Will counter-factual claims and Big Pharma cash sway critical midterm votes?

mitchAt a time when Americans experience high anxiety and financial insecurity due to medical costs — with more than 20 percent of those with health insurance experiencing trouble paying for necessities, more than a quarter of them saying they had bills in collection, and 13 percent forced to borrowed money as a result of illness — politicians and special interests are closing the midterm campaigns as if they can prank voters. Just how gullible do they think the electorate can be?

Republican congressional candidates, after howling about the Affordable Care Act and campaigning unsuccessfully to repeal it in dozens of votes for years, including in the first of the Trump Administration, now are claiming to constituents that they support key parts of Obamacare.

Even as GOP state attorneys general argue in a pending federal court case to gut ACA protections on preexisting conditions, minimum benefits, and lifetime limits, Republican candidates are telling voters, counter factually, how much they embrace and support those Obamacare components. They’re trotting out sad tales about their own relatives’ illnesses to claim to support a position that they opposed in legislative votes and actions just weeks ago.

They’re avoiding discussions about how their attacking the ACA by promoting purported “options” that may leave patients in the lurch when they most need health coverage.

Big Pharma pours cash into campaign war chests

Lawmakers are barking about excessive prescription drug prices — at the same time that Big Pharma is shoveling millions of dollars into their campaign war chests, including contributions exceeding $100,000 since the start of last year going to 34 of them.

U.S. Reps. Greg Walden of Oregon, a key Republican committee chairman, and Kevin McCarthy of California, the House Republican majority leader — each received more than $200,000, Kaiser Health News reported. The nonprofit, nonpartisan, and independent service that reports on health and medicine has set up a needed, nifty, interactive database so voters can see which of their lawmakers have chowed down at Big Pharma’s trough.

Even if Americans can be magically mesmerized by partisans’ mendacity on health care matters — a top election issue, on par for many voters with the polarizing president himself — Mitch McConnell, the Kentucky Republican and U.S. Senate Majority Leader, has reminded voters about the stakes involved in the midterm vote.

He discussed the soaring federal deficit, described in a USA Today Op-Ed, thusly: “The Monthly Treasury Statement for fiscal 2018, the year that just ended Sept. 30, [reported] the deficit was $779 billion — a $113 billion, 17 percent increase over the $666 billion deficit recorded last year. This was the biggest one-year increase in the deficit since 2009, when the Great Recession wreaked havoc on federal finances.”

Do soaring deficits require slashes in Medicare, Medicaid, Social Security?

McConnell argued that increased spending had ballooned the deficit — not the $1 trillion-plus, GOP-passed tax cut for wealthy corporations and the richest Americans. He said his party, which controls the House, Senate, and White House, has no responsibility for the nation’s fiscal standing.

And he said it could be dealt with only by slashing Medicare, Medicaid, and Social Security — social safety programs that Americans pay into, support by significant margins, and rely on for their health and well-being. He said the GOP, unless voters decide otherwise in the midterms, would take on these programs, as well as returning to efforts to repeal Obamacare.

Politicians from the major parties could not differ more about Medicare, the major health program for Americans 65 and older. They’re as split on Medicaid, the nation’s largest health care program affecting roughly 1 in 5 Americans. President Trump could not have made it clearer how he intends to deal with Medicaid, recently appointing Mary Mayhew, an official from Maine to head the program. In Maine, voters approved an ACA-related expansion of Medicaid. But the state’s governor and Mayhew fought the expansion tooth and nail.

In my practice, I see the harms that patients suffer while seeking medical services, and their struggles to access and afford safe, efficient, and excellent medical care. The ACA is imperfect, and, in a less politically divided world, lawmakers would deal with its shortcomings and work in bipartisan fashion to improve Americans’ health care and coverage for it. This is what voters want, as they have said repeatedly in public opinion surveys.

Living on the brink, even with health insurance

Instead, three institutions have gotten a stark view of how, even with the ACA and more Americans insured than in a long time, medical costs stagger too many of us. As the New York Times reported:

The New York Times, the Commonwealth Fund and the Harvard T.H. Chan School of Public Health used the survey [of almost 1,500 respondents] to examine the sliver of the American population who use the health care system the most. To be included in the results, a respondent had to have been hospitalized twice in the last two years, and to have seen at least three doctors. In some cases, when patients had died or were too ill to answer questions, relatives  who had taken care of them participated in their place. Their experiences may serve as an early warning system for problems that all of us may face: Because the estimated 40 million people in this population visit doctors, hospitals, nursing homes and pharmacies the most, they are the likeliest to see the weak points in the health care system.

The organizations found that illness and injury can strike any of us at any time, and, except for an elite few, it can devastate patients and families, leaving them in financial ruin. Health coverage can help. It’s not enough, and more needs to be done to share risks and burdens of sickness and injury.

The national debate, too often loud and ugly, has focused for years now on health insurance coverage. It is key, but it is only one part of a huge, costly system that needs major fixes. That can’t happen without respectful discussion, candor, rigor, evidence, and honest facts. Voters have a critical opportunity in just a few weeks to hold politicians accountable. It’s their privilege and responsibility to do so in our democracy.

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