The House of Representatives recently voted to repeal the Affordable Care Act (ACA) and to substitute the American Health Care Act (AHCA) in its place. The statements from our members of Congress indicate that they have forgotten that the full name of the ACA is the Patient Protection and Affordable Care Act, and they have abandoned the protections that Americans have enjoyed these last six years. They seem to believe that health care is just an expensive luxury, and that the U.S. government should not meddle with luxuries.
Health care comprises a sixth of our workforce and a sixth of our economy, and is frustratingly complex (as a doctor, I should know). It is easy to think that this is only about money and who should pay the costs. However, having our government ensuring access to health care is akin to government’s appropriate role in protecting our inalienable rights of life, liberty and the pursuit of happiness.
Life: Access to health care by itself saves lives. A 2009 Johns Hopkins study of over 23 million child hospitalizations showed that a child who lacked insurance had a 60 percent increased risk of dying during a hospitalization. For adults, being uninsured increased their risks of dying by 40 percent, the same increased risk of death for a heavy smoker. A study from Massachusetts, before and after their 2006 health care reform, demonstrated one additional death for every 830 without health care coverage. Quite simply, being uninsured worsens one’s chances of survival.
Under the AHCA, 23 million of our citizens will lose access to health care. As a result, 28,000 additional Americans will die each year for lack of coverage. Is it right for our government to stand by and let this many Americans die from correctable medical conditions?
Liberty and happiness: Living in fear of the next illness, or carefully avoiding sports or ladders because the next accident could bankrupt you or your family, is not freedom. The guarantee to life and liberty is a mutual promise from every citizen to every citizen. We the people must have each other’s backs.
The Patient Protection and Affordable Care Act has had many detractors. Health care is very expensive, and the complexity of the delivery of care has meant that some have borne too much of the cost, or received too little of the care. Both the fairness and the protections of the ACA should be improved. But the AHCA does not do that. It makes things much worse by tearing the safety net of Medicaid and disenfranchising 23 million of our fellow citizens, while $600 billion is siphoned off from health care to allow Wall Street gamblers to keep more of their winnings. This is not the American way of doing things.
Health care helps every family, every business, every school, every individual perform at their best. The protection of every citizen requires investment from the entire community. Fragmenting care fragments our community.
Tragically the House of Representatives misunderstood what is at stake, and set a course that will hurt millions of Americans, and thus hurt us all. It is now up to the Senate to stop this, to invest in all of us. The health of our nation is a good investment that pays off in decreased absenteeism, decreased presenteeism, and a healthier, more productive workforce.
Do we choose to have more American children suffering? More adults dying? Do we really want a sicker, more frightened America? The Senate gets to choose. Sens. Orrin Hatch and Mike Lee are designing our nation's future commitment to health, a life-and-death decision for millions. Beg them to make the right choice.
William E. Cosgrove, MD, is a past president of the Utah Chapter of the American Academy of Pediatrics. He is vice chairman of the Utah Medicaid Medical Care Advisory Committee and a board member of the Salt Lake County Board of Health.