If mismanagement of a pandemic, widespread corruption, impeachment, the end of government oversight and accountability, racism, the caging of immigrant children, abuse of the powers of the state, and continued voter suppression are not enough to decide your vote this election season, here are seven public health issues that might guide your thinking. The four PHP writing fellows and the three editors have each taken one and offer short reminders of what is at stake in the 2020 election on the local, state, and national tickets.
We could have made a longer list of topics and policies of importance that we have covered over the past year – for instance improved unemployment insurance, paid sick leave policy, the need for excellence in mental health care – but you know where to read if you want more.
“Every human society must justify its inequalities: unless reasons for them are found, the whole political and social edifice stands in danger of collapse,” the economist Thomas Piketty wrote. The enduring fact of American poverty exhausts and humiliates us, but remains unjustified. Poverty has become more concentrated in the last four years and social mobility is at a low point. The two adults in a family of four each needs to work a 77-hour work at the federal minimum wage of $7.25/hour to feed, clothe, and house their family. This is not a living wage. And then we punish them: In Mississippi, a family’s income must be less than $5,400 per year, one quarter of the” poverty level,” to be eligible for Medicaid. Think about that desperate number when you vote this week.
– Michael Stein
LGBT health and human rights
Those who can vote should consider the Trump administration’s record on LGBT health and human rights. Domestically, the Trump administration has opposed the Equality Act, appointed anti-LGBT justices, supported employment discrimination against LGBT people, banned transgender service members from the military, kicked people living with HIV out of the military, and used Title IX to discriminate against transgender students. Internationally, the administration refused to condemn attacks on LGBT people in Chechnya, denied LGBT asylum seekers fleeing violence, and proposed cutting over $1.35 billion from President’s Emergency Fund for AIDS Relief budget. The President has joked about Vice President Pence’s desire to hang LGBT people. The health of LGBT Americans is again on the ballot in 2020. The LGBT community and our allies must vote like our health depends on it – because it does.
– Nicholas Diamond
Women’s sexual and reproductive health
Fifty-four. Never married, no children. Spinstery by choice. Justice Ginsberg’s death has me thinking about all I have achieved because I had the ability to make choices about children, marriage, and professional life. The nomination of Amy Coney Barrett to the Supreme Court is a threat to the future of Roe vs. Wade, access to contraception, and women’s ability to control our reproductive and sexual health. Barret will likely join the Court. My vote in November won’t change that, but vote I will. The suffragists didn’t give up, even in the darkest hours. Honor their legacy. Vote in November!
– Jennifer Beard
The education system is under siege. Over the past 4 years the Trump administration relitigated Title IX to make it harder to report sexual assaults on college campuses, continued fights against affirmative action programs originally designed to increase minority attendance in schools, and sanctioned Betsy Devos’ desire to valorize “choice” as a reason to defund public schools and move education into the domain of private enterprise. A vote cast in November is a chance to reclaim the education system as a space of refuge and learning that prepares the most vulnerable students for full lives.
– Edward Alexander
The health insurance Marketplace has holes. Consumers who don’t qualify for subsidies face high premiums and deductibles. In states that haven’t expanded Medicaid, low-income Americans don’t have sufficient subsidies. Though these holes were largely created by Republican ACA-bludgeoning, they still need to be fixed. Biden plans to patch the ACA by expanding subsidies, extending coverage to low-income Americans in non-expansion states, and creating a public option. Trump aims to shred the ACA and allegedly replace it with a new plan. (Notably, he failed to present one in his first term, even with a Republican-controlled Congress.) The ACA gave 20 million people health insurance. Biden is poised to provide paths to insurance for some of the 11% of residents in the US who are still uninsured. The Republican administration’s policies have left more Americans uninsured every year of the last four.
– Gray Babbs
We knew this was coming. Scientists warned the world and were preparing for a pandemic for decades. We had systems in place – protocols, supply chains, chains of command, funding, even a pandemic response plan prepared by the previous administration. Instead of protected we were lied to. Instead of saved, attention and funds were deliberately directed elsewhere. Lies and secrets grew to a needless 220,000 dead and the nightmare is not over. A president does not need to be a scientist, but does need to listen to them. Leadership through a pandemic means paving the way for a galvanized and well-resourced workforce to do their jobs, and supporting them in doing so. We need leadership almost more than we need a vaccine, especially once we get one.
– Tasha McAbee
Each of us inherited from our fore families the fallout of human-driven climate change. Extreme weather patterns increase likelihood of catastrophic events, events that produce higher concentrations of air pollution, longer duration of droughts, and shorter harvest seasons. Entire communities of children, older adults, people of color, and low-income families experience increasing risk of malnutrition, dehydration, and death. The current administration consistently and frequently rolls back and replaces current policies designed to reduce the effects of climate change. We must elect a candidate who is willing to embrace climate science and advance agendas that protect the planet and its people.
– Pat Williams
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