Recently, a patient with end-stage kidney disease told me that his insurance company stopped covering one of his essential medications. It took me hours of phone calls to reinstate this lifesaving treatment. Another patient — frail and elderly — was on the verge of having to move to a nursing home. An intensive blitz to coordinate visiting nurse services, physical therapy, Meals on Wheels and home hospice allowed her to stay in her home.

Advocating for patients is as much a part of medical care as the medical care itself. Diagnosing the problem and prescribing the treatment helps only if the patient can actually get the care. So doctors and nurses spend much of their time fighting on patients’ behalf with hospitals, specialists and insurance companies.

Should that advocacy extend beyond the doctor’s office, when politics has palpable effects on patients’ health? If my patient with kidney disease loses his health insurance, it would be just as life-threatening as the loss of his medications. As his doctor, am I equally obliged to advocate politically to ensure that health insurance remains available?

Right now, the Senate is considering health care legislation that threatens the coverage of millions of Americans. The American Health Care Act, which the House passed in May, would slash Medicaid, raise rates, increase deductibles, cut subsidies and weaken patient protections. Losing insurance — or being priced out of the market — is tantamount to losing health care. For patients with cancer, heart disease or diabetes, disruptions in medical care are as grave a threat to health as blood clots, metastases and sepsis.