Healthcare, the Poor and the High Cost of Fear: A Very Personal Essay


Author’s warning: this post contains no statistics, data or maps.

Sometime in the early 1980s I was outside with my brother, who was around six years of age. As with many young boys, something in him beckoned a challenge, so he decided to ride his tricycle with his eyes closed. Three steps and one emergency room trip later, my family was back at home, sitting around the kitchen table discussing how they were going to pay for the hospital visit, stitches and return doctor’s office trip to remove those stitches. This was my first recollection of the US healthcare system and the problems the uninsured face.

You see, both of my parents worked. Both worked a lot of long hours, but they didn’t make enough to support the five children they had. Some will immediately find fault in the quantity of children. In our lofty, problem-solving middle-class minds, we like to determine how many kids the poor are allowed to have, how many snack foods they are allowed to purchase, or whether or not they should buy any form of entertainment. We quickly find fault in the decisions of the poor because we are conditioned to believe that the poor somehow made bad choices to end up with such a fate. On the flip side, we are conditioned to believe that the wealthy worked very hard and deserve everything they have. I know firsthand it isn’t that simple.

As a child, I can remember going to the doctor only in the most severe of cases (after all of the obligatory vaccination years, of course). I went to the dentist two-three times in 18 years. My friends, on the other hand, who were lucky enough to come from families whose employers provided insurance, seemed to be chronically ill, always on one antibiotic or another, allergic to a myriad of things I didn’t even know grew in the area and pathologically addicted to the indoors. My brothers and sisters and I, growing up in the country, spent all our time outside, usually building forts, skinning knees, camping with our tick-laden basset hounds, swimming in dirty ponds and absorbing bacteria by the tons. Somehow, we escaped these strange plagues our wealthier friends continually battled. We were lucky to have fresh air and forests as good medicine, because I later learned that most of our childhood was spent without any form of medical insurance.

As I grew up, went to school and eventually joined the workforce, I was careful to select jobs that provided insurance. I did all of the right things – or so I thought. Yet, up until about three years ago, I was still paying off a ten year old hospital bill from a procedure that * check the fine print * wasn’t entirely covered by my Aetna policy. Percentage becomes extremely important when dealing with price tags in the thousands. And, no, this was not some cosmetic job – it was surgery to remove growing, painful fibroids.

Not long after the surgery, I moved to Canada. Like most programmed Americans, I was suspicious of free healthcare. First, because it isn’t free – not really. Canadian income taxes are higher in order to provide healthcare for all. Second, I was taught to believe that “you get what you pay for”, as if that’s a healthy concept. I expected outrageous waiting times, grossly unequipped hospitals and negligent doctors (since, naturally, all of the good doctors would have left for the States). I ate some serious crow the first year. My eyes were opened. So THIS is what it is like to not have to worry about fine print, employers without insurance options and preexisting condition loopholes?!  Even my experience with minor surgery there was incredibly uncomplicated, my surgeon – top notch, and aftercare, thorough. Yes, my income tax was higher during those years, but I had the satisfaction of knowing – if seriously ill – I wouldn’t need to worry about getting the treatment I needed or a huge bill waiting in my mailbox. Even better, I had a clear conscience knowing even the poorest person would get the treatment they need. Now, of course some of you are screaming out, “But the rich get better medical treatment there, too!” Well, yes. Such is the world – the rich do have access to more and better. But the key difference in Canada (and in most developed countries) is this: all are cared for.

This is just my own picture of healthcare in Canada versus the States. When I returned in 2008, I was met with the same old dilemma of finding a job with good insurance and attempting to understand jargon designed to confuse a person right out of coverage, and when they need it most. My venom-spitting, anti-universal healthcare colleagues were still at it – still maligning countries they have never visited much less received treatment in. 

I have many friends whose situations have been far grimmer than my own. One friend of mine, who is dealing with a serious illness, has been in tremendous peril as the drugs that keep him alive have been delayed or caught in some bureaucratic loophole. Any time he moves out of state, he has to reapply to even get into the system in order to – again – prove a need for assistance. Each state has its own system and set of requirements (often exceptionally hard to navigate) for those who qualify for assistance out of financial need. These programs are the very ones some wealth-pandering politicos would love to axe. Those who are ill and low income are under constant and pervading stress simply trying to access social / health services – and we know what stress does to an already compromised immune system.

Other friends have refused lifesaving cancer treatments – if they were even offered them – because, if they succumbed to the disease, their family would be left with the debt. These are real decisions… Do I allow myself to die in order to save my family from medical debt? How many of us have opted not to check off the insurance form box to pay more, in the event of a serious illness, such as cancer, for better treatment that otherwise wouldn’t be covered? WAIT A MINUTE… I won’t get the best treatment unless I pay additional money to the insurance company that is already getting a big portion of my annual income!

Why aren’t we outraged?

Now – thanks to our current climate of extreme conservatism – poor women are being forced to undergo violations of body and mind simply to get on the pill to prevent pregnancies! The pregnancies the wealthy accuse the poor of having too many of! Irony? And, community health centers continue to close their doors as state funding for low-income clinics are slashed.

What I hear from those opposed to universal healthcare – other than ignorant misconceptions about “lack of choice” and fear mongering around socialism – is that they do not want government to handle what should be a free market matter. But whom is this supposed free market serving? There are numerous middle- and upper-middle class individuals who go through their savings paying for overpriced pharmaceuticals and pricey treatments for the increasing number of cancers and “lifestyle” diseases debilitating this country.

Perhaps there are some things that the market cannot and should not have domain over. Perhaps there are some things – so precious and important – that a bottom line driven sector should never be in control. Air quality, water quality, food, natural resources… all have been nefariously misused by the great free market. That’s precisely why we have federal regulations. Healthcare should be no different. It isn’t a luxury.

The poor should not be denied a life because they are poor. The poor should not have to justify their existence. I believe there are things no human should be denied – no matter what their situation – and these things are clean water, clean air, open spaces to play and move in, food that is not laden with toxins, affordable housing and access to healthcare. Are these extreme demands?

What I would like to see is a new set of questions developed, when arguing the case for universal healthcare, that take the focus off of why poor people are sick or poor or have kids … I want to know why such a small number of people are so incredibly wealthy when such a high percentage of individuals are facing poverty in this country? I want to know why some people feel they work harder than the working class because they’ve made more money? I’d like to know why we call ourselves a great nation when we are so willing to sacrifice many of our citizens? And, why we are so fearful of providing basic healthcare to everyone but rejoice at going into trillion dollar debt over wars that have NO positive results (other than making a few men rich)?

Our healthcare system is slave to a corrupt and criminal insurance industry and a government that serves them. We live in terrible fear that poor people are somehow the cause of our worries. Look around. Think it through. How much have we lost over the past 50 years and to what? How much have you lost over the past few years and to whom? Trace it back.

A compassionate, strong and truly great nation takes care of its people. Until we stop serving the few, we will remain but a mirage dissipating with time.

Following Deer

“to the seeds,
to the beginnings; to one clear word for which
there is no disguise and no alternative.”

I have grown accustomed to mourning and rejoicing in tandem. It seems throughout my life some of the most profoundly joyful moments, good news, and inconspicuous but thrilling arrivals have found their way to me in the footsteps of sadness, change, and difficult times. If there is a lesson in this trend, I am still learning, growing with every new turn and opportunity to respond and adapt.

Just as I was accepting a job offer and entirely new course in life – including a major residential move – a friend lapsed into serious condition, then left this old, dusty world just a day beyond my acceptance of this new path. I was watching deer move delicately across a green meadow, the new morning sweet and endless, as my friend struggled for breath and held the hands of friends and family too numerous to name. Just as I stumbled up a mountain path, where a small doe stood sniffing the air, my family – back in Indiana – dealt with struggles of their own, how to honor an aging loved one’s wishes while serious health issues pressed against good conscience. And all the while my own conflicts provided sullen backdrops against the abundant beauty around me.

 Is it right to be happy when others are not?

How do we fully live while grieving for those who are dying or have gone on?

I grapple with my need to move quickly in the midst of so much emotion. By nature, I am a mover. To remain still, coming from my history and character, welcomes potential peril. I move on, even when my heart is broken and everyone around me lingers, catatonic in hurt. I move with the clouds. I say goodbye as the wind pushes memory and time over ridges, against the horizon. I carry stories. I speak them, and speak through them. I move, too, in the gray space, as everyone naturally moves away from our grasp. Friends, lovers and family circle the wheel, just as I. 

There’s ache in my heart for the many losses faced over the years, for the pains and sicknesses that have plagued those I love, and for the reality that, yes, our limited, linear life becomes ever more apparent as loved ones fly off into hereafter. Childhood, for those fortunate enough to be awarded this innocent time, is short. For many, childhood is merely a time to fight for survival. Fair or unfair, the wheel turns. We mourn. We move on.

As I reflect upon my time in Colorado and the deer that greeted me on my morning walks, I am reminded of a moment of holiness and complexity in my twenties. Holy is a word I choose intentionally. I was facing a devastating loss, dealing with the inevitable end to an ugly situation. I was very alone – not in the physical sense – but the dejected sense of being alone, when surrounded by people who could not or would not understand or acknowledge who I am or the obvious circumstances around us. I was about to walk into a hotel, when I saw a couple of young does rush across the busy county road. The first made it in a daring leap between automobiles. The second was not so lucky. Just as she made it into the first lane, a truck hit her hind legs… and without the slightest pause, continued to drive away. The doe stumbled twice but managed to cross into the National Forest land just beyond.

Without thinking, I left my stunned companion and darted across the road and scrambled under the barbed wire fence. Looking back, my companion simply walked into the hotel and closed the door – a final impasse. I keenly remember an urge to find the doe. I knew she must be in bad shape, if even alive, and I couldn’t stop my legs from moving into the thick green tangle of late summer foliage. I must have walked for an hour before reluctantly turning around to head back. That’s when I saw her. She was on her side, just beyond a thick stand of trees, lying on ferns. I neared and met her eyes. I could tell she was dying. I leaned down and placed a hand on her side as she took her last few breaths.

There was something in the acknowledgment of that final moment of life that was comforting. Sad, yes, but… the truth of being fully there, present and with this transition, soothed my mind. And, something tells me my being there soothed her also.

It is what it is…

Deer vision is unlike our own. They see in the context of movement. What doesn’t move isn’t there or isn’t framed in their visual landscape. Every movement is new. Every motion is a beginning. There’s no need to worry about things that are not felt and perceived. Life and death happen at the most basic visceral level of movement in moment.

From the accounts of my friend’s last moments on earth, he was surrounded by dozens of friends and family. My own family struggles with tough decisions, but they are together – witnessing, acknowledging each other’s feelings. Grief and sadness stand near our moments of happiness – inches away, at times. But these are all feelings that come and go, enter and leave. What remains are those moments of simply seeing each other – real in the music of being real – moving delicately off into fields, through the landscapes of dying and being born. We comfort and celebrate by being witness to the movement of each other – and again, by moving into those new spring meadows.