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Markkula Center for Applied Ethics

A One-Two Punch to Health

Medical Care

Medical Care

The Affordable Care Act and Fuel Economy Standards

Margaret R. McLean

This article was originally published in MarketWatch on March 22, 2017.

Margaret R. McLean is Associate Director of the Markkula Center for Applied Ethics, Santa Clara University.  Views are her own.

Republicans are making good on two campaign promises: to repeal the Affordable Care Act and to roll back fuel standards put in place by the Obama administration.

But the proposed American Health Care Act is far from the “something great” President Trump promised as a replacement for the ACA.  It delivers the first punch to our health.  The Office of Budget Management released a staggering report on the consequences of its implementation—24 million people lose coverage and costs skyrocket for many including the elderly.  The Wall Street Journal reports that in one Nebraska county, a 62 year old earning $18,000 per year and currently paying $760 per year for health insurance would shell out $20,000 per year under the new plan, a figure that boggles the mind.  Clearly this Nebraskan cannot forfeit more than a year’s wage for health insurance.  Opportunity to buy is no guarantee of capacity to buy; opportunity to buy holds no assurance of access to health care when needed.

Certainly, our current system needs fixing—some of the insurance exchanges do not work well; some people pay too much for too little coverage; and some chaff under the mandate that they either buy insurance or pay a fine.  Congress needs to tackle these concerns now and create a reasonable, workable economic fix that does not leave millions uninsured, just one cancer diagnosis or car crash away from bankruptcy.

The second blow to our health came when the president announced the rollback of tough fuel economy standards for cars and trucks. The burning of fossil fuels increases air and ocean temperatures resulting in more frequent and severe drought, wildfires, and flooding.

Ironically, on the same day the new fuel standards were announced, 11 well-respected American medical societies, including the American Academy of Pediatrics and the American College of Physicians, released a report on the health effects of climate change.  The news is far from great—climate change is real and it’s making us sicker. American doctors are seeing more heat-related illness, an uptick in asthma, an increase in flood-associated deaths, and a rise in insect borne infectious diseases such as Lyme and Zika.

Like the right hook thrown by the healthcare bill, this environmental punch lands directly on the most vulnerable—children, pregnant women, the elderly, low income families, and those with chronic illness.  Even if we are not worried about the lack of ice for polar bears, we should certainly be worried about our health and that of our children.

I have a colleague who quips, “Ethicists worry so you don’t have to.”  Well, I think it’s time that we all start worrying about our health and access to affordable medical care.  Right now, we are neither taking preventive steps, like slowing climate change, nor providing our most vulnerable people reliable access to medical help when they do get sick.   We can only do the “something great” President Trump talks about when access to health care is guaranteed and we can take a deep breath of clean air.

Mar 20, 2017

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