Trump Should Stick to Spray-Tans
By Vismaya Kharkar
Trump’s proposed health-care reform plan, known officially as the American Health Care Act, is a hotly contested and audacious move by the Trump administration against Obama’s healthcare reform initiative. Trump’s plan would effectively reverse or modify many key policies of the Affordable Care Act, ranging from the availability of Medicaid payments to the status of individuals with “preexisting conditions.” These changes would impact a broad range of issues within the public health sector, from those as wide-sweeping as women’s health to those as niche as – perhaps surprisingly, for a president with a reputation for an obvious spray-tan – the tanning bed industry. While this industry lies on the fringes of most Americans’ minds and healthcare concerns, it presents an example of effect that simple government actions may have dangerous consequences when it comes to public health. Trump’s new stance on the tanning-bed industry counteracts measures designed to prevent skin cancer and represents a step away from government intervention in public health.
Artificial tanning, a staple of the American beauty and fashion scene, was developed in the late 1970s and has been popular ever since. In 2012, around 28 million Americans claimed to have used tanning beds; the largest portion of these Americans were young, white women living in the Midwest. Strikingly, in the same year, almost 19,000 small businesses in America were tanning salons. The majority of tanning beds use a combination of ultraviolet light waves, UVA and UVB rays, to darken the melanin in skin; however, UVB rays are most common in standard tanning beds. Ultraviolet (UV) light in general is a common carcinogen–exposure to UV light has been linked to 90% of melanomas – and it also can produce dependency due to its slight mood-enhancing effects. Furthermore, UV light aso increases the probability that a benign mole turns malignant, as well as the risk of developing both squamous-cell (upper-layer) and basal-cell (base-layer) carcinoma.
To attract customers, many tanning salons claim that tanning beds artificially promotes the body’s absorption of vitamin D, absorption which is ordinarily carried out by sunlight. At the same time, the tanning industry routinely dismisses concerns regarding the dangers of tanning beds as false claims perpetuated by dermatologists hoping to make money. Although UVB light, the most commonly used UV light in tanning beds according to tanning bed manufacturers, promotes vitamin D absorption, dermatologists do not recommend tanning beds for this purpose. To make matters worse, research has found that contrary to the claims made by many tanning salons, UVA light makes up the majority of light emitted by these tanning beds, invalidating the idea that tanning beds promote vitamin D absorption[4, 7]. Despite this evidence, tanning salons are popular, especially among teens.
Recently, however, the tanning industry has met its match: the combination of (1) a two-year recession, (2) the redoubling of skin cancer awareness efforts by public health researchers, and, most importantly, (3) a tax imposed via the Affordable Care Act. Caught among these three factors, the formerly prosperous, five-billion-dollar industry is slowly but surely dying out. In particular, the 10% tax imposed by the Obama administration in response to the negative public health effects of artificial tanning has cut revenues as well as sales, halving the size of the industry. Many tanning salon owners are now turning to Trump’s health care plan, which will remove the tanning bed tax, in hopes that it will revive the industry.
This potential rebirth of the tanning bed industry creates an environment in which risky health behaviors are unregulated, and would be a step back by the government from action related to public health issues. The logic used by the Trump administration in taking this step is that the tanning bed industry is mainly composed of American small businesses with a substantial workforce and a steady rate of growth, and that harming this industry has the potential to harm the American economy. However, the negative health effects of tanning present both significant economic and public healthcare concerns that outweigh the need to maintain the jobs it provides, indicating that it is perhaps more important to curtail the tanning industry than to leave it alone. This is because the more healthcare a community requires, the higher overall healthcare costs will be per capita. Additionally, chronic diseases, including cancer, drive up public and private healthcare costs to corporations with employees missing work; treating chronic disease constitutes a high portion of healthcare costs: “96 cents per dollar for Medicare, and 83 cents per dollar for Medicaid.” Prevention of chronic diseases is one of the best ways to reduce this cost, and cutting back on the tanning bed industry is one example of a preventative measure, against skin cancer, specifically, that will do so. Higher healthcare costs eat up disposable income, especially in middle- and lower- class households, very quickly. Because of these high expenses, the Trump administration should shift its healthcare priority to preventing skin cancer in the American populace by keeping the tanning bed tax. Ultimately, the focus of public health policy should be to protect the American people.
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