During Thursday’s get-together to discuss healthcare at Blair House – and yes, I deserve a medal or something, because I watched the whole damned thing except about an hour of the afternoon session that I dozed off and slept through – I kept hearing republicans refer to the American healthcare system as ‘the best healthcare in the world’ and that is simply not true.
We have tiny little islands of excellence, but we also have huge abyss-like pools of deprivation and indifference. We have the best care anywhere…if you are rich, well-insured, or already have healthcare provided by the government. But if you are one of the millions of uninsured or underinsured, or who risk losing their healthcare because of a tenuous job situation, or if you are simply priced out of the market because you are self-employed or employed by a small business that can no longer afford to provide insurance – well, those little islands of excellence are a long ways away and you are in a leaking boat.
Best healthcare in the world? Hardly. We’re number 37. (That link goes to the New England Journal of Medicine, here is the youtube video.)
This is where it is important to remember that health care is one thing – but it comes to us via a system that is utterly and completely fucked up, and that 48 million Americans have no access to until they are so sick they end up in an emergency room, where the care is the most expensive and the least efficient, and if a patient isn’t sick enough to be admitted, they end up discharged with an appointment they can’t afford to keep and a prescription they can’t afford to fill.
Now I know that the plural of anecdote isn’t data, but first-hand accounts are often the most telling, most moving, best examples. So if you know someone who works in healthcare ask them if they know of anyone who has been forced to quit a job and get a divorce to get a sick kid on Medicaid. We all know of at least two or three cases. Usually it is a patient, but sometimes it is a coworker. Years ago – I think it was in Wichita but it all runs together when you move every two years for a few decades so I can’t be 100% sure – I worked with a nurse who had a baby with a heart defect. Her son used up all of his insurance benefits from both her policy at work and her husbands. For him to get coverage after his transplant rejection drugs benefit maxed out, she and her husband divorced and she quit her job so he would qualify for medicaid. I have also known a lot of military nurses, lab scientists and other allied health professionals who joined the medical officers corps to get healthcare coverage.
Hell, it kept us in!
Every time it came time to decide “do we stay or do we go?” we stayed – because after that second hitch, you can see the end of twenty and a defined pension and lifetime healthcare. That was a key consideration before it sucked this bad out there!
And if I did not have this benefit now, my life would be a hell of a lot more complicated and less pleasant. For one thing, I would probably have to take a hell of a lot more medication and risk all the side effects that entails. I take narcotics every day – specifically, I take thirty mg. of Oxycontin, and that would be enough to foster an addiction if taken improperly and carries a dependence risk when taken properly. I also take 200 mg. of Celebrex and 5mg. of Cyclobenzaprine. If I still spent ten hours a night running units to the ER and working traumas and ICU transfusions, and occasionally having to fight for my life with a desperate or psychotic patient, I would certainly have to take higher doses of at least two of the three drugs that are – so far – successful in the attempt to get me on the other side of fifty before I have to have bilateral knee replacements.
Because I have healthcare, I had the option to make a decision three years ago to quit working a regular schedule and instead do some other important things like raise my granddaughter to school age while I keep the classic all original equipment for a few more years.
Because I have healthcare, I have been able to carve out a little niche for myself editing, writing, researching, that sort of thing. It required other concessions on my part, and some of my friends in the burbs shook their head at the choices I started making about four years ago that ended with me cashing in my chips three years ago and withdrawing from the ratrace (problem is, even if you win, you’re still a rat) but every last one of them went from confused to jealous as soon as I reminded them that I don’t have to worry about my healthcare access disappearing with my full-time job.
A single-payer system, or even a strong public option that truly small businesses could rely on, would free up so much creativity and small business investment and economic stimulation in this country that we would have the closest thing to full employment you can have and not have runaway inflation.
In my former line of work, I met a lot of firemen and cops, and a huge number of them own bars – at one time I thought it was in the KCFD union contract that when you became a Lieutenant you were issued one, but a friend who is a fire Captain and on his third bar, each one nicer than the last, disabused me of that notion a few years ago, so I gave up trying to get a KCFD gig…
I worked with all sorts of entrepreneurs who used the time a hospital or public service schedule affords to do other things. I worked with two women in one hospital who made boutique soaps and sold them online and at local arts fairs and in specialty shops and natural foods stores. I knew a guy in environmental services who had a fish business – he rented fish tanks to professinal offices and used his days off at the hospital to service the tanks and deliver fish food to the offices. I knew a lab scientist who owned and operated a science store. A young friend – I trained her to stick needles in living flesh – now sticks more needles in fabric. She is a fabulous dressmaker and makes a lot of money doing it, but not enough to quit her job and still have healthcare, even though she turns down enough work to work full time and hire an assistant.
Ask any one of those people and they would tell you that they would pursue the successful businesses they have passion for full time, invest in them and hire employees…if they weren’t tied to their jobs in order to keep their health care.
I’ve told you before about the second job I had for a few years when we landed here – I worked for a friend in a blues bar and wrote for the Blues News before I got political – my politics were never addressed when we were in the military, they were no ones damned business. Anyway, working there is how I originally got to know Mike Finnegan – hell, I was pleasantly surprised – and delighted – to find out that MY Mike Finnegan and the blog roundup guy at Crooks & Liars were the same guy!
There is one big – huge, actually – difference though, between writing about politics and wars and national security and stuff and reviewing performances and recordings. Back then, I got calls from agents and artists every day, begging me to please go see this band or they wanted to send me that CD – Boy, did I have a lot of long-lost friends and relatives when I could just walk past any doorman in town because my name was always on the guest list or I could walk through the stagehands and bands entrance to Sandstone for Aerosmith or the Anger Management Tour or the Beastie Boys or Oz Fest and watch from the side of the stage – Here’s the bottom line – if you are backstage for B.B. King, Little Milton, KoKo Taylor or Bonnie Raitt – or you are in charge of the beer tent at a three-day music festival – your friends fight over who gets to to tag along with you to work.
Not so much when they have to spend six hours on a train to Jeff City and back to watch the idjits in the state lege prove that we’re in the running with South Carolina and Texas for batshit-craziest state legislature – Yellow Dog done conceded Kentucky can’t compete with us folks ‘crost the big river earlier this week, so it’s down to three – and it not only costs them fifty bucks for the train ticket, there’s no free booze in the green room, and they don’t get a free tee-shirt or to make out with a bass player (til the next time they order a pizza.)
But it’s still good work if you can get it, and don’t have to worry about health care.