Health care issues are always on the ballot, and voters support better access.

Health care issues are always on the ballot, and voters support better access.

(AP Photo/David A. Lieb) In this May 1, 2020 photo, campaign workers David Woodruff, left, and Jason White, right, deliver boxes of initiative petition signatures to the Missouri Secretary of State’s office in Jefferson City, Missouri. Missouri voters approved Medicaid expansion by a 53 percent to 47 percent margin.

Not much was said overtly about health care reform during the few hours of election coverage I watched on Election Day. Regardless, American voters know that the way we do business with the health care system is unsustainable.

We cannot continue to spend over trillions of dollars each year (mostly through our tax dollars) to maintain the delivery of health care that is poor quality, grossly inefficient, and leaves our patients in debt. Election news often mentions inflation and abortion as issues motivating many voters. Both are, of course, health issues.

American consumers have seen health care prices rise to the stratosphere for years while health care benefits dwarf wage increases. Health care in the US is an economic issue because it is primarily funded by the taxpayer and therefore, like all such issues, will be on every vote.

By its very nature, abortion is a medical procedure and in many cases, like an ectopic pregnancy, it is an emergency and life-saving procedure. Therefore, giving doctors and patients the legal protections they need to freely make clinical decisions will also be included in any vote. But the recently concluded election had at least two health reform votes openly on the ballot — one was in a U.S. Senate race in Pennsylvania and the other was a ballot measure in South Dakota.

John Fetterman, the lieutenant governor of Pennsylvania who flipped that state’s open Senate seat from red to blue, has openly put health care reform on the ballot. His campaign website states: “I believe that health care is a basic, basic human right, not a privilege. But healthcare in America is too expensive and complicated. I believe that in the richest nation on earth, we have a moral duty to ensure quality health care for every American and to end the disgusting practice of corporations profiting from people’s health and well-being.

Fetterman makes the case that politicians in swing states can win as long as they pass comprehensive health care reform because that’s what American voters, whether red or blue, know needs to happen.

Even in red states, there is a hidden desire to find a way to fund health care for all. Before this year, six red states saw the issue of Medicaid expansion come to the ballot via a ballot initiative. In each of those states—Idaho, Maine, Missouri, Nebraska, Oklahoma, and Utah—the electorate chose to expand Medicaid even though the respective legislatures had already rejected it.

This year, a seventh state, South Dakota, saw a similar initiative on the ballot. And once again, red-state voters passed Medicaid expansion. Together, these ballot measures would add a total of about 900,000 low-income people to Medicaid rolls nationwide.

Why are these ballot measures successful? One analyst suggested three reasons: listening to neighbors who would benefit, returning federal tax dollars back to the state and protecting the solvency of rural hospitals and health clinics. Assuming these reasons reflect the reality of health care ballot measures, I would suggest that more comprehensive reforms to the business of health care can also be accomplished with ballot initiatives.

American taxpayers have been trying to give themselves and their neighbors universal health care for 75 years. We want our neighbors to have the care they need. We all want our fair share of federal tax dollars to be spent to improve our lives and those around us.

We see the failure of corporate medicine in rural America, and we know that we cannot leave any person or any part of America behind. American voters will not be done with health care until we find a way to provide better, simpler, and therefore less expensive care for every American citizen.

Joseph C. Jarvis, MD, Salt Lake City, is a public health physician and author of two books on health care reform, The Purple World: Healing the Harm in American Health Care and For the Hurt of My People: Original Conservatism and Better , Simpler Health’ care.” He is the executive producer of a soon-to-be-released documentary: “Healing America.”

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