People without insurance are more likely to have certain diseases go undetected until they’re far along. And so they die sooner.
Uninsured women with breast cancer are 30–50% more likely to die from cancer or cancer complications than insured women with breast cancer.
Uninsured women are 60% more likely than insured women to receive a diagnosis of late-stage cervical cancer.
Citing this evidence and more, this group of physicians endorses expanding Medicaid. As doctors focused on women this makes sense.
And, as another research summary shows, there are huge benefits to women from the Affordable Care Act.
But when Medicaid expansion proponents extrapolated from studies on the number of preventable deaths each year, expansion foes got angry.
Some claimed that LePage and other expansion proponents had been called “murderers,” despite the fact that no one discussing 157 preventable deaths used that word. (It should be noted that the figure of 157 is not precise but rather is within a range of possibilities cited in a highly respected research study.)
In fact, murder is a crime of one individual against another. Declining to take a particular policy step cannot be murder.
At the same time, the evidence is crystal clear that increasing coverage has major health benefits.
It’s not murder to not expand Medicaid, but it matters. And it’s not outrageous to say so.
Expansion foes are also contradictory.
Even as some opposed to Medicaid expansion (misleadingly) tout the insurance exchanges as an alternative to expansion for people under the federal poverty level, some of the same people seem to suggest that it’s wrong to claim impacts on life and health.
Why would anyone support having people get federally subsidized insurance — or any insurance for that matter — if it didn’t save lives and improve health?
Besides this contradiction, there has been a tendency to stigmatize low-income working people who can’t afford insurance
There are many reasons why people find themselves in poverty.
In many cases, they used to make more money but had a string of bad luck. They might have had a heart attack and can’t work as much. Or maybe they lost a job and can’t find a full-time position but are working full-time.
In other cases, they started in a poor family and it has been difficult to climb out. Not having health coverage in fact makes such a change in circumstance more difficult.
Whatever the reason, there will always be people with very low incomes. Putting the blame on the individuals who are there at any one point in time ignores that reality.
Take the 62 year old woman with a heart condition whose husband wrote me, telling me that she works part-time and won’t get coverage unless Medicaid is expanded. She used to work more but now can’t. And even if she were to qualify for coverage under Social Security Disability Insurance (and that’s not for certain), what should she do while her case is being assessed? That takes months. Should she do without the prescriptions and medical visits she needs?
Another step from expansion foes is coming. And it looks like it will be to claim that people eligible for Medicaid are criminals, undeserving of care. (Can you imagine saying this to the husband of that 62 year old woman?) A push poll is out there now.
Rather than looking down at people who lack the income to afford insurance, we could be working together to make sure that we can prevent unnecessary illness and deaths. Franklin Roosevelt called for us to do so over seventy years ago.
Each person suffering or dying when this could be prevented is a human being, who is, in the words of the Declaration of Independence, “created equal.”
Admitting that health coverage matters should be the first step we take to support each person’s dignity, security and life.
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