The first thing that needs to be said to the heartless boneheads who, at the last Republican presidential debate, cheered at the idea of letting a hypothetical 30-year-old cancer victim who hadn’t bought health insurance die, is that this is no mere hypothetical situation. The second thing that needs to be said is that most such people in real life don’t “refuse to get” health insurance. They either cannot afford it (and their employer doesn’t provide it), or they are rejected by insurers because of pre-existing conditions.
If you are a young person, earning a take-home salary of perhaps $20,000, are trying to raise two kids on your own, and you live in Texas, for example (Medicaid eligibility is set state by state), you would not be eligible for Medicaid coverage. Your two kids would supposedly be eligible, but not you. Meanwhile, if your employer, like most employers who are paying minimum wage, doesn’t offer some kind of group policy, if you were lucky enough not to be rejected for some pre-existing medical condition like diabetes or a heart murmer or something, you’d have to come up with perhaps $3,000 to cover yourself with a plan that would not pay for doctor visits, just major hospital bills. But say you were paying $800 a month for rent, and another $3000 a year to keep some 12-year-old rust-bucket of a vehicle insured and on the road to get you to work and home. That would only leave you $7,000 to feed and clothe your kids and yourself. Would you take $3000 of that to pay for health insurance for yourself and reduce your money for living expenses to $4000 for the year?
Of course not! It would be coming right out of your childrens’ mouths!
All over America, especially these days with one in five of us either out of work or working at some job like the one described above or worse, while looking for a decently paying job, millions of individuals and families are struggling with this desperate problem.
The only exam the uninsured in America can count on is a wallet biopsy
And what happens is this. First off, they don’t go to the doctor when they get sick, or when they feel that something is wrong — say they see rectal bleeding, or feel a lump somewhere that a lump shouldn’t be, or they feel dizzy, or whatever. They soldier on and hope it will go away.
That’s what a dear friend of mine, a writer married to an actor, did. When her family fell on hard times between gigs, they found themselves without insurance coverage. Without any insurance, and with two kids to support, she did not go for regular physical checkups, which were expensive, so a cancer that might have been spotted early and taken care of, had she been covered and gone for regular doctor visits, was able to grow and metastacize. Worse, because she had a cancer, she could not get insured even when her husband got a job that offered coverage. The only reason she got into a hospital at all was that her doctor, at some personal risk for violating the rules, had her wheeled into a big New York hospital right past the financial intake office, and got her assigned to a bed, from which she could not be evicted once admitted. She ultimately died of her cancer. Ironically, she had for years been a fierce advocate for women’s health and for insurance coverage for all freelance writers like herself.
The morally challenged scum who heartily and heartlessly cheered for the death of a hypothetical 30-year-old were really cheering for the death of my friend, and millions like her.
But this obscenity goes much further.
I read in Daily Kos about the fate of a 63-year-old guitar maker, Steve Patience, whose sister eloquently raged at the laughing “assholes” whom she said were actually mocking her own brother. She explained that he had devoted his life to making beautiful hand-made guitars, working 14-hour days, but never earning enough to get by (her family had had to help him out on occasion just to keep things going). He could not afford health insurance, but at 63, though he had been forced to retire to get Social Security benefits, he was two years too young for Medicare when he learned he had metastatic cancer. A hospital emergency room wouldn’t even examine him despite rectal bleeding and intense pain and just sent him home on pain relievers. When he was finally — too late — seen and diagnosed with cancer, thanks to $2000 that friends provided for him to be seen by a proctologist, it took six weeks to get the hospital to let him in. It wanted $20,000 up front just for use of a room for the examination procedure. Only when his heart started to fail did he get admitted as an emergency patient. Some emergency! It was like making an auto accident victim with a head injury wait six weeks to be admitted for an MRI to spot a blood clot in the brain.
This is health care in America today for those without the resources to buy insurance.
I thought about this some more, recently, when I sat down to play my guitar, a hand-made 1972 instrument built by J.W. Gower, an independent maker who worked out of a trailer at his home outside Nashville. It’s an extraordinary instrument–apparently the second he built (the first is in the Nashville Guitar Hall of Fame). I don’t know if Gower had health insurance, but it’s a fair bet he never had any. The thought of such a master craftsman or his co-builder wife having to forego medical care for lack of insurance, or even having to worry about such a thing, makes me sick.
Most of the things of beauty that enrich our lives — guitars, harpsichords, hand-crafted pottery, paintings, beautiful music of all genres, etc. — are created by artists and artisans who barely earn enough to live on. They do the work they do because they love it, but they earn so little at it that the idea of health insurance is a luxury that many don’t even bother thinking about.
Basically most of them just hope not to get sick, or to die fast when they do.
The rest of us, who buy their creations, or who listen to their music or watch their plays or drink from their mugs, don’t even do that. We just forget about their problems.
And then there are those who enjoy the fruits of these artists’ labor and turn around and laugh at them when they do get seriously ill.
There are others who are even more obscene still, though. They don’t laugh at the suffering of the poor. Rather, they actively work to keep them that way. I’m thinking here of the real scum — the Wall Street bankers, huge pharmaceutical companies, insurance firms (including Blue Cross), and other giant industries that have lobbied hard to block real health care reform, such as expansion of Medicare to cover everyone — and who then will, with no sense of shame, put something like fine baroque music on their telephone “hold” system to add a touch of class to the “customer experience.” Meanwhile, many of the musicians who perform that music can’t even afford health insurance.
It’s bad enough that we as a society close our eyes to the suffering of the tens of millions who are unable to get decent health care in this richest country in ther world. It’s worse yet that some obnoxious jerks are so blinded by their fears, their ignorance or their rank ideology of smug selfishness and greed that they can mock that suffering, but it’s purely evil that corporations and the wealthy can avail themselves of works of art and craftsmanship and pose as connoisseurs, and even use those creations to help generate profits for themselves, while actively working to block all efforts to make health care available to the creators of those things.
Enough! It’s time for us to do what the rest of the civilized modern world has done, and establish a system of Medicare for all Americans, cradle to grave, as is advocated by Physicians for a National Health Program.