HEALTH CARE/Joan Retsinas

Making America Sick Again: A Swarm of Midges

Let’s Make America Sick Again – the implicit mantra of this Administration.

Forget health insurance. Look beyond the health care horizon for a swarm of attacks – like midges. Somehow we must bat them all away, even while they descend at once.

Consider chlorpyrifos. Never heard of this pesticide? No matter. The people who know about it are the scientists who identified its hazards to workers and children, the bureaucrats who banned it in home-gardens in 2000, the chemical companies that make it, and, now, this Administration. This Administration wants to reverse the ruling by the Obama Administration that banned the pesticide in large-scale farms.

Consider lead. Scientists have warned of its hazards, leading the government to restrict lead in drinking water, in arable soil, in house-paint, in toys, in our plates and bowls. Yes, this is Big Brother paternalism; but most Americans, fearing the effects of lead on their children (and, according to recent data, on themselves), have weighed industry’s need to maintain profits against our need to stay healthy. No more. On the chopping block: the restrictions for lead in automobiles.

Indeed, how dirty can we make the air? For the past decade, government, allied with environmentalists, struggled to clean up the air. But this President promised coal-mining regions that he would restore jobs that the Environmental Nanny had axed. Nobody believes that coal will rebound. And nobody wants to return to the days of dangerous mines, retirees fighting emphysema, and air-borne contaminants. Except this President. On a related chopping block: the Clean Power Act, which seeks to limit the carbons released from power plants.

Some of the midges – the ones attacking social services — are small. The Low Income Heating Assistance Program, for instance, does not swallow much of the nation’s budget, but does help thousands of people heat their homes. A Trump spokesperson called “LIHEAP” “ a lower-impact program … unable to demonstrate strong performance outcomes.”

Even Scrooge would demur at cutting funds for Meals on Wheels, but this Budget-Cutter wants to strip a few thousand home-bound patients of lunch. He also wants to cut the School Lunch Program – too many poor children are gobbling up the nation’s taxes. He wants to pare food assistance programs – barring the subsidies for pregnant immigrant women who lack proper documentation. He wants to relax gun restrictions even though guns contribute to thousands of deaths, including deaths when children play with adults’ pistols. The people who run domestic violence programs are bracing for cuts. Those victims will eventually find their way to hospital emergency rooms, or to morgues.

Hospitals won’t escape the chopping block. Too often patients suffer from the treatments that are supposed to help; yet this Administration is cutting funds for The Agency for Health Care Quality and Research, which combats iatrogenesis. The AHCQR analyzes data on treatments from spinal surgery to prescription mishaps to telemedicine. Since 2010, the Agency’s research has led to a 21% reduction in hospital-acquired infections. The goal of AHCQR is noble, but not noble enough to withstand the Budget-Cutter’s paring knife.

Hospital staffing too will grow more difficult. Cuts in Medicaid dollars may force some rural hospitals to curtail services, or close. To compound rural hospitals’ plight, the restrictions on H-1B visas for Foreign Medical Graduates from specific countries leave some hospitals with vacant residency slots.

Ironically, this Administration may succeed in restricting legal abortions: it has promised to do so. With a few new justices, the Supreme Court may eventually let state legislatures decide the options for women. Yet this “pro-life” president cannot eliminate illegal abortions. Wealthy women will go to other states, or countries, for legal abortions. Some poor desperate women, though, will seek the back-alleys where illegal practitioners rise up to meet demand – a historically well-trod path. And some of these women, with botched abortions, will end up in hospital septic obstetric wards, or in morgues.

Even without repealing Obamacare, this Administration can still make Americans sicker and sicker.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, May 15, 2017

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