Speaking of Health Care

Spring break has not turned out exactly as I had planned. The bliss of a week without teaching or meetings, the chance to runaway with my husband for one night to a “dress-up party” in Washington, D.C., the ability to feel thoroughly prepared for next week’s onslaught…all out the window because of the flu.

On Saturday afternoon, I was chatting with our college friend who was to be our overnight babysitter. As the conversation ended, my younger son walked in coughing. By bedtime his fever was 104. We gave him some medicine hoping to affect a good night’s rest. At 4 a.m. I found myself changing vomit-soaked sheets. By 10 a.m. we were in the pediatrician’s office receiving a flu diagnosis and prescriptions for anti-viral and anti-nausea drugs. By noon, the healing had begun. We were no worse for wear save a few sleepless nights and the stupor that comes from watching too much TV.

Through the coughing, the fever, and the vomit, I did not think twice about getting us to the doctor’s office ASAP. I did not think, “Can I afford the co-pay? How much will the medicine cost? What if I don’t get the medicine; how long will he be sick? How much work will I have to miss? Will I lose my job? What will happen if I miss that meeting or have to take a sick day I don’t have? What happens if my older son gets sick? Or my husband? Or me? Can we afford prescriptions and co-pays for all of us? Should I pay for this and skip my preventive dentist appointment scheduled this week? It will cost about $100 too.” I also did not think, “Darn it. I should not have bought new shoes for my teenager yesterday. I should’ve been thriftier at the grocery store because you never know when someone is going to get sick.” I didn’t think of any of this. Instead I thought, “If I can get him the Tamiflu, he won’t be so uncomfortable. He’ll be able to sleep. He’ll be able to get back to the things he enjoys sooner. And, let’s be honest, I also thought, “Maybe he’ll be well in time for that overnight get-a-way.” I could be selfish for him and for me and that is a privilege.

Like every member of Congress, my husband and I receive affordable health care coverage as part of compensation for our work. Indeed, right now, as of 5:05 EST on March 14th, it is a privilege many working families and poor families in the U.S. have too. That is because of the Affordable Care Act (ACA), commonly known as Obamacare. But it won’t be 5:05 EST forever and members of congress, who like me, don’t think twice about going to the doctor are considering repealing the ACA and replacing it with a GOP sponsored plan that will repeal the Affordable Care Act and end health insurance for 24 million of our fellow citizens according to the just released estimates from the Congressional Budget Office (https://www.cbo.gov/sites/default/files/115th-congress-2017-2018/costestimate/americanhealthcareact_0.pdf ).

The new plan seeks legitimacy through the language of choice. People without coverage will be uncovered because they will “choose” to be uncovered. But as we all know, there are “choices” that are not necessarily choices at all. Premiums and co-pays that are unaffordable, plans that don’t cover you or your family because of health conditions you already have, caps that keep you from receiving the mental health coverage you need, which incidentally, helps people manage their chronic physical health conditions in ways that bring down health care costs. The Affordable Care Act is not perfect. Because of choices not to expand Medicaid by 19 states, the program does not work the way it should in those states. People there are experiencing premiums that are too high. But this is an easy fix. Accept the Federal government’s offer to expand Medicaid. We are finally talking about this in North Carolina but it may be too little too late. There are also other parts of the law that should be strengthened. But in spite of whatever flaw you choose to point to, under Affordable Care Act, more American citizens are covered than at any time in history. That is a success. Any logical approach would fix the things that are not working in the Affordable Care Act, not scrap it.

But it’s not about logic. It’s about money. And money is about values. Under the proposed repeal plan there are big winners and they are people who are winners already. (http://www.cbpp.org/research/federal-tax/house-republicans-aca-repeal-plan-would-mean-big-tax-cuts-for-wealthy-insurers ). A small group of U.S. citizens will win because they will get huge tax breaks if the money that funds the ACA is shifted away from covering all Americans back to their bank accounts. Who else wins? Insurance companies. They will be back in the business of charging whatever to whomever for whatever. How will my family fare if the repeal and replace plan is enacted? I’m not sure. But I am sure that many of my fellow citizens will suffer. How do I know? Because, as a country, we’ve tried this before. We’ve tried letting people choose whether they should buy coverage or not. We’ve tried more limited regulation on insurance companies. We’ve tried Medicaid caps and various waiver programs to see if the states can be “creative and efficient.” (Guess what? They are very creative and efficient at covering fewer people!)

So as we listen to competing narratives on the Affordable Care Act and the new GOP plan, perhaps we should think about our values more than we think about how much any one of us might dislike the particular president associated with each plan. What choices do you want to make for your family? What feels like a choice to you and what does not? Would you want for all what you want for yourself?

As I snuggled on the couch with my sick son yesterday watching the Wizard of Oz, I was struck when the wizard said to Dorothy, “Let us return to the land of E Pluribus Unum.” Out of many, one. Yes, please. Let’s do return to that. What is it that we want for ourselves? And can we find it in our hearts to want it for all? I want everyone to be able to do what we did this weekend. Seek healthcare when you believe you need it without a second thought.

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