$88 Billion for Health Care; Raising the Tobacco Age; 2020 Healthcare Push

April 08, 2019 by Chris Pirschel ONS Staff Writer/Producer, and Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

Health Care Costs Americans $88 Billion in 2018

According to a Gallup Poll released on April 2, 2019, Americans borrowed approximately $88 billion to pay for health care in 2018 (https://news.gallup.com/poll/248081/westhealth-gallup-us-healthcare-cost-crisis.aspx). At a National Academies of Science healthcare conference (http://www.nationalacademies.org/hmd/Activities/HealthServices/QualityCareforSeriousIllnessRoundtable/2019-APR-04.aspx) on April 4, the main takeaway was that many Americans surveyed reported that they could not afford to have a serious illness like cancer. The cost of care, even with insurance, is more than many can financially withstand. Oncology nurses know how patients must maneuver through the system to defer costs (https://voice.ons.org/news-and-views/why-do-oncology-nurses-need-to-screen-for-financial-toxicity), sometimes resulting in delayed or alternative approaches to care.

Drug prices have become a clear bipartisan issue on Capitol Hill. Right now, high insulin price is the rallying cry, but cancer drugs are always included in the conversation and financial toxicity has become a widely recognized issue (https://voice.ons.org/news-and-views/financial-toxicity-and-its-burden-on-cancer-carefinanhttps:/voice.ons.org/news-and-views/financial-toxicity-and-its-burden-on-cancer-care). What’s the solution? It hasn’t been found yet, but U.S. Representative Ami Bera (D-CA), a physician, has offered a single-payer alternative (https://thehill.com/blogs/congress-blog/healthcare/436904-a-pathway-to-universal-health-care-coverage). It’s bold. It’s expensive. It’s controversial. But it’s a starting point. Let’s see how far his plan goes.

Raising the Tobacco Age of Sale to 21

In an effort to combat youth smoking, House Representative Robert Aderholt (R-AL) proposed new legislation to raise the legal age of tobacco consumption to 21 (https://thehill.com/policy/healthcare/437241-gop-lawmaker-to-propose-raising-tobacco-age-of-sale-to-21). Curtailing underage tobacco use is a universal issue for lawmakers on both sides of the aisle. In February 2019, the U.S. surgeon general ranked electronic tobacco consumption as a national epidemic among young Americans (https://voice.ons.org/advocacy/surgeon-general-declares-youth-vaping-an-epidemic). With the U.S. Food and Drug Administration’s authority, the federal government is cracking down on the marketing, distribution, and sale of e-cigarettes and tobacco products aimed at young people (https://voice.ons.org/advocacy/short-term-insurance-plans-fda-curbs-youth-vaping-drug-cost-legislations).


Now, some states are stepping up and restricting the age at which their own resident can purchase tobacco products, and other states could follow, making it a trend at the state legislative level. ONS and its members are highly active in the conversation, providing expert testimony to local lawmakers about the perils of e-cigarette usage (https://voice.ons.org/stories/providing-expert-testimony-in-the-virginia-state-senate).

New Healthcare Push After 2020 Election

In the first week of April 2019, President Trump visited the U.S. Senate and pushed for a vote to repeal the Affordable Care Act. Republican Majority Leader Mitch McConnell (R-KY) told him that no vote would be brought to the floor. The president backed off his stance, seeing no possible victory, tweeting that he and his administration would make a renewed push after the 2020 election (https://thehill.com/policy/healthcare/436854-trump-predicts-new-health-care-law-after-2020)—if the vote goes his way.

This situation was evidence that these political moves are just that—political machinations meant to solidify both sides as each prepares for the 2020 presidential election. Public opinion polling says that Americans do not trust the president to protect key elements of coverage (https://thehill.com/homenews/administration/437087-most-voters-in-new-poll-say-trump-cant-be-trusted-on-health-care), and the Democratic-controlled House is forcing votes to use against the Republicans (https://www.politico.com/story/2019/04/03/house-trump-obamacare-1312041) next year. The campaign games are beginning, and it’s important that patients aren’t lost in the healthcare conversation. Oncology nurses advocates are key to that discussion and educate lawmakers through personal stories and practice experiences (https://voice.ons.org/stories/health-policy-begins-with-you-educate-your-representatives-in-cancer-care).

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