want to give a shout out to Nurse Practitioner (NP) Keisha Saunders, who works in her hometown. Click her name to read the article in the Washington Post. It is not really about her, but about the poor people of Northfork, WV, where she grew up, left and came back to help. It is about the Medicare that they may all lose in the overwrought demands to repeal the Affordable Care Act (ACA)/Obamacare. Unfortunately, most of these people do not realize that they would not qualify for Medicare without ACA. The town voted overwhelmingly for Trump, thinking he would bring coal mining back to them, and the boom times would return to their town.
Nothing can be further from the truth.
Read the article for tales that range from the banal to the severe. Many have abandoned the town, as Keisha did before her brother died of kidney cancer at 25. It is possible that he could have been saved, but he did not have health insurance at the time, and the medical care in their area was dismal. The first place was apparently unable to catch it because they were simply inadequate. It is also possible that his age and/or race was held against him at the second hospital, which did not catch the disease in the emergency room because they assumed he was trying to get drugs illicitly.
That, however, is the surface story of this article; how desperate the population is medically. What is more important is how desperate they are mentally. These are people who voted for Trump because they are in dire need. There are no jobs in their area, or even nearby, where there is a coal mine. There is no understanding that the need for coal has dropped considerably in this country and worldwide. People seem to refuse to believe that those jobs are not coming back.
The Department of Energy did a report in 2016 that points out a reason for the decline:
“Coal production has declined because of increasingly challenging market conditions for coal producers,” the report said. “In addition to complying with environmental regulations and adapting to slower growth in electricity demand, coal-fired generators also are competing with renewables and with natural gas-fired electricity generation during a time of historically low natural gas prices.”1
Natural gas and renewables have increased the decline in worldwide coal consumption. Additionally, other countries are mining and producing their own coal and switching to renewables as well, leading to a decline in the price for coal exports. Overall, coal is not a growth industry, and companies have failed over the years, shutting down mines and ending careers. The noose is tightening on the neck of the coal giant.
According to a data dump that I did at https://www.eia.gov/outlooks/steo/query/, has been static for at least 10 years, if not longer. Coal consumption overall is down considerably in the United States, approximately 2065 megawatt hours per day (annually) in the ten year period of 2006 to 2016. Solar, Wind, GeoThermal power, Natural Gas and other alternate energy sources are eroding the use of fossil fuels and will continue to do so. In addition, there is only so much coal in the ground. It will eventually be gone.
Adding delusion to reality, the people that remain in towns like Northfork are generally old, ill or old and ill. Even if the mines came back, they could not work in them. They are not dedicating themselves to learning new skills. They need the provisions of the ACA program – desperately. But no one quoted in the article seems to realize that. One woman blames President Obama for prescription costs that are below what they would have been, and under the current program, will continue to fall. This is not a cheap provision, and it will probably be scuttled in the next version of health care. But she does not know the particulars of the program. She just knows that the cost of drugs has risen, which is not the fault of the Medicare program, but a number of factors, including pharmaceutical rate hikes.2
What will happen to these people if changing provisions of the ACA go against them? What will happen if insurance is more expensive for those who have existing conditions? What about those who are working, but poor, and not eligible for Medicare? What happens to those who refuse to get health care and then find out that they need it (one such person is in the article)? How will they afford it? The ACA program is a complicated one, as the next iteration will be. People do not understand what they have now. Will they understand what they are getting in the future if the safety net is removed?
On November 8, 2016, a group of people who felt they had been abandoned by the nation voted for a firebrand who claimed, in spite of never having lived a life even remotely related to theirs, that he understood their pain and had the cure to all of their problems. They voted for Republicans who hitched a ride on #45’s sordid coattails. The ‘rewards’ of that vote are going to be realized soon. Very soon. It will be interesting to see how it affects Northfork. Be in prayer for them and NP Saunders and for our nation. We will need it.