Dr. Strangecare or: How I learned to stop worrying and love being sick

President Trump and his congressional Republican counterparts are waging an all-out war to destroy the Affordable Care Act (ACA) and further privatize medical treatment in the U.S.

While the ACA, commonly referred to as Obamacare, is not perfect, the Republican health care proposal, the American Health Care Act (AHCA) or Trumpcare as it has been dubbed, threatens to further reduce coverage options and drive up health care costs. In its current form, the Trumpcare plan leaves 24 million people without health care coverage including cuts to Medicaid.

Any health care system that doesn’t provide basic health care to every citizen is immoral. America should extend affordable health care to all of its citizens and restrict health care profiteering.

Perhaps the only thing every side can agree on is that the ACA is dysfunctional. Even former President Obama says that coverage needs to be expanded and costs lowered. Care is sub-par, piecemeal and expensive. For uninsured and underinsured Americans, finding a primary care physician is tedious or impossible, wait times are long, care is still often unaffordable, and patients often wait to seek treatment until the problem must be handled in an emergency room. While the AHCA and the push to repeal the ACA seeks to alleviate these problems, it ends up exacerbating them.

It is often said that America has some of the most technologically advanced and the highest quality health care in the world. This is true, but only if you can afford it.

Under Obamacare and Trumpcare, the people who suffer the most from the failings of the system are the middle class and working-class poor. If someone is on welfare that person automatically qualifies for government assistance. If someone is rich enough that person can afford to pay for high quality insurance or outright treatment. If someone is in the middle class or working-class poor that person falls into the American health care void.

With the high cost of health care, it is increasingly difficult for middle-class Americans to afford useful health insurance unless they work for a company large enough to provide it. Nothing on the health care marketplace compares to employer-funded insurance. Even with good insurance, middle-class Americans can find themselves deep in unmanageable medical debt due to the high cost of care and copays.

Middle-class Americans, by definition, do not qualify for Medicaid or government assistance to pay for insurance. Also, if someone’s disposable income is too high, then that person can’t file for bankruptcy. This creates a health care gap among the middle class.

As a result of the barriers to access, Middle-class Americans are left to choose: living or staying alive. Many people choose to go without insurance and pay the ACA mandated fine. Some get ACA coverage but avoid using it to save money. Some people have no choice, get no coverage and die.

Such was the case with Shane Patrick Boyle, a Houston artist who died because he couldn’t afford his diabetes treatment. After moving to Arkansas to care for his ailing mother, Shane lost his prescription benefits. Shortly before he died, Shane set up a crowdfunding campaign to pay for his medical treatment and avoid going into debt, not realizing how serious his condition had become. He died just a few days before his goal was met, exactly one week after the death of his mother.

That is what a lack of affordable and obtainable health care does to Americans, sentences them to death.

Shane’s story isn’t an outlier or an anomaly, it happens every day. The CDC reports that of the five leading causes of death in America annually (heart disease, cancer, stroke, chronic lower respiratory disease and unintentional injuries), 20 to 40 percent of the deaths in each of the five categories are preventable.

Insurance is a system of shared risk. It only works if healthy people pay into it. If the only people paying into it are using more coverage than they are paying in, the entire system falls apart. That is why the key provisions of the ACA are so important; the mandate ensures the risk is shared and not allowing screening for pre-existing conditions ensures the sick get coverage.

Some people are upset with the mandate because they feel the government is forcing them to pick up the tab for someone who they perceive as “irresponsible” or “lazy.” Privatized health care insures we are all already picking up the tab through higher health care costs.

When sick people go to the emergency room, they are not turned away. When they rack up exorbitant medical debt as a result and can’t pay it, the hospital doesn’t just take the loss and write it off, it spreads the cost out amongst its paying customers.

Without the government to negotiate prices and keep them low, hospitals, pharmaceutical companies and medical device manufacturers know that the insurance companies will pay them no matter what, so they raise prices artificially.

One of the biggest problems with the health care debate is that health care is defined as a commodity, a good to be bought and sold on the open market when, in fact, it isn’t. Health care is a necessity and, furthermore, it is an obligation of the government.

Governments are formed to protect the interests of the governed and preserve them. What greater interest is there than life? No freedom or right is more paramount than the right to live. Something is backward when a society places the freedom to acquire wealth over the freedom to be.

The steps we must take as a country are to do away with insurmountable medical debt, force health care companies to operate under a nonprofit model and extend health care access to all citizens. What works in other developed countries can be used as reference points for crafting this new system.

The ACA gives us a starting point to work up from, but before we can move forward, Democrats and Republicans must come together in a bipartisan effort to create an affordable American health care act or admit that protecting American lives is not their priority.

If you are interested, you can donate to Shane and Judy Boyle’s memorial fund.