularly to provide support, troubleshoot and discuss advocacy work that occurs throughout the state.

Medical debt relief

The group’s biggest achievement so far has been a Medical Debt Relief Project. SNaHP worked in partnership with the nonprofit organization RIP Medical Debt and Akron City Council to help relieve millions of dollars in medical debt for Akron residents.

In fall 2022, the group began discussions with members of city could and by March 2023, the students had organized a group of their peers and local physicians to attend city council meetings, provide public comment testimony, and publish an op-ed impelling the city’s mayor to act decisively on this issue.

After several weeks of negotiations, the city allocated $500,000 to a contract with RIP Medical Debt, enabling clearance of an estimated $50 million in medical debt for Akron residents.

“We’ve been able to build on this experience and further our relations with the council through other initiatives. In October 2023, students once again testified in front of Akron City Council regarding a resolution in support of Medicare for All. The resolution passed 12-0 with one abstention!” Shamsi enthused.

Other activities

On campus, NEOMED’s SNaHP student group hosts what Shamsi called “power lectures” on topics related to single-payer health care and other issues.

The group also was invited to develop a lecture on advocacy as part of the Patient, Physician and Community courses for second-year medicine students.

“We’re super excited to be considered by our professors as knowledgeable and personable enough to introduce our peers to the complex topics we’re passionate about,” Shamsi said.

She added, “We’ve been incredibly fortunate to have very supportive mentors, both, at NEOMED and at Akron City council, and have faced very little pushback in most of the work we do.”

Beyond CV building

Shamsi has found working on advocacy efforts to be empowering as a student.

“Advocacy of any kind can be a transformative experience for students, providing them with skills and perspectives that extend well beyond academics,” she explained. “From my involvement with SNaHP [and other organizations], I’ve enjoyed so many personal benefits like networking opportunities, political awareness and leadership skills. But beyond that, and most importantly so, it helps me understand the importance of being informed about societal issues and taking action to bring about positive change, which is such a rewarding experience.”

She noted the value of the mentors and network that she has built through her involvement with SNaHP, as well as the opportunity to make a tangible impact on the community.

“We’ve taken an active role in our community, which means that, at least for the years you’re at NEOMED, we’re surrounded by the fruits of our labor and the hope that you’ll be inspired to continue your work beyond school,” she said. “We’ve got opportunities to do research nationally, and the opportunity to truly make your voices heard via testimony at local, state, and national hearings.”

Her passion for advocacy almost led Shamsi to law school instead of medical school.

“Medical school won, obviously, because I learned and saw that the scope of work we do as physicians is not limited to our patient encounters, or even the hospitals we practice in,” she shared. “I’m so excited to make a positive impact on each and every one of my future patients, and to continue to find ways to advocate for whole patient populations and their betterment as well. It’s always so cool to see physicians who excel at both advocacy and medicine, and I hope to join their ranks one day!”