You’ve got to admit the past few days have been Washington nail biters. There was Obamacare (also called the Affordable Care Act, or ACA), slowly mounting the stairs to the guillotine. Up on the platform, blade-release rope in hand, was Donald Trump, quite GQ in his black Brioni and matching hood.
The foul and hazy horizon was more eye-blistering than usual for the 24 million low-income voters – many of whom likely voted for Trump and against their own interests – about to lose their health insurance with a quick yank of Donald’s rope. But even Republicans, whose frosty wives had already banked the extra cash from their tasty new tax cuts, had to draw the line somewhere. Somewhere in their trickle-down thinking, did a sudden flash of pity emerge at the thought of all those constituents suffering or even dying of preventable illnesses? Or was it was plain old survival instinct in the wake of town hall meetings where those same constituents shouted down any support of Trumpcare.
For the handful of you who continue to maintain that these Health Tips should be nonpolitical, limited to topics that keep you healthy, youthful, and disease-free, do you get it now? Doctors are morally obligated to be involved, and they have been. The AMA, AAFP (family physicians), ACP (internists), and AHA (hospitals) all took the same stance, begging Congress not to axe Obamacare/ACA.
In fact on election day, fearing Trump would try to repeal the ACA, physicians voted for Hillary Clinton 2 to 1.
With Obamacare safe for now, understand there are many more challenges ahead that, in one way or another, continue to involve your health and the physicians trying–sometimes struggling–to take care of you. I’m going to spend the rest of this Health Tip reviewing how a handful of Trump’s ill-considered budget proposals will directly affect your health and that of generations to come.
But before I start, I was thinking about Vladimir Putin and his enthusiasm for Trump. Well before the election, he must have known all about Trump and his Republican cohort’s plans and probably had his smart Kremlin advisors guessing about Trump’s cabinet picks.
“Aha!” he thought, “He’s creating a kakistocracy! He’ll pick cabinet members who will back him 100%. In a few years, the US will be a completely uneducated, chronically ill, filthy country that will collapse from its own undoing.” Thrusting a clenched fist skyward, he shouts, “Good time to watch Idiocracy again. So much funnier than Triumph of the Will.”
Here’s whose tracheas get crushed by Donald’s iron boot
Housing Trump’s budget trims $3 billion from Community Directed Block Grants, whose dollars provide subsidized housing for the poor and elderly. Currently, there are multi-year waiting lists for these apartments. Many of the buildings are in terrible shape. Some years back, I was medical director for a city program called Elderly In Distress. I saw dozens of such subsidized apartments and even back then they were often roach- and crime-infested and unheated, with erratic plumbing. People couldn’t get to doctors because the elevators were broken.
Ben Carson, Housing and Urban Development secretary, who by all accounts knows nothing about housing except that he owns a few, says he agrees with Paul Ryan’s proposals to have lease limitations and work requirements for anyone living in public housing. Trump’s new Americans thus will actually add to our already burgeoning homeless population.
Health and Human Services Here’s an outrage that triggers the grinding of my molars to dust. Trump’s budget trims almost $6 billion from the NIH (National Institutes of Health). In case you were unaware, the NIH consists of 27 separate institutes, including those that support cancer, eye, heart, lung, blood, and human genome research. NIH not only does research on site, but spreads its grants like peanut butter to researchers across the entire US (many of whom are immigrants, just as an aside). Without government support of HHS, Trump’s new American may be unable to cope with illnesses that other, more progressive countries have kept under control.
The Department of Education suffers $9 billion in cuts as 20 programs are eliminated or seriously reduced. Cabinet appointee Betsy DeVos, whose life experience does not include public schools, wants this money directed to charter school vouchers. Read this chilling Rolling Stone piece, which describes her appointment as education secretary as marking “the crowning achievement of the Christian right’s campaign to infiltrate America’s secular institutions.” Her idea of a charter school is Christian-based education with a return to school prayer, “Christian values” (whatever these are), and putting intelligent design, that quasi-debate between evolution and creationism, into the curriculum.
This mega-cut would mean losing programs in literacy, critical thinking, teacher training, and workshops that help low-income students prepare for college. By defunding education, Trump’s new Americans will slowly but steadily get dumb and dumber. For those who believe art is a valuable adjunct to education, the National Endowment of the Arts (NEA) disappears, as does the Corporation for Public Broadcasting, which supports PBS (Channel 11) and National Public Radio (WBEZ).
The Environmental Protection Agency Slashed by $2.6 billion, loses 3,200 employees. These are the folks who direct industrial cleanups, monitor air and water quality, and penalize polluters. During my medical training, I treated lead poisoning in kids and black lung in miners. Growing up, I couldn’t see the skyline in Gary, Indiana, for the thick, throat-clenching pollution. Today doctors treat an increasing number of patients who have multiple chemical sensitivities. Our kakistocracy and the folks who voted these selfish clowns into power are the only people on the planet who still deny the existence of climate change. Trump’s new Americans will look more and more like the residents of Flint, Michigan, whose water is contaminated with lead.
If you’re interested in a full list of what Trump’s budget seeks to eliminate, click here. It is very disturbing.
But there’s a bit of good news on the horizon, brought to you by Big Pharma. Spotting a worrisome trend in generalized anxiety, they’ve developed a new drug that will tweak your neurotransmitters just enough to keep you in survival mode. Drug reps are confident it will be covered by health insurance. If you’ve not seen the commercial for it, click here.
And be well,
David Edelberg, MD