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Roman 15 (Jesse; Jesse Roman received his MD from the University of Puerto Rico School of Medicine in 1983. After undergoing training in Internal Medicine at the San Juan VA Medical Center in Puerto Rico, he joined the Pulmonary & Critical Care Medicine Fellowship Program at Washington University School of Medicine in St. Louis. In 1991, Dr. Roman joined the faculty at Emory University in Atlanta as Assistant Professor of Medicine. He served as Pulmonary Section Chief at the Atlanta VA from 1994 to 2000, Associate Division Director from 1997 to 2001, and Professor of Medicine and Director of the Division of Pulmonary, Allergy & Critical Care Medicine at Emory University from 2002 to 2009. In 2007, Dr. Roman was named Associate Vice President and Director of the newly created Emory Center for Respiratory Health within the Woodruff Health Sciences Center at Emory. Dr. Roman has written extensively in the area of lung tissue remodeling and inflammation and the role of extracellular matrices in the control of cellular functions with over 120 original papers, book chapters, and review articles. His research has been continuously funded by federal (NIH, Department of Defense, Department of Veterans Affairs) and non-federal organizations, and his national reputation is evidenced by his permanent and ad hoc memberships in several VA (VA Career Scientists Program, VA Oncology Study Section) and National Institutes of Health study sections (AIDS and Related Research; Lung Injury, Repair and Remodeling (LIRR); NIH Director’s Pioneers Award). Dr. Roman has served on important committees of local and international professional organizations including Chair of the Program and Planning Committees of the RCMB Assembly of the American Thoracic Society. He served on the Scientific Advisory Council of the Pulmonary Fibrosis Foundation, as Past-President of the Georgia Thoracic Society, and as President of the Southern Society for Clinical Investigation. Dr. Roman is also a member of the Steering Committee of the NIH Idiopathic Pulmonary Fibrosis Clinical Research Network, “The Puerto Rico Healthcare Crisis,” Annals of the American Thoracic Society, Volume 12, Issue 12, https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201508-531PS) //pa-amad
Considering its implications, the impending Puerto Rico healthcare crisis should not be overlooked. To fix it, the Puerto Rico Healthcare Crisis Coalition suggests that Medical Advantage reimbursement rates will need to be restored by CMS; that federal funds will need to be provided for local health insurance to meet the Medicaid/Medicare match obligations; that the Health Insurance Tax (amounting to $200 million) on small businesses in the island to help pay for the ACA should be eliminated, considering the limited benefit to the population; and that the local health plan (Mi Salud) will need to be stabilized, which will require Congress to increase federal payments by 2017. Finally, the group stresses that Puerto Rico’s healthcare system is a patchwork of rules and suggests that the system be reengineered by CMS (17). Clearly, this is a complex problem, but one that needs tackling soon before it spirals out of control. Although politics, race, and economics may cloud the issue, let’s remember that the health of Americans is at stake. Bailey Ashford could never have predicted what would become of the healthcare system in Puerto Rico, but there is no doubt that if he were to live today, he would have galvanized physicians, healthcare advocates, foundations, industry, and federal and local government officials to find a solution to this problem to, as he put it, “salvage this man, this woman, this child for one hundred percent efficiency in the future.”