The Downward Healthcare Slide: Tearing the Social Fabric (original) (raw)

It is no secret that the American working class has been eviscerated, that children born since 1990 are not likely to have a standard of living that is better than that of their parents, and that real incomes for working families have remained unchanged for the past 40 plus years even as productivity continues to rise, leading to ever higher concentrations of wealth by an ever-shrinking proportion of the population. To a greater or lesser degree this pattern is being repeated in most Western capitalist countries throughout Europe. People are being squeezed by years of austerity policies that shred the fought-for gains in the social safety net, often with devastating consequences. In the UK, for example, austerity cuts reduced the resources of first responders while efforts at profit maximization guided planning decisions concerning social housing. One result was the tragedy of the Grenfell Tower fire, whose death toll is still unclear. Recent reports suggest that shortcuts were taken in the renovation of the housing block for the sake of cutting costs, and that austerity cutbacks in public safety meant that fire services were strained in their response to the fire. Whatever the reason, clearly those people on the bottom rungs of society (and their numbers grows each day) are the most vulnerable and most harmed by continued policies of austerity. It should not surprise anyone that the result is both a general distrust of all government agencies, and an anger voiced both in demonstrations (left and right) and in the voting booth (Brexit and Trump). Much is being said about the current efforts by the Republican Party to "repeal and replace" the Affordable Care Act (ACA), commonly known as Obamacare. After all, given years of trying to undo this legislation with over 50 votes in the Senate, it was assumed that now with control over all levers of government that Republicans could achieve their goal. Repealing, as it turns out, has proven to be problematic for several reasons: 1) once given, it is hard to take away benefits from people; 2) people in states that expanded Medicaid coverage put pressure-whether moral or simply electoral-on officials who consider reversing this expansion; 3) all estimates of the impact of various plans to undo the ACA indicate that tens of millions of Americans would either lose coverage or no longer be able to afford policies on offer. 1 Republican suggestions that "availability of" healthcare is the same as "access to" healthcare is at the core of their proposals for change, though critics point out that million-dollar homes are available for purchase but that does not mean everyone has access to those homes. In fact, the US is the last stable society that does not provide healthcare as a human right, one for which residents take healthcare for granted much as they take for granted that the lights will turn on, that streets will be cleaned, and that clean water is available. 2 Yet, even the ACA is wanting, leaving countless millions uninsured and without proper healthcare; "[f]our years into the rollout of the Affordable Care Act's major provisions, 29 million Americans still lack health insurance" (Gabriel, 2017: n.p.).