Death toll of the uninsued

Medical staff move bodies from the Wyckoff Heights Medical Center to a refrigerated truck on April 2, 2020 in Brooklyn, New York. (Photo: Angela Weiss / AFP) (Photo by ANGELA WEISS/AFP via Getty Images)

Before You're Done Reading This, Someone Will Die of Political Neglect

This is arithmetic, but it's arithmetic that hurts.

While you are reading these words, somebody in this country will die needlessly. Under cause of death, the coroners' report should read, "political neglect." We made the political choice to let them die.

One of the most straightforward ways to measure our lethal neglect is through deaths by uninsurance. The lack of health insurance is killing someone as we speak. By my calculations (which I explain in detail here), slightly more than 30,000 people die every year from lack of insurance in this country. That's nearly 83 deaths per day, or 3.45 deaths every hour. That's one death, on average, every 17 minutes or so.

"If [the left] leaves single-payer healthcare and the Green New Deal on the battlefield, it will have lost the moral clarity that makes its message so compelling."

Those figures don't include death from under-insurance, but that's common in the United States, too. Americans routinely tell pollsters that they have put off needed medical care because they can't afford the copayments and deductibles. Sometimes they die as a result. Those figures are not easy to find, but they certainly bump up the likelihood that someone will die because of our political choices while you're reading this.

That someone may well be a child. Before the day is over, more than thirty children will be dead because of our indifference to economic inequality, structural racism, and the destruction of our environment. That's based on the UN Rapporteur's finding that 600,000 children had died needlessly in the United States over a 50-year period. That comes to 32 children per day, or more than one child per hour.

We haven't even factored Covid-19 into these figures yet. The pandemic may have peaked, but people continue to die from it. And the death toll increased exponentially because of our political choices. According to one analysis, one out of every three Covid-19 deaths in this country "are linked to health insurance gaps." That's slightly more than 200,000 deaths in the last year.

As of this writing, the weekly rolling average for Covid-19 deaths is 192 per day, sharply down from pandemic highs. If the ratio holds, that means 64 people are still dying every day from deaths associated with inadequate insurance coverage. That's 2.6 deaths per hour, or one death every 22 minutes on average.

Then there's air pollution. According to one study, it kills nearly 200,000 people in this country every year. That death toll disproportionately targets Black, Brown, and poor communities. That comes to more than 520 deaths per day, or one death every 1.65 minutes. Political neglect causes other deaths, too, but how much mortality can the human spirit take at one time?

If you read at the college-educated average of 300 words per minute, you'll be done with this material within two or three minutes. That doesn't give you much chance of outracing the Grim Reaper, but you'll never know for sure. That's the point, isn't it? We never know these anonymous people, the faces and lives that make up these statistics. That's why we don't feel it. That's why we let them die.

"The problem isn't numerical, but moral. It seems to me we're obligated to focus on the lives we aren't saving, not the ones we've saved."

At this point, mainstream Democrats and their supporters will often step in to point out that the Affordable Care Act has saved a lot of lives. That's true. Before the ACA was passed, an estimated 45,000 people died every year in this country from a lack of health insurance. That figure has been reduced substantially, which raises what you could call an interesting philosophical point: Should we celebrate the lives that have been saved, or focus on those that continue to be lost? It's a "morgue half full, morgue half empty" question, I suppose.

Except that the deaths haven't been reduced by half, but by roughly one-third. And the problem isn't numerical, but moral. It seems to me we're obligated to focus on the lives we aren't saving, not the ones we've saved. Those lives include the uninsured, the under-insured, the children dying from poverty and neglect, and the massive death toll from environmental pollution.

Which brings us to the progressive Democrats in Congress. They haven't been saying much lately about Medicare For All, and they seem to be deferring the Green New Deal for another day. They've been focusing on tactical gains: lowering the Medicare eligibility age, broadening its coverage, and expanding other forms of health care access. I have to admit I mixed feelings about that. On one hand, I applaud them for attempting to embrace the responsibility that comes with proximity to power (if not power itself). But I can't forget that somebody's dying right now.

Those incremental gains would save more lives. But one of the left's greatest strengths has been its moral clarity, its urgent insistence that every life matters. If it leaves single-payer healthcare and the Green New Deal on the battlefield, it will have lost the moral clarity that makes its message so compelling. That clarity contributed to the Bernie Sanders phenomenon, to the rise of a new left contingent in Congress, to the progressive shift among millions of rank-and-file voters. It will also leave thousands of lives on the battlefield.

This is arithmetic, but it's arithmetic that hurts. It's an arithmetic of the heart. As long as progressives stay silent about the lives that are still being lost, something doesn't add up. Nothing does, in fact, except the number of lost lives--a number that went up while you were reading this.

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