By Laurie Huang
If you’re tired of seeing political candidates on your screens every election season, yelling and talking over each other in an attempt to convince you that their vision for the future of health care in America is the correct one, you’re not alone. Perhaps no other issue in America has become as notoriously politicized as health care. Nearly every aspect of health care, from our insurance system, to drug manufacturing, to the act of wearing face masks, has become political in one way or another. And people are sick of it.
“Take the politics out of health care!”– after decades of debate, it’s an exhaustingly familiar refrain, especially to Americans who just feel worn out by political infighting. Striving toward improved health should be the one thing we can all agree on. Liberals and conservatives may disagree on how we pay for it, or how the system is structured, but at the end of the day, we all want access to high quality health care, right?
Yet despite this common ground, health care continues to be the buzzword of political debate everywhere. As political affiliation becomes more and more tribal, identification with one party or another has become shorthand for what kind of public health and health care policies you support.
Mask Wearing and Vaccination Fuels Polarization
The ongoing COVID-19 pandemic has only served to draw the lines even deeper in the sand. Mask wearing has become a symbol of party alignment—a majority of Democrats say they frequently or always wear masks in public, while a majority of Republicans report rarely or never wearing masks.
This divide was fueled by President Trump, who loudly and regularly mocked other public figures, such as President-Elect Joe Biden, for mask-wearing. His sentiments were echoed by other senior members of his administration and many Republican members of Congress who also refused to wear masks, publicly questioning their efficacy. Interestingly, of all the members of Congress who tested positive for COVID-19 in 2020, 34 were Republicans and 13 were Democrats.
The anti-vax movement is similar. Republican lawmakers in a number of states are shutting down vaccine mandates, citing parental freedom of choice in deciding whether their children should be vaccinated or not. It is no coincidence that Kentucky Governor, Matt Bevin, described the mandates as un-American. The appeal to patriotic values is a frequently used Republican dog whistle that instantly politicizes the issue at hand. Similar arguments have been made against mask wearing, arguing that being forced to wear a mask infringes on personal freedoms.
Implications for the Future of American Health Care Policy
It is easy to decry this politicization as a modern phenomenon that does nothing but actively tear down the real goal: making sure every American has easy access to safe and high quality health care.
But politicization of health care in and of itself is not the problem. Health care has been a political topic in America ever since the country’s founding. Thomas Jefferson famously used his political influence to promote widespread adoption of the first smallpox vaccine during a period of history when vaccination was still a nascent and unknown science.
From a public health perspective, health care and politics are inescapably intertwined. Government power is the most effective tool public health professionals have to enact broad structural change for the betterment of public health in America. When we seek to implement public health and health care reforms through government action, we make health a political issue. Health care is an inherently political topic and trying to pretend otherwise only stifles attempts to enact reform.
What should be apolitical is the facts. Science should be apolitical. When one party supports following CDC guidelines and one party dismisses them, that is not politicizing healthcare, that is just ignoring the facts. When both sides acknowledge the same facts, the same science, then public health and health care can exist in the political sphere in the way that they should.
Allowing health care to be viewed as a political topic encourages debate and iterative improvement of potential health reform plans. The passage of the Affordable Care Act continues to be one of President Obama’s lasting legacies, and the recent popularity of strong progressive candidates such as Bernie Sanders and his universal health care plan pushed now President-Elect Joe Biden to adopt a more comprehensive health care policy.
Understanding how health care and politics work together is an essential tool for change, but it won’t be a tool that we can utilize to the fullest until we all embrace the idea that health care is political, and developing strategies to improve health is a political debate worth having.