Health Care/Joan Retsinas

Think Locally: the Health Mantra for 2020

Forget Uncle Sam, no longer the champion of health, more its adversary as he presides over an increase in the ranks of the uninsured and underinsured, a return to pre-existing condition exclusions, and a “pass” for convenience stores to sell vapes.

Healthwise, the motto for 2020, is: Think locally.

Here are a few “think local” common sense regulations.

• Protect children in swimming pools. President George Bush in 2007, moved by the drowning of Secretary of State James Baker’s granddaughter in a hot tub, passed the Virginia Graeme Baker Pool & Spa Safety Act (P&SS Act) for public pools. Residential pools, in-ground and above-ground, have no such federal requirements for fences, gates, latches. It falls to states, municipalities and counties to act. Twenty-one states and more than 180 local agencies have adopted the International Swimming Pool and Spa Code. If your community has not, nudge it.

• Discourage soft drinks in fast-food children’s meals. In a nation plagued wth a widening girth, children would benefit from milk, juice, or water as alternatives. Eighteen states have mandated alternatives. Starting May 20, in New York City, water, juice, and milk will be “default” options (parents can request soda). This is a Nanny-State regulation, but children often need nannies.

• Ban “distracted” driving. Drivers who are texting, talking, eating, reading are endangering themselves and others. If the mortality and morbidity statistics haven’t prodded your legislators to bar driving-while-doing something else, prod them.

• Discourage teenage vaping. If the nation wants to curb vaping before it morphs into a crisis that recalls tobacco’s early days, states will have to step forth, with bans, restrictions, and taxes. Twenty states tax vapes. (Vermont now levies a 92% tax on wholesale products). Do taxes work? A 2014 study of e-cigarette sales in 52 US markets found that a 10% price increase reduced sales of disposable cigarettes by about 12%, about 19% for reusable ones. A 2018 analysis linked higher prices to a decline in the frequency of teenagers’ puffing away.

• Outlaw the Christian ersatz insurance schemes. These “associations,” allowed in the Affordable Care Act, have spread their marketing tentacles, urging Christians to pool monthly ”dues” to help one other. The associations exclude some treatments (often mental illness), they have a low cap on payments, and they can and do walk away from sick enrollees, leaving them in debt. Some states have curbed them (e.g., Washington, New Hampshire, Texas); urge your state to follow suit.

• Enact “common sense” gun restrictions. While some adults may want to live in a Wild West of guns, children and battered spouses don’t. Surely we can protect them. Our hodgepodge of state and local regulations varies on waiting periods (New Mexico has none), on type of weapon outlawed (Connecticut, after the Newtown school massacre, banned a slew), by who can buy a gun, by safety latches (California requires them; Alaska doesn’t) and by rules for “ghost” guns assembled by 3-D printers. (California, Connecticut, New Jersey, Washington and New York outlaw them.) We can make it hard for people convicted of spousal abuse to get guns, make it hard for children to shoot their parents’ guns, and make it hard to use “ghost” guns.

• Require fire and carbon monoxide alarms. Most states require smoke alarms in residences, and require hard-wired alarms in new construction, but not all. Texas, for instance, does not require carbon monoxide alarms in residential buildings; Missouri does not require smoke alarms.

• Work toward cleaner air. States cannot do what the EPA is supposed to do: dramatically lower automobile emissions. But states can follow California’s lead. In 2017, the state passed the Clean Air Vehicle Decal program: low and zero-emission vehicles can use the HOV lanes. Hardly dramatic, given the high cost of low-emission vehicles, but at least a gesture that acknowledges the problem.

• Make food safer. Listeria tied to string cheese. Possible Listeria in frozen hard-boiled eggs. Salmonella linked to fresh-cut fruit. The below-the-fold stories broadcast the risks. We cannot eliminate those risks; but pubic health departments can alert us to the dangers. Your legislature may want to cut the budget of your health department; argue against the cut.

We are urged to buy locally. It is time to legislate locally.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, February 15, 2020

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