“My health insurance costs me $625 every month and I still pay a lot over-the-counter.” I’m on a Greyhound bus from Knoxville, TN to Washington, D.C. and it has broken down in a small town in rural Virginia. We have been waiting over six hours for a new bus to arrive out of North Carolina, so my conversation with the busdriver has shifted from the weather to more significant issues. The essence of his remarks? “Our health care system is broken and no-one seems to want to fix it or knows how to do so.”
Millions of Americans spend up to $500 – $1,000 per month on their health insurance, putting the United States at the top of the list of high-income countries’ medical expenses. However, researchers have not found that Americans use their medical system more often. Then why does all this money not translate into healthier people? Research points to the high prices of drugs, procedures and administrative services.
In 2010, President Obama signed the Affordable Care Act (ACA) into law. Ever since, Republicans have attacked the law, often referred to as Obamacare, and have carried out multiple attempts to reform or repeal it. The last four elections were dominated by discussion on the law and President Trump made repealing ACA a cornerstone of his campaign. The Republican party has succeeded in dismantling many parts of the law, but they have not successfully been able to unite around new legislation.
Republicans have abstained from another attempt to repeal the ACA this year. Moreover, many Republicans up for re-election are talking back their reform-or-repeal votes. Why? The issue of health care has steered away from the ACA and has instead focused on pre-existing conditions. Many Republicans voted to repeal the law. This meant taking away health care from people whose health conditions predate someone’s insurance coverage and stripping the provision that allows a child to stay on its parents’ insurance until age 25. As these two features of the bill remain very popular since its introduction, the Democrats have put them front and center of their campaign this year.
This year, Democratic groups spent nearly half of their money on health care ads: 44 percent of Democratic House races and 50 percent of their Senate campaigns discussed the issue. The divide with Republican races is stark, as the issue does not even make it into the top five issues for Republican Senate campaigns. Democratic candidates have blanketed the airwaves with their personal health stories: Senator Claire McCaskill from Missouri talks about her fight with breast cancer, while Senator Tammy Baldwin from Wisconsin describes finding her mother, who had a drug abuse problem, passed out. The opioid crisis is an issue that has received a lot of the attention of candidates talking about health care.
I met Laurie Meschke, a Professor at the Department of Public Health at the University of Tennessee, at her office in Knoxville, where she outlines how this opioid epidemic has a major impact on families across the country. “While we have made access to prescription drugs more difficult, we see a stark increase in the use of heroin and thus in overdoses.” She emphasizes the interrelatedness between health care and policy and how to improve the country’s health care system. “Policy has the greatest impact on health care and it’s driven by politicians. But I think we are on the right track. I don’t think a complete repeal is good, but revision of our federal systems is always necessary. People change and so does our economy. I think we have to look at our tax laws and make sure that uber rich people are paying their fair share.”
So while people on the news and in Washington D.C. are mostly talking about Kavanaugh or Khashoggi, my busdriver from Tennessee and voters across the country will be thinking about their health care when they cast their vote on Election Day.
Iris Bos, boardmember of Stem op een Vrouw, is currently travelling across the United States. For the John Adams Institute she will write several blogs on the midterm elections. “I hope to illustrate that this election is about more than President Trump and the question whether the Democrats will gain a majority in the House on November 6th. This election is about the country’s broken healthcare system and its ongoing system of voter suppression, but also about a wave of women running for office.