Victoria Brownworth

Medical debt is sickening -- and Dr. Oz doesn't seem to care

Never addressed in the 2020 primary was the extent of medical debt, despite a presidential race in the middle of a once-a-century pandemic hospitalizing people for days, weeks and months. The cost was astronomical. Medical debt has accrued exponentially since.

Every candidate had a plan to revamp our broken healthcare system during the 2020 Democratic primary. They ranged from Medicare for All (Bernie Sanders) to expanding the Affordable Care Act (Joe Biden).

Elizabeth Warren said a significant number of Americans got their health insurance from their employers. Pandemic lockdowns meant millions lost it. Kamala Harris touted a variation of Medicare for All. Amy Klobuchar pushed for lowering the age for Medicare to 50.

The debate suggested whoever won the general would dedicate to fixing the system many have tried restructuring – including Hillary Clinton, who attempted in 1993 to institute a universal healthcare initiative – until the GOP ended the possibility of passage.

In 2010, Speaker Nancy Pelosi shepherded the Affordable Care Act into law – which then-Vice President Biden called a “big fucking deal” after President Obama signed it. What the ACA did – Sarah Palin dubbed Obamacare – was set up a healthcare marketplace to buy insurance plans with different levels of coverage and affordability.

The ACA also expanded Medicaid to the working poor. It allowed dependent children to stay on their parents plans until they were 26. It forced insurance companies to charge men and women the same rates, instead of overcharging women for being female. The ACA addressed preexisting health conditions, forbidding companies from rejecting applicants on the basis of their prior health status.

The ACA was the most sweeping healthcare initiative since Lyndon Johnson signed Medicare and Medicaid into law in 1965. Thus Democrats did not expect pushback from Republicans on a law allowing millions of uninsured Americans to buy coverage.

Republican governors rejected Medicaid expansion. Some sued to deny adoption in their states. This meant millions of Americans in those states remained uninsured and vulnerable to medical debt.

Never addressed in the 2020 primary was the extent of medical debt, despite a presidential race in the middle of a once-a-century pandemic hospitalizing people for days, weeks and months.

The cost was astronomical.

Medical debt has accrued exponentially since.

A new study finds that healthcare is now the country’s largest source of debt. One in 10 Americans carry medical debt ranging from $250 – more than a week’s wages for a minimum wage worker – to $10,000.

That latter number is most common. According to healthcare.gov, a three-day hospital stay – the average – costs more than $30,000.

These medical debts are largest in states run by Republican governors who refused to expand Medicaid under the Affordable Care Act.

Moreover, many households can’t pay cost-sharing in private health plans. That means they’re unable to pay for deductibles, copays and coinsurance like prescription plans. This makes it less likely for people to buy health insurance, even from the healthcare marketplace.

An investigation conducted and published by the Journal of the American Medical Association found that “an estimated 17.8 percent of individuals in the US had medical debt in collections in June 2020.”

That’s well above what was previously thought.

The JAMA investigation was conducted before the true costs of the pandemic had been accrued and analyzed. Yet even without those numbers, the amount of medical debt was staggering at $140 billion.

To put that in perspective, the total 2020 US State Department budget – including USAID – was $52 billion. The total US Department of Justice budget was $35 billion. Medical debt is nearly twice that.

Members of Congress, among them the House Progressive Caucus, frequently take to Twitter to call for student loan debt relief.

But what about medical debt?

According to a new study from the American Journal of Public Health, crowdfunding isn’t an answer. Researchers found that the funding acquired was “highly unequal, and success was low, especially in 2020.” A mere 12 percent of campaigns met their fundraising goals.

Moreover, crowdfunding raised far less money throughout 2020 in states that had more medical debt, higher uninsured rates and lower incomes – notably states controlled by Republican governors.

These states also have the highest percentage of people of color who are significantly more likely to have medical debt than their white peers and who were disproportionately impacted by the covid.

At a GOP debate in Pennsylvania on April 25 for what is arguably the most-watched Senate, five candidates railed against “lockdowns” and “mandates.” Mehmet Oz, a cardiothoracic surgeon and celebrity medical TV personality, was the most strident. He claimed his son was being forced in medical school to wear a mask against his will.

No one discussed the impact of the pandemic on the healthcare system nor on the debt being carried by average Americans.

Who will pay for their care? How do we end medical debt?

With the 2024 presidential election looming, it’s a question future candidates on both sides of the aisle must prepare to address.

LGBTQ+ Americans face an 'incalculable' risk of harm in the right-wing culture war

While many are aware of Florida’s “Don’t Say Gay” law signed by GOP Governor Ron DeSantis on March 28, few are aware of how many similar bills have been signed or proposed in state legislatures.

The rightwing has turned Disney’s backlash against DeSantis’s law into a full-fledged fight. There are already T-shirts with the Disney logo and “Disney groomers” available for sale. On the back: “bring ammo.”

The GOP and MAGAs like Jack Posobiec – who was suspended from Twitter briefly for posting an image of the T-shirt and for linking Disney, LGBTQ-plus people and pedophiles – have turned violent.

Utah, Oklahoma and Alabama have passed similar anti-LGBTQ-plus laws. 2022 is on track to set a record for anti-LGBTQ-plus legislation. Since January, 238 such bills have been proposed, a rate of more than three a day. Limiting the rights of trans youth to medical care, limiting access in schools to basics like bathroom use, and limiting who gets to participate in sports – are the focus of about half the bills.

According to an NBC News analysis, about 670 anti-LGBTQ-plus bills have been filed since 2018. The number has increased each year. According to NBC, there were 41 bills in 2018, slightly more than 60 in 2019, nearly 150 in 2020, 191 in 2021 and 238 bills this year.

As Florida's “Don’t Say Gay” law suggests, silencing discourse of any kind about sexual orientation or gender identity is the goal.

The GOP theory seems to be that if kids don’t hear about queer and trans people, they won’t become queer or trans. That these identities are likely embedded from birth (or before) is a concept the purveyors of “Parental Rights” bills don’t want to grapple with.

Ask any gay, lesbian, non-binary or trans person about their identity. Most will say they always knew. Most will say they were who they are, even if they didn’t yet have a name for it. Books and other materials allowing LGBTQ-plus youth to feel comfortable in their identities and most importantly, not isolated, are key to safe, healthy adolescence.

A national survey from The Trevor Project, an LGBTQ-plus youth suicide prevention and intervention group, found that 42 percent of LGBTQ-plus youth seriously considered attempting suicide last year.

“LGBTQ youth are not inherently prone to suicide risk because of their sexual orientation or gender identity but rather placed at higher risk because of how they are mistreated and stigmatized in society.”

During the off-year election in November 2021, the push to ban LGBTQ-plus-themed books began in earnest. Glenn Youngkin, now governor of Virginia, campaigned on getting “offensive” books out of schools. Top of list: books dealing with race and LGBTQ-plus issues.

In 2022, school boards are debating books allowable in classrooms. Texas, Mississippi, Arizona and Tennessee have passed laws ostensibly banning books with LGBTQ-plus content. These include the classic works of James Baldwin, Walt Whitman and Stephen Sondheim. Among other books banned are Alice Walker’s Pulitzer Prize-winning The Color Purple and Harper Lee’s classic To Kill a Mockingbird.

In Texas, GOP Governor Greg Abbott proffered a “Parental Bill of Rights” so parents decide what their children are taught. In November, he declared a “war on pornography” in schools, which, while unspecific, seemed to include all – and solely – LGBTQ-plus books.

Texas state Rep. Matt Krause, who chairs the Texas House’s General Investigating Committee, queried the Texas Education Agency over his concerns that books in Texas schools were allowing subversive discourse on race, sexuality and gender identity. Attached to his letter to the TEA was a 16-page list of 850 book titles published from 1969 to 2021 that deal with issues of race, gender identity and sexuality.

The Dallas Morning News revealed that “of the first 100 titles listed, 97 were written by women, people of color or LGBTQ authors.”

In January, Mayor Gene McGee of Ridgeland, Mississippi, withheld $110,000 in funding from the Madison County Library System, the first-quarter funds the city owes the county’s library program. McGee is opposed to what he calls “homosexual materials” in the local library and said he would not release the funds until they were removed.

Those who argue this is “just” a red state phenomenon aren’t paying attention. Suburban school boards in blue states are focusing on “parental rights.” On April 5, Pennsylvania, with a critical Senate and gubernatorial race, voted an anti-LGBTQ-plus bill out of committee. It will soon come before the legislature where it’s expected to pass.

During confirmation hearings, the Republicans interrogated Judge Ketanji Brown Jackson repeatedly about LGBTQ-plus issues. Senator Marsha Blackburn, attempting a gotcha on trans issues, asked Jackson to define the term woman. Jackson declined, saying “I can’t.”

“You can’t?”

“Not in this context. I’m not a biologist.”

That exchange became a focal point for the right.

The next day US Rep. Bob Good addressed House Speaker Nancy Pelosi as "Person Speaker" rather than “Madam Speaker,” as she is customarily known. Good said it was in deference to Judge Jackson.

A week earlier, Charlie Kirk, a right-wing activist, was suspended from Twitter for saying Assistant Secretary of Health and Human Services Rachel Levine, a trans woman, as a man, to his 1.7 million followers.

These aggressive actions, like Blackburn’s interrogation and Kirk’s attacks on Levine, as well as the many laws and policies being pushed by the GOP, have a ripple effect on LGBTQ-plus people.

Especially youth.

Chasten Buttigieg, spouse of US Secretary of Transportation Pete Buttigieg asked “what kind of state are you building [in Florida], where you're essentially pushing kids back in the closet? … You're saying, 'We can't talk about you. We can't even talk about your families.'"

Buttigieg’s point is a salient one.

Most families have at least one LGBTQ-plus person. Most books, TV series and movies marketed to children refer repeatedly to heterosexuality and its many manifestations as well as to gender.

Yet the GOP would have you believe mentioning one’s gay, lesbian or trans family member in the classroom is “grooming” them in a nefarious sexualized plot while the prevalence of heterosexual imagery is manifold. Does anyone really believe Encanto is grooming kids?

The midterms will determine who runs the Congress next year.

If the GOP wins, harm to LGBTQ-plus Americans will be incalculable.

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