Health Care First

 Image shows an orange popsicle.In my babysitter days, inevitably I faced a problem. Splitting resources like desserts led to fights. Until I discovered a way around it: make one kid the cutter and the other one the chooser. Problem solved. When you prepare for others what you must consume, servings even out.

In case you haven’t noticed, there’s a brouhaha over a healthcare bill. It’s not really a new thing. Like Jupiter’s swirling Great Red Spot, the healthcare debate has lasted for decades. In election season, candidates forecast social and economic hurricanes like political meteorologists. In the last federal one, voters sandbagged for immigration over health care. Meanwhile, what do politicians lose if they cut Obamacare? Will they keep their plan coverage? Will they keep their seats? Their serenity? Their pensions? If they suffer a loss, do they care? Voting actions speak louder than thunderous speeches and tweets. Will there be consequences to policy change? Will another issue fueled by the winds of fear trump it? I’m not distracted by government personnel changes. I have some thoughts.

When my retinas went Teflon in college, I valued health care. While my parents coordinated my checkups and teeth cleanings and vision exams as I grew up, my own time in the hospital and exam chairs as a young adult led to a greater understanding of the medical system. I slogged through Explanation of Benefits statements and called about billing issues. I read itemized surgery bills. I tried to make healthy lifestyle choices. Living without health insurance was not a path I wanted after graduation. Quality care matters. When I wasn’t covered by an employer, I bought an individual plan. When I moved to a different state, I fanned out potential individual insurance plans on the parquet floor in my apartment. I noted how premiums increased compared to my old employer plan, an inverted relationship to the thickness of plastic health insurance cards. I remember when those cards resisted stress.

As years passed, my fear of not affording care while facing additional vision loss stayed with me, but I learned about human nature. Customer service jobs taught me how quick customers lose patience when stressed, projecting pain onto innocent workers. Working in massage therapy taught me how people view self-care as a luxury. Reading books like Five Days at Memorial revealed the devastating choices healthcare workers dealt with when faced with scarcity. Working in debt collection shows me how people ignore finance. And the consequences when unlucky life changes land. And how sheer forgetfulness happens in a world of sunny distractions.

Recently I was talking with my brother-in-law who works in banking. We may not agree issue to issue, but we value a budget. When there’s a need to cut spending it makes sense to reduce costs across the board. Consider those hard decisions to find out what matters most. “It’s the 5% rule,” he said. “Everyone cuts their department by 5%, and no one gets a pass.”

We’re in this together. We all make sacrifices.

The stormy political climate leads me to examine my tax dollar uses. There are many areas I support in spirit: education, health care, infrastructure, public spaces like parks, endowments for the arts, and research. When I examine the heart of each category I’m left with this: they are secondary when you’re sick. If we want to prosper and grow and to live meaningful lives, we need access to affordable health care. Physical health and mental health. Primary care, ERs, hospitals, the VA…it’s all health care to me. Affordable medical care rates as my top government issue.

I want two changes for my highest concern.

Change #1: Sever ties to employer-based coverage.

Currently, plan coverage is generally tied to your profession. In a way HR reps working within business constraints determine your access. Except of course if you are too old, too young, or too disabled–do I have that right–to work, then you can apply for perhaps Medicare or Medicaid or a plan from the shrinking Health Insurance Marketplace.

Give employers the flexibility to spend in other ways. What jobs would exist if employers reallocate healthcare costs? What jobs would workers quit if they didn’t need employer-based plans?

Change #2: Drop the private options and go single-payer with the Fed.

Our healthcare system is basically a for-profit venture. Nevermind the idea of cost-saving measures morphing into death panels. With wellness as a business there are clear incentives for drug makers to guide patients to the path of perpetual care instead of developing cures through expensive and possibly fruitless research. Tests and procedures have a billing code. Discussions with your doctor do not. Doctors don’t work for free. Care system administrators don’t work for free. There are high costs in the business of healthcare. When profits matter, some Americans suffer due to an inability to pay. Class determines care.

Should you have to support your neighbors if they struggle with health issues? To say that you won’t support others is the same as saying you won’t accept pooled resources. Say you opt out of the plan system. Illness happens. Will you always be able to self-heal when costs are high? Will you have the cash savings for ambulance service or the ER? Are you going to stumble off to the woods to die of a critical condition rather than use communal medical resources? OK, this is gloomier than a Tim Burton movie. Yikes.

We can eat a well-balanced diet, exercise, socialize, and craft meaningful lives. And any of us could get hit by a wayward car. We can’t prevent every downturn in health. Is it okay to be bankrupted by illness? Is it okay to die prematurely when you can’t afford preventive care? I’m over health care as a biz.

Expecting a broken umbrella to keep you dry against the rain is foolish. You can’t work efficiently when you’re sick. When you’re not working you’re probably not getting paid. You can’t go to school and learn well when you’re sick. You can’t defend your country dependably when you’re sick. Health care first.

If other government programs must die to fund it, I want health care to live. I’m not expecting taxpayers to increase the ingredients of the tax benefits pie. Every sector takes a budget cut like a real 5% rule for this basic need.

Internet ranting achieves limited results. I’ve contacted my representatives to express my support of affordable access to health care for all Americans. I vote. Do you know your reps? Are you an active voter locally to federally? Do you call or write your reps about your tax dollar concerns? They are not mind readers. Find your reps by zip code here.

I don’t have all the answers. I don’t have all the information. Maybe employer-based is more inclusive than a private marketplace. Maybe privatization would be more inclusive than a government-backed system. Maybe cash is king. I’m willing to explore alternatives. I’m not willing to support limiting access to health care which limits prosperity. Serve everyone from the same healthcare pie.

Have you determined your priority for your tax dollars? Is healthcare coverage important to you? What are better alternatives to having health care based on status like employment? Have you been denied coverage? Do you purposely not buy health insurance? Tell me about it.


8 Comments Add yours

  1. Casee says:

    I divide my life up as BHI and AHI. Before health insurance and after. Before I had insurance I had unaddressed health problems. I couldn’t afford insurance so I did what I could paying cash to doctors. Then I couldn’t do that. I would later find out that an untreated issue will now be a permanent problem for me. It saddens me that something that could have been taken care of rather easily if I had insurance will haunt me the rest of my life. Single payer systems have their own issues like long wait times and not always getting the latest in treatment. I know my representatives but they, like most of them answer to money and l don’t have enough to turn their heads. 😁 I don’t have hope that we will get out of this healthcare mess until we are on the brink of national bankruptcy. Then politicians can vote their conscious and not how the big money people want them to.

    1. Thanks for sharing this, Casee. There are real consequences when access to care is limited.

    2. What a strong blog, only some of which I understand because I am British and live in the U.K. Over the years I have paid more tax and National Insurance than was financially easy for me as a single parent. BUT when my son got meningitis in his 20s and recently when I needed emergency heart surgery (which would have cost £15000 privately) I received state of the art care free at the point of delivery and , of course, it wasn’t completely free because, at 81 my taxes had already paid for it. When politicians talk about private health insurance providing choice they lie, they are talking about money. When we are ill we need the best care and we need it at once. I agree with you, Casee, it is a moral matter. As a society it is in our interests to look after each other and I am happy to share the income from my taxes to help others. Having lived in the US I loved the principles of Obamacare and now, sadly our Tory party, under Theresa May,are trying to dismantle our own wonderful National Health Service. Doctors and medical staff provide skilled and cheerful care. they are overworked and many are underpaid. The important thing is that they are committed to the service they provide. With an aging population worldwide health care becomes more complex and more expensivensive. We need to take a look at our priorities …profit or a good, healthy community. It costs in tax terms but I believe it’s worth it. I shan’t be voting Conservative in our upcoming election and tdoubt our idealistic Jeremy Corbyn will get in in spite of his honesty. I worry for my grandchildren.

      1. Thank you, Bridget, for sharing your thoughts and experiences from a British perspective. At the core, we care about the same things. I do wish for something like a National Health Service here.

      2. I think there are deep philosophical differences between our two countries’ approaches to health care and community support. Probably historical and difficult to change. But maybe with enough public support you will reach a compromise.

      3. I’m pulling for humanity!

  2. Casee says:

    Perhaps one day USA citizens will see healthcare as a basic human right. Just like clean water etc. I’ve gotten cynical over time but I hope the American people wake up to this.

    1. Unfortunately the U.K. Is moving towards privatisation. We need to accept that higher taxes which will benefit everyone are necessary.

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