Give Me Healthcare or Give Me Debt!

Our guest today is Rebecca Wood. Rebecca lived all over Virginia before her relocation to Massachusetts. Rebecca worked with many organizations and offices on Capitol Hill. Her healthcare work includes rallies, protests, press conferences, and conventions. Most notable, she told her and daughter Charlie’s story at the introduction of Senator Sanders’ Medicare For All Act of 2017 and testified before the House Ways and Means Committee hearing on Pathways to Universal Coverage in June 2019 (Rebecca’s statement begins about at about 18:10). Rebecca also regularly volunteers for Remote Area Medical, which provides access to healthcare for underserved communities and is active in the push for universal school meals.

Show Notes

CW: Medical and dental trauma

We don’t usually start our podcasts with data or statistics, but last week Gallup released a shocking poll that clearly reflects a new reality for the country: 38 percent of Americans now say they put off medical treatment because of the cost sometime in the past year (2021). This is a HUGE leap over just a year ago, when only 26 percent of Americans were putting off care. Gallup has been conducting this poll for over 20 years, and this is the worst we have ever seen. Even more troubling, 26 percent say they put off treatment for “very serious” conditions or “somewhat serious” conditions, and THAT is another huge leap over just a year ago, when “only” 18 percent of Americans were putting off care for very serious or somewhat serious issues. We’re now three years into the pandemic, and employment rates have improved. So what the fuck is going on here that our access to healthcare is now worse than during the height of the pandemic when the economy was shut down and there were no vaccines?!?

Rebecca tells a story that illustrates how delayed care hurts American families. Ten years ago her daughter Charlie was born prematurely due to Rebecca’s severe early onset pre-ecclampsia, a potentially deadly condition for both mom and baby. Charlie was in the Neonatal ICU for three months. Their family had “good insurance” through Rebecca’s then-husband’s employer. Over the next several years, like many micro-premies Charlie needed enormous amounts of care. They faced automatic denials, outrageous deductibles and huge copays from their insurance company. Due to the high out of pocket costs for Charlie’s care, they went from being financially comfortable, to going through their savings, putting off their plan to buy a home, and living paycheck to paycheck.

Even worse, Rebecca had to make choices between paying for her daughter’s healthcare and her own. Like so many American parents, Rebecca put Charlie’s needs first, sometimes rationing her own medications and eventually putting off an important dental procedure. That delayed dental procedure led to an infection that spread to her entire mouth and jaw, forcing her to the emergency room. Doctors feared the swelling could cut off her airway. After days in the hospital, Rebecca followed up with her dentist, where she had to have all of her teeth pulled and parts of her jaw scraped away.

In 2017 when the Affordable Care Act came under attack, Rebecca feared repeal would make Charlie uninsurable due to preexisting conditions. So Rebecca became a vocal activist. She used her family’s experience to call out the profound policy failure that has caused so many American families to suffer.

The new Gallup Poll found:

  • “In 2022, Americans with an annual household income under $40,000 were nearly twice as likely as those with an income of $100,000 or more to say someone in their family delayed medical care for a serious condition (34% vs. 18%, respectively). Those with an income between $40,000 and less than $100,000 were similar to those in the lowest income group when it comes to postponing care, with 29% doing so.
  • Reports of putting off care for a serious condition are up 12 points among lower-income U.S. adults, up 11 points among those in the middle-income group and up seven points among those with a higher income. The latest readings for the middle- and upper-income groups are the highest on record or tied with the highest.”
  • 32% of women and 20% of men reported putting off medical treatment, representing a 12-point increase from 2021 for women and a five-point increase for men. The resulting 12-point gender gap is well above the seven-point average gender gap since 2001.”
  • young and middle-aged adults” were “much more likely than older adults to say they or a family member delayed medical care for a serious condition. This is likely due to the fact that Americans aged 65 and older are covered by Medicare.”
    • “A new high of 35% of adults aged 18 to 49 said they or someone in their family put off care, while 25% of those aged 50 to 64 and 13% of those aged 65 and older said the same.“

The poll unfortunately did not break out the data by race and ethnicity or by insurance status.

So why are we seeing this double-digit increase in folks putting off medical care right now?

We have our theories, including the fact that people put off medical care during the pandemic. Now that things are getting back to normal, the healthcare system is even more stressed than it was before the pandemic, making it even harder to get care when you need it. We also think inflation, runaway cost sharing and the loss of the child tax credit are partially to blame. (“Cost sharing” is Orwellian healthcare industry jargon for “f*&ing you over.”)

At the risk of repeating ourselves, we think the solution to this problem is Medicare for All. If everyone is in, medically necessary care is covered, and price controls keep costs down, fewer people will be forced to delay care due to cost.

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