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?

Where I’ve Been

Dearest Readers,

Yup, you’re right, I haven’t been posting lately.

There are a number of factors that I hold responsible–of course, I cannot possibly be held responsible for my own shortcomings as a blogger  ;-).

I’ve been having a bout of the flu, and it seems endless.  I came down with it a week before my trip to Israel–I don’t remember telling you about the trip to Israel, so now you know–and it let up a couple of days before I left, so I thought I was out of danger.

The flight was magical.  I happened to be seated next to an adorable Jewish fellow, not too far from my age, and it seems that we have lived parallel lives.  We yakked for about twelve hours, sprinkled with power naps.  We exchanged communication details at the baggage claim, and I went to my usual Hotel R. in Jerusalem (actually the apartment of a good friend) and I am told that I hit the rack and slept for a week.  I believe that’s true, in retrospect.

I had all sorts of icky business-type things to do in Jerusalem.  My passport had expired, so I went to the Ministry of the Interior, took a number, and waited for two hours among the wheezing toddlers and Muslim women covered head to toe while their husbands sported bare heads, muscle shirts, and cutoff jean shorts.  Shoulder-to-shoulder, Orthodox Jewish couples all in black, National Religious couples in headscarves and colorful knitted kippas. Everyone jostled for baby buggy space.  Everyone looked vaguely worried.  Government offices make everyone worried, because your fate is in the hands of some clerk who might or might not be having a bad day.

At the bank, things were really bad.  I had a bill with the National Insurance agency that was normally directly debited, but having been in America for almost four years, I had lost my bank password, and could not obtain another without passing my debit card through their own ATM, so I was screwed there.  No possibility of doing it over the phone, either, since that also requires a password.  Oh, and they force you to change your password every six months, because they got hacked a few years back and are more stringent now.  That’s probably a good thing, but it trashed my bank account and all the other accounts connected with it.

So, when I finally was able to present myself to a bank officer, I found that my account was not only frozen, but had accrued more than four times the original debt in fees and interest.

I heard that one could get those fees taken off by hiring certain lawyers who specialize in such matters, but their fee was more than what I owed, so I decided to just pay it and cut my losses.

But whom to pay?  The bank officers said not at the bank.  The original source of the debt said not with them.  Who, then?  I did what every Israeli does when having banking issues: I went to a different bank.

Used to be that you could do that, just open another account, and then deal with the other bank in your own time, or not at all.  But now they have a centralized system for catching bounders like myself, who only want to pay their bills, past and present.

The new bank was ready to open me a new account, but wait!  My other frozen account came up on their computer like a zombie rising from its grave.  This new bank was eager for my business, though, so they were kind enough to tell me the name of the government office where I could pay my dept.  But they didn’t know where it was.

Frustrated as hell, and fuck if it wasn’t too cold and damp for ice cream (which usually soothes my inner savage beast), I trudged back up the hill (did I tell you that Jerusalem, and most of Israel, for that matter, is bristling with hills?) and fell back into bed.

After a reasonable nap I turned my energies toward finding that damn office.  First I searched for its English transliteration, which usually lands you on the Hebrew site of government offices, but no dice,  This must be a really elite office for people who have been out of country so long that their bank accounts have frozen.

So I hitched up my britches and switched my keyboard over to Hebrew, and voila!  Found it.  Turned out to be about four blocks from where I was staying.  And it looked like it would be open the next day!  You must understand, dear readers, that Israeli government offices, as well as banks and other official places, are not open according to what Westerners consider to be “normal business hours.”  For instance, most banks are open Sunday and Monday from 8:30 am to 1:30 pm, Tuesday 8:30 am to 12 pm and again from 4 pm to 6 pm.  Wednesday we’re back to 8:30 to 1:30, but Thursday mixes it up by only being open from 4-6.  Got it?  Me neither.

And it’s not homogenous among the various official offices.  You have to go to their sites and make a note of their hours.

So: having identified the location and opening hours of the office for bad debt payment, I dragged myself down there the next day and found it packed.  I guess there are a lot of debtors around, and you can’t tell by looking at them who they are.  I mean, I think I look fairly respectable.  If you met me on the street, you’d never know that I was a person who had her bank account frozen because she was a debtor.

But that’s in the past.  I paid my bill, received the usual sheaf of paperwork that I never look at no matter what language it’s in (dear readers, one thing you should know about me is that I never read instructions unless I have pieces left over, or get an alarming string of numbers on my computer screen, or have my bank account frozen).

The important part is that they gave me a piece of paper with official signatures, seals, and stamps on it, and declared my debt to be “mevutal,” cancelled.

I marched into my (former) bank with the papers, and the officer set busily about reinstating my account.  She looked quite downcast when I told her that I intended to close that account.  She looked so downcast, that I settled for putting the account on hold, but in good standing.  I made her PROMISE that my account would not accrue any fees, because bank fees accompany every transaction, even depositing money.  At my bank it costs 6.5 shekels just to make a deposit.  That’s about $1.25, depending on the exchange rate.

Well, then I had to go back through all those government offices and make sure they had received all the information on their computers.

That done, I went on to have a spectacular flirtation with the man from the plane, which ended with both of us fleeing in terror.  Luckily he has a cooler head than I, and prevailed upon me to stay friends.  OK, I really like him.  He is a magnificent guitarist, and we had a lot of fun playing together, he playing and I singing, in an empty underground parking lot.  Then we went to a dangerous park and smooched for a couple of hours.

“How long does it take to get to the Dead Sea from here?”

I thought he was asking just because he wanted to know, so I said “45 minutes, depending on traffic.”  It was 11 at night by this time, not much traffic, I suppose, although rock throwers are always a hazard, everywhere in Israel now.

“Let’s go,” he said in earnest.  “Come on, let’s go.  I want to see the sun rise over the Dead Sea.”

I have in fact seen the sun rise over the Dead Sea, and it is spectacular.  The Dead Sea is full of bromium, which combines with other chemicals to make bromide salts that are lighter than water but heavier than most air, so they hang in a pearlescent haze over the sea.  When the sun comes up over the desert hills, the bromide cloud refracts it and shatters it into thousands of sparks of pinks, purples, and golds.  Just gorgeous.  And bromide salts are a natural antidepressant!

Unfortunately, my health prevents me from staying up all night anymore, so I had to decline.  Rats.

So, as the old-time song goes, we “kissed, shook hands, and parted.”  Not for the last time, I am quite sure.  I hope.

A couple of days later, the remnants of the flu raised their heads and turned into bronchitis.  Luckily, I happened to be visiting a couple with whom I am particularly close, and alarmed at the dreadful cough I had developed, they dragged me to their doctor, and the husband braved the Israeli Arab village of Abu Ghosh (which has historically been friendly, but in these times you just never know).  Thankfully he did not get rocked or firebombed the way so many of my friends have, and the antibiotic worked wonders, and I felt better in a couple of days.

Comes the trip back to the US, and I was blessed with a whole row of empty seats, with no fascinating man to keep me awake.  So I slept until all the babies simultaneously woke up and began campaigning for their breakfasts.

On American soil again, I hit the ground running (driving, really), went and picked up my dog, and slogged home through the haze of jet lag.

Over the next few days I thought I was having a protracted case of jet lag.  I usually don’t get much in the way of jet lag, because I think my body has given up on the idea, having been schlepped through so many time zones, and it doesn’t look to be stopping any time soon.

Unfortunately the “jet lag” turned out to be: either a relapse of the flu, or some other new, different, and wonderful virus.  I spend my days and especially nights alternating between racking chills and burning sweats.  I have threatened my body that if it doesn’t straighten up and fly right I will drag its sorry ass to the doctor.  It seems unimpressed.

Wishing all of you a healthier New Year than I’ve been having so far,

Laura