Opinions
America’s healthcare act schizophrenia
Sticking stubbornly to our broken model is wrong

Earlier this month, the Republican-controlled House of Representatives voted once again to repeal the Affordable Care Act. House Speaker John Boehner (R-Ohio) said the Act is “making our economy worse, driving up the cost of healthcare and making it harder for small business to hire workers.” He has plenty of Americans behind him in that belief. A majority of Americans want the Act repealed, though 82 percent support the Act’s new rule that bans insurance companies from denying coverage to people with pre-existing conditions. Our nation has developed Care Act schizophrenia.
When the Supreme Court ruled on the Affordable Care Act a couple of weeks ago, I found myself in the perfect laboratory of national opinions, surrounded by families, businesspeople, and gay flight attendants all passing through Atlanta’s Hartsfield-Jackson airport. As CNN announced the breaking news that the Supreme Court had left the Affordable Care Act standing, passengers waiting for flights started speaking out:
“There goes the middle class,” groused a guy behind me.
“Now we know what we need to do—get that guy out of office,” snorted a woman sitting with her elderly mother.
“This is why our forefathers left England. It’s Socialism!” insisted a history-challenged senior.
Right now, more Americans have come around to accept gay marriage than are in favor of the Affordable Care Act. What’s behind this virulent hatred of a national healthcare program? Ignorance.
Now, I’m not saying that there aren’t legitimate concerns about the ACA in its current form. We can have a good debate about the details of its roll out. But first let’s put some common arguments to rest.
- “The U.S. has the best healthcare in the world.” Not if you agree that healthcare should prevent untimely deaths. The U.S. is in eighth to last place in the industrialized world when it comes to life expectancy. The only relatively developed nations we outlive are the Czech Republic, Estonia, Hungary, Mexico, Poland, Slovakia and Turkey. We rank dead last among highly industrialized nations. Not exactly what you would expect for the third wealthiest country in the world with the “best” healthcare.
- “We just can’t afford universal healthcare.” We’re already paying the price tag for universal healthcare, just not getting its benefits. The U.S. pays two-and-one-half times per person as much for healthcare as the average for all other industrialized nations. Pre-existing condition exclusions blocked many Americans from getting health insurance, and high premiums still block others. So many of the 50 million uninsured Americans use the emergency room as their primary healthcare provider.
The average emergency room visit costs $1,318, or $1,565 for patients over age 45. Worse, by the time uninsured people get to the ER, their conditions are much more costly to treat. For example, we spend more than any country in the world on hospital admissions for preventable diabetes. When patients can’t pay, you and I are already picking up the tab through increased insurance premiums, and increased taxes as hospitals write off their losses.
- “Well, we don’t want to be like Canada, with its rationed healthcare, or socialist like France!” Agreed, we’re an innovative capitalist country. But since we’re paying more and getting less for our healthcare dollar, just saying “no” to “socialist ObamaCare” isn’t good enough. Let’s borrow a better business model from one of the industrialized nations that has a successful healthcare system without resorting to universal healthcare. Have you got a country in mind? If you do, you must have gone back in time, because ever since Israel changed its system in 1995, we’re the only nation in the industrialized world that does not have universal healthcare.
That’s right, it’s not just Canada and France that have universal healthcare, but also Australia, Austria, Bahrain, Belgium, Brunei, Cyprus, Denmark, Finland, Germany, Greece, Hong Kong, Iceland, Ireland, Italy, Japan, Kuwait, Luxemburg, New Zealand, the Netherlands, Norway, Portugal, Singapore, South Korea, Spain, Sweden, Switzerland, the United Arab Emirates, and the United Kingdom. And they all pay less per person, and all live longer, on average, than we do.
Not a single American I’ve spoken to who is opposed to the Affordable Care Act knew this most basic fact.
The truth is, we can’t afford not to have universal healthcare. Among those employed, medical expenses are the No. 1 cause of household bankruptcies in the U.S. You can sock away savings all of your life, but when genetics, age, bad habits or bad luck bring a major medical issue to your home, too often all financial reserves are lost.
So go ahead and call universal healthcare “socialism.” I believe government has two core functions: to defend the nation’s people against enemy attack and defend citizens from unnecessary death. No town buys its own tank and jet fighter for a possible war, and very few households could save up enough for a medical catastrophe. This is why societies have governments in the first place, not just socialist governments.
Take it from Mitt Romney, who supported an individual mandate to establish universal healthcare in 2006, “Folks, if you can afford health care, then, gosh, you’d better go get it. Otherwise you’re just passing on your expenses to someone else. That’s not Republican, that’s not Democratic, that’s not Libertarian. That’s just wrong.” Sticking stubbornly to our broken, privatized model is just plain wrong.
Stephen Fallon is president of Skills4, a healthcare consulting firm that provides services to CDC and HRSA funded providers, primarily gay- or minority-based agencies and clinics. Reach him via skills4.org.

President Felon has decided the presidency is too much for him to handle, and has in essence turned it over to Elon Musk. He will instead chair the Kennedy Center for the Performing Arts, Board of Trustees, and work to destroy that institution. I wonder if Trump even knows the history of the Kennedy Center, or its mission.
He could easily find out if he looked at its website. “In 1958, a Republican president, Dwight D. Eisenhower, signed bipartisan legislation creating a National Cultural Center in the nation’s capital. In November of 1962, President and Mrs. Kennedy launched a $30 million fundraising campaign for the Center’s construction. Former President Eisenhower and his wife Mamie participated in the event, which demonstrated the bipartisan support for a world-class center for the performing arts in D.C. In 1963, President Kennedy signed legislation to extend the fundraising deadline for the Center. Two months after President Kennedy’s assassination, by an Act of Congress signed into law by President Lyndon B. Johnson on Jan. 23, 1964, the nation’s National Cultural Center was designated as a living memorial to President John F. Kennedy. By this Act, President Kennedy’s devotion to the advancement of the performing arts in the United States was recognized.”
The mission of the Center is also there. “The Center’s mission is established in its authorizing statute: present classical and contemporary music, opera, drama, dance, and other performing arts from the United States and other countries; promote and maintain the John F. Kennedy Center for the Performing Arts as the National Center for the Performing Arts; strive to ensure that the education and outreach programs and policies of the John F. Kennedy Center for the Performing Arts meet the highest level of excellence and reflect the cultural diversity of the United States; provide facilities for other civic activities at the John F. Kennedy Center for the Performing Arts; and provide within the John F. Kennedy Center for the Performing Arts a suitable memorial in honor of the late President.” To fulfill the mission as the nation’s cultural center, the Kennedy Center presents world-class art by the artists that define our culture today, delivers powerful arts education opportunities nationwide, and embodies the ideals of President Kennedy in all the Center’s activities provided throughout the living memorial.
Clearly, with the federal government, and the world in chaos, much of that due to his recent decisions, Trump seems to have determined ending drag shows at the Kennedy Center will be his number one priority. I’ve been thinking maybe he wants to go down in history in the same way as Nero, ‘who fiddled while Rome burned.’
It is perplexing, at the advanced age of 78, Donald Trump has decided to become the nation’s culture czar. The man who has likely never sat through an entire play, or concert, and who knows less than nothing, about the arts. On the other hand, this is no more ludicrous than his being president for a second term with still no real knowledge of what the various federal agencies, he has now given control of to Musk, actually do. Why is the free press, those that still exist, not asking him, or even his Press Secretary Karoline Leavitt specific questions about this. Asking them if they know what USAID actually does. Can they name the programs, do they know how much money Iowa farmers will lose if USAID closes. Then ask if they know what the Department of Education does, what percentage of the money spent nationally on education comes through them? What role does the Department play in the education of children with disabilities, and those who are poor, and qualify for title one funding? What role do they play in the lives of the countless of millions of people with disabilities through the Rehabilitation Services Administration, which is in the Department of Education. Do they know the history of that being moved from what was HEW in 1980 when the Department was set up by Congress? Do they know or care about the Civil Rights work of the Department of Education? We know as a racist, and homophobe, Trump likely doesn’t care about that.
I keep imagining Trump and Musk standing together in front of a mirror. One sees himself reflected back as Hitler, the other as Mussolini. Maybe, in his new role as chair of the Board of Trustees of the Kennedy Center, Trump can commission a new play on this. A possible title could be ‘Musk and his mistress, an American tragedy.’
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Romance and sobriety can mix with the right steps
Seek guidance, engage in community, focus on positivity

With Valentine’s Day upon us, there can be pressure to do something nice for that special person. The day offers profound joy and significant challenges for those who take it to heart. While many participate and celebrate in their own way, countless others may avoid it at all costs.
For individuals in recovery from substance use and addiction, dating, and relationships can carry an added layer of complexity as sobriety and personal growth intersect with the emotional demands of intimacy. Fortunately, there are practical tips for sober dating and community resources in Washington, D.C., for those recovering from substance use.
There are challenges in romantic relationships because of the inherently unpredictable nature of romance. Anyone going through anything challenging in their life knows this to be true when romance enters their life at a difficult time, such as recovery from a substance use disorder. Unfortunately, for those in recovery, engaging in social situations like dating that might involve alcohol or drugs, often a feature of modern dating, can be triggering.
According to the National Survey on Drug Use and Health, 22.96% of Washington, D.C. adults 18 and older used illicit drugs in the past month. Drug Abuse Statistics also indicate that 22.5% of D.C. adults over 18 binge drink at least once per month.
Within the LGBTQ community, these issues are often amplified because of strained family relationships and individuals struggling with sobriety and romantic relationships. According to SAMHSA, sexual minority adults were more likely than straight adults to have had a substance use disorder in the past year. About one-third of bisexual males, bisexual females, and gay males had a substance use disorder in the past year, along with one-fourth of lesbian females.
Romance and sobriety can mix with the proper steps and do not have to be avoided. For example, prioritize your recovery and make sobriety the non-negotiable foundation of your life. Before entering into a relationship, have confidence in your ability to maintain your recovery.
Most importantly, be honest with those you are beginning a relationship with, whether in recovery or not. Transparency about your recovery journey can set the tone for a healthy relationship. Discuss your boundaries and triggers early to avoid misunderstandings.
Building trust requires open and honest communication about past struggles and current goals. Clear expectations about triggers and personal needs can create a safe environment for both partners.
When you are dating, choose sober-friendly activities. Choose dates that don’t center around alcohol or drugs. Hiking, art classes, coffee meet-ups, playing sports, going for walks, casual lunches, or visiting museums can provide fun, sober alternatives. Be creative, and search locally for things to do. Exploring activities and creating routines that support a sober lifestyle can deepen the bond and reduce risks.
Finally, lean on your support network. Stay connected with sponsors, therapists, or support groups to process emotions that arise during dating and relationships. According to the D.C. Department of Health, 10.7% of District of Columbia adults identified as either lesbian, gay, bisexual, or transgender. LGBT adults were more likely than their non-LGBT counterparts to report 15-30 days of mental health not being good, which includes stress, depression, and problems with emotions.
Some support resources in the area include the DC LGBTQ+ Community Center, which serves as a vital resource for the LGBTQ community, supporting health and wellness. In addition, there are resources through the D.C. Office of Human Rights LGBTQIA+ resource portal. Finally, there is the 988 Suicide and Crisis Lifeline, which can be reached anytime to talk to a trained crisis counselor who can help if you are experiencing suicidal thoughts, substance use, mental health crises, or emotional distress.
If Valentine’s Day and the pursuit of romance create obstacles, seek guidance, engage in community, and focus on positivity.
Romantic relationships in recovery require a balance of vulnerability, self-awareness, and unwavering commitment to sobriety. By addressing challenges head-on and embracing the growth opportunities, individuals in recovery can experience fulfilling and meaningful connections.
Marie Garceau has been working in the field of substance use and addiction recovery for over a decade. She works at DRS and primarily focuses on reaching out to the community and spreading awareness.
Opinions
Trump’s anti-immigration policies inspire similar efforts around the world
Individual rights, dignity, diversity now under threat in US

My personal experience with the American migration system is quite peculiar.
I left Russia, where I was a refugee, in 2018 after I had a serious problem with immigration authorities because of my LGBT activism. I left Russia for Israel because the tourist agency told me that Tel Aviv is the best place for me to get an American visa. My wife and I had an invitation to speak at an American disability rights conference about intersectionality, but we were secretly planning to ask for asylum in the U.S.
The U.S. denied our request for American visas. This led to a situation when we were stuck in Israel without our belongings, money, any right to work, or a proper status. Finally, four months later we had to move to the UK to ask for asylum. I’ve never had a chance to come to the U.S.
I have dreamed of living in the U.S since elementary school, but now I’m extremely glad that I’m not there.
I have been a queer refugee in three different countries, including the UK, where I’m living right now. So anti-immigration steps taken by the Trump administration have felt very disturbing and personal to me; not just because the U.S. is de facto the country of immigrants that became great because of them, but also because of the potential influence that the U.S.’s anti-immigration politics could have on the UK and Europe.
Nigel Farage’s Reform UK is taking the lead in a recent British voting intention poll, and one of the reasons is the outstanding support that billionaire Elon Musk shows to the party. Despite the fact that Musk has quite a complicated relationship with Farage, financial and propaganda support from Musk is able to change the British political climate.
Ordinary British people I have met and political analysts are asking themself whether it possible that MAGA is spreading anti-immigration and aggressive ideas to the UK, and if so, what it would mean for the UK sovereignty.
Reform party supporters were involved in anti-immigration pogroms that were happening in the UK in August 2024 and is also known for their anti-LGBT and especially anti-transgender policies.
Farage in June 2024 released a pre-election party manifesto in which he pledged to “ban transgender ideology” in schools, including stopping social transitioning for trans youth, insisting that “transgender indoctrination is causing irreversible harm to children.” Ageism and xenophobia are once again walking hand in hand with anti-LGBT policies.
Reform UK also promised to leave the European Convention on Human Rights and replace the Equality Act 2010, and those steps would definitely harm LGBT communities.
So, under the Reform Party, the ones who live at the intersection — LGBT refugees, like me, and LGBT asylum seekers — will be in particular danger, not just in Britain, but also in Scotland, Wales and Northern Ireland.
The far-right is gaining more and more power in the UK.
Thousands gathered in Central London on Feb. 1 to support British far-right influencer Tommy Robinson, who the British government has jailed. Robinson is also famous for his anti-immigration campaigns and transphobia and also gets political and financial support from Musk.
Some people in the demonstration were wearing “Make England Great Again” caps, an obvious reference to MAGA.
I, on the other hand, never in my life felt safe on a street before I came to the UK. It doesn’t matter who was in power — Labour or the Tories — in the country. I have never faced even one percent of the discrimination I experienced in Russia and Ukraine as an autistic person. When I came to the UK, it felt like time traveling to the future where diversity is accepted and celebrated. I can hardly imagine that if Reform comes to power, British society will suddenly change their attitude toward LGBT refugees. The law could become worse, but the ideas of universal human rights in the UK are too strong to be messed up so easily. At least I hope so.
Now LGBT rights activists in the UK are even thinking about welcoming trans* asylum seekers from the U.S. and helping them to get status and support in the UK. I spoke about this during a break with representatives of the Rainbow Migration group in London, soon after Donald Trump signed his transphobic executive orders.
Because American trans* people who work in the military and government are losing their jobs while the UK has the NHS — a free medical healthcare system for everyone, including tourists and asylum seekers, free medical prescriptions for the poor — and a lot of social support like free housing for asylum seekers, free solicitors, strong community support provided by charities, and so on, it is possible that some trans* people would now become refugees here.
The UK and European countries are, of course, not the most obvious choice, according to PinkNews. Some LGBT Americans are considering a more geographically close destination, such as Canada, as their possible destination.
I think it could sound surprising for some Americans, but most of the European Union countries are much less friendly toward refugees than the UK.
Musk’s attempts’ to promote MEGA, Make Europe Great Again, has even more chances to succeed in Germany, especially considering the level of support he shows to the Alternative to Germany party. AfD is also known for its support of Russia, which is using openly homophobic and transphobic rhetoric in justification of their war in Ukraine. Russian state propaganda says it is acceptable to kill civilians to stop the spread of an extremist LGBT ideology.
Musk’s ideas that Germans should stop condemning the Holocaust together with AfD sympathy for Russia is an extremely dangerous situation for LGBT refugees. Even straight refugees in conservative-dominated Bavaria are wary of mentioning their support of LGBT people to local authorities.

All authoritarian regimes began their persecution by targeting the most vulnerable and marginalized people before they move to restrict freedoms for the entire population.
I learned about liberty, individual rights, dignity, and diversity as a child by watching American movies, but these values are now under threat in the U.S. And the American government is beginning to spread a completely opposite idea that is threatening universal human rights in Europe and beyond. It is now possible to stop the process, but it soon may become too late. I’m not so scared of Trump’s actions, but I am scared that not enough efforts have been made to oppose them in the U.S. and beyond.
Editor’s note: The author uses trans* in order to be inclusive of nonbinary and gender queer people.
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