A few days after print publication, Knight's syndicated newspaper column, which moves twice a week, will be posted. The most recent will appear at the top.

Wednesday, February 15, 2017

In health care, are the wages of sin still death?

Bill Knight column for Mon., Tues. or Wed., Feb. 13, 14 or 15

Valentine’s Day is celebrated this week, when St. Valentine is remembered as the Patron Saint of love. But he’s also the Patron Saint of plague and epilepsy, which in ancient times was interpreted as a sign of sin. In Christianity, the “seven deadly sins” are anger, envy, gluttony, greed, lust, pride and sloth, and as one looks at Republican plans to eliminate the Affordable Care Act, several sins sure seem present – maybe even to the self-identified Christians who voted for GOP control of the White House, Congress and Supreme Court.

Ironically, the deadliness of ripping health-insurance coverage from millions of Americans is oddly reminiscent of Republicans’ false claim of ACA’s “death panels.” And people with epilepsy or modern or milder equivalents of plague may soon have to rely on St. Valentine for intercession for their conditions.

Further, if there are deadly sins at work in Washington, they might be put into context when considering the “Seven Social Sins,” which India’s heroic reformer Mahatma Gandhi first published in 1925.

Gandhi said they should be known “through the intellect but [also] through the heart so as to avoid them.”

Gandhi’s list: commerce without morality, knowledge without character, pleasure without conscience, politics without principle, religion without sacrifice, science without humanity, and wealth without work, Regular Americans can recognize for themselves where these social sins occur as millions of our fellow citizens are adversely affected by losing insurance they gained through the ACA or its exchanges.

However, Kaiser Health News reported that even workers covered through employer-sponsored health-care plans could suffer consequences:

* Waiting periods for coverage, which before the ACA could be set by employers, is now limited to 90 days. That could rise to whatever employers want.

* Maximum limits on coverage used to be common before the ACA, which removed limits that formerly restricted coverage over a time period, like a year, or the lifetime of a policy. Costs above such limits were paid by insurers under the ACA. That could disappear, too.

* Another result could be fewer preventive services such as vaccines, flu shots, blood-pressure and cholesterol screening, and tests for hepatitis C, colorectal cancer and diabetes – plus preventive measures for women (from breast and cervical cancer screening to pre- and post-natal services) and for kids (who benefit from the ACA’s no-copay for hearing, vision and autism screening). If ACA is repealed, no plan will be required to continue such services.

Prevention is especially vital since the biggest opportunity to reduce health-care spending in the United States is in preventive care, according to a study out this winter in the Journal of the American Medical Association. JAMA found that Americans spent $3.2 trillion in 2015 on health care, largely driven by chronic and usually preventable conditions such as heart disease, diabetes, and back and neck pain. (The latter two ailments over the last 20 years showed spending increases of about 6 percent every year.)

The JAMA analysis also says that within the next decade, health-care spending will make up almost 20 percent of the U.S. economy. (That compares to about 11 percent for much of Europe, 10 percent for Canada and Japan, 9 percent for Australia, and 8 percent for the United Kingdom, according to the private Commonwealth Fund foundation.)

So anticipating an aging (and more expensive) population makes cost-cutting significant, and prevention and the services that help patients and health providers reduce susceptibility to diabetes, heart diseases and so on are important.

It would seem to be a sin to ignore the need. Maybe commerce without morality?

It would seem to be a sin to ignore people: politics without principle?

After all, as acclaimed Christian author Shusaku Endo of Japan wrote, “Sin is not what it is usually thought to be. It is not to steal and tell lies. Sin is for one man to walk brutally over the life of another and to be quite oblivious of the wounds he has left behind.”

[PICTURED: Poster from Sojourners -]

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