My Personal Story
A couple years ago, I was living in The Bahamas and I was privileged to have an expat health care plan that was 100% paid for by my employer, Two weeks into my first living abroad experience, I was diagnosed with acute appendicitis which was advanced enough that surgery was performed in Nassau.. Cost for the surgery and hospital stay? USD 0. Hospital stay under that plan in the US? USD 1,200. The plan covered 100% of all medical expenses, unless they happened in the United States. Why the variance in price? I’ll use an Endoscopy as an example. A private Endoscopy in the UK runs USD 2,5001. In Australia that same procedure will set you back USD 1,8002
I’m currently on an ACA plan that costs USD 455 per month. That’s the least expensive plan available to me where a USD 8,000 or more deductible doesn’t have to be met first. I recently had an Endoscopy here in the United States. My out-of-pocket expense was USD 1,300. The top line cost for services was over USD 20,000.
Health Insurance and Poverty in the LGBTQ+ Community
Recent reporting from the Fort Myers Florida Weekly shows 2.8M Floridians are uninsured3. That’s roughly ten percent of the entire population of the state. The number doesn’t include those who only have catastrophic coverage or plans only that only cover the bare minimums with high deductibles and co-pays. Emergency Rooms become the primary care physicians for this segment of the population. Small rural communities like Williston, Florida no longer have ERs, forcing patients to travel to bigger cities like Gainesville. Small rural counties like Citrus no longer have publicly owned hospitals and rely on a charity board to cover the expenses of some lower income patients.
Nationwide, sixteen percent of the LGBTQ+ community making under USD 45,000 doesn’t have insurance with the number being higher in states without Medicaid expansion4. Twenty seven percent of our community makes under USD 24,000 a year and twenty seven percent are food insecure. Both figures are higher than that of the non-LGBTQ+ community in Florida5 . The focus of our LGBTQ+ political organizations has largely been on civil rights, but we’re leaving those members of our community behind who fall into these categories. One of the ways we’re doing that is by supporting establishment Democrats who while LGBTQ+ friendly aren’t supportive of Medicare for All or broader social programs to help all the members of our community.
Some Startling Facts About Health Care in General6
37 million American adults didn’t fill a prescription because of costs.
36 million people skipped a recommended test, treatment, or follow-up because of costs.
40 million people didn’t go to a doctor to check out a health problem because of costs.
57 million people had trouble covering their medical bills. An average family of four with employer-sponsored insurance spent $12,378 on employee premium contributions and out-of-pocket costs in 2018.
87 million Americans are either uninsured or underinsured.
What is Medicare for All
“The United States trailed other countries in making health care affordable and ranked poorly on providing timely access to medical care (except specialist care),” the report reads. “Problems were often particularly acute for low-income adults.”7
At its core this program is a single-payer system, where all Americans are covered by Medicare, not just the elderly. Various versions of the reform include provisions that would bar insure companies from selling similiar plans and it includes provisions for negotiations with pharmaceutical companies, providers and facilities to bring the cost of health care down. Divorcing our health insurance system from employment status and wages is another primary benefit this program.
How Do We Get There?
Senator Elizabeth Warren proposed a multiple step plan that begins with lowering the eligibility age for Medicare from 65 to 50 and fighting corruption in the prices that Big Pharma charges for drugs. The Medicare program is currently unable to negotiate for drug prices, a major roadblock in this process. Nearly $1 of every $5 of Medicare expense comes from prescription drugs, with many of the mostly commonly prescribed medications outpacing inflation including those essential for treatment of cancer, Diabetes and stroke prevention8.
What’s Standing in the Way of Medicare for All?
Moderate Democrats beholden to campaign contributions from Big Pharma, the insurance industry and the health care industry are a large piece of the problem. U.S. Congresswomen Stephanie Murphy accepted over USD 250,000 in contributions from these industries. US Representatives Debbie Wasserman-Shultz and Darren Soto also received sizeable campaign contributions from these industries during the 2020 cycle9.
The Partnership For America’s Healthcare Future was founded by health insurance companies, Big Pharma and Hospital companies with the express purpose of defeating Medicare for All.
The partnership includes some of the biggest names in the healthcare industry, including the American Medical Association (AMA), Pharmaceutical Research & Manufacturers of America (PhRMA), Federation of American Hospitals (FAH) and Blue Cross/Blue Shield10.
All told, the members of the partnership have a lot of money and influence to spend on Capitol Hill. They spent a combined $143 million lobbying in 2018 alone, according to data from the Center for Responsive Politics. https://www.opensecrets.org/news/2019/03/big-pharma-insurers-hospitals-team-up-to-kill-medicare-for-all/
Republicans are naturally opposed to the plan which if it manages to squeak past moderate Democrats in the House, faces an even more uphill battle in the Senate.
What Next?
The need to raise awareness in the LGBTQ+ community of the severity of the health crisis in our country is essential to furthering the expansion of Medicare. This starts by examining the privilege that comes with being an upper middle-class or upper class member of the LGBTQ+ with a corporate health insurance plan. Challenging the notion that our allies in government need to go further and support this initiative while painful is also a necessary step. DEI initiatives must include seats at the table for the impoverished and uninsured members of our community either directly or through surrogate non-profit organizations.
Our goal should be for everyone to be lifted on the rising tide of equality, and that none of our sisters and brother be left behind, regardless of where they live or their socioeconomic status.
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