With John McCain’s support, and a tie-breaking vote by Vice-President Mike Pence, the Republican party managed to bring the Better Care Reconciliation Act of 2017 to repeal and replace the Affordable Care Act (aka Obamacare) to the Senate floor for debate. Originally proposed in March 2017, 488852623this bill made it out of committee in record time.
The Senate rejected the bill Wednesday, but Republican leaders are now trying to gain support for a slimmed-down version. It’s unclear exactly what the “skinny” bill would include, but so far all versions of the Republican health plans include variations of measures to decrease government support of Medicaid by approximately 850 billion dollars over the next 10 years and leave 20-25 million more Americans without health insurance. Many of them substantially increase average premiums.
In contrast, health care proposals that actually benefit the public, sometimes at the expense of Big Insurance, Big Food, and other “Bigs”, seem destined to be shuffled from committee to committee for years without ever being openly debated in Congress and in front of America. Something is wrong here. Why should health care bills designed to enrich big business be prioritized over those that promote a healthier America?
The Stop Subsidizing Childhood Obesity Act, introduced by two Democratic senators in 2012, would have ended federal tax subsidies for advertising promoting the consumption of products that are unhealthy for children. That money would be re-routed to provide more fresh fruits and vegetables to elementary school students in low income schools.
The idea that we should stop government support for unhealthy products and use those funds to promote better health instead seems like a no-brainer. Except for the fact that if it passed it would stop giving Big Food companies a tax break when they encouraged our kids to eat cakes, candy, sugar sweetened beverages and other foods that are clearly bad for them. Yet the bill has never made it out of committee and has been resubmitted to each Congressional session.
In 2014, Democratic Representative Rosa DeLauro proposed the Sugar-Sweetened Beverages Tax Act, also known as the SWEET ACT - another plum languishing on the vine. The SWEET ACT would place an excise tax on sugar-sweetened beverages in proportion to the amount of sugar they contain. Even better, the tax income would go directly “to the prevention, treatment, and research of diet-related health conditions”, instead of into the pockets of Big Food. The day after it was submitted to the 113th Congress it was referred to the House Subcommittee on Health and there it stayed until the end of the Congressional session. Back to square one. It was re-introduced to the 114th Congress on March 26, 2015 and was promptly referred to the House Ways and Means Committee and the House Energy and Commerce Committee. It still has not made it to open debate. This is especially tragic because it is an extremely cost-effective proposal. Passage of the SWEET Act would have a projected savings return on healthcare costs of $30.78 per dollar spent. For an annual investment of $50 million, America would save over $1.5 billion. This is a great bill for everyone except the sugar sweetened-beverage and high fructose corn syrup industries.
Let’s also not forget the bipartisan Treat and Reduce Obesity Act of 2013 that recognizes obesity as a disease in accordance with the American Medical Association and mandates Medicare part D reimbursement for multiple resources including dietitians, lifestyle counselors, and pharmacotherapy to prevent the complications of obesity rather than waiting for them to develop (and accounting for approximately 200 billion dollars of direct health care costs per year). The bill also instructs the Health and Human Services Department to develop and implement a comprehensive new research and outreach plan to combat the obesity epidemic and to foster our understanding of this disease. This is now in committee as the Treat and Reduce Obesity Act of 2017. The lethargy in moving this bill and others like it forward and the continual overfeeding of big businesses that profit from these delays has become an epidemic unto itself.
To be sure, the U.S. Congress has passed bills that provide better health care to the public at large. For example, the Healthy, Hunger-Free Kids Act, which provided more nutritious school lunches for our children, was shown to be a cost-effective way to improve school attendance and academic performance. Unfortunately, it has been recently gutted by Secretary of Agriculture Sonny Perdue. Of course, the Affordable Care Act did increase coverage for 35 percent of Americans who are obese and would have continued coverage for the 40 percent of Americans who are projected to develop Type 2 diabetes. However, if the current Republican proposal passes, these would become pre-existing conditions, even if they developed in childhood - and insurance costs could become prohibitive.
The legislative branch of government in particular is supposed to represent the best interests of the American population. As far as our health goes, the Republican congress seems to have lost track of this goal. It has consistently allowed legislation that favors better health to languish in committee while it railroads through those bills that favor insurance and other big industries. The question now is what type of bill to we want to make it to the floor of Congress - those that support millionaires or those that support millions of Americans?
Dr. Michael Rosenbaum is a Professor of Pediatrics and Medicine at the Columbia University Medical Center in New York City and is also a practicing pediatrician and a recent graduate of the Columbia University Op-Ed Public Voices Program.
The views expressed in this article are not those of Reuters News.