Voting by Mail = Better Health (and Not Just Because of Coronavirus)

I was engaged in a  conversation this morning with a large group of healthcare leaders about how the threatened and actual dismantling of the US Postal Service is not just a way to suppress the vote, but is also a way to ensure that we further cripple what’s left of our country’s efforts to improve not just public health, but all health. There are people in our government who are so desperate to be re-elected they have truly given up on caring about how their actions affect US citizens of all parties (assuming some of them ever cared).

What some people who may or may not live at 1600 Pennsylvania Avenue think is that it will be Democrats who will are disproportionately impacted by this move. Apparently, such individuals don’t read down past the opening paragraph of articles that pretty much universally show that both political parties are equally negatively impacted by compromising our citizen’s right to vote by mail.   Regardless of party,if you make it hard to vote by mail, you disenfranchise seniors, people with handicaps, people with small children (like, say, suburban housewives), and people who work 9-5 jobs and whose employers don’t believe in time off to vote.

But putting politics aside (oh please God – just give me one minute without politics), here’s a fact: any actions that limit mail-in voting, absentee voting, or whatever you want to call it are a threat to public health no matter what political party you favor. The obvious reason is, of course, that many people would rather mail in ballots because it helps them avoid exposure to COVID-19, which will definitely be a real risk if we are forced to stand in long, crowded lines to vote in person. But we already know that many in our government don’t care about this issue or making it worse.  Sorry, was that a political statement?  I mistook it for a fact.

Anyway, what the current Administration fails to report is that there are even more risks to public health than coronavirus, and those risks are the direct result of their efforts to suppress the vote by slowly subjecting the U.S. Postal Service to death by a thousand cuts. Those include:

• We are about to enter flu season, so forcing people to commune at the voting booth also forces them to be exposed to Flu risk in a year when we have already been warned that flu shots will be in shorter than usual supply.
  • Somewhere between 30,000 and 60,000 people die of flu in a normal year – in a year with compromised immune systems and limited access to flu shots, it could be worse
• If you slow down the mail, you slow down the mail-order drug delivery system that so many have come to rely upon during the pandemic.
  • Use of mail order grew 21% over last year
  • Now, more than 330,000 veterans receive prescriptions in the mail every work day.
  • If you slow down the mail, you increase patients’ out of pocket drug costs by 3x, since copays in person are for 30-day dosages and mail-order copays are typically for 90 day dosages.
  • If you slow down the mail, you reduce medication compliance and increase emergency room visits because those that use mail order pharmacy are more compliance with their medication regimens
• If you slow down mail order pharmacy and you care about business but not people, it still hurts; all of the nation’s largest insurers rely on mail order pharmacy for their fiscal health– so if these are your PAC contributors…
• If you slow down the mail, you slow down reminders to get colonoscopies, eye exams, dental exams and other essential screenings that prevent expensive, life altering diseases
  • And you also slow down the ability to use important at-home testing kits like Cologuard
  • Oh, and by the way, you also slow down and reduce the utility of the array of about-to-emerge at-home COVID-19 tests that still require mail to get read! The slower the result, the greater the spread
• If you compromise the US Post Office you also slow down social security checks and paychecks and other income people need for luxuries such as food, shelter and…see Maslow’s Hierarchy of Needs, starting from the bottom. If you’re a fan of the movement to pay more heed to Social Determinants of Health (SDoH), consider the effectively operating US Mail service to be one of them.
  • You could also slow down landlord’s receipt of rent checks, which may cause them to evict people whose checks are chronically late, which they will be if all mail is late (see paychecks, social security, above), especially if the moratorium on evictions is lifted.  Losing your home isn’t great for your health.

Well I could go on and on, but instead I will offer a fight song in the spirit of the moment, written as an homage to the Marvellette’s classic tune, Please Mr. Postman. Enjoy (and VOTE!).

Please Mr. Postman

(Wait) Oh yes, wait a minute Mister Postman (Wait)
Wait Mister Postman
Oh yeah
(Is there a ballot in your bag for me) Please, Please Mister Postman
(Why’s it been a very long time) Oh yeah
(Since our election was someone’s bad punch line)

There must be some word today
From the postmaster so far away
Please Mister Postman, look and see
Is there a ballot, a ballot for me

I’ve been squirmin’ here waitin’ Mister Postman
So patiently, for just a chance, to vote for better
Sayin’ it’s my turn to count, you see!

Please Mister Postman (Mister Postman, look and see) Oh yeah
(Is there a ballot in your bag for me?) Please Please Mister Postman
(Why’s it been nearly four years of time) Oh yeah
(Since I felt like this country was mine)?

So many say you’ll pass me by
‘cuz the election has gone so awry
You need to stop to pick up my letter
Please don’t help all those damn vote suppressors!

Please Mister Postman look and see (Postman postman)
Is there a ballot (oh yeah) on its way from me? (Postman postman)
You know it’s been so long (Postman postman)
Since I felt like this country was mine (Postman postman)

You better help a voter, help a voter
Oh, you better help a voter
Please, please Mister Postman (Wait a minute Mister Postman)
Brave the snow and sleet one more time for me
You better help, help a voter
help a voter, help a voter, help a voter
Please Mister Postman
Deliver my letter to an election unfettered
Help a voter, help a voter
Help a voter, please Mister Postman
Wait a minute, wait a minute oh oh

And from me, please spread the word far and wide (Twitter, LinkedIn, Facebook, Instagram, Sidewalk Chalk, Billboard, Carrier Pigeon…I’ll take it)

Voting-by-mail is good for public health
#PleaseMrPostman
#You’veGotMailYou’veGotHealth
#USPSDeliversHealth