Health care is a right, not a privilege

By Caitlin Kelly

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If you move to the United States from any nation with single-payer government-run healthcare, you might be gobsmacked by what you encounter here.

You’ll learn new words and phrases like:

“pre-existing condition”, “co-pay”, “annual deductible” and “usual and customary.”

If you get a full-time job with benefits, you will be mostly preoccupied with how much medical coverage it offers you and your family, at what cost, and with what amount of deductible — i.e. how much more money you have to shell out after already paying a monthly premium for what is supposed to be full coverage.

It’s a bizarre, byzantine way to handle healthcare, because it puts millions at risk, as anyone following the current, bitter political debates over repealing and replacing the Affordable Care Act, (aka Obamacare), well knows.

If you work full-time for an employer who can afford to offer it, you’ll get health insurance through them, often heavily subsidized.

If not, welcome to free market capitalism!

My husband worked 31 years at The New York Times, as a photographer and photo editor. He retired from there, although we’re both still working. As a retired former staffer, he pays $400 a month for his health insurance. That, we can easily handle.

The company decided to save money by refusing this same subsidy to retirees’ spouses — so I pay $1,400 a month for the same plan. That’s $20,000 pre-tax I have to earn just to avoid medical bankruptcy — the single greatest cause of personal fiscal disaster in the U.S.

I’m a reporter, so as I debated choosing a much cheaper plan I queried the billing managers for two of our physicians. Both said: “Hell, no! If you like what you’ve got, keep it.”

They know better than anyone what a crazy and costly mess you can face if your cheap-o plan doesn’t cover something like — oh, you know –— the anesthesia for your four-hour surgery.

That surprise bill could be high enough to knock you out cold once more.

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My first steps with my new left hip, February 2012.

As an aging jock with orthopedic issues that have required multiple surgeries and a lot of physical therapy — the co-pays alone costing up to $60 a week — not having excellent coverage is a gamble I’m not willing to make.

 

As more and more Americans are forced into the “gig ecomomy”, i.e. self-employment or precarious, poorly-paid contract work, we’re forced into free-market pricing for our most precious possession — our health.

 

Yet I find it almost incomprehensible to read this, in the liberal New York Times:

When Representative Mo Brooks said it was unfair that healthy “people who lead good lives” should have to subsidize the insurance of unhealthier ones who presumably don’t, he bluntly raised an often unspoken question that runs through policy debates in Washington: Who deserves government aid and who does not?

Such proposals can be — and often are — couched in the language of economics, with advocates and critics calculating the efficacy of incentives, returns on investment and long-run savings. As Ben Carson, the Trump administration’s housing secretary, commented last week while touring publicly subsidized housing in Columbus, Ohio, “We are talking about incentivizing those who help themselves.”

But the judgment of who is deserving — as opposed to what is most effective — is at heart a moral one.

In pushing for repeal of the Affordable Care Act last week, Mr. Brooks, an Alabama Republican, suggested that people with pre-existing conditions deserved to pay higher premiums, because they had not “done things the right way.” That could include a cigarette smoker’s lung cancer — or a newborn’s congenital heart disease.

Couching this as “government aid” completely distorts the larger issue — are you really happy living in a country where you’re just fine — but millions of others aren’t?

This kind of self-righteous garbage, the “deserving”, makes me so angry.

Yes, those who live in a single-payer system do pay the costs of treating other people’s cancer (some are smokers!) and diabetes (some are obese!) and people who injure themselves while high or drunk or are torn to pieces by a dangerous, distracted driver.

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No one admires or wants to support stupid, careless behavioral choices.

But I’d rather know that everyone can get good care quickly than smugly snuggle into my personal bubble,  knowing for certain that others live in terror of losing their insurance or access to the drugs and care they need.

I grew up in Canada, to the age of 30, never once seeing or paying a medical bill. Nor have my parents, who still live there, in two different provinces, despite multiple surgeries and, for one, months of big-city hospital care.

I’m no fan of endless taxation. But a vast percentage of the U.S. federal budget goes to defense, waging endless wars against often undefeatable enemies.

And the outrageous rates I pay are giving health insurance executives’ massive salaries. I find that disgusting.

I believe healthcare is a right, not a rare privilege only granted to those who someone decides is “deserving.”

Five ways I’ve become American — and five Canadian holdovers

A typical Baseball diamond as seen from the st...
A typical Baseball diamond as seen from the stadium. Traditionally the game is played for nine innings but can be prolonged if there is a tie. (Photo credit: Wikipedia)

In the 24 years (!) since I left Canada, where I was born and raised, for the United States, it’s inevitable I’d take on some of the characteristics of my new home. Although I was always mistaken in Toronto for someone south of the 49th. parallel — I talked and walked too quickly, laughed too loudly, was far too ambitious and direct in my speech.

“You’re American, aren’t you?” is not a compliment there. (My New York City-born mother married my Vancouver-born father and moved north. She has since become a Canadian citizen. Both my husbands have been American, one from New Jersey [divorced 1995] and one from New Mexico, [married 2011.])

And yes, I realize, these are generalizations — there are Canucks who enjoy baseball and Americans who love to travel and desperately want some form of government health care.

Here are five ways I’ve begun to feel more American:

1) I enjoy watching baseball. Sitting in the stands for hours, inning after inning, watching the sky grow dark and the lights grow brilliant. Popcorn and a chili dog for dinner. Overpriced souvenirs. Hokey games on-field like the race between the hot dog, the ketchup and the mustard. I play second base and can hit to the outfield, (and did not grow up playing), so I now appreciate it more as a player.

2) I love how Americans do business. They just get on with it! I’m amazed and grateful for the chances I’ve been given to succeed and thrive, by people who don’t know me from childhood or my family or with whom I attended college or grad school. That takes guts and decisiveness, both of which I value deeply.

3) I fight like a demon over healthcare, bills and any form of my rights. The single biggest change an immigrant to the U.S. must make, and quickly, is realizing no one is looking out for our interests but you (and possibly your lawyer.) Coming from a nation that’s much more of a nanny state, Canadians tend to look to the government for their solutions. Not Americans! I think this is not a bad thing, but I do not envy those with little education, poor English skills or a shy personality.

4) I’m optimistic. This is huge. I didn’t used to be. But if you’re not, you’re toast. The United States, for all its many problems — a completely useless and fucked-up Congress, growing income inequality, outrageous costs for post-secondary education, racism, the war on women — rewards those who see the glass as half-full. Whiners do poorly here. I hate whiners.

5) I generally think people create their circumstances and success. Within limits. I can’t vote, so I’m not a Republican. But barring severe mental, physical or emotional disability, I think people can achieve much without endless hand-wringing or government intervention. I was a Big Sister, a volunteer mentor to a 13-year-old girl, about 14 years ago. It was a shocking eye-opener. I had long been a default liberal, but saw within minutes that her toughest challenges were being created by her own family, whose emotional abuse, manipulation of taxpayer-funded benefits and habitual behaviors left me stunned. (Yes, I was very naive.) I absolutely believe in giving help to those in real need, but have no patience with those who abuse it or take it for granted.

And yet…

1) I believe, strongly, that excellent health care is a right, not a privilege accorded only to those with jobs, or whose employers choose to be generous. Free-market health care is an obscenity and stupidly expensive.

2) Unions matter. Barely seven percent of private sector workers in the U.S. belong to a union. Workers are too often treated like crap; they can be fired any time, for any reason, with no penalty or severance. It still shocks me how weak labor is and how powerful the wealthy.

3) I revere nature. I feel more at home in a canoe than in an SUV. I completely fail to understand kids who refuse to play outdoors and parents who allow this. If you don’t feel a passionate, deep-rooted (pun intended) attachment to the natural world, why would you fight to nurture and protect the environment?

4) I know, and have always known, that I’m a global citizen. I’ve carried my own passport since early childhood and it’s my most treasured possession, in addition to my green card. Every nation is intimately linked to the others, and Canadians travel widely. We know it, we value it. (Only 30 percent of Americans own a passport — 60 percent of Canadians did, according to government stats, in 2009-2010. If you’ve never left your borders, how can you possibly understand, and care about, how others think?)

5) War stinks. It’s a terrible waste of lives, money and taxpayer income better applied to a whole host of issues — education, health care, infrastructure. It’s appalling to watch billions spent on two wars at once in the U.S. I never understood why I didn’t know more about Canada’s essential role in D-Day until my American husband took me to Normandy to the beaches and cemeteries there. For Canadians, going to war is seen as a nasty, last-ditch necessity, not a matter of national pride and economic interest.

bonus: Skepticism!

Canadians are generally much slower to warm up socially and professionally. We’re not (as many Americans have been taught to be) “real friendly.” Why bother? Until we know, like, trust and respect you, what’s the upside? In my time in the U.S., I’ve been scammed, cheated and lied to with breathtaking impunity — as my Mom warned me would likely happen. It’s left me weary and wary of glad-handers. I also now know, and have hired, a private detective and multiple lawyers. I get it.

This worldview also complicates trade and diplomacy between two countries, as their underlying principles are often quite different — American risk-taking versus Canadian caution; American in-your-face-ness versus a more European reserve.

Whether because I’m a journalist whose life has been spent questioning and challenging authority, or it’s cultural or I just like being a curmudgeon, this is one Canadian-ism I’m hanging on to for life.

What cultural differences matter most to you in your daily life?

This Is Obscene

A surgical team from Wilford Hall Medical Cent...
Only if you can afford it...Image via Wikipedia

How about an overnight 39 percent rise in your rent? Car payments?

No, just your health insurance:

Senator Dianne Feinstein, Democrat of California, sharply criticized Anthem Blue Cross of California on Tuesday over its plans to raise health insurance premiums by as much as 39 percent, and she said that the move provided a vivid example of why major health care legislation is needed.

“It is unconscionable that Anthem Blue Cross would consider increasing health insurance premiums for Californians by as much as 39 percent, especially at a time when so many people are experiencing economic hardship,” Ms. Feinstein said in a statement. “I can think of no better example of why we need health insurance reform, and this kind of behavior is a stark reminder of why any reform plan should establish a rate authority to keep insurance rates affordable.”

Full New York Times story here.

From Truthout:

In a statement Monday, Anthem Blue Cross said the planned rate hike was due to the “weak economy” and called on lawmakers to “go back to the beginning and get health care reform done right.”

“… As medical costs increase across our member population, premium increases to the entire membership pool result. Unfortunately, in the weak economy many people who do not have health conditions are foregoing buying insurance. This leaves fewer people, often with significantly greater medical needs, in the insured pool. We regret the impact this has on our members. It highlights, why we need sustainable health care reform to manage the steadily rising costs of hospitals, drugs and doctors.”

So people are really sick and desperate will pay more for their health insurance — with, of course, a concomitant 39 percent increase in their paychecks or maybe a 39 percent rate reduction from their car insurance or rent — and the rest of the poor suckers who can’t even afford to buy insurance anymore will simply go without.