Wednesday, March 31, 2010

Health Care for "Poor People"

Woven among the various reasonable arguments against health care reform was the complaint, “Why should I have to pay for health care for people too lazy to get it themselves?”

This, “blame the poor” argument is so cruel and ignorant it nearly takes your breath away. It’s just another example of how a personal bias can sound like the obvious answer - facts be damned.

The health care horror stories I’ve personally encountered in recent years have nothing whatsoever to do with poor or lazy people.

Last year I wrote about my friend, I’ll call her Cindy, who gave up her health care policy when she could no longer afford it. Cindy is a private business owner. She works at least 10 hours a day and often longer, at least 6 days a week. Each year as her health insurer raised rates (though she was healthy and never made claims), she increased her deductible to keep it affordable. Eventually her deductible reached a whopping $10,000. So she didn’t show up in the statistics showing tens of millions in the U.S. without health insurance; that is until she eventually couldn’t afford even that either.

Not long after I wrote about Cindy I got a mass email from a Noblesville health care reform opponent. It was authored by a doctor who described a derogatory stereotype of an African American, inner city “welfare queen,” and then asked, “And our Congress expects me to pay for this woman's health care?”

It would be so simple if that’s what health care reform was all about – a distant, threatening, lazy minority. But it isn’t. The Doctor apparently isn’t aware that the average family living below the poverty line in America has at least one adult working full time.

Another Noblesville couple I know, I’ll call John and Sherry, also work long hours as private business owners. When Sherry needed radical dental surgery they didn’t even consider getting care in the U.S. They have dental insurance, but it came with a annual cap that wouldn’t begin to cover the cost of the multiple surgeries Sherry needed. So John and Sherry made two trips to Costa Rica and three trips to Mexico where Sherry was treated in first class facilities by American-trained doctors for less than a 3rd the cost of care in the U.S. (including the cost of travel). That they felt they couldn’t afford care right here in Indiana is nothing less than depressing. That they found it so inexpensive in a nearby and otherwise backward country is demoralizing.

Yet, in the Let It Out sidebar of the Indianapolis Star, over the past year I’ve read comment after comment moaning, “How can Obama make me buy health care for lazy people?”

That's an oversimplification on steroids?

Cindy and John and Sherry aren’t lazy or poor people and their problems with our health care system have nothing to do with how hard they work. The problem is a marketable product (health care) that doesn’t operate very well in a free enterprise system. That’s what my friend and client, Ben encountered.

Ben is also a private Noblesville business owner who found himself doubting he should purchase a home because of our dysfunctional health care system. A few weeks before closing on a modest Noblesville home he found he needed a heart stint procedure. In the years previous, he’d been paying an ever-increasing rate for health insurance. As a result of the procedure, he feared his insurer would raise his rates even more. The procedure went well and he got good care here in Noblesville, but he now knew he couldn’t shop for a new policy because he had a pre-existing condition. With so much financial uncertainty, should he buy a house?

He decided to go ahead with the purchase the same day President Obama signed the new health care bill into law.

As Ben and I stood outside the house chatting about his dilemma, he told me about a friend of his in a depressing, dead-end job. The friend is bright and hardworking and wants to quit his job and start his own business, but doesn’t because he’s afraid of leaving his family without the insurance his dead-end job provides.

So much economic activity has been strangled by our screwed-up health care system. And most of the problems have nothing to do with “lazy poor people.”

Remember just a few years ago when bankruptcy laws were reformed making it harder to file? TV and radio talking heads and politicians attacked bankruptcy filers as people living beyond their means, racking up debt they knew they could never pay back, “people who think the world owes them the good life.”

But a recent study conducted by Harvard University found that in reality 62% of all personal bankruptcies in America are caused by medical bills. And here’s the killer - 78% of those people who filed for bankruptcy because of medical bills had health insurance when their illness began.

This doesn’t happen in countries with a national health care system. And these aren’t just numbers, they represent thousands of destroyed lives and devastated families every year.

But still last week I saw someone post on Facebook, “I think the government should just stay out of health care and not take money from me to pay for lazy poor peoples health care.”

Complete and utter ignorance. And with so much blatant evidence to the contrary, it’s willful ignorance.

Wednesday, March 17, 2010

What Dreams May Come

I’m seated at a table. Someone is behind me, their arm wrapped round my neck holding me tight to the chair. As I struggle, another unseen person grips my left arm forcing it flat against the tabletop. A third person lays the head of a huge snake on my arm. It slithers forward and bites my hand, it’s fangs pierce the soft skin between two fingers. Across the table, my 15 year-old daughter sits crying.

I woke with a start, breathing heavily and my heart pounding. I stared at the ceiling in the darkened bedroom thinking, “Where does this shit come from?” It took a half hour to get back to sleep.

Next morning when I drove my daughter to school, I described the dream to her but left out the part about her being in it. It was just too weird.

I’ve always been baffled by the origins of dreams and never accepted the psychological explanations. Still they’re fascinating.

Years ago the younger of my two sisters described a troubling, reoccurring dream. In it, she can fly, but is trapped in a large house. She’s pursued by crowds of people. She strains to fly out of reach, her flapping arms bumping the ceiling as the fingertips of her pursuers graze her stomach and chest. As the room fills with people reaching for her, she crashes through a set of French doors into another room, and again flutters against the ceiling, just barely out of reach.

I remember my older sister’s ex-husband, a psychologist, listening intently as the dreamed was related, searching his mind for a clinical explanation.

My wife’s dreams are every bit as weird as mine and come in predictable themes. When she tells me, “I had an upsetting dream last night,” I often reply, “ Let me guess, you’re in your hometown back in Michigan and you’re outside a familiar house and someone is either chasing you into the house or watching you menacingly from it.”

When my kids were little I often dreamed that they were in danger and I couldn’t reach them or was too late to help. These often contained a location or circumstance of importance from the days leading up to the dream.

Nineteen years ago as my wife was pregnant with our 2nd child, I did some roof work on our house. I don’t like heights, but I had to crawl across the highest point of our steep roof to do the work. It took me forever to scoot along the ridge on my butt and do the work that an experienced roofer could have done quickly.

A couple nights after that I dream I’m back up on the roof scooting across the ridge, looking down at the street and neighboring rooftops. I hear the scratch of footsteps behind me. I turn to see our oldest son, two and a half years old at the time, walking toward me playfully along the narrow spine of the roof with a half eaten cookie in his hand. The familiar scuff of sleeper suite foot-pads scratches along the shingles.

He’s going to fall. Of course he’s about to fall! And I’m battling my own fear of heights to get at him before he does.

But neither of us fell. I woke in terror before it could happen, then walked to his room in the dark and peered over the crib to see him sleeping safely in the drug-like sleep of children.

In another puzzling dream, recalled from my college days, I’m a defendant in a courtroom accused of something terrible. I mean really terrible. I don’t know what it is, but it’s something so vile and unforgivable people are sneering at me.

I’m innocent. How can I make them understand? I look to the judge and jury, slowly scanning their faces, only to realize that they’re all girls I dated in high school or college. My heart sinks, thinking, “I’m screwed!”

What could that possibly represent? I’m really a pretty nice guy. Sure I’ve made some foolish and selfish mistakes in life, but c’mon.

After knee surgery this past January one would have thought the soothing, narcotic painkillers would have made for restful sleep. Instead, the drug held me sloppily along the shoreline between sleep and waking. I would fall into a dream – a handful of nails, a hammer and pile of lumber – I’m building something, then suddenly awake staring at the ceiling. Close my eyes again and the waves take me down into another vision – tripping down several stairs – I reflexively jerk awake again, look around, close my eyes and sink into yet another vision.

Greta and I exchanged weird dreams stories over dinner recently. Our daughter, Sally eyed us both suspiciously. “My dreams are always good,” she shrugged.

“What? You’re kidding me?” I asked. “Always happy?”

“Yep,” she smiled. “Always good things.”

You lucky dear. I hope it’s always that way.