Here Comes Trouble: Stories from My Life

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Donna Smith

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

September 21st, 2010 11:23 AM

A Divide So Wide, A Disconnect So Deep

Our national obsession with individualism and the attainment of personal wealth is so sick and so deep for some of our fellow citizens that even the bonds of marriage are often no match for the selfishness.

A woman with advanced breast cancer schedules her chemo and her radiation so that by the time the worst physical side-effects set in, she is at the weekend and can sufficiently recover to allow a return to work on Mondays. She has negotiated remote work-time on chemo days and the day after. She pays for her family’s for-profit, private health insurance because her husband is a small business owner whose business has felt deep losses during the recession. She must keep working if she wants the care that is attacking her cancer.

If it sounds brutal, that’s because it is.

I had occasion to chat with her husband. He believes that I am misguided in my work for a progressively financed, single standard of high quality care for all. He said, “You know, government can’t and shouldn’t do everything for us. It’s up to us to pull ourselves up by the bootstraps.” Huh?

He really used those words. While his wife struggles to keep the premiums for the for-profit, health insurance paid, his bootstraps are sagging. Yet, he shows no sign of wavering from his entrenched position. He is not particularly active politically. He is not in the Tea Party or the Republican Party or any party. Yet his obsessive selfishness learned through intense cultural and societal indoctrination is so strong that he can bury the reality his wife is living and cloak himself in righteous anti-establishment, anti-government propaganda.

Arrogance and authority drip from his words along with his fury in even thinking about publicly funded healthcare. He is furious that anyone would even suggest an alternate way to handle our healthcare system. His love for his wife and his sorrow for her suffering are no match for the depth of his belief in self-will run riot as national policy.

I do not bother to count the insistent dead of the crisis for this man. If he cannot even consider the benefit to his own wife of a system which would not force her to sing for her supper or work full-time for her chemo, then I have no confidence that he’ll care about the dead gathering around him – the casualties of the national adherence to his personal philosophy and beliefs about individual responsibility.

For this man, healthcare is not a human right. Perhaps more accurately, for this man’s wife, healthcare is not a human right.

He laughs at me when I lay out some of the arguments for more sensible policy. We pay twice as much for our healthcare yet our outcomes are nowhere near the best in the world. No matter, to this every man. He snickers.

There will be little chance to sway this fellow even when his wife’s cancer might have provided a teaching moment or two. What I really wanted to say to him was unsaid. I grieved for his wife, who was not with him this Sunday morning because it’s a bad day for chemo effects and because a working Monday is bearing down on her.

As I listened I realized even more clearly that fighting for healthcare as a human right will not eliminate American born and bred hatred for the weak and the poor and the sick and others showing imperfection as identified by those who feel themselves superior enough to judge such things. Passing civil rights legislation years ago did not eliminate racism or racists in America.

I thought about this woman with her advanced breast cancer and with a husband whose faltering small business makes it really hard for them to makes ends meet. I thought maybe I should tell him to pull up his own damn bootstraps, get a job with benefits and give his seriously ill wife a break. Why don’t you have an equal responsibility when the woman you promised to cherish and love and support is so very sick? I’d yell and tell him he understands relying on others for help – look how his wife, even at her own great personal peril, protects him and his ability to keep trying to make his business profitable. But that wouldn’t be the argument I’d want to make anyway.

Someday, when such a woman is diagnosed with breast cancer, she’ll keep working so long as she is well enough to do so, and under a single-payer, Medicare for all type healthcare plan, she’ll get her care when she and her doctor decide it best for the course of her illness and recovery not when it’s best for her continued earning of enough cash to pay insurance premiums and out-of-pocket expenses. The family will not avoid all the potentially negative financial impact of serious illness, but they will know that no matter what they will have healthcare. Medical decisions can be truly medical decisions, not financial ones.

The health insurance bill passed by Congress last spring does not interrupt this process of brutality. I wish it did. But so long as accessing healthcare is tied to one’s ability to pay (premiums, co-pays, deductibles and other out-of-pocket expenses), more patients will make stilted decisions based on job-related, private, for-profit benefits and suffer greatly as a consequence.

I remain haunted by the words I heard this man say. Clearly he believes his own rhetoric. And clearly he is not alone in his blindness to the human suffering of others – no matter how close the relationship. These are the voices of voters out in the trenches. They are guided by a belief in themselves and that somehow that belief will make more responsible individuals who populate a more successful America.

We have a long way to go in educating one another. But we may have to remember that those who firmly believe in self-actualization through personal responsibility alone will not be our allies in the fight for healthcare as a human right. They turned America’s romance with rugged individualism into defiant selfishness. Thank goodness these souls are in the minority. It’s just troubling to hear their grumblings, and the voices of compassion combined with the sound fiscal policy of improved Medicare for all will have to be at least as clear and stronger. Onward.

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