Thread by @Cajsa

Prosperity Gospel preaches that the poor are poor because they are unworthy, that they do not love God enough. The rich are rewarded because they are good Christians. In a way, the American health care system often feels like Prosperity Gospel, which is at heart, eugenics.

The quality of the health care someone can access is dependent on how good a job they have, how valuable they are to the economy. Yes, we have the ACA and it redresses the balance to a degree, but copays and deductibles still put health care out of reach for many

While Prosperity Gospel is a malignant mutation of traditional Christianity, it fit so well with the whole mythology of "Protestant Work Ethic" and Horatio Alger, etc. it spread like wildfire, even infecting the nonbelievers via New Age bullshit.

Doctors who refuse Medicaid or Medicare patients - that's rationing healthcare. We allow doctors to refuse patients because as a society, we have already accepted that poor people's lives are less worthy, they deserve to die because they didn't get a good enough job for insurance

We accept eugenics all the time when we tolerate homelessness, hunger, and lack of healthcare. It's all a singular decision, that some lives are worth less than others because they are not effective contributors to the economy.

And if we advocate for universal healthcare without addressing the racial health disparities that exist, well, that, too, is accepting that some lives are more expendable than others.

For me, when my niece's amniocentesis showed her son would have Down's Syndrome, I hoped she would abort. She didn't. He's a lovely young man who has graduated high school and lives a happy life. But yes, I would have advocated abortion if my niece were not a rabid anti-choicer.

So, to be completely honest, that is eugenics. My niece was well off and able to afford the multiple surgeries he needed early in life and he will be comfortable as long as she is alive. So, she made a choice that worked. But he has no siblings. What about when she dies?

Here in Oregon, we expanded Medicaid to 180% of poverty by rationing care. Cover more people, but not cover super-expensive things based on quality/quantiy-of-life questions. That was eugenics
journalofethics.ama-assn.org/article/oregon…

However, Oregon's plan was controversial and alarming precisely because it didn't allow poverty to be the reason people didn't get the care they needed. So long as the reason is poverty, we are fine with eugenics. This country has been fine with poverty eugenics forever

I think I cannot state strongly enough how easily we accept eugenics so long as it's not our horse being gored. Take health care reform. If we cover every resident of the US from cradle to grave without copays or deductibles but do not address racial disparities - it's eugenics.

Black people get substandard care, their concerns are ignored, their pain is discounted, and they have worse outcomes in every measurable way - except when explicit steps are taken to address racial bias. (Rarely done.) Money does not solve the problem, look at Serena Williams.

It's also ironic that many successful reductions in disparities in gender and race have been accidental.

Anyway, I saw eugenics trending and just think we need to get over the idea that eugenics is not already the American Way of health care.