Sunday, August 12, 2012

The Healthcare Darwinists.

I have a medical condition that, regardless of how well I have been taking care of myself,  has the possibility of me ending up in the hospital. It is lifelong and, if not properly treated, potentially fatal.

Being in the hospital can be frustrating. There is the quality of the food, the lack of privacy, and the 7 a.m. lab work which can leave the inside of my arms looking bruised and bloodied.

As unpleasant as hospitalization is, my family is thankful that it is an option for me.  Even though there are copays and deductibles, insurance covers most of the cost. (At least, most of the negotiated cost: the difference between what the hospital bills the insurance company and what the insurance company pays the hospital is absolutely staggering.)

I'm lucky.  I recognize that.  There are very many who are not so fortunate.

Every time I read complaints about Medicare or the Affordable Care Act, I think of others with conditions such as mine. What does it mean, when people without insurance are faced with the fact that there are others who would rather they were dead than shell out a little more in taxes? Why should the life of my fellow sufferers mean less than mine?

The people who complain "My family's all healthy, why should we have insurance?" I dismiss as idiots. Yes, you're healthy. Congratulations, but there is no guarantee that you will stay that way: my life-altering condition was not diagnosed until I was 41. And cancer, diabetes, and car accidents can strike people of any age.

It's the people with insurance who say, "We pay for our own insurance, why should we pay for anyone else's?" that infuriate me.  Do they really not get that they are placing a value -- a relatively low one, at that -- on human lives?

Or maybe they just don't care.  Maybe this is simply a particularly nasty variant of Social Darwinism, with survival of the fittest being defined as survival of those lucky enough to have a job with benefits.  Or maybe it's fear; so many people live so close to the edge these days that paying for anything else seems unaffordable.  I don't think so, though: I am sure most of the conservative public figures screaming about "Obamacare" are very well-heeled indeed.  Their less-well-off followers don't seem to understand that they may be one lost job (all too common in this economy) and one treatable but expensive diagnosis away from utter ruin.

Considerations about healthcare can color a host of unrelated decisions.  For poor people, it can be as simple -- and difficult -- as the choice between medications and food.  People sometimes get married for health insurance coverage; people who otherwise might not sometimes stay married for health insurance coverage.  I know people in both camps. And although I personally know no one like this, I am positive that there must be women and men out there who stay in abusive relationships for health insurance coverage. 

All because of a problem for which every other developed nation has found a solution.  Do people simply have no compassion?

I can understand complaints about how the programs are run.  I have them myself: I think the United States would be better served by moving to a single-payer universal care system (which the ACA does not begin to establish), for both financial and humanitarian reasons.  That's not going to happen: for-profit insurance companies (and they are so very profitable) are going away no time soon.  But, kludgy as it is, the ACA is better than nothing.  Surely only partisan politics of the most virulent sort can object to a program whose repeal would increase the deficit by $230 billion.

It is certainly true that no one gets out of this world alive.  I find it both appalling and disheartening that so many of my fellow Americans seem to be perfectly okay with people leaving it sooner than is necessary.

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