I wrote this back in August, 2009. At the time, Palin was making her big splash about death panels, and the health care debate was lost in the fracas. By December, Palin and her death panels won the Lie of the Year Award from PolitiFact, but the damage had been done: the sound and fury was too loud, even though it signified nothing.
We remain mired in health care debate. Though the smoke from the death panels has cleared, new ridiculous problems have arisen to take its place. The seed of the piece remains as true as it did when I wrote it, though the death panels have fallen to the level of satire.
Plus, my father really wanted me to post this. I have to make Dad happy once in a while.
This health care debate–I admit I haven’t been following it all that closely. I suppose that my reasoning is somewhat lazy, as is my response to it, but not my feeling about health care. That isn’t lazy at all.
I haven’t been following because as soon as there’s the kind of vitriol and spew in the media that has been involved in this so-called “debate” the issues are lost to us. There are no more examples of what would help, how it might work, who it would effect; instead it becomes about who is the most inflammatory, who can come up with the most hysterical argument, and how we can continue to be mired in the crap unchanged and unchallenged to think in new ways.
But this is about me and my life, and I would like someone to recognize that.
For example, since we are self-employed around these parts, we also have to pick up the tab on our health insurance. Do you know what it costs? Close to 600 bones a month. Do you know what our co-pay is? Thirty bucks every time we set foot in an office, no matter if it’s to take a temperature or get a splinter out. And forget our deductible: we actually had to make the choice between 2,500 dollars per year or 10,000. I think we could call this level of insurance “catastrophic.”
What about eye care? Non-existent. For us, that means that every year, though our 5-year-old son needs glasses for something considered “medical,” his glasses are not covered by our insurance. Do you know how many glasses a kid goes through? Hundreds of dollars a year spent on specs. And my husband and I who merely have age-deficient eyeballs cough up hundreds of dollars to keep the words from blurring on the page and the traffic signs in focus.
Dental: Non-existent. This despite all the studies that have shown that good dental care is one sure-fire way to keep health costs down because of all the attendant ailments that accompany crappy teeth and gums. But that aside, let’s just talk about dollars: two hundred+ bucks apiece to get our teeth cleaned and tuned up every six months. Why do we go that often? So we can avoid the much more painful thousands of dollars that result from crummy gummies. I had to pay close to two thousand dollars a few years ago for a root canal and all its attendant horrors; I would like to avoid that again if possible, so I go to the dentist.
Of course, we have other mouth woes that we both keep ignoring; my husband’s teeth have become so crunched together they’re wearing down and I’ve been missing a tooth in back since my twenties. As a result, my teeth are wearing unevenly and flopping over. But maybe we would have those things fixed if we weren’t hemorrhaging so much money down the other medical rat holes.
Back problems? Forget it; out of pocket. I have chiro coverage, but never once has my chiropractor been paid through my insurance plan because he’s not a member of their tribe or something. Mental health issues? Better to be healthy but crazy, I suppose.
And we’ve got good health. What happens if one of us gets really sick? God help us. Individual health plans are notoriously skint on their lifetime limit–we’ve got two million bucks of coverage and then–buh-bye. Talk about a “death panel.” Seriously, what happens if they have to fix a liver or kidney, or my heart? Do we run up to the two million and then the insurance adjuster says, “I’m sorry–we were just about to plug in that heart of yours but you’ve reached your limit.”
We’re the lucky ones. Whether by fiat or hard work we’ve been fortunate to have enough money to buy our own health insurance. Many don’t. Many of our friends, who are completely and solidly middle class, cannot afford to spend the extra money each month on their own medical insurance.
The result? Treatment for the most severe form of cervical cancer in a free clinic in Los Angeles. Pre-diabetic health monitoring that is so spotty as to be pointless. Out of pocket expenses of many-multiple thousands for a CPAP machine to keep our friend breathing through the night. Amount paid for emergency oral surgery: ten thousand dollars in cash. Two hip replacements for our friend, a young woman in her twenties, which she couldn’t pay for, and then had to claim bankruptcy. Type 1 diabetes with no insurance–a horror my step-sister has navigated partly by ducking back into school to get insured again. Otherwise, her now “pre-existing condition” rules her out of almost all other plans. What happens when she graduates?
These are ailments affecting people in their twenties through their forties. This is not a discussion about how to care for the elderly. This is about people in the prime of their life who would, with proper preventive health care and better access to good medical teams, live a long time. These same people may have their lives dramatically shortened because they cannot afford insurance.
So these discussions are an obfuscation which offend me personally. I take umbrage with these cavalierly hurled arguments because they are playing with the lives of people I love, active members of American society, taxpayers and voters, who may die prematurely because the health care system won’t care for them.
And what about my Dad?* Where is he in the discussion? The death panels apparently have him and his Stage 4 cancer singled out, but I don’t think he feels tremendously threatened by these medical bureaucrats waving their mighty pens of death over his head.
In fact, he’s relieved that his whole medical team understands in black and white terms that he does not want his life prolonged unnecessarily. That he has the choice to say no to being hooked up to machines and medical devices which may hand him a few more days or weeks, but in a manner which would hardly be called “vital.” That he may choose between that and living out his days comfortably, without strident measures, without hysteria or intubation, without medicine that is as potentially toxic as it is prolonging.
Is that last inkling of life so truly desirable, if sculpted by equipment, money, interventions, and resources that give no comfort or solace? Is the mere fact of living enough, no matter what the condition of the life? Is it life for life’s sake, or life for living?
If you ask me, and nobody did, I think this “health debate” is about a country’s unwillingness to step up to care for its citizens in a responsible way. I think it is about companies and industries so mired in bureaucracies of their own making that they cannot envision another way. I think it is about people’s lives being less important than the evolution of the pay-to-play system, and nickel-and-diming by the insurance industry. I think it is about trying to unravel the Gordian knot woven during the horrid evolution of the PPO, where codes of symptoms and ailments became more important than a holistic view of any given patient.**
We are the ones who pay the price of their inflexibility with diseases and easily treated injuries winding up in the least efficient places on earth: the Emergency Room. Or unable to save money for our retirement because we’re too busy spending it on glasses and CPAP machines, claiming bankruptcy for medically imperative operations, and insurance that is so expensive we have little left at the end of the month. So this disingenuous legerdemain being perpetrated to take the issues out of the hands of patients makes me pretty damned angry.
You can call it a death panel if you want, but I’ll take it for what it is: life and living under our own terms.
*Painting by my father Charles Moone, called “Self Portrait,” painted in 1972. His headstone reads: “Where Will You Spend Eternity?”
**Sometimes there are even articles to back up my opinions! A nice article called the “Five Myths About Health Care Around the World” from the Washington Post, which I found on Metafilter after I wrote this. Call it synchronicity.