Nel's New Day

January 30, 2020

Health on Downward Slide under DDT

While many people fixate on the impeachment trial of Dictator Donald Trump (DDT), he is further destroying health care while causing illnesses. After polling shows that Democrats received higher approval for healthcare than Republicans, DDT attacked his HHS Secretary Alex Azar. Then he tweeted:

“I was the person who saved Pre-Existing Conditions in your Healthcare. I will always protect your Pre-Existing Conditions, the Dems will not!”

DDT fought to take healthcare protections for people in his repeal-and-replace proposals and in his support for a federal lawsuit that removes pre-existing protections in healthcare. When DDT couldn’t repeal the Affordable Care Act (ACA), he moved to take Medicaid from millions of people by giving states block grants for Medicaid that caps federal funding for coverage. The badly named “Healthy Adult Opportunity” allows states to turn away qualified applicants, deprive people of needed medication, and limit health benefits. Medicare/Medicaid administrator Seema Verma, who wants to remove as many people as possible from Medicaid, said, “This policy is about helping people achieve the American Dream.” Her argument is that people who can’t get Medicaid is a “good outcome” because “they don’t need the program anymore.” DDT’s plan will force many people out of nursing homes.

The GOP and DDT hope that they can wait until after this year’s election to deal with the Affordable Care Act so people won’t know that they will lose their health care with no replacement by electing GOP control. A majority of the Supreme Court has helped by denying a request to expedite the challenge to the ACA from the House of Representatives and Democratic-led states. 

A serious problem with current healthcare in the U.S. is that it allows health insurance that provides little more than “thoughts and prayers”—and the purchasers don’t know that the companies may not pay for their medical costs. “Traditional” insurance has legal requirements because of the ACA, but “alternative” coverage doesn’t have these regulations, many of them from “faith-based” providers. This fake insurance will expand with DDT’s possible new rules with workplace Health Savings Accounts. Denial of payment can come from “lifestyle” choices, “preexisting conditions” prevented in traditional insurance, and caps in coverage. For example, the Aliera plan requiring purchasers to belong to a religious group and oppose abortion, appears to have coverage. One client, however, was told to “trust in God” when the company refused to pay the $200,000 for back surgery after it told the purchaser that the cost was covered. “Faith-based” healthcare sharing “ministries” take monthly contributions from over a million people and work like GoFundMe programs. These inexpensive plans use misleading—sometime fraudulent—advertising because DDT’s executive orders give them that permission.

The religious plans were exempted from the ACA individual mandate to get votes from Democratic senators representing conservative states, and DDT succeeded in repealing the individual mandate in 2017. He also took executive action to promote insurance with substandard coverage, and the plans flourished with little or no oversight. They can refuse any claim and define “pre-existing” any way they wish, such as a broken arm. Preventative and mental health care are also not covered. Their customers lack any recourse because of no regulations and the contracts they sign.

Even people with traditional insurance pay higher premiums than anticipated from the ACA because the law lost the individual mandate that everyone have health insurance. “Healthy” people decide to not get health insurance, with their assumption that they will never need it. When they need care, they go to emergency rooms and leave the costs to the hospitals or the government.

An increasing number of people with traditional health care can’t afford medical care such as visits to doctors and medication. A study published in JAMA Internal Medicine reports that more people in the U.S. lack funds for medical care than twenty years ago. Problems come from the rise of “narrow networks, high-deductible plans, and higher co-pays.” Between 1998 and 2017, the share of adults 18-64 unable to visit doctors increased from 11 percent to 16 percent, and those with health insurance, the share rose from seven percent to almost 12 percent. Adult Canadians reported only 1 percent of adults over 45 with a chronic disease unable to meet medical needs because of high costs compared to 18.7 percent in the U.S.

Last year, 25 percent of people in the U.S. said that they or a family member postponed treatment for a serious medical condition in the past year because of cost, compared to 19 percent in the previous year. Another 8 percent reported a delay for a less serious condition, bringing the total to one-third of the U.S. population. The percentage tied that in 2014, the first year of complete ACA implementation.

Meanwhile, health insurance and drug industries make a huge profit. Insurance premiums increased 22 percent since 2014 and 54 percent in the past decade while wages remained largely flat. Deductibles increased by 36 percent since 2014 and 100 percent in the past decade. In 2018, people in the U.S. borrowed $88 billion for healthcare costs, and healthcare costs–the leading cause of bankruptcies–force 530,000 people to annually go into bankruptcy. 

Many people prefer for-profit “Medicare Advantage” plans because they get dental and eye coverage that people on traditional Medigap plans lack. This year, the program added even more “advantages” to help older people. Those who use these plans, however, may be unfamiliar with government audits showing that Medicare Advantage plans pose “an imminent and serious risk to the health of… enrollees” and overcharge taxpayers by $10 billion a year. Another report shows that the plans are not submitting accurate claims data, and they may be paid for services that they provide.  Last year, six senators described wrongdoings by several corporations including UnitedHealth Group, Aetna, Cigna and Humana—tens of billions of dollars in overcharges, failure to cover required care, inaccurate provider directories, etc.

Conservatives argue against single-payer health care with two primary reasons—they want freedom to not have health care and the system costs too much. In just 2017, U.S. insurers and healthcare providers spent $812 billion on paperwork and other administrative activities, according to a study reported in the Annals of Internal Medicine. These costs are 34.2 percent of U.S. total national health expenditures in that year and twice what Canada spends on healthcare administration in the same year. U.S. insurers and providers pent $2,497 per person on healthcare administration in 2017 compared to Canada’s cost of $551 per capita. The study found that “Medicare for All” could save over $600 billion per year, just on bureaucracy.

While DDT removes healthcare from people, he makes health worse in the United States. For decades, health professional believe that exposure to radiation can cause cancer; now DDT wants to “relax” regulations for radiation in the U.S. to “have a positive effect on human health.” According to a witness at a congressional hearing, exposure to radiation and other carcinogen that stress the body makes people healthier by putting bodies’ repair mechanisms work better, like exercise and exposure to sunlight. DDT’s transition team member Steven Milloy, who supports this idea, also denies human-made climate change and any health risks from tobacco. Milloy, a Fox consultant, also supports the use of pesticide DDT and asbestos.

DDT makes people sick in other ways. Anxiety, depression, and anger are the highest since 2007. People in the U.S. have a 20 percent higher stress rate than most of the 143 countries in the 143 countries in the Gallup poll, including Venezuela and Rwanda. For the first time, counselors see patients in therapy because of politics.

A report from the New York University Law Schools State Energy and Environmental Impact projects that the rollback of about 100 environmental protection rules will cause, in the next decade, “1,630 more incidences of premature deaths, 120,000 additional asthma attacks, and 140,000 missed school days and 48,000 lost work days.” The EPA estimates an additional 300 to 1,500 human death each year from air pollution.

A 2019 study shows that fracking is tied to skin, genital, and urinary diseases. Researchers theorize that drilling activity may be related to risky sexual behaviors. Disruptions to buried bacteria and chemical exposures in drinking water may be an affect. Other studies show links to cardiovascular and respiratory issues such as asthma.

DDT has also scrapped regulations to define “organic” beef, pork, and chicken and loosened inspections for pork which can also affect health.

A major problem from DDT’s focus rejection of education about sexual and reproductive health is the spike in rates of STI (sexually transmitted infections) within the United States. For example, gonorrhea infections increased by 82.6 percent within a decade. Almost half the states lack both sex education and HIV education, and Title X funding has been taken from many health care providers. DDT’s administration increased the budget for abstinence-only programs by 67 percent although these programs don’t work.

Much less health care with increased illness. What can go wrong?

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