What does it mean to be a #healthcare voter?
I guess I will start this post off with an apology, I’m sorry! Why am I apologizing you ask, since state legislatures across our country are about ready to be gaveled into session I’m going to talk politics for a minute. More specifically, I am going to jump into what I think it means to be a healthcare voter.
Before I jump into politics, I want to begin by defining some terms first. To begin with, and probably most importantly, the United States is not a Democracy, we are a Republic. By definition a Democracy is a way of governing which depends on the will of the people. Without boring you to much, there are multiple types of Democracies: Direct, Representative, Constitutional, or Monitory. A Republic means the power is in the hands of individual citizens. To but it another way, in a Democracy laws are made by the majority vs a Republic were laws are made by the elected representatives of the people. You want a non political science answer? On a high level, one of the main reasons that abortion (abortion is healthcare) is now legal in some states but illegal in others is because we live in a Republic. Elected officials in each state are determining the legality of abortion, if we were in a Democracy abortion would be settled by a national vote (most votes wins).
Generally speaking, we tend to believe that an elected official is the person with the most votes. Since it’s almost impossible to win an election without declaring as a Republican or Democrat, logic would dictate that the winner of a race is the person who received 50% plus 1 of the total votes cast. This is why I said “almost impossible”. For example, in “Almost Impossible” District, there are 10 citizens. Of those 10, 8 are registered to vote. Of those 8, 6 turned out for the election. Lets say the Democrat won 3 votes, the Republican won 2, and an Other won 1. The Democrat is now the elected representative of the district even though only 30% (3 votes/10 citizens) of the district supported them. Of registered voters in the “Almost Impossible” district, the Democrat only won 37.5% (3 votes/8 registered voters) of registered voters. Even if you base the victory on those who turned out, the Democrat won 50% (3 votes/6 voter turnout) of the vote, another way to say that is half the district does not support the Democrat. Contrary to popular belief, mathematicians and statisticians play more of a role in our country than we realize or care to admit. More on that later.
One more definition, Tyranny. Tyranny is a cruel and oppressive government or rule. The hard part, what does cruel and oppressive mean. Is there a clear definition or is it like the Supreme Court’s definition of porn, we know it when we see it.
I lied, one more definition. Time. The trouble with talking politics is the dynamic nature of time. Politics change. Conservatives today love to point out that it was Republican’s who passed the Civil Right Laws of the 1950’s and 1960’s even though Civil Right laws today are generally thought to be a liberal or “woke” idea. As a political scientist, I would be remise in my responsibility of a political science degree holder if I didn’t point out that those 1950/1960’s Republican’s would not be allowed anywhere near the party today because they would be considered too liberal but that’s another story for a different blog post. For the purpose of this post, I am defining time as today and probably tomorrow.
Why does any of this matter? Lets jump right in and take a look at abortion.
First, regardless of what the religious conservatives say, abortion is healthcare. A conservative type will argue that I’m calling it healthcare because its doublespeak for murder. Basically, I’m trying to cover up murder by calling it healthcare. If you believe that then war is also doublespeak for murder, lets face facts all wars (even the just ones) are murder. We can go back and forth on this for ages and never arrive at a true consensus. However, this is not why I believe abortion is healthcare.
Abortion is healthcare because it is a medical procedure that can help improve the quality of life of someone who is in immediate need of help. Quality of life is different from healing. It is truly amazing if someone can successfully raise their rape baby, don’t get me wrong, but lets be perfectly honest. Just because someone has accomplished this feat doesn’t mean everyone can. There are no, I repeat, no absolutes when it comes to a persons health (physical and/or mental). Everyone is different and we need to give healthcare providers the tools and authority to help everyone, not just religious conservatives that believe a certain way.
Not for not, if you look into the history of abortion, it has been happening in some form since the beginning of time. Since we have the tools and resources necessary, I rather send those in need to the best facilities possible, without any shame or stigma attached. History shows abortions are apart of the human experience, lets finally accept that so we can work towards better reproductive health. Ok that is both patient and healthcare voter advocacy, but that is alright since this is my post and website.
In addition to possibly raising the quality of life of someone, there is another reason why abortion is healthcare. Medicine, regardless if its surgery, physical therapy, or medication, more often than not can be applied to a multitude of illnesses and conditions. A perfect example is Methotrexate.
Methotrexate, is a chemotherapy agent and immune-system suppressant that is commonly used to treat cancer, autoimmune diseases, and ectopic pregnancies. This chemo drug can help my rheumatoid arthritis, aid in a family members cancer treatment, and provide a safe abortion to patients with ectopic pregnancies. Abortion is healthcare because it can affect all of us in some way, not just mothers in need.
If there are any politically active religious conservative types reading this right now they are probably calling me names. I’ve not been able to verify this yet, but they claim there are exemptions in abortion laws for ectopic pregnancies so my point is invalid. Like I said, I have not been able to verify this independently. Regardless, that is not why I brought up the methotrexate example. I brought it up because of something called the pharmacist conscience clause.
What is the pharmacist conscience clause you ask? It allows pharmacists to refuse to dispense medications to which they (pharmacists) have moral objections too. Since we live in a Republic, conscience clauses are established on a state by state basis.
Why is this important? Let’s go back to my “Almost Impossible” district example. Lets say, that it was the Republican that won the district with their 3 votes. For my example, lets say Mr. Conservative is best friends with the leadership so he gets placed on the legislative committee with jurisdiction over pharmacists and whether or not a conscience clause law will be considered. Since Mr. Conservative is a Trump or Marjorie Taylor Green extremist type they naturally support a conscience clause without even hearing from women or patients like me who have successfully utilized methotrexate for a higher quality of life. You now have a elected official, who won their district despite half supporting someone else, determining medical care for someone in their state who couldn’t pick Mr. Conservative out of a lineup of 2 people. Yes, this is a hypothetical example but it is based in the reality of our political system. Idaho’s outgoing Republican Lt Governor, I can’t mention her name without getting nauseous, won her primary with only 30% of the vote (there were 5 candidates if I remember right, 70% of her party voted for someone else) but became a national joke for her blind faith in the orange one and white supremacists. My hypothetical is based on real-world examples.
Now, over my very strong objections, the world does not hang on my every word or thought. This means that there are some very strong religious or extremist types that believe it is their job to judge others for their actions who are pharmacists (I don’t care about a pharmacists personal religious beliefs until they decide not to distribute a medication that a patients doctor/care team have determined is need). Within hours after Roe was overturned, many if not most of these religious or extremist type pharmacists immediately started to refuse to distribute methotrexate based on their state’s pharmacist conscience clause. Here is some more reference material that better articulates what I’m saying: https://www.cnn.com/2022/07/22/health/abortion-law-medications-methotrexate/index.html
Now, here is why I’m not holding back my personal opinions vs making this post more like a political science paper. If you have read any of my posts or follow me on social media, you know that I live life in a lot of pain due to my rheumatoid arthritis. Despite this pain, I still work full-time, own my own home, car is paid for, no credit card debt, earned 2 degrees, and am not a convicted criminal. My personal advocacy is fueled by the nightmare thought of a Mr. Conservative (in this case it could be an elected official or a pharmacist) type going after opiates.
Oh Alan, now you are starting to sound like one of the orange one’s stupid conspiracy theories. Maybe, but here is a 30 second hypothetical. In conservative led states like Idaho, boarder issues are a popular scare tactic during elections. According to conservatives, we are about to lose our country to a tsunami of illegals apparently carrying their candy colored opiates/fentanyl and full of bloodlust. Its your basic “hide the woman and children because we are all going to die” political tactic.
For the time being, it seems only the loudest of racists seems to be fully supporting this tactic. In an attempt to get more traction with normal people, we are starting to see more and more “evidence” being pushed about overdoses from candy colored fentanyl. Its masked under public health and politics, but make no mistake, it is more about the fear and racism than anything. Why do I say that you ask? Research shows over and over that most of these overdoses are due to patients with addiction issues, not from chronic pain patients like myself. Depending on the study, patients (like me or someone with cancer that requires heavy opiates for their pain management) have the same addiction percentages as those from the general public that become alcoholics. A serious problem yes, but not one that rises to the level of national security like conservatives are claiming in their politics.
Abortion, illegal immigration, and addiction…I might not be able to ski right now but I still know how to send it!
Why am I going down this rabbit hole you ask? One of my biggest objections to the Mr. Conservative types (elected officials in this case) is that they are not drawing a distinction between opiates/fentanyl and drugs like cocaine. Especially opiates, and in certain circumstances fentanyl, have legitimate medical uses. For example you ask, one of the main reasons I can still work full-time, own my own home, able to pay for my car, have no credit card debt, earned 2 degrees, and am not a convicted criminal is because of my regular use of opiates (I would have to check my medical records but I think I was prescribed fentanyl after I fell for a couple of weeks). Regardless of what elected officials like Mr. Conservative might think, for me opiates and medical fentanyl are medications, no different than a NyQuil or heart medication.
Tyranny is a cruel and oppressive government or rule. Every time an elected official holds an overdose event with crosses on some sacred some Mr. Conservative type invariably floats the idea of making opiates illegal. The argument is some BS about eliminating overdose deaths while reducing the number of illegals crossing our border. I say BS because the argument is solely based on political ideology and not from a quality of life perspective. If a Mr. Conservative type were to get their way they would have created an cruel and oppressive government for chronic pain patients like me (I can’t get methotrexate or opiates is this night mare scenario). In my opinion, we would now be living with a tyrannical government.
Being a healthcare voter is hard and complicated under the best of circumstances. The general public thinks healthcare is about healing which is defined as making us feel better after the catching the flu or mending our broken arms after a car accident. Patient advocates, like myself, believe healthcare is about raising our quality of life, which is different from healing. Elected officials often use issues within healthcare to divide us into political parties or population segments for elections. Doctors want to help, even if that means they could go to jail for violating some conscience law. Chronic Patients just want to go skiing or hiking again because the view of nature is so much more powerful than the cold waiting room of the hospital. So how do we operate as a healthcare voter?
First, in our Republic, it is important to realize that sometimes the other side, the extremists, are going to win in local, statewide, or national elections. In order to combat this, we still need to play the game, even if it does seem to be stacked for the stereotypical rich, old, white guy in a suit late night tv loves to make jokes about. The game is designed to be competitive, so if you don’t have the money for tv spots for example, you can still win a local election by door knocking. Sometimes too, making the extremist work extra hard can prevent them from being appointed as a committee head…this is often a win for chronic patients like myself.
National healthcare issues like abortion are more dynamic and get more attention than say a state pharmacy board meeting, however, its the state pharmacy board meetings that pharmacist conscience clauses begin. If our country is going to continue to be polarized (ruling from extremes) then will need advocates at pharmacy board meetings and Medicaid hearings in order to combat the extremes. The President, Governor’s, and other state elected officials might be able to control the debate on issues like abortion, but its pharmacy board meetings and funding for Medicaid committee meetings that will ultimately move healthcare to a patient centered methodology.
Finally, and most importantly, what does quality of life mean to you? As I mentioned earlier, healthcare is much more than simply healing. If it was just about healing, I would be in trouble because there is no cure for my rheumatoid arthritis. So that is why I’m using the phrase quality of life. The thought of a higher quality of life makes me smile. So answering, what made you smile yesterday, what makes you smile today, what framework will help ensure you have the ability to modify your quality of life definition tomorrow so you can still smile in the future will help others walk in my shoes I believe. Being a healthcare voter means ensuring that all citizens, regardless of political ideology, has the ability to smile whenever they want. So being a healthcare voter means ensuring everyone has the ability to smile more.
