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.

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