Trump-Pence would be disastrous for U.S. public health.

 

trump_pence_hazardous

Trump and Pence, both a threat to U.S. public health. (Tasos Katopodis / AFP/Getty Images)


Joseph Lachman, 9/13/2016

The Trump-Pence ticket is a threat to the health to everyone living in the U.S., and perhaps the world. Their policy proposals and stances regarding crucial public health issues are at best naive, and at worst, completely wrong. We’re not going to waste time here arguing about a lot of the science here; we’re going to trust peer-reviewed research and expert scientific consensus and look at the Trump-Pence ticket’s views in comparison.

Guns

Yes, guns are a public health issue.  (If you don’t believe me, ask Surgeon General Vivek Murthy, who said in an interview with NPR, “violence of all kinds is a public health issue. When you have large numbers of people dying from preventable causes, that’s a health care issue.”)

Donald Trump buys into the myth of the “good guy with a gun,” a phrase made famous by Wayne LaPierre, executive VP of the NRA that has no evidence to support it.

After the Orlando shooting, he said in an interview with CNN, “If you had guns in that room, if you had — even if you had a number of people having them strapped to their ankle or strapped to their waist where bullets could have flown in the other direction right at him, you wouldn’t have had that tragedy.”

You’d be surprised who strongly disagrees with this position – Law enforcement. Police officers have emphasized that having more armed civilians doesn’t improve a lot of active shooter situations.

For example, the New York Times noted that Maine enacted a law allowing people to carry concealed firearms without a permit or training, despite the objections of Portland Police Chief Michael Sauschuck.

Trump also mentions mental health reform to prevent shootings and massacres, but this does nothing to address the horrifying numbers of gun suicides that occur every year. The Centers for Disease Control and Prevention reports that in 2011 alone, there were 21,175 suicides committed with firearms. That’s on top of 11,208 gun homicides that year. In contrast, the Violence Policy Center found that there were 529 justifiable homicides with firearms in 2012, barely more than 505 unintentional homicides in the CDC’s 2011 report.

Vaccination

For this one, all we have to look at is Trump’s Twitter feed, where he has made his unscientific views available for all to see:

Vaccines are safe. The study suggesting the link to autism was debunked years ago, and the scientist who published it was thoroughly discredited, so we’re not going to waste time debating that here.

HIV/AIDS

This one falls on Pence’s shoulders. For a more extended explanation of Pence’s failure, see an earlier piece on this blog: Why we shouldn’t allow Mike Pence to decide public health policy.

As governor, Pence didn’t have the tools in place to fight the opioid crisis and HIV outbreak. He waited 2 months to lift the ban on needle exchange programs, but never actually provided state funding for them at a time when federal funding was also banned.

He cited his moral beliefs as justification for blocking effective evidence-based public health policy, and as a result hundreds are people are trying to cope with HIV for the rest of their lives.

Trump doesn’t have much policy experience, so if he left many public health policy decisions up to Pence, this is what we could end up with – moral idealism over effective policy.

Sex education / Contraception

This brings us to another of Mike Pence’s completely baffling stances. He believes the only proper sex education is abstinence-only, a continuation of the failed policy of the Bush administration, which spent $1.4 billion in Africa with very little to show for it. (See NPR for an explanation of Bush’s failed abstinence policy in Africa.)

Buzzfeed went back and found an interview where Pence said:

The other part is that, frankly, condoms are a very, very poor protection against sexually transmitted diseases, and in that sense, Wolf, this was — the secretary of state [Colon Powell] may be inadvertently misleading millions of young people and endangering lives.

(emphasis is mine)

Pence is dead wrong. While abstinence is in theory the best protection, abstinence education as policy is ineffective, and reduces the chance that people will use protection when engaging in sexual intercourse. However, when used correctly, condoms are a very effective way of preventing transmission of STDs. To quote the CDC: “Laboratory studies have shown that latex condoms provide an effective barrier against even the smallest STD pathogens.” While they are not perfect, they are an vital tool in preventing the spread of infectious disease. We can’t afford to have an administration that will force its morality on us and other nations in place of implementing smart public health policy.

Healthcare

This is one of the big ones. Trump’s campaign website attempts to make sense of his disjointed collection of policy ideas. Here are some problems with them.

The Uninsured Rate – The Affordable Care Act isn’t perfect, but one thing to note is that the uninsured rate is at a historic low. However, the Committee for a Responsible Federal Budget, using research from the nonpartisan Congressional Budget Office, concluded that Trump’s proposal would give about 1.1 million people coverage, while 22 million would lose coverage.

Preexisting Conditions – Trump said he would want to continue covering people with preexisting conditions, but offers no policy proposal that would do this. Repealing “Obamacare”, AKA the Affordable Care Act, would end coverage for these people.

Getting rid of the individual mandate – Repealing the individual mandate is an insane idea, since it can lead to what is called the insurance death spiral. If individuals aren’t required to purchase health insurance, then the healthiest individuals will opt out, since they get the least benefit from the system.

This leaves the remaining pool to pay slightly higher costs. The higher costs convince the next healthiest tier of insurance holders to give up their insurance, since they’re the next least likely to benefit, and the now increased cost makes them feel they should go without.

Furthermore, some people think they should just get it when they need it. If the plans cover preexisting conditions, shouldn’t they just be able to get it later? This type of thinking helps accelerate the death spiral.

The solution? Keep the mandate. Essentially, the healthiest individuals are helping the less healthy pay for their coverage, and it’s a system virtually all modern industrialized nations use, such as Britain, Denmark, Spain, Norway, Sweden, France, Germany, Canada, Mexico, and Singapore among others. Everybody gets sick sometime and needs insurance, but under Trump, we would go backwards.

Climate Change

This is the most important, and should be the defining issue for this election.

Donald Trump does not believe climate change exists. 

Realizing that theory is beyond ridiculous and impossible to defend, he modified his stance recently. According to The Hill, he still refused to acknowledge the consensus and said: “There is still much that needs to be investigated in the field of ‘climate change.'” He put the additional quotation marks around “climate change” to emphasize his denial.

Saying that the debate isn’t settled is a trick. The tobacco companies used it before to delay action on smoking, and oil companies are using it now to delay action on climate change. Don’t listen.

In reality, the debate was settled long ago. The question now is how much damage will occur, and what we should do to fight it. Nearly every other major industrialized nation on the planet is taking steps to combat climate change, but Trump would take us backwards, and that’s a risk we can’t afford to take. His position is consistent on his website, which says literally nothing about the defining issue of our era.

As a businessman, you would think that Trump would be concerned about the way climate change might threaten his investments. In fact, his application for a sea wall to protect his golf course in Ireland that specifically indicates the threat of climate change suggests that maybe he isn’t being truthful. But if that’s the case, it looks like he’s willing to ignore the issue and let anti-intellectualism win the day, as long as he protects his own business interests.


If Trump wants to “make America great again,” he is going to need to reevaluate many of his policy stances. Public health is the foundation of a strong nation, and Trump isn’t willing to accept the science that should shape our public health policy.

Also remember this – you don’t need to be an expert to accept expert consensus, but you do need to be one to deny it.

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About jslachman381

I'm a Yale graduate who majored in History of Science, Medicine, and Public Health.

View all posts by jslachman381

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One Comment on “Trump-Pence would be disastrous for U.S. public health.”

  1. D.T. Nova Says:

    “After the Orlando shooting, he said in an interview with CNN, “If you had guns in that room, if you had — even if you had a number of people having them strapped to their ankle or strapped to their waist where bullets could have flown in the other direction right at him, you wouldn’t have had that tragedy.”

    You’d be surprised who strongly disagrees with this position – Law enforcement. Police officers have emphasized that having more armed civilians doesn’t improve a lot of active shooter situations.”

    More surprising: even the NRA criticized him for this one.

    Like

    Reply

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