Why We Need Universal Health Insurance In America

I have a confession: since the election, instead of meditating first thing in the morning, I’ve been obsessing over the news.  

It’s a terrible habit.  I can see the negative effect it has on my bodymind.  I need to Just. Say. No.

Problem is, this is not mere news voyeurism.  This is eye-opening, consciousness-raising, holy-fuck-what-could-they-possibly-be-thinking revelations about the minds of My Fellow Americans.

Here, from one of my favorite medicine/science/tech news outlets, is a revealing piece on what a few handsful of voters have to say about the new “repeal and replace” iteration that has just passed the House.

For all y’all who hail from ports afar, this is about the current Administration’s effort to purge the government, and by extension the health insurance system, of “big government.”  What is Big Government, you ask?  From my observations, it seems to mean “any regulations that protect consumers and/or the environment.”  

Here, give this article a read if you have a moment.  It’ll provide a bit of thought material for when you read the anecdote that follows.

https://www.statnews.com/2017/05/05/ahca-freedom-voters/

It was a busy evening in the ER at the Crossroads of Life and Death.  I shuttled back and forth between my domain in the Pediatric Emergency Department and the general ER, pinch hitting the “simple” cases so that the adult ER specialists could attend to heart attacks and strokes.

A guy in his late 30’s had fallen off a ladder while cleaning the gutters on his house.  Unfortunately, he landed on his bum, causing two of his lumbar vertebrae to pancake together.  The neurosurgeons were wheeling him to surgery, but the prognosis was grim: they did not expect him to walk again.

His wife was huddled in my arms, weeping uncontrollably.  He had been laid off from his skilled factory job (no unions in that town).  They were patching things together, with their two oldest boys–they had five–and the father, growing a landscaping business, just starting to climb out of the hole.  Christmas was coming, and they had no health insurance.

“It can’t get any worse!  It can’t get any worse!”  She chanted this over and over.  I tried in vain to comfort her, or at least shut her up, because I know one thing very well:  it can always get worse.

It got worse right then.

The special radio that communicated with the ambulances crackled to life, giving us a quick briefing on the critical patient they were bringing us.

A 17 year old white male, motor vehicle accident, multiple major trauma.  This was my case, since he was under 19.  I peeled the poor lady off of me, apologizing, and ran to get the trauma team ready.  Readiness is everything in the ER.

He was banged up, all right, and needed lots of attention from the surgeons.  I got his vital signs stable and turned him over to the OR team, then stripped off my blood-soaked outer gown and wandered back into the main ER.

The unfortunate wife was still there, now huddled in the arms of the social worker.  Uh-oh.  The social worker was only called in at night when there had been an unexpected death or some similar disaster.  I strolled over.

The wife saw me and burst into even more violent sobs.

“Y-you know you s-said it could always get worse?” Her voice edged on hysteria.  “That boy you just worked on.  That’s my oldest son!”

I still tear up when I write this.  

She didn’t have to say another word.  I knew exactly what was driving her panic.

Her two breadwinners, smashed up, facing long hospitalizations, surgeries, rehabilitation, long recoveries.

Her other four kids, the youngest in kindergarten.

Their home, nearly paid for…but not quite.  They would lose it.

Their fledgling business, down the tubes.

Bankruptcy, in those days (the 1990s) highly stigmatized, especially in the ranks of skilled laborers.  

Public Assistance.  Their children would be ostracized.

Medicaid.  At that time, there was only one doctor in town who accepted Medicaid patients.  His waiting list for new patients was out the door and around the block.

This is why we need universal health care.

Medical disaster is the #1 trigger for personal bankruptcy.  This is not due to “poor planning,” as some of those in Washington (and many voters who, justifiably or not, feel financially secure and don’t like to share) like to preach.  There are literally thousands of ways to plan very well, only to have disaster leap out of hiding and gobsmack you.

If you doubt that investing in America’s health, and by that I mean the health of ALL Americans, is “good for business,” consider this: 

Healthy women make healthy babies.  Healthy babies require well child care.  Healthy children grow up to be healthy adults, who require much less healthcare spending than do sick adults.

Healthy adults enter the workforce, where they contribute to the economy, resulting in a net gain in productivity, which will offset the initial investment in their healthy childhood.

After this initial investment in maternal-child health, at some point there will be a small percentage of children and adults who have congenital or acquired conditions, such as diabetes.  With appropriate healthcare, many conditions are so manageable as to make their economic impact negligible–but only with active management.  The flip side is a deficit both in functional health and productivity.

Health is wealth, in the words of my late grandfather, a tradesman who became disabled, lost everything, and never recovered.

Health.  Is.  Wealth.

Is that not a simple concept to grasp?

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18 Comments

  1. We are so lucky to have the NHS here. But politics is ruining it.

    Reply
  2. This is a story that is oft repeated and I’m fairly certain about that. The poor defenseless lady. The story made me cry. I wonder what became of the family?

    Yes, Model T and all the rest of the effers of the GOP in the house, are heartless son of a bitches. If people think the AHC Act is bad, just wait till they have no insurance at all. I predict a health care crisis with lots of folks dying because they have no way to obtain government assistance. They want to tamper with Medicaid/ Medicare as well and heaven help the poor and/or needy and the elderly. Those law makers have a pea sized brain and no empathy for the poor and or the common man.

    Reply
    • If I did not see it happening before my eyes, I would not have believed it. Turning back the clock on the amazing advances we’ve seen in the past 40 years! Sometimes I just can’t stop crying. And I too wonder what happened to that family. I hope they were part of a church family, which is likely, given the “Bible belt” location where this took place. Religious communities can be very helpful for those who are programmed that way. For those who aren’t, well, you know how that goes. “No rest for the wicked,” as if any human is qualified to judge!

      Reply
  3. I live in Canada with medicare in addition to a health insurance policy through my corporate job. I know that I am very lucky. I also know that given my mental state, had I not been so lucky, I would either be dead or have made multiple attempts to be.

    I have family in the US and the situation you describe scares me too.

    Reply
  4. Reblogged this on Xunnie in Wonderland and commented:
    If you’re in America, chances are you don’t have to look very far to see someone in your circle of friends and family, etc that doesn’t have health care; or didn’t have health care until after 2014.
    We need health care in America! Americans are arrogant enough to think we’re “the best country in the world”, but we are still fighting over something as ridiculous as a child being born with a heart condition. (Jimmy Kimmel’s monologue this week? anybody?)
    The point is we need to care about one another. We need to take care of each other. Don’t leave it to the politicians and corporations. They’re just effing it up. laura’s post sat me down and she writes about something I’ve been meaning to post on, so I’m sharing her post.

    WE NEED HEALTH CARE IN AMERICA.
    #Iamapreexistingcondition #voteNOontheAHCA #supporttheACA

    Reply
  5. CC

     /  May 6, 2017

    Laura, this is an excellent and thought provoking post.
    I do the same thing..read the news..too much.
    I wonder about Universal Health Care. The ACA was actually not truly workable for people unless they were covered under Medicaid. I keep wondering why we cannot just expand Medicaid? I know that most Republicans are against that. I am truly angry about the cuts to Medicaid. I feel that was the answer in the first place. Some sort of expansion like Adult Chip..which they had…but better.
    It would be too long to write out all of my concerns…but my major concern would be choice of doctors. Choice of hospitals. Wait time. Would doctors retire at an even faster rate than they are doing now and no new students enter the medical profession? Would the scientific and medical discoveries and research that we have continue to be at the peak that it is? These are just a few.
    I believe everyone should have healthcare. I cannot stand Paul Ryan. He has been wanting this since he ran with Romney. Believe it or not, Bill Clinton and Ryan are good friends and wanted things along the same lines. I just don’t know….
    I am wondering what your thoughts are on how well Universal Health Care really works…because Medicare has it’s flaws. I’m still wondering why we couldn’t as a country have both private and continue with Medicare and Medicaid and fix it. I would love to hear your thoughts on this. I am truly concerned.

    Reply
    • Hi CC,

      The expansion of Medicaid, which turned out to be extremely successful in reaching minimum wage workers (everyone who helps us all the time in grocery stores, etc etc etc), most of whom have to work two or three part time jobs to pay the rent. These people often struggle with chronic illnesses like Chronic End Stage Kidney Disease, diabetes, and everything else. Without insurance they end up getting sicker and sicker and costing the health system many times more than if we could just get them care in the first place.

      Then there are people with chronic diseases that don’t qualify for individual insurance and are self employed. Example: a teapartier friend of mine has a live-in girlfriend who is in her thirties. She has been diabetic since childhood. He was ranting (ranting) about how Blue Cross gave her a quote for $2500/mo for health insurance. I have one of those letters from BC too! So I told him to shut his face and tap into their state’s ACA exchange. She got insurance for less than $500/mo, which covers her insulin pump and her frequent hospitalizations.

      The provision for contraceptive is huge for women who don’t have lucrative jobs or rich husbands. Oral contraceptive pills can run $50/mo without coverage, not including professional fees. Getting an IUD can set her back $500-800.

      The ACA is not perfect, but it’s made a measurable difference in the health of Americans. The prudent thing would be to analyze its failings and fix them, rather than lobbing a scatter bomb at it and saying “screw the casualties.”

      I very much appreciate that you sincerely want to learn about the ACA and why it’s good and why we are set to see incredible harm done to vulnerable populations if it’s gutted without careful planning and implementation of an improvement.

      There are many, many sources for learning about this. I like this primer from Consumer Reports because it has more specifics than some: http://www.consumerreports.org/health-insurance/what-the-gop-vote-to-replace-the-aca-means-for-you/

      When I wrote to Sen. Ted Cruz about my dismay in throwing out the baby with the bath water, his reply seemed to hinge on Planned Parenthood. Uh, right, Ted. Let’s just go right on back to the fucking 1950’s where women died from backroom abortions.

      I’ve spoken recently with a friend who came into some money. He’s all for tax cuts and especially for cutting those taxes that benefit the working poor. Why should be pay for people who haven’t managed to pull themselves up by their bootstraps?

      Well, let’s see. These people often work 60 hours a week at minimum wage jobs. That’s still not enough to pay for basic necessities like food, housing, daycare, diapers, and birth control…and Wal-Mart still doesn’t offer insurance.

      OK, he says, but how come they haven’t progressed in their education and gone to college? Minimum wage jobs are for high school kids. (He actually said this.)

      Well, not everybody is as bright as you are. Maybe they have an IQ of 90, plenty good for Burger King but won’t get you into college. And as we’ve seen for decades now, there are many more college grads than there are college grad jobs. That’s why there are so many waiters and waitresses with PhDs.

      Right. So we have vulnerable populations and the working poor. That is why we need the ACA or something much better. And by “better,” I don’t mean better for the self-righteous or the just plain mean and stingy. In a country this rich, taking from the poor to give to the rich is a sick, sick joke, and I’m not laughing.

      Universal health care can never be perfect. I experienced Israel’s version and was frustrated by the bureaucracy. On the other hand, I had a great primary doc, and my hospitalizations were covered 100% always. My meds cost me 10% of what they cost me here in copays. It was a little more work than here, in terms of having to go to different places to apply for specially referrals, but in value, I couldn’t possibly argue. The one time I really could not wait a month for a referral, I used the “private” service, which in spite of costing a fortune did not cost anywhere near the fortune it would have cost in the States. For instance, I had broken my wrist and needed to skip the orthopedic referral in order to get to the hand surgeon (I knew I had frayed a tendon is why I wanted to go that route, and I had to travel to the States in a week). I saw a faculty level hand surgeon, had an emergency MRI, and got packed up to ship for less than $1000 US. I know it would have been out of reach for me now, but I had it then, and it saved my hand because the tendon was about to snap and might have, had I traveled with it. With a two-tier system like that, and I think England and Canada have something like that, at least everyone has their basic needs met. Israel is very strong on preventive care, too. Every year I got a call–by a real human, not a robot–to schedule my skin exam, mammogram, colonoscopy, etc., all paid by my plan. Unlimited doctor visits, same day. And my plan, the most popular plan for adults, even has an integrative health center where you can purchase deeply discounted packages for reiki, acupuncture, reflexology, massage of various types.

      Maternal and child health is always 100% covered, including childbirth doulas, which lower maternal and infant mortality.

      Well that was kind of a vomit, and I don’t know if it makes one bit of sense, but there you have it ๐Ÿ˜™

      Reply
      • CC

         /  May 6, 2017

        No it makes sense..I just worry about being able to choose doctors, like I said and good docs quitting, others not going into the field. All these things are and were happening under ACA.
        I think man ppl would have a hard time going along with it..I think it’s complicated..but I definitely agree something needs to be done. I think the ACA must vary by state bc I have known some that fell on the middle. They couldn’t afford one that they would ever meet the deductible and didn’t qualify for the Medicaid in their state.
        It has me very worried as,well.
        Thank you for your thoughts. I worry as much as you do. Your thoughts are always ones I value.

        Reply
  6. What a tragic story!

    Reply
  7. Would you be OK if I cross-posted this article to WriterBeat.com? I’ll be sure to give you complete credit as the author. There is no fee; I’m simply trying to add more content diversity for our community anbd I liked what you wrote. If “OK” please let me know via email.

    Autumn
    AutumnCote@WriterBeat.com

    Reply

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