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Cancerous Growth

The US cancer mortality rate is finally falling. But the gap in outcomes between the rich and the poor is actually widening — another reason why we need Medicare for All.

A doctor wears a stethoscope as he see a patient during a visit to the Miami Children's Hospital on June 2, 2014 in Miami, Florida. Joe Raedle / Getty

A new study reveals that the US cancer death rate has dropped 27 percent since 1991. This is fantastic news: the nation’s number-two cause of death is getting less deadly by the year.

For some people, that is. At the same time, the gap in cancer mortality between the rich and the poor is actually widening. The concurrence of these trends can mean only one thing: we’re making breakthroughs in medicine, but our deeply unequal system means that not everyone is benefiting from them.

It’s a cruel society that makes “revolutionary advances” in detecting, preventing, and treating life-threatening illnesses, and then offers only the rich an opportunity to attain them. A baseline of economic inequality compounded by a parasitic private insurance industry has yielded a situation in which the wealthy are hoarding the spoils of medical and technological innovation. To ensure that everyone can reap the rewards of our collective social progress, we need a more equal medical system and a more equal economy. We can start by implementing Medicare for All.

The main reason for the disparity in cancer death rates among the rich and the poor is no secret to medical professionals. “Poverty has been a relentless obstacle to receiving cancer care because of lack of, or low insurance coverage,” one doctor told CNN after reading the new study. “No insurance or low-coverage insurance also reduces the incentive to visit the doctor for symptoms and even more for preventive health practices, such as smoking cessation, yearly physicals, and immunizations against cancer-causing viruses.”

If you’re uninsured, you’re not going to the doctor unless you absolutely have to. But the problem is even bigger than that. Twenty-nine percent of Americans reported delaying medical treatment last year because of the cost. That is triple the share of Americans who are uninsured, which means that private health insurance isn’t actually synonymous with regular access to treatment for an additional tens of millions of people. Meanwhile, profit-motivated private insurers deny claims all the time. Claims denials for cancer treatment are common enough that GoFundMe has a how-to for crowdfunding your own cancer treatment.

Medicare for All can immediately and unequivocally solve these problems. Under a single-payer health care system, everybody would be automatically insured. And instead of facing potentially prohibitive co-pays, premiums, and deductibles, insured people (everybody) would be able to go to the doctor for free. We would pay for it through progressive taxation — just like how we pay for war, but we’d be saving lives instead of destroying them. And the coverage would be comprehensive, meaning no claims denials. If the doctor orders the treatment, it’s available to you, cost-free.

Before you ask: yes, this is completely affordable. It’s actually less expensive than the system we have now, in addition to being less confusing and inhumane.

Cancer mortality rates among the poor are partially attributable to other factors besides health care access. Poverty often means fewer convenient healthy food options, which can increase the incidence of certain cancers. Poor people are also more likely to smoke, as tobacco companies desperate for new profit streams have have targeted low-income communities in the wake of revelations about smoking’s links to cancer. Medicare for All can’t solve these problems overnight. But it can make screening and treatment free, meaning people without money will be more likely to catch cancer in its early stages and survive.

And Medicare for All can do something else to end cancers associated with poverty: it can make poor people less poor.

The cost of health care is Americans’ top self-reported financial concern. The number-two spot goes to debt, which is likely more evidence of the same problem, as 79 million Americans have medical debt or trouble paying bills. If you’re one of the 28 million uninsured, a medical emergency can cost a lot of money, so that accounts for part of the problem. But again, the percentage of people saying that health care costs are their main financial concern is higher than the percentage who lack insurance. Insured people still have to deal with co-pays, premiums, and deductibles as well as constant claims denials.

Medicare for All would eliminate these personal health-finance concerns outright, and ease poverty in the process. This would likely result in better health outcomes irrespective of access to treatment — which is still Medicare for All’s most direct intervention, and a good enough reason to pursue it, even without the added bonus of mitigating economic hardship for the working class.

We live in a golden age of cancer research, characterized by radical discoveries and breakthroughs. But we also live in a highly class-stratified society, one where a handful of capitalists own infinitely more wealth than the vast majority of people, and where reasonable proposals for social advancement are squashed because they threaten corporate profits. The latter circumstance is preventing us from making the most of the former.

In this way and in many others, capitalism is strangling our potential, keeping us from enjoying the full fruits of human ingenuity and creativity. In order to change that, we’ll need to end private ownership of productive assets and replace capitalism with socialism, a system predicated not on greed and ruthless competition, but on solidarity and equality.

That’s perhaps a distant dream at the moment, but there are demands we can make right now to bring it closer to reality. Let’s start by giving the American Cancer Society cause to delete their online guide to appealing denied treatment claims. Let’s win Medicare for All.