Sunday, June 25, 2017

For the record: Senator Hatch's abandoned and malignant heart

There can't be a lot of doubt as to whether the Senate health bill would lead to increased mortality rates, because there's just so much evidence: a direct association between lack of insurance coverage and death rate:
significant body of research has demonstrated the health benefits associated with health insurance expansion, including reducing the rate of death among the population. One study found that state Medicaid expansions that preceded the ACA were associated with a significant reduction in mortality. A recent analysis of these pre-ACA Medicaid expansions demonstrated a 6 percent decline in all-cause mortality due to Medicaid expansion. Another analysis showed that following implementation of the ACA’s provision that allows young adults to remain on a parent’s health insurance until age 26, mortality rates decreased among Americans ages 19 to 25. In particular, mortality caused by diseases amenable to health care dropped among young adults, while trauma-related mortality did not. And a study of patients with cancer between the ages of 20 to 40 found a statistically significant association between insurance coverage and reduced mortality from any cause. (Center for American Progress)
Thanks to the experience gained from the 2006 Massachusetts health care law (CAP explains), which Democrats pushed through the state legislature over Republican Governor Willard Mitt Romney's nine vetos, we can quantify the number of American lives that are being saved by the Affordable Care Act every year, and estimate pretty closely how many American lives would be lost if the House "American Health Care Act" proposal had become law; taking the Congressional Budget Office calculations as to how many people would lose health insurance under the proposal, some 216,900 more people would die, from 2018 through 2026, than if the ACA were left intact.

We can't say with equal certainty how many people the Senate bill will kill—that has to wait until the CBO score for the bill comes out in the next couple of days—but there's no reason to think it would be a lot different. And, Senator Hatch, these are born people, meaning that the legal system of any country on earth can ask if their deaths are wrongful or not; unlike abortion, which is outlawed in many countries but not legally called homicide in any of them.

I don't blame Senator Hatch for feeling people are being rude in suggesting that he and his fellow congressional Republicans are murderers, but if he knows why they're saying it, he at least needs to look at the evidence (from the CBO and a peer-reviewed paper in the Annals of Internal Medicine that hasn't yet been challenged) and explain why he thinks it's not valid. He can't just ignore it or limit himself to complaining about how uncivil it is.

It's probably wrong to call it murder without qualifications, I'll give you that; the correct term is negligent homicide. Or depraved-heart murder, in some states, including Utah, whose Supreme Court
defines “abandoned and malignant heart” as “depraved indifference,” and “an utter callousness toward the value of human life and a complete and total indifference as to whether one’s conduct will create the requisite risk of death of another.” State v. Standiford, 769 P.2d 254 (Utah 1988).
In showing a complete and total indifference as to the deaths your vote could lead to, that's where you are.

More from The Guardian, which interviewed some Medicaid patients on the wrong end of a Senate death sentence.

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