Reason # 91: Medical Care
Why do we need to defeat Donald Trump and ensure that a Democrat occupies the White House?
Medical care in the Unites States is very advanced but it is also very complicated to access and very, very expensive. As a consequence, access to affordable medical insurance may not just represent a life-or-death dilemma but also be the precipitating event in family bankruptcy.
I spent most of my adult life treating patients with lung cancer and other cancers of the chest; I know what happens to people with lung cancer and no health insurance. First, since they haven’t been screened, when they do get cancer, it is typically in advanced stage where the chance of cure is not good. Second, they have a hard time getting the tests needed to diagnose and stage their cancer. They have no other option but to go to a free clinic, where the beleaguered doctor has to beg, borrow and steal to try to get someone to perform a free CT scan or blood tests. In Los Angeles, where I worked, the charity hospital has a university affiliation and the underserved who go there get good care from residents and interns. If the poor are in rural districts in red states, fat chance of quality care. The bottom line is that the uninsured with cancer die at much higher levels compared with those with a medical insurance policy.
I have also seen what happens to folks who are forced to pay for some or all of the care needed by uninsured parents, children, relatives or friends. The bills can be catastrophic, wiping out a lifetime of savings within a few weeks. Medical bills are one of the most common causes of bankruptcy.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366487/
In 2010, more than 20% of Americans i.e. an astonishing 46 million people faced this dire prospect. Was this “America the great”? Do we really want to go back there again?
Who were they? They were the elderly, the unemployed, those working for a minimum wage from employers (approximately 25%) who didn’t care enough to give up some profit by paying for health insurance, those with preexisting conditions, like diabetes or cancer, the urban poor, drug addicts, those with mental illness, street people – the wretched of the earth. Oh, and did I omit to mention that racial minorities were and still are disproportionately uninsured?
Let’s just look at one example. Meet Beverly, from Appalachian Ohio. Her husband abandoned her and their two children when she was in her early twenties. She began a long downhill slide into drug abuse and addiction and was arrested. She ultimately was married to five dysfunctional husbands and often lived on public assistance. She had no health insurance.
Clearly, a decent society needed to take action. Barack Obama and Joe Biden stepped up by supporting the Affordable Care Act, mocked by Republicans as “Obamacare”.
According to the Department of Health and Human Services HHS
“The law has 3 primary goals:
• Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL).
• Expand the Medicaid program to cover all adults with income below 138% of the FPL. Not all states have expanded their Medicaid programs.
• Support innovative medical care delivery methods designed to lower the costs of health care generally.”
https://www.hhs.gov/healthcare/about-the-aca/index.html
If you are of a mind to read the full text of the entire bill, go to the link below.
https://housedocs.house.gov/energycommerce/ppacacon.pdf
What was the role of the states? They were empowered to set up “state-based health insurance exchanges. You can guess what happened in red states. By 2014, 26 states declined outright to participate and seven negotiated.
Ultimately, due to backlash from Republican states and the Supreme Court, the beneficial effects of ACA have been substantially forestalled or even cut back.
https://journalofethics.ama-assn.org/article/state-implementation-affordable-care-act/2013-07
Congress voted to enact the Affordable Care Act and President Obama signed it. By 2016, the uninsured had fallen to 10%, 26 million Americans! More than 20,000,000 Americans now had new medical coverage.
When Trump took office in 2017 and began to attack the ACA, the number of uninsured swelled back up to more than 33 million in 2019. Is this what “Make America Great Again” means?
When Biden and Harris took office in 2021, the number of uninsured Americans began to drop again. A CDC report showed that the number uninsured had dropped to 7.6% (25 million) in 2023, down from 33 million in 2019 during the Trump years.
It would take a modern Charles Dickens to portray the misery of the uninsured during the COVID pandemic. They couldn’t even get tested (while Trump was giving away precious testing machines to his friend in the Kremlin).
Why are so many people still uninsured? Here is a partial answer from KFF.
“Despite policy efforts to improve the affordability of coverage, many uninsured people cite the high cost of insurance as the main reason they lack coverage. In 2022, 64% of uninsured nonelderly adults said that they were uninsured because the cost of coverage was too high. Many uninsured people do not have access to coverage through a job, and some people, particularly poor adults in states that did not expand Medicaid, remain ineligible for financial assistance for coverage. Additionally, undocumented immigrants are ineligible for federally funded coverage, including Medicaid or Marketplace coverage.”
https://www.thebalancemoney.com/what-is-the-obamacare-timeline-3305756
The uninsured do not just suffer and die. Because they lack preventive and routine care, they typically show up at hospitals with advanced disease, often in critical condition and require prolonged, complex and expensive care. The losses are reflected in the cost of your health insurance. This is penny-wise; dollar-foolish.
Let’s conclude by looking back at what happened to Beverly, remember her, the uninsured woman from Appalachian Ohio. She got her act together, got off drugs and obtained health insurance via ACA in 2018. But you ask, Ohio, that’s a red state? True but although these states have repeatedly placed roadblocks to ACA, their citizens are smart enough to understand the personal benefits of ACA assistance in their lives.
OK, but 2018 was during the Trump administration. Is this an example of how “Donald Trump saved the Affordable care act”? What? Donald agrees. “I saved it.” His running mate J.D. Vance told the same lie. If we didn’t already know that Donald Trump was a pathological liar, and if the stakes were not so high, this might be laughable. What is the truth?
Trump did everything in his power to overturn ACA; he clawed back funding. His administration asked the Supreme Court to rule it unconstitutional. He urged Congress to repeal the ACA. I know that short time memory deficits are a sad component of the human condition for us all, but how it possible that American voters have forgotten the historic and dramatic moment, when Republican Senator, John McCain broke the tie with his “thumb down” vote to save ACA from destruction by Donald Trump?
So, if you hate Democrats, but value your personal health and, even if you have no pity for the underserved with no health coverage, your self-interest should tell you that it is foolish to vote for Donald Trump.
Tomorrow we will consider tax cuts and tariffs.
Oh, I almost forgot to mention that Beverly’s last name is Vance. She is J.D. Vance’s mother. Go figure. Mom, watch out that sonny-boy doesn’t take away your healthcare.
https://www.washingtonpost.com/health/2024/10/12/jd-vance-mother-health-insurance-obamacare-aca/
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To date, I have written 91 Reasons NOT to vote for Donald Trump . They are archived at my Facebook page
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Fred Grannis
October 14, 2024