יום שני, 17 ביולי 2017

Rural America fights back against Obamacare repeal



  By Tim Wheeler





PORT ANGELES, Wash. – “Health care is a human right! Now’s the time to stand and fight!” That was the chant by Clallam County Democrats as they marched in the Fourth of July parades in both Forks, “Logging Capital of America” and a few hours later here in Port Angeles, county seat of this rural community on the North Olympic Peninsula.

All along the march in both towns, masses of people were sitting on folding chairs to watch the patriotic floats, tractors, logging trucks, fire engines and high school marching bands. But when the Clallam Democrats arrived with that chant, the people stood and applauded. Some cheered or even took up the chant. “What do we want?” a woman leading the marchers shouted. “Health Care!” answered the crowd. “When do we want it?” “NOW!”

Especially enthusiastic were women, mothers with young children, and younger men. Many in the crowd were Latinos and members of the Native American Indian tribes on the Olympic Peninsula who joined in the applause and cheers. Mike Doherty, a veteran former Clallam County Commissioner who has participated in dozens of these July Fourth marches exulted. “I’ve never seen such a positive response from the crowds!”

The reason is clear. Clallam County is a rural community and like rural America, is the hardest hit by the Republican drive to repeal Obamacare. Eric Lewis, CEO of the Olympic Medical Center, warned that about 22,308 residents of Clallam County are covered by Medicaid. At least 7,000 of them will lose their health care coverage immediately if the Republican cuts to Medicaid are approved.

As a public hospital, OMC must continue to treat everyone regardless of ability to pay, he told a meeting of OMC Commissioners last month. OMC will lose $105 million over the next ten years, a disaster since OMC barely breaks even in its struggle to stay afloat financially. It is a disaster so stark that the Commisioners decided to write to Trump protesting the proposed Medicaid cut.

The crisis seems not to move Senate Majority Leader Mitch McConnell who continues to orchestrate the drive to repeal Obamacare even as nine of his Republican colleagues in the Senate have announced they will vote “no” on the measure.

Sen.Bernie Sanders of Vermont is traveling into rural areas to help organize fightback against repeal. He told a “Care Not Cuts” rally in Covington, Kentucky, July 7, that McConnell’s bill will terminate health coverage for 230,000 of McConnell’s constituents in Kentucky. Added Sanders, “We will not allow 22 million to be thrown off health insurance in order to give $500 billion in tax breaks to the top two percent” of wealthy tax evaders.

An article in Newsweek (Jan. 22, 2017) co-written by Margaret Greenwood-Ericksen and Mahshid Abir, both of the University of Michigan Medical School cites a report issued last December by the Center for Disease Control that for the first time in 20 years life expectancy declined in the U.S. last year “particularly in small cities and rural areas where people are dying at much higher rates.”

They add, “This shocking trend is driven in part by increases in mortality rates for white working class Americans many of whom live in rural America.” These are regions Trump won and the Republicans continue to dominate even as uninsured people in these states fall ill and die from lack of health care coverage.

“What is to be done?” the authors ask. “It is critical to maintain the expansion of Medicaid. We must find a way to expand coverage for the rest of rural America. Two thirds of uninsured people in rural areas live in non-expansion states.”

As of Jan. 1, 2017 19 states have refused to expand Medicaid, they write. These are the so-called “Red” Republican states in the “deep” South and Republican controlled states in the middle of the country.

The Republican drive to repeal Obamacare and terminate Medicaid expansion, they warn, “will result in a sudden decrease in the insured rates, leading to a dramatic increase in uncompensated care which will likely drive further rural hospital closures. This will result in a crisis of access to emergency care and harm rural economies, condemning rural America to an unbreakable cycle of poor health and poverty…..We need to act now to save our heartland.”

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