Writing about health care reform is like trying to eat alphabet soup with a knife. It is shaky, messy, and at the end of the meal, or the rant, one ends up less satiated than at the beginning. Frustrations abound. Choppy sentences and fragmented thoughts float about the bowl.
I, however, happen to be a glutton for a messy debate, and even though I have avoided, for some time now, commenting, writing, or detailing my thoughts on the whole debacle, it is about time I dug my knife in.
Gluttony in a Type 1 Diabetic is not exactly what the doctor ordered.
But what if you, like me, didn’t have a doctor? What if you, like me, were emphatically told no. No coverage. No way.
Shortly after my 21st birthday I was diagnosed with Type 1 Diabetes. I was still in school and at the time had, what I now consider, pretty fabulous health insurance.
“No more mindless snacking,” my new doctor said. “No more drinking,” she also added.
“If you do this right, you have the opportunity to live a long and healthy life. You get to be more aware than the average Joe.” Lucky me.
What she didn’t mention were the holes that test strips, insulin, lancets, needles, blood work-ups and blood sugar meters would burn into my pockets. What she failed to divulge was that, from this point forward, I was, according to the insurers that be, tainted. I had bad blood and a rotten pancreas.
When I graduated my insurance security blanket was quickly pulled off and I was thrown, head first and shivering into the young-adult-without-health insurance pool. Blue Cross tossed me off their boat without so much as a life jacket. Those bastards didn’t even drop me by a buoy.
I started ordering insulin from Canada. I stopped seeing a doctor.
How was I supposed to do it right when I no longer had a professional guiding the way? I was a year into the disease and I needed someone to hold my hand. I needed someone to walk me through it.
I did everything I could, but every letter I received denying coverage stating that I was uninsurable due to my “pre-existing” condition felt instead like walking through fire. I would grow hot and red all over with rage, with shame, and most of all with fear. Every letter engaged and enraged me with a kind of pain that I thought reserved only for broken hearts or deaths in families.
I worked for a small company that didn’t offer benefits. I was screwed.
All you can feel in those moments is that your life is not worth funding. You are not worth the cost. You are dispensable, too expensive, and yet you don’t remember ever trying to sell yourself. You simply asked for your life, and the insurer said no.
I was thinking about this on my American Airlines flight back to Los Angeles a few weeks back when the voice of a frantic stewardess named Jane rang out of the intercom.
“Is there a doctor on board?” she called out. “Please,” she continued, “a doctor or a nurse on board you are needed NOW in row 19.”
A different stewardess coming from the tail, rushed to the overhead bin containing the plane’s first aid equipment. She grabbed a defibrillator kit and an oxygen tank and sprinted back down the aisle.
I overheard Stewardess Jane again, reassuring a concerned passenger that in her “thirty-five years of flying, there has never not been a doctor on board.”
Sure enough, two M.D.’s sprang from their seats. Soon, they were – without a flash of hesitation, without so much as an inkling of doubt – at the man’s side. They didn’t ask if he had insurance. There was no talk of deductibles or hourly rates of private practitioners.
They each settled into newly self-assigned seats on either side of the man, and, for the remaining three hours of the five-hour flight, treated the infirm.
When we landed they exited the plane with him, accompanying the paramedics to the ambulance, one of the doctors toting his own young son on his hip.
“That’s why they have that oath,” a gentleman in his eighties happily grumbled in the seat in front of me, slowing flipping through his Wall Street Journal, without so much as looking up.
That oath, I thought. That oath…
The Hippocratic Oath, widely believed to have been named for the father of western medicine, Hippocrates, is – contrary to popular belief and television dramatis – not a requisite statute of most medical schools.
Since its early days around the 4th Century B.C.E The Oath has been re-written and appropriated to fit in with the conjectures of modern society, but at its core, remains a blueprint for astute moral navigation.
In a section of its most modern version it reads:
“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”
If Blue Cross or Kaiser drafted a new version it would probably read a little something like this:
“I will remember that I remain a member of high society, with special obligations toward money and toward all my fellow human beings with money, those sound of mind and body and money but not the infirm.”
There are also, a few key words that have been glazed over.
First: obligation. This means obligatory. It implies a moral imperative. If you are obligated, you are bound. There is not, nor should there be, any wiggle room in an obligation.
Second: all. This doesn’t imply all with money, or all with current Kaiser memberships. All means all, as in all-inclusive.
Third: as well as. The Oath doesn’t talk about pre-existing conditions. There are no exclusionary clauses or fine print.
The Hippocratic Oath is about human beings helping other human beings, without strings, without second mortgages on homes or refrigerators filled with medications but not food. It isn’t about gouging people for their lives— it is about saving them.
It is about making life better.
My disgruntlement rests in the issue that most doctors, as detailed in the above anecdote, operate according to this code, whether they are required to recite it, or not. They are lifesavers, ready to jump to attention, or run down the aisle of a plane at a moment’s notice. And yet, the privately held insurance companies, to whom we entrust the care of our health, do not operate according to or feel bound by any sort of moral code.
This is not a shocking revelation, but if we know this, why then are they still the geese with the golden key when they don’t lay the golden eggs? They hoard the eggs and they throw the bad ones out.
If their motives are not driven by an obligation toward a common good, why do they get to choose who lives and who dies. Why do their letters designate who is worth saving and who is not.
In a perfect world, the Oath would be a requirement – an obligation – of insurance companies. Why shouldn’t they be held accountable for inappropriate care? Why shouldn’t they lose their licenses to insure when they hike up deductibles and deny coverage?
I know, as someone smartly pointed out to my pathetically bleeding liberal heart, that privately held insurance companies will never feel altruistically compelled toward aid. They are monetarily driven, through and through the corporate pig, hook, line, and stinker.
I also know that, as it stands now, it isn’t as simple as cutting out the middleman or kicking the insurers to the curb when they don’t play fair.
Sigh. That oath… that oath! I can still hear the man in my head.
So what is the answer? How about another question?
Why are we the only industrialized nation that does not guarantee access to health care as a right of citizenship?
Private for profit is no longer an acceptable model. The right to health. A national health service. Single payer universal health care. Is that really so much to ask for?
Aren’t all lives worth their weight in flesh, not gold?
You don’t think of how simple it can be until 38,000 feet in the air, someone’s chest compresses and they can’t breathe. Until someone shouts over an intercom and two qualified doctors come running. No paperwork. No bullshit. Just those adhering to an antiquated Oath and the preservation of life – because nine times out of ten, doctors aren’t the ones saying no.
So there you have, at least some, of it, my messy bowl of soup. I’ve splattered it all over the table.
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Well said. As a citizen of your northern neighbour, I can’t even begin to imagine the choices that some U.S. citizens must make when it comes to their personal health. Of course, I pay more in taxes that you do, but the potential payoff in times of a medical emergency seems like a good deal to me.
Awesome job- you nailed it, and yet, someone out there will argue back at this. “What next, are we supposed to provide houses and cars for everyone too?” Most likely, this person will consider themself a Christian and see no contradiction.
working in the health care field as a provider, i have to say that the system certainly needs serious overhaul. single payor health care sounds like a great idea – until you look at the long term effects that are starting to impact england and germany – touted years ago to be two of the more exemplary models of health care in the world…now struggling to control costs and moving to privatization.
the recent US health care bill was absolute dog shit save for one part – the fact that insurers should not be able to exempt pre-existing conditions and deny coverage. i see it in my rehab patients every day and it is appalling.
if health care was decentralized and the consumer had a much larger selection of companies (breaking up the monopolistic big blues and kaisers), and pools of employers or employees were provided more competition and choice across the board, i think people would see a greater reduction in their premiums.
however, per nih reports and confirmed by bls.gov, over 55% of premiums and health insurance spending goes to administrative overhead and costs. does anyone really think that figure would go DOWN with a single payor system? it’s the exact crisis england is facing now.
don’t get me wrong – single payor is an absolutely excellent solution and ideally a great way to meet the needs of a population. the cost, however, for a country with a ballooning federal deficit thanks to inane policy and wasteful spending by the past 4 presidents have left this country economicaly crippled. adding on more debt isn’t the answer.