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Thursday, October 19, 2017

Reprinted with permission from Alternet.

As Senate Majority Leader Mitch McConnell sweats to cut deals over his bill to dismantle federal healthcare safety nets, the latest polls are finding that the more people know about its details, the more they’re fearful of its impacts and will blame Republicans.

But when it comes to the nation’s overall health and our insurance-based system’s ability to address those needs, Americans should remember that the U.S. now lags far behind most wealthy nations. Should the Republican bill should it pass and become law, it will only make a bad health care status quo much worse.

McConnell’s bill will turn a nation with plenty of hardship into an even harsher place, as the ill effects of poverty become more visible as access to preventative and ongoing care will be reduced for tens of millions.

“There is no shortage of evidence showing that the Trumpcare bill recently stalled in the Senate is toxic and harmful,” wrote Stephanie Connolly, research director for Social Security Works. “It would cause 22 million Americans to lose their health care over the next decade. Medicaid protections for seniors and people with disabilities, including long-term care, would be threatened. Affordable coverage for individuals with pre-existing conditions—including cancer, Alzheimer’s disease, and even pregnancy—would no longer be guaranteed. Health care plans would no longer be required to cover essential services that can keep preventable conditions from becoming deadlier and costlier. And premiums for low- and middle-income seniors just under the Medicare eligibility age would rise dramatically.”

The downward spiral doesn’t stop there. The lack of access to care “would cause tens of thousands of unnecessary and preventable deaths each year,” she said, before returning to the politics of the moment by noting the healthcare status quo—Obamacare, Medicaid, Medicare, and other federal health safety nets—“has literally saved lives and kept costly conditions from bankrupting households.

That’s true as far as that goes. But the current baseline for the overall health of Americans and responsiveness of the current system is uneven at best. Anyone paying medical bills knows the system favors those who can afford premiums, co-pays and deductibles. Compared to other wealthy countries, the health of Americans is terrible, and our system is a bureaucratic mess and a money pit.

“Senators, the United States is a sick country,” writes Eduardo Porter for the New York Times’ Business Day. Compared to 16 other rich nations, we have “the second highest mortality from non-communicable conditions—like diabetes, heart disease or violence—and the fourth highest from infectious disease. In terms of infant and maternal mortality, Americans are the worst off… And early death is hardly surprising, since Americans lead a pretty sickly life. Teenagers and young adults report higher rates of obesity, chronic illness, sexually transmitted infections, mental illness and injuries than peer countries.”

Porter nails it when he states, “the United States’ higher tolerance of poverty undoubtedly contributes to higher rates of sickness and death.” Like many other health policy experts, he notes that Obamacare’s expansion of Medicaid for lower income households has cut death rates from “treatment for things like H.I.V., heart disease, cancer and infections.” Porter said he understands the GOP’s philosophical belief that health is a matter of personal responsibility, not the government’s job, but he notes that Americans are paying a steep societal price for their lousy personal health and expensive healthcare system.

“Yet there is a solid economic argument for protecting your fellow citizens’ access to health care that does not rely on arguments from empathy, charity or the like,” Porter writes. “A sickly, poorly insured population can be expensive.”

A profit-based healthcare system already is expensive, especially when compared to other wealthy nations. The federal government spends about 8.4 percent of the gross domestic product for health care for about half of the country (Obamacare, Medicare, Medicaid, etc.). In contrast, Great Britain spends 7.7 percent of GDP to cover almost all its citizens. Canada, Italy, Finland—all countries with a single-payer system—spend even less.

As Nicholas Kristof writes on the Times’ editorial page, Americans spend an average of $10,000 a year for health care, compared to $1,680 per person in Poland. He cites the CIA’s World Factbook to note the U.S. is 42nd in longevity and “we’ve had a smaller increase in life expectancy over 25 years than other industrialized countries have.”

Like Porter, he recites statistics about the dismal American status quo, to say nothing of the downward spiral where the Republicans want to take the country.

“Today American babies are one-third more likely to die in their first year of life than Polish children are (and twice as likely as Italian, Portuguese and Czech babies!),” Kristof writes. “Meanwhile, American women are four times as likely to die in pregnancy and childbirth as Polish women… If we had Italy’s child mortality rate, we would save 12,000 American babies’ lives each year—that’s 33 children’s lives saved every day.”

Kristof concludes by saying the only sane solution is for the U.S. to join the rest of the industrialized world and provide health coverage for all—“or else we ration care and people die.”

Rationing care and allowing people to die describes exactly what McConnell seemed set on doing late Thursday; he reportedly was willing to eliminate the healthcare bill’s tax cuts—a boon to the top 2 percent of income earners—and simply dismantle Obamacare and eviscerate Medicaid by cutting future appropriations by more than a third.

In other words, if the Senate majority leader gets his way, an already unhealthy country is going to become sicker, and an already costly system is going to become more expensive. And everything that is currently wrong with our system and making it harder for Americans to lead healthier lives will only get worse.

Steven Rosenfeld covers national political issues for AlterNet, including America’s democracy and voting rights. He is the author of several books on elections and the co-author of Who Controls Our Schools: How Billionaire-Sponsored Privatization Is Destroying Democracy and the Charter School Industry (AlterNet eBook, 2016).

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