Universal Health Care: What’s not to love?
Health Class at Chapel Hill High School was taught by the same instructor responsible for Driver Education, a heavy-set man whom I will refer to here as Mr. Hardee Burger. I should point out here that a remarkable number of students had access to cars — either their parents’, their friends’ or their own — and for the most part, Mr. Hardee Burger’s job was easy at worst, if not utterly redundant. As a result, most of his practice sessions consisted of instructing student drivers to head to the nearest Hardee’s drive-thru window, after which they were allowed to drive wherever they pleased as long as Mr Hardee Burger’s meal and subsequent nap were not interrupted by a wrong turn or a sudden stop.
Health Class, however, was where Mr Hardee Burger truly came alive. Every afternoon for an entire semester, I struggled to stay awake for his lackluster lectures on sexually transmitted diseases, saturated fat, and teen pregnancy. Most of the lessons vanished into my memory even before they had a chance to take shape, but one has stayed with me my entire life. It was the very first day of class, and Mr. Hardee Burger began the semester by asking us what was most important to us in life — an unexpectedly introspective question in a class that none of us would have been taking if we hadn’t needed it to graduate. Of all the many answers the class shouted out, ranging from the abstract to the concrete, the one that topped the list was money — before love, before family, before relationships. Mr Hardee Burger seemed crestfallen. ‘What about your health? I can’t think of anything more important than having good health’: an obvious segue into what would be a long and tedious semester, but a point that for me provoked the first serious reflection on what it meant to be healthy. I had until then, like many of my adolescent peers, taken my health completely for granted. I was what Bill T. Jones aptly calls one of the ‘arrogant well’; I was in good shape, I thought, because I deserved to be. Mr. Hardee Burger had pointed out that I was lucky to be healthy and that luck, like everything else, can easily run out.
One student in the class then raised his hand. ‘But if you have money, you can buy good health.’
‘But what if you’re terminally ill?’
‘If you’re terminally ill, you’re screwed either way. So make sure you have enough money to make it as painless as possible.’
‘But what if –?’
A fascinating debate ensued with half the class competing to come up with a still more impossible health care scenario, and the other half attempting to prove how ample wealth could avert disaster under any circumstances. After a few minutes, Mr Hardee Burger interrupted and insisted we pay attention to the day’s text. But the question still hung in the air: health or money? Chicken or egg? And regardless of which came first, wouldn’t it be better to have chicken?
In 2009 as the health care debate rages on in the United States, I have come to realize the revolutionary lesson Mr. Hardee Burger was attempting to instill: good health has no price. In today’s climate, our driver’s ed instructor — swallowing the last of his burger with a hearty belch and settling back for a nap while the next generation of high-income earners learns to parallel park — would be considered a socialist rebel. And as one of the 47 million uninsured in the United States, his lesson has a particular resonance with me.
The only time in my adult life I’ve had comprehensive health care coverage was during the seven years I spent living in Europe. As an employee at a German company, my insurance was paid in part by my employer and in part by me; I was enrolled in a one of Germany’s many nonprofit health care options, funds that guarantee coverage even when its members are hit with unemployment (as I later was) or a major health crisis. There was no medical exam to undergo, no questionnaires about my current health, no deductible to weigh against a lower premium. I earned slightly more money than I earn now as an adjunct professor and theatre practitioner, and yet had access to one of the best health care systems in the western world. I recall very clearly how this access began to pick apart the psychology of the ‘arrogant well’; I noticed throughout those years in Europe how hesitant I was to seek medical assistance, not certain of whether or not what ailed me was worth spending money on. I even recall asking an administrator how much I owed after a visit, a question which seemed to both amuse and perplex her. Slowly, as the years went on, I adopted the attitude that many of my friends seemed to have already: if you’re sick, you go and get treated, so as to avoid more sickness and, more importantly, to avoid spreading what you have. There’s nothing noble in showing up to work sweating off a fever; if anything, your colleagues look at you with annoyance for bringing your virus with you to the office. And, contrary to popular American myth, access to health care did not seem to encourage anyone to go more often to be prodded, poked, and drilled; in fact, in a place like Berlin, where junk food consists of a fresh-baked streusel-schnecke from the local bakery — as opposed to a neon-orange invention by Frito-Laye — the average person is far more health-conscious and far less likely to fall sick from the fat-induced illnesses that plague the American public.
I recall an incident several years ago where my cousin, who has fought obesity since childhood, was gripped with sudden and severe pains in her abdomen. She was writhing on the floor unable to walk when we finally decided it was time to drive her to the emergency room. We got as far as the entrance when it occurred to her what the cost of admission might be; if she were to lie down on one of the beds in the hospital and allow herself to be examined, she could easily end up with a bill topping a thousand dollars — and that’s if nothing serious were found. Still grimacing with pain, she asked us to take her back home. A few months later, she had to have kidney stones removed. Only she knows how much more painful they had become in the time between that first visit and the final, unavoidable one.
There is, of course, the other side to the story. My father died of multiple myeloma in 2003 after suffering a series of debilitating strokes. Over twenty years’ worth of insurance through Blue Cross/Blue Shield meant that there was little that wasn’t covered, including the new jacuzzi that was put in the bathroom once it was determined that he would no longer be able to safely manage a shower. Throughout his illness and countless treatments, I was struck by the attitude taken on the part of hospital staff toward patients known to have ample coverage. My father, who could’ve easily taught freshman chemistry to some of the very people who were practicing medicine upon his ailing body, did not, when he was conscious and able, allow any substance into his system without first finding out exactly what it was (I often wonder whether he felt it was a blessing or curse to know all too well the chemical structures of the toxic fluids being siphoned into his veins). In one instance early in his illness, a nurse entered his hospital room with a glass of water and a packet of pills, which she promptly ripped open at his bedside. ‘Hold it,’ he said, ‘What exactly are those?’ ‘These? Painkillers,’ she said merrily. ‘But I’m not in pain.’ ‘No? Well, they’re here if you change your mind.’ The nurse left, leaving the pills in a tiny dish on the bedside cart. My dad tossed them in the trash. When I asked whether he didn’t want to hold on to them, he snorted. ‘They do this everyday. They come in, they don’t say a word about what they’re giving you, and rip open the package. Every ripped package is considered a used product. That gets added to the total bill and that total bill gets sent to the insurance company.’ We were both left to puzzle over who benefited from this blatant waste. Not my father. Nor the nurse, apparently. But whom? And at what cost to those patients who didn’t have ample insurance, but who perhaps could have used a painkiller?
I am not a risk-taker by nature. I would be very happy to have health care and am happy to pay a reasonable rate for it. However, I have yet to find a plan that fits my definition of ‘reasonable’. Plans which provide no funds for preventative care, including annual physicals and pap smears; plans which make no allowance for mental health care other than 20 – 30 sessions with a therapist and then only if the patient has a proven history of alcoholism (beginning after the insurance plan was purchased, as any alcoholic behavior prior to insurance coverage would be considered a pre-existing condition); and low-cost plans which look good on the surface, but then only kick into action following a deductible ranging into the tens of thousands … all such plans seem to me to somehow resist the notion of health care coverage while at the same time being advertised as ‘affordable’ and ‘comprehensive’.
President Obama now has the boulder of health care on his shoulders and is nearing the top of the proverbial hill in the Hades that is Washington, DC, while a pack of Republican dogs circle the valley, waiting for him to fall so they can gnaw him to shreds. I don’t yet know how to qualify such vicious resistance to one of the most basic of human rights. What’s to oppose in guaranteeing affordable healthcare for every person in the country? What’s to oppose in making certain that people with acute injuries or sicknesses can receive emergency medical attention whether they’re covered or not? What’s to oppose in creating a society in which health is not a privilege reserved for the wealthy, but a right –like freedom of speech and the pursuit of happiness — enjoyed by all? When I listen to the horror stories conjured up by the far right and disseminated with alarming speed about the dangers of guaranteeing health care for every resident in the United States, I can only wonder if the dearth of quality mental health care in this country has begun to take its toll on a massive scale.
I refuse to abandon hope that this particular President, already with a proven track record in accomplishing the impossible, might once again perform an unthinkable miracle. Knock on wood I’ll be in good enough health to see the day.