Eliminating Access to Health Care is Bad for Public Health and Public Safety
By Zachary Norris
Republicans are not letting up on their ongoing effort to take down the Affordable Care Act, despite their stunning defeat and the fact that 61% of people support improving the historic law rather than repealing it, according to a new Washington Post-ABC News poll. Their potential success would be disastrous — not just for our public health, but also for our public safety.
What does healthcare have to do with public safety? A lot. Public safety is about more than crime prevention. For our communities to really be safe, we need to have reliable access to healthcare.
In the process of expanding health insurance coverage to an estimated 20 million previously uninsured people, the Affordable Care Act’s essential health benefits mandate has vastly increased access to coverage for treatment for mental health conditions, which affect an estimated one in five Americans each year.
GOP leaders don’t seem to understand that making sure insurance covers basic needs, like mental health services and substance use treatment is not just about strengthening the health of those individuals who gain coverage (as important as that is). It is also about creating safe and healthy communities for all of us.
Among American adults with serious psychological distress, the percentage who were uninsured dropped from 28.1 percent to 19.5 percent in the first three years of the ACA, and it’s a good bet those declines continued into 2016 and 2017. In addition, there are 23 million people in the U.S. who have substance use disorders, and 10 percent of those received treatment during the first year ACA coverage took place.
Lack of mental health care and substance use treatment in particular, results in more people being criminalized and incarcerated, which makes us all less safe, healthy and free. That means more people with these conditions getting targeted and arrested by police, and more people ending up in jails and prisons, which are poorly equipped to help them with their problems. According to the National Alliance on Mental Illness, individuals in the midst of a mental health crisis are more likely to have contact with police than get medical help. The result? Two million people with mental illness are booked into jails each year, with nearly 15 percent of men and 30 percent of women booked into jails suffering from a serious mental health condition.
When seen in this context, perhaps it is predictable that the same administration that is pushing for repeal of the Affordable Care Act is the same one advocating for a return to the failed “dumb on crime” policies that lead to increased spending on prisons and jails.
The GOP gets it totally wrong. The fact is, we need to provide people with more access to mental health services, substance abuse treatment and other critical care, not less. Politicians in Washington would be wise to remember the adage that an ounce of prevention is worth a pound of cure. Jobs and healthcare are a more effective public safety strategy than building more jails and prisons. A study in Washington state, for example, found that extending substance abuse treatment to low-income people resulted in lower overall medical costs, reductions in arrest rates, and reduced law enforcement spending.
The bottom line is that making America safe is about more than sloganeering and “get tough” messages. It’s about making sure people are able to stay healthy and strong so they can contribute in a positive way to our communities and our economy. Conservatives are fond of saying that a job is the best social program there is. Well, health care should at least come in a close second. And it is certainly a better investment than wasting money by putting more and more people behind bars.