Overnight there blossomed numerous Constitutional scholars on my Twitter feed. Countless Americans, members of both parties, representatives in Congress and average citizens debating the rights guaranteed us in the US Constitution.
The right to access Twitter. The right to participate in inflammatory discourse online. The right to maintain a social media platform. The right to oppose an election. The right to storm the Capitol.
Like many Americans I have delved into the discourse with voracious fascination this past week, unable to pull myself away from the civil rights debates happening during such an unprecedented time in our nation’s political history.
But the backdrop for me and my colleagues in health care is marred by other events just as unprecedented – a pandemic, raging wildly uncontrolled, overwhelming our health care infrastructure and claiming multiple American lives every minute.
And while the politicians are debating about their rights to Tweet, Americans are desperately in need of a right to health care.
Even before the pandemic began, the US health care system was in dire straits and the lives of Americans at risk. A jarring analysis published last year in the Journal of the American Medical Association summarized the data bluntly: For the first time in decades US life expectancy is dropping.
We boast of our status as the most developed nation in the world but our citizens are no longer enjoying the gift of longevity promised by the medical advances of the 21st century.
The authors of the study delved deeply into several possible explanations for our drop in life expectancy and postulated that while the opioid epidemic might play a role, other factors such as structural inequities, obesity, tobacco use and access to healthcare are also contributors.
As a primary care physician, what strikes me is how many of these factors are preventable when communities have access to health insurance and preventive medicine. Yet, every day I see patients forego care due to costs, a crisis that has been magnified immensely during this pandemic because of massive job loss and under-insurance. And, much like the death tolls in this pandemic, the crisis of under-insurance is one that disproportionately affects Black communities and communities of color.
Last week I did a free telephone visit with a patient who recently lost insurance at the same time she received a report about an abnormal mammogram. As I helped direct her to a free clinic for ongoing care, my heart ached to imagine her losing access to her clinic because of insurance issues. Earlier in the month I discussed finances with a patient requiring blood thinners – a father who brought me receipts so I could help him decide which medications fit his budget.
This is an American reality, now worsened by a pandemic claiming thousands of lives every day, a virus that has devastated our citizens more than any other population globally, and an administration that has shown stark indifference to such a crisis.
While medical schools and residencies are increasingly being asked to train our students in compassionate and equitable care, pillars of medicine which are critically important, it is an injustice that they are asked to graduate into a system that fails to be compassionate.
Our generation will be one defined by loss. The pandemic is now the third leading cause of death in America and the number one cause of death for young adults in many parts of the nation. In addition we will be grappling with the psychological and emotional trauma of the racial violence perpetrated against minority communities and the rise of anti-Semitic nationalism.
We have to approach this ongoing crisis with the urgency and compassion it deserves. We demand equity and compassion from our criminal justice system, let us make the same demands of our health care system.
There can be no civil rights debate without discussing the right to health. If there was any time to talk about Medicare for All, universal health care coverage for Americans regardless of their ability to pay, the moment is now.