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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

October 2nd, 2012 4:43 PM

Dead Woman Working: So Much Fear, So Little Time

For many Americans, perhaps millions, the daily struggle to survive involves a significant amount of disconnection from our own realities.  Worry and fear about staying afloat financially can and do cloud lives all around us – we mark our next steps by what we can afford not by what we desire or even what we need.  And we bury the despair deep enough to keep on keeping on.  We smile.  We go on with daily life.

Especially in the area of our healthcare needs, millions of us are at the mercy of a system that claims to be about healing but is often more about the same greed and profit-mongering that permeates the rest of American society.  For most working people in America, being ill also means we’ll take financial hits from loss of work time, out-of-pocket medical costs and unanticipated expenses – and all of that after paying for health insurance either at our jobs, through our taxes or both.    

In America, having health insurance does not mean the financial problems related to health have been solved.  Health insurance is not healthcare.  Health insurance is a financial product sold to protect our health and our wealth which may do neither thing very well.  Often, deductibles, co-pays and co-insurance and other uncovered expenses are so high that even insured Americans wait for care, self-medicate with over the counter medications, and get our diagnostic help from whatever we read on the Internet or can glean from other media sources. 

Some patients, like me, end up fighting with their insurance companies to get them to cover medications, tests, and other care that our doctors believe necessary.  It is a system built on fear.  Being fearful drives us to desire insurance coverage, being fearful pushes us to wait too long to seek medical care, and being afraid makes us try very hard not to be sick. 

Then the fear often finally drives us to seek some sort of respite or even escape from the reality lest we are forced to face much more of what we cannot alter in short order.  Most Americans I know rarely discuss personal financial distress with one another.  We’ll talk about the most delicate of personal problems, but not money troubles.  Measuring personal success in monetary terms is such a deeply ingrained part of our culture, that even discussing money problems is distasteful, shameful, ugly and more to be avoided than just about any other topic in polite conversation.  We suffer in financial agony alone.

If we cannot afford needed healthcare, we might get some help from neighbors and friends if the health issue is deemed serious enough and if we can prove we’ve done nothing to exacerbate either the health problem or the money strain.  And sometimes being sick or having someone in the household who is sick leaves little time or energy for proving our financial suffering can be truly found to be not of our own making.  It’s no wonder we fear financial problems and get wooed into purchasing health insurance to protect us.  But then it can be an incredible blow to find out first hand that we weren’t protected much at all by that insurance.   Health insurance is not healthcare.

Many people want to think that the new healthcare law will stop the vicious cycle of healthcare crisis related bankruptcies and personal financial trauma in the U.S.  It won’t do that because it’s built on the same house of cards that Wall Street has built for corporate profit-making over generations.  The master who is served first is not the patient or our caregivers.  It’s about the money.

My husband always repeats one word when I point out the latest injustice in healthcare, and that word is “collusion.”  He is right, but I think the problems in our for-profit healthcare system are even more insidious than some sort of collusion theory or model of corporate control.  It’s messier and more frightening – and more difficult to target in one fell swoop.   Even if I can win a battle today with my for-profit insurance carrier, tomorrow I may have another battle with a provider or a billing service.  There are endless levels of players who may entangled me as a patient or caregiver or as an advocate fighting for an improved, expanded Medicare for all for life model system.

Some may wonder why I focus on individual healthcare struggles when I write.  That’s simple, really.  I trust that the struggles I face and those faced by friends close to me are pretty widespread in the general population because we represent a fairly typical distribution of backgrounds, financial standing and experience.  I get tired of the quiet shame about money issues and trying to find ways to justify the problems I have faced.  And like most Americans I know, I want to escape sometimes, and I want some respite from the worry I was promised would abate once I purchased health coverage.  It’s a simple ask.  And the fix could be just as simple.  And we could pay for it with a Robin Hood Tax, a small tax on Wall Street trading.

One single standard of high quality care for all under an improved and expanded Medicare for all for life model would do it.  And we can get there in this generation if we stay focused and clear on the prize.  It sure would be nice to stop being so terrified – and to know what it feels like to just think about getting better when we’re sick.  And it would be nice to stop putting so much pressure on our neighbors and friends to succeed financially during difficult times by accepting that the system is sick.  Improved and expanded, Medicare for all for life.  A day without healthcare terror is coming to the U.S., and so is the day when the system will finally be judged as inferior rather than the people injured by it.

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