Access Challenges

According to the CDC, 48,830 people died in the US in 2021 from gun-related injuries.  Of those, 54% or over 26,000 deaths were due to suicide.  These alarming figures along with the bevy of mass shootings, should cause considerable focus on the need for mental health intervention.  However, we should not allow the tail to wag the dog.  Access to guns is a catalyst for both suicides and mass shootings.  “Access to care” on the other hand, is the focus on individuals unable to receive healthcare due to lack of insurance. 

We should understand that access to care does not always lead to the receipt of care or the pursuit of care by those in need of it.  Also, receipt of care does not necessarily mean delivery of appropriate or proper care. Lastly, appropriate evidence-based care does not guarantee favorable health outcomes. Like gun laws, or lack thereof, there are many determining factors at play when providing and receiving care.  These are all the circumstances that resulted in the mass shooting in Maine 2 weeks ago.

In the US, an outstanding 90% of the population have healthcare coverage. The challenge is the 10% without coverage represents 33.4M people. With the incredible rate of mass shootings in the United States over the last 10 years, (there have been 4,283 mass shootings, killing 4,298 victims and wounding at least 17,632), it feels like access to guns is easier than access to care.   Yet, the two accesses are invariably connected.  Unfortunate, but successful discharge of firearms will likely cause victims to need care regardless of insurance status.

The ATF estimates there are 434M guns in civilian circulation, more than twice the amount owned by the military.  That’s enough guns for every US resident with plenty to spare. There are 200M more guns in civilian possession than lives covered by health insurance.  According to the Pew Research Center, even though only 30% of Americans own at least 1 firearm, guns are present in 68% of US households.  That means that roughly 222M people potentially have access to a firearm.

Our government has determined that the business of guns is more important and more lucrative than the lives of its citizens. The original intent of the second amendment’s provision of gun ownership was to protect one’s property, livelihood, and life.  I wonder if the authors of the constitution would have had any reservations if they were able to predict the impact of this law 250 years after America’s independence.

In 1788, the Second Amendment’s guarantee of the right to bear arms referred to a single-shot musket or long gun that could be reloaded and fired a maximum of 3 times in a minute by the most skilled infantrymen. Contrast this to a modern day fully automatic AR15 that can shoot 600 rounds per minute and the semi-automatic version that can fire 45 rounds per minute. Today, in just 65 seconds, an experienced rifleman can discharge a full clip and reload a new magazine in an AR15. What civilian target requires that amount of force to be subdued or overtaken for protection? Often at the end of the barrel are healthcare responders trying to save lives.

The right to bear arms is protected by law but not one’s health? We know the answer. I’m certain the nation’s founders did not foresee this irony when they penned the Second Amendment.  In 1776 neither the musket nor the lack of healthcare access was an existential threat to the colonies.  Ironically, this great nation, they helped to create, exceled in technology, manufacturing, and in nearly every industry. These successes led to the rise of mass production of powerful firearms and the increasing need to protect one’s property and wealth.

Health challenges evolved from America’s industrial prowess and its byproducts.  Advanced food harvesting, processing, and storage techniques create both beneficial and unfavorable side effects on health. Economic luxuries and conveniences that procure sedentary lifestyles compound the situation. American indulgence, preferences, choices, and vices act as an accelerant. In an environment of liberalism mixed with capitalism, all these factors distort our priorities, contribute to access to firearms, or produce challenges stressing the need for access to care.

Because the leaders in our government have failed to deliver a legal or regulatory solution to the gun crisis, our healthcare providers and healthcare systems are constantly besieged by gun-related tragedies.  Because preventative care, access to care, and a means to pay for care for all is not bullet-proof, whether you own a gun and whether you have insurance, you pay the bill when the ease of access to guns and challenges of access to care collide.

Private gun ownership is a constitutionally protected right. U.S. civilians own more guns than those in the next 24 countries with guns combined. Approximately 40% of all households in the United States possess firearms. Except for recreational use, hunting, sports, and entertainment, guns destroy lives. Mass shootings and death-by -gun continuously plague our nation. Gun violence places tremendous strain on our healthcare system in waves of occurrence with indifference to access to care. Given these facts, guns are an epidemic in the US that we have been unable to cure.