Content Note: Classism, ableism, poor shaming, Trumpcare

Image Description: Red medical bag with a with white cross on it and a stethoscope resting on it.

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CNN has been out at my place since yesterday, and I didn’t get a chance to get caught up on newsletters or internet because I was at work…but even from the little bit that I picked up about Trump’s new healthcare plan, I’m seeing problems.

I liked Obamacare. I was happy to see that so many people, particularly disabled people and people with pre-existing conditions, finally got healthcare. If I’d been American when my brain arteriovenous malformation was discovered, I doubt that any health insurance that my family could have afforded could have covered the cost of the surgery to repair it, let alone the cost of hospitalization and rehabilitation after the post-surgery stroke and the years of medical follow-ups. My surgery wasn’t emergency, but it was important — given that I was only 22 when my AVM caused my first brain bleed, it was likely to cause another, potentially much more serious one, but no one could say when. Would we, had we been Americans, decided to take postpone a costly surgery as long as possible, or not do it at all, and just hope for the best?

It might not have been an option. As a Canadian, I was able to make my decision based on the risks of having the surgery or not having it, and cost wasn’t a factor. Given that there was a 75% that they could treat the AVM with no ill effects, but later in life I might have another bleed while driving down the highway or holding a baby and potentially lose control of my left side, the choice seemed easy. I just hit that 10% that comes out of a major surgery in that area of the brain with severe damage, and that’s what happens when you play the odds. At least the AVM is fixed, and I didn’t have to worry about whether my healthcare was going to bankrupt my family.

I can work, but it’s complicated (ultimately because of my disabilities.) The jobs that I can do are usually part-time, low-wage, with no benefits. I’m one of the lucky ones — because I live in a low-rent building and because a government program covers the cost of my medications, I can still pay all my bills.

Jason Chaffetz, Healthcare, and Class Privilege

One of the bits about Trump’s new plan that I did hear yesterday (because it’s all over my Facebook feed) was the Jason Chaffetz interview with CNN. If you haven’t had a chance yet to hear the very definition of class privilege, take a listen (or read the transcript below the video, from 1:47 to 3:02):

Alisyn Camerota: What if it leaves lower-income Americans uninsured?

Jason Chaffetz: Well, we want them to be able to provide, have a method so that they can get access to it. There are things that we really do like, for instance dealing with pre-existing conditions, allowing people up to the age of 26 to —

Alisyn Camerota: You’re going to keep those tenets?

Jason Chafferz: Yup, these arbitrary lines of states —

Alisyn Camerota: Sure.

Jason Chafferz: So I think there’s a lot of good things that we need to —

Alisyn Camerota: But access for lower-income Americans doesn’t equal coverage.

Jason Chaffetz: Well, we’re getting rid of the individual mandate. We’re getting rid of those things that people said that they don’t want. And you know what? Americans have choices. And they’ve gotta make a choice. So maybe rather than getting that new iPhone that they just love and that they want to go and spend hundreds of dollars on, maybe they should go invest in their own healthcare. They’ve got to make those decisions themselves.

Alisyn Camerota: So, in other words, for lower-income Americans you’re saying that this is going to require some sacrifice on their part.

Jason Chaffetz: Well, we’ve got to be able to actually lower the cost of healthcare. I mean, one of the things we’re concerned about is healthcare inflation is just consuming the American budget, both for the families and and at the federal government. We have to be able to drive those cost curves down and provide good quality access. We do think that with more choice, that you will get a better product at a lower price, and that’s good for everybody on the entire spectrum of income.

Chaffetz goes on to say later that a potential outcome of the plan is more access, less coverage (3:54).

Let’s run down Jason Chaffetz’s assumptions about lower-income Americans and their lives, as indicated by this conversation:

1. They’re frivolous and don’t make good spending decisions.
2. They have money that they can put into saving for healthcare and just aren’t doing it.
3. They should sacrifice even items that arguably aren’t even luxury (many people don’t use a land line anymore and depend on a cell phone) to bring down health care costs for everyone, when it doesn’t seem that he’s holding higher-income Americans to the same standard.

There’s also an implication that giving up that cell phone should be enough to provide people savings enough to get all the coverage they need, when the new plan has shown no proof of that so far. This tweet talks about the cost of a phone vs the cost of a young woman’s angle surgery.

The GOP Doesn’t Like Low-Income Americans

It’s a relief that Trump has decided to keep the Obamacare regulations on pre-existing conditions and staying on parents’ plans until 26, and that he’s committed to making the plan portable across state lines. And when Jason Chaffetz went on FOX to further explain his comments, after social media exploded, he said that, “What we’re trying to say — and maybe I didn’t say it as smoothly as I possibly could — but people need to make a conscious choice and I believe in self-reliance. And they’re going to have to make those decisions.” That sounds much better than the plan he described on CNN.

However, I wouldn’t forget his words in that first CNN interview. GOP policies regarding low-income Americans tend to be punitive, assuming that all low-income people are either out to scam the system or irresponsible, and that higher-income people are deserving of better treatment. When we consider that the GOP also wants to cut Medicare, this healthcare bill as described by Chaffetz on CNN is all those things; even though he’s tried to walk it back, we shouldn’t be shocked if that’s exactly what Trump’s healthcare plan turns out to be.

The American Medical Association agrees that the current version of “Trumpcare” won’t provide adequate health care for vulnerable Americans. AMA President Andrew W. Gurman said in a press release:

“The AMA supported health system reform legislation in 2010 because it was a significant improvement on the status quo at the time; and although it was imperfect, we continue to embrace its primary goal — making high-quality, affordable health coverage accessible to all Americans,” AMA President Andrew W. Gurman, M.D. said. “As drafted, the AHCA would result in millions of Americans losing coverage and benefits. By replacing income-based premium subsidies with age-based tax credits, the AHCA will also make coverage more expensive — if not out of reach — for poor and sick Americans. For these reasons, the AMA cannot support the AHCA as it is currently written.”

Other groups have joined the AMA in its stance, including the American Hospital Association and the American Academy of Family of Physicians.

I’m Worried

Canadian healthcare is far from perfect. Obamacare wasn’t perfect either. And I’m only learning about this new plan, and I’m willing to see how it pans out.

But I’m worried, even just after hearing Chaffetz’s CNN interview, that disabled people who can’t work and other groups living in poverty are going to suffer under this new bill. Please be prepared to fight for them.

They need your voice.

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