51,000 deaths per year is just the starting point
A government’s budget is about much more than numbers: It’s a moral document that reflects a nation’s values. Chief among those should be providing for the most vulnerable. This includes guaranteeing health care for Americans; shoring up Medicare, Medicaid and the Affordable Care Act; providing food assistance to needy people, including the elderly and children; funding science and medical research; and requiring the very richest to pay their share of taxes.
Within this framework, it’s clear that Donald Trump and the GOP’s One Big Beautiful Bill Act is a moral failure in the making, where greed, cruelty and sociopathy are masquerading as responsible public policy. In a recent interview with “Democracy Now!,” Rev. William Barber correctly described it as the “Big, Ugly, Destructive, Deadly Bill.”
If enacted, the legislation will further tear apart an already weak social safety net and strip health care from millions of Americans. Medicare, Medicaid and the Affordable Care Act (ACA) will be cut by more than 1 trillion dollars. The massive tax cuts from Trump’s first term will be extended. Hundreds of billions will be spent on defense and the administration’s mass deportation campaign against undocumented immigrants. The legislation will create one of the biggest transfers of wealth in American history: hundreds of billions of dollars — and likely trillions — of dollars will be taken from the poor, working class, and the middle class and given to the wealthiest Americans and corporations. According to the nonpartisan Congressional Budget Office, the bill will cause the federal deficit to explode by at least $3.3 trillion over 10 years.
The very richest Americans already have more wealth than they could reasonably spend in several lifetimes. For example, the top 10 percent of Americans control approximately 70 percent of the nation’s wealth. By comparison, the lower half of the American population controls a pitiful 2 to 6 percent of the nation’s wealth. The amount of wealth owned by the American middle class is less than that owned by the top 1 percent.
Wealth and income are directly correlated with how long a person lives and their quality of life. At its core, the “Big Beautiful Bill” will help the rich to live longer and be happier while everyday Americans will live even shorter and more miserable lives.
In early June, Dr. Alison Galvani, director of the Center for Infectious Disease Modeling and Analysis at the Yale School of Public Health, joined with other public health and policy experts at Yale and the University of Pennsylvania in signing an open letter to Democratic Sens. Ron Wyden of Oregon and Bernie Sanders of Vermont, both of whom serve on the Senate Finance Committee. The group, in warning about the bill’s potential impacts, predicted the unnecessary deaths of at least 51,000 people each year in the United States.
In a recent conversation, Dr. Galvani explained how public health is directly connected to the health of American democracy and why authoritarian governments cause sickness, death and shorter lives for the people who suffer under them.
America’s democracy crisis is not just one discrete thing. It overlaps with most, if not all, areas of society and life. What do we know empirically about the impact of authoritarianism on public health and well-being?
Authoritarian regimes often suppress scientific inquiry, censor data and discredit experts, which is devastating for public health. Accurate data and open scientific discourse are fundamental for identifying health threats, developing effective interventions and responding to crises (e.
