Americans Never Really Wanted A Fairer Health Care System, And They're Not Going To Get One Anytime Soon
A recent New York Times article laments the "halfhearted opposition" to the pending passage of the American Health Care Act (AHCA, aka Trumpcare) by powerful groups such as doctors, nurses, hospitals and patient advocates. Health policy experts condemn the "fast-tracking" of the ACHA in the Senate. And the Jeff Sessions' hearings and other Russia collusion noise, crowd out national reporting on the AHCA as the Senate is weeks away from passing their health care reform bill.
The AHCA passed by Congress and currently undergoing revisions in the Senate, rewards the healthy and wealthy and punishes the sick and poor. Some people are appalled and baffled by the impending passage of legislation that brings more inequality into an already unequal system. Isn't it more sensible to provide the most financial assistance to people that need the most health care? Well this is America, where a near majority believes it's okay that the rich can afford better health care than the poor.
The Poor Cost Too Much
Many people think the sick are responsible for their illness(es) due to their engagement in "voluntary health risks" or "changeable behaviors." Never heard these terms before? Me neither. I guess using the term unhealthy lifestyle didn't sufficiently make the point that sickness is a choice, and an expensive one at that.
By some estimates an unhealthy lifestyle cost hundreds of billions of dollars each year in medical care. A recent study contracted by General Electric estimated the cost of cancer care due to an unhealthy lifestyle at around $34 billion per year. Other studies put the annual costs of treating alcohol abuse at an estimated $176 billion, smoking at $137 billion and obesity at $147 billion (2008 number for obesity). These issues—cancer, alcohol abuse, smoking and obesity—costs nearly a half trillion dollars in health care each year.
But cost concerns are not what allow the Republican Congress and Senate to easily take away health insurance from the sick and poor. The truth is that despite the passionate town halls, we don't want the poor to live as long as the wealthy. We would save money if they did not. According to the Congressional Budget Office (CBO) score of the AHCA, that savings is about $3 billion, to start (represents reduction in Social Security payments due to early deaths).
And besides, the wealthy engage in the same unhealthy behaviors but we don't chastise them for doing so. In fact, we continue to build our health care system around their needs and desires. We even subsidize their health care expenses at a higher rate than we do the non-wealthy, with our employer-provided health care tax exclusion. And, who drags out the health care and drug innovation argument to justify America's overpriced health care system. Rich people. So you have poor people subsidizing tax incentives for the wealthy and health care innovation that mostly benefits the wealthy, because the poor can't afford it.
And under the Republic-crafted AHCA, the poor will continue to suffer the condescension of the powerful and wealthy while having their pockets picked to improve the health and wealth of the very rich. And we're okay with that…
Get Ready For A "Crap" Show
America is in the midst of an opioid epidemic, has an intractable obesity problem, drug and alcohol problem, and gun violence problem. HIV/AIDS is still a major health issue in some communities and depression diagnoses increase every year. Treating the sick and the poor is expensive and no amount of moralizing about healthy behaviors will change that. Besides when you are just scrapping by that cake, cigarette or alcoholic beverage may temporarily relieve the stress of a difficult life, and stress is a serious health hazard too.
Our national goals should include limiting the stressors in the lives of the poor that sometimes lead them to make unhealthy choices. These stressors include, primarily, unaffordable and/or unsuitable housing, lack of access to healthy foods because of transportation or other issues, and low-paying jobs that don't provide a livable wage.
The alternative is that America remains shortsighted and cruel, and passes a health care bill that even Donald Trump reportedly calls "mean."
We can call the Senate health care reform plan secretive and wrong, it is, but we don't really care because if we did, we could stop it. We won't and things are going to get really bad, for the poor and wealthy.