Originally published in the Dedham Times December 1, 2017
“I just want a country where affording health care is easy and getting shot in the street is hard. Why is that so much to ask?”
– Greg Greene, June 14, 2017
This quote, originally delivered as a tweet, has stuck with me ever since I saw it. If the Democratic National Committee were smart, they would use it for their campaign slogan. But it also speaks to the great divide we have in the United States today, amplified by the usual gridlock in Congress and the unusual behavior of our president. Our problems stem from a disconnect between the ruling class in this nation, who are clearly not interested in the well-being of their people, and the average citizen, who is so fed up and disillusioned with the government that they no longer believe our problems are surmountable.
There were 372 mass shootings in the US in the year 2015, killing 475 people and wounding 1,870, according to the Mass Shooting Tracker. FBI data shows there were approximately 11,000 gun-related homicides in 2016. According to the CDC, firearm deaths rose for the second straight year last year. According to the United Nations Office on Drugs and Crime, America has six times as many firearm homicides as Canada, and nearly sixteen times as many as Germany. It’s been five years since twenty children and six adults were murdered at Sandy Hook Elementary School, and no major changes have been made in our federal gun laws.
How is this acceptable? Why are we treating these man-made incidents, done with man-made weapons, as if they are unpredictable acts of nature, like earthquakes and volcano eruptions? The answer is political courage, which is severely lacking in our government today.
After the recent massacres in Las Vegas, Nevada, Sutherland Springs, Texas, and Tehama County, California, it seems this type of horror is becoming part of everyday life in American society, and our nation’s leaders have done nothing to stop it. The federal assault weapons ban was allowed to expire in 2004 with the help of a Republican Congress and President George W. Bush. According to a Princeton University study, the number of mass shootings went down during the ten years that the ban was in effect. This same study indicates that mass shootings doubled since the ban was lifted.
In Australia, there is an entirely different picture. After a mass shooting in Port Arthur in 1996 where thirty-five people were killed, conservative Prime Minister John Howard instituted a sweeping reform in the country’s gun laws, including a mandatory buyback program, where 600,000 firearms were purchased and destroyed by the government. Since then, there have been no mass shootings (defined as incidents resulting in four or more victims), and according to a study by the Journal of the American Medical Association, the Australian gun reform is also responsible for a decline in gun-related suicides and homicides.
Our problem here is that regardless of the facts and figures, there is a strong contingent of people in America who will simply point to the Second Amendment and say what happened in Australia, and other developed countries that have reformed their gun laws, cannot be done here. However, this amendment was written 230 years ago, at the same convention where the concept of a slave being worth three fifths of a human being was agreed on. A revision is merited. If we’re being honest about the debate over guns in the U.S., we have to agree that the weapons available in 1787 are not the same as the arsenal of mass murder that exists today. It would take 30 musketeers to match the output of one AR-15 rifle. Even a good soldier in the 18th century could only fire his weapon three times in a minute; the AR-15 can fire 100 shots in that time frame.
The Massachusetts Legislature was quick to respond to the Las Vegas shooting by banning bump-stocks, which were used by the shooter to convert his semi-automatic weapons to automatic weapons. However, there is still work to be done. In response to the 2016 Orlando nightclub shooting, where the shooter used a Sig Sauer MCX semi-automatic rifle and a 9 mm Glock 17 semi-automatic pistol to kill 50 people, Attorney General Maura Healey moved to make copycats of banned assault weapons illegal. The Gun Owners’ Action League, the Bay State arm of the NRA, held a rally at the State House to protest the action. An unfortunately large group of House members, including my own, signed on to letters urging Healey to reconsider the order.
Wherever one may stand on this issue, we ought to at least find common ground in the basic idea that the status quo is completely unacceptable. I do not want to raise a family in an environment where my children could be victims of an armed madman’s whim. The weak laws we do have on the books are clearly not effective. We run the risk of becoming a shut-in society, where people simply do not feel safe enough to attend public events and restrict themselves to working and going home to watch Netflix. For example, consumer spending on Net video is projected to hit $13.6 billion this year, surpassing box office sales by more than $2 billion, according to PricewaterhouseCoopers. Is that really the land of the free? We seem to be sacrificing our rights to life, liberty and the pursuit of happiness in order to protect the right to bear arms.
The author of the document which enshrined those words, “life, liberty and the pursuit of happiness,” Thomas Jefferson, also had sound advice for us on the utility of laws made centuries ago:
“Laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths discovered and manners and opinions change, with the change of circumstances, institutions must advance also to keep pace with the times. We might as well require a man to wear the coat which fitted him as a boy as civilized society to remain ever under the regimen of their barbarous ancestors.”
This brings me to my second point: health care should be a human right.
Despite the best efforts of President Obama and most, but not all, Democrats in Congress, we are still left with a confused mixture of public and private health insurance plans with no relief in sight from skyrocketing costs. According to the Kaiser Foundation, during fiscal year 2016, combined federal and state spending for Medicaid in Massachusetts totaled about $17.1 billion, or over a third of the entire state budget.
State spending on Medicaid increased by about 32.5 percent between fiscal years 2012 and 2016. So while we have improved our coverage of people, we still have not resolved the challenge of an unsustainable fee-for-service payment system. When the Affordable Care Act went live in October 2013, I was working at the Massachusetts Health Connector. The state’s website for calculating premium tax cuts was down for months, leaving people unable to sign up for plans. For many of them, the most effective solution was to simply place them on MassHealth, the state’s version of Medicaid. This did not involve a complicated tax formula or plan selection process – we simply entered their information into the system and they were able to see their doctors.
Unfortunately, even in Massachusetts, people like Pete Frates have to endure astronomical costs for their health care. Frates, who suffers from ALS and has helped to raise millions for research via the Ice Bucket Challenge, requires around-the-clock care for his disease. His family has said it costs between $80,000 and $90,000 a month to keep him alive. His care is not entirely covered by insurance, forcing the family to seek outside donations to allow him to remain at home.
This is all too common in our society: we learn of a friend or relative who has fallen ill or suffered a grave injury, and inevitably a fundraiser or GoFundMe page is organized because insurance doesn’t cover the costs. President Kennedy called disease one of “the common enemies of man.” Why don’t we truly fight this enemy together, harnessing the same ferocity with which we fight other adversaries?
One of the most repeated arguments against universal health care is that it is seen as “socialism” or somehow antithetical to liberty. However, according to Forbes, of the eleven countries ahead of the U.S. in economic freedom, ten have universal coverage. In fact, as stated in The Atlantic, “The U.S. stands almost entirely alone among developed nations that lack universal health care.” There seems to be a deep-seated fear of “socialized medicine” among our political leaders, yet we already have Medicare for our seniors, Medicaid for our poor, as well as Tricare for our veterans, and we are still a capitalist country.
A Medicare-for-All system would resolve the payment problem and cover the 28 million people who still have no health insurance. If our health care system is expanded and reformed correctly, Medicare will be able to negotiate better prices for services and medicine than the insurance companies, which will bring down the skyrocketing costs, or “bend the cost curve,” as President Obama said. The plan proposed by Senator Bernie Sanders was estimated to cost $1.38 trillion over the first ten years, according to an analysis by UMass economist Gerald Friedman. Since President Nixon declared a War on Drugs in 1971, the United States has spent over a trillion dollars on that failed effort. According to the Department of Defense, taxpayers spent about $168 billion (roughly $950 billion in 2011 dollars) on the Vietnam War, and according to Brown University, $5.6 trillion on wars since September 11, 2001. According to the University of Texas, NASA’s total inflation-adjusted costs have been more than $900 billion from its creation in 1958 through 2014. Political courage, again, is what has stalled this long sought-after solution.
The Republican-controlled House has voted to repeal the Affordable Care Act over 50 times and President Trump made Obamacare one of the central punching bags of his campaign, calling it a “disaster” and vowing to “repeal and replace” it on day one of his first term. They are more focused on finding new ways to cut taxes for the rich than new ways to provide health care for Americans.
Many gun rights advocates, including President Trump, have argued that we do not have a gun problem in this country, but a mental health problem. As the old, worn-out trope goes, “guns don’t kill people, people kill people.” If conservatives in Congress truly believe that, they should be in favor of expanded access to mental health services for the people who need it most. However, the American Health Care Act, which the House passed this year only to see it defeated in the Senate, would have cut Medicaid funding and decreased access to mental health counseling. So while our government would not even entertain background checks or closing the gun-show loophole in the wake of the Sandy Hook shooting, voting down the Manchin-Toomey Amendment in 2013, they were more than eager to cut the mental health services they point to each time a massacre happens.
Ever since the Wagner-Murray-Dingell bill was filed in 1943, the uphill legislative battle to achieve national health insurance has been inching forward. Massachusetts may have to lead the way again on this issue. State Senator Jamie Eldridge filed a bill, S.619: An Act Establishing Medicare For All in Massachusetts, which would create a single-payer health care system for Massachusetts, guaranteeing coverage for every resident of the Commonwealth. I would like my legislators to become co-sponsors of this legislation.
The most encouraging news comes again from the Upper Branch of the General Court. The Massachusetts Senate recently passed a bill that includes an amendment, filed by State Senator Julian Cyr, to study the costs and benefits of a single-payer health care system in the state. This shows a willingness, at least, to move forward in the direction of true universal coverage. The House has not yet taken up this bill.
It is my hope that in the days ahead, our lawmakers on both sides of the aisle will stop worrying about their own re-election and start following the facts where they truly take them. I believe this path will lead toward increasing the health and safety of the people they swore to represent. As the late Robert F. Kennedy said, “There are those that look at things the way they are, and ask why? I dream of things that never were, and ask why not?” It’s past the time for us to ask this question of all our elected officials.