If you are a person with a lot of choices, with a job that offers health insurance, with a social security number and a safe place to sleep and knowledge of where your next meal is coming from, I can see how you might think a market-based healthcare model is a good idea. You might be annoyed at your doctor, or the confusing bill, or the insurance company, but when something shitty happens to you, you aren’t really worried that you’re not going to be able to get help.
And I know that a lot of people in this position of privilege think (wrongly) that these basic pieces of a stable, comfortable life are accessible to anyone willing to work hard enough to get them. That everyone has basically good options but some people take advantage while others are lazy, entitled, or whatever other excuse might bubble up. This is infuriating because it is so, so wrong. It’s like that old adage of being born on third base and thinking you hit a triple. A lot of folks were born without even a bat to swing. Those folks are just as human as you are.
So imagine you are 58 years old, and your daughter just had a baby. You left your original home many years ago to be with your family in the US after your husband died in an “accident” in mysterious circumstances and you had no way to support yourself. It was dangerous at home and you were frightened. You wanted to be close to your daughter and help out and start a new life. So, you came. You babysat, and helped at home, and did the grocery shopping– you did grandma stuff. But after a little while, you started to feel a little weak. You noticed blood in your stool a few times, but you didn’t think about it too much. Eventually, though, you got worried and told your daughter, who took you to a free clinic. They told you you needed a colonoscopy, but they required a $2000 payment up front, and that was far out of reach. So you took iron pills to help with the anemia you had developed, and waited. A few months passed, and things got worse, not better. You went to another free clinic that was friendly to people without papers, and hoped they could help. The nurse practitioner was kind to you, but told you the same thing: you needed to get this test. She gave you some help (the hospital could get you on a payment plan, the consulate might be able to help you out, the health department offers colonoscopies to people who meet certain criteria), but still, you worried. Would going into this system get you deported? Would you wind up deep in debt and burdening your family? If they did the test and found something, could you even afford to get treatment? You couldn’t cross the border– you’d never get back in, and you don’t have family or money to help you back there anyway. You are stuck. And you are sick. You are getting sicker.
This is what happens to people when healthcare is something you have to buy, like a sweater or a latte. This is what happens to people who got dealt a shitty hand and have to choose between options that all suck. They don’t want to be free-loaders, they just don’t want to suffer and die of treatable illnesses. They didn’t come here to steal your jobs and make you pay for them, they just want what everyone wants– safety, family, a good life.
I see versions of this story every week. Sometimes we can help. Sometimes there are too many forces working against us. But unless you can look that woman in the eye and tell her that her illness isn’t your problem and you don’t care if she lives or dies, you should take a hard look at the system. Yes, we have laws that compel emergency rooms to treat people with emergent problems. But if you have a serious progressive illness, or a chronic illness, or something that’s killing you slowly rather than quickly, you are SOL. What’s wrong with this picture? Healthcare needs to be a right, not a privilege for people who have jobs and credit cards and social security number. We’re all humans, and human bodies break down sometimes. We know how to fix them– we just have to decide that it’s worth it.
It’s worth it.