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

June 25th, 2010 10:49 AM

I Can See Healthcare From Here

DETROIT – As I wake each morning here in Detroit at the US Social Forum, I glance just a few hundred yards across the way, and I know people have healthcare without regard to financial or other barriers. And it hurts like hell to see the cars “over there” winding along the river inside Canada and know that as I sit here in my own nation, I am without the basic human right to healthcare just because I am an American.

The feeling I get every time I glance that direction is the same one I had when I was a patient in Cuba during the filming of SiCKO. I feel sick to my stomach with anger and sadness and wonder why I have spent the past 25 years of my life fighting for healthcare that in other nations – other rich nations and other poor nations – is long accepted as what people in a civilized society extend to and protect for one another.

I am gut-punched all over again. I want to curl up in a ball on the floor of my room and weep. I want to rage at the top of my lungs until the pain pours out somewhere else. I want to grab my husband and my kitty and a few of my old family photos and go where my life is valued enough to allow me to seek and receive care when we need it. Yes, I admit it. I am sick to death of the excuses for why we cannot extend healthcare to all without bankrupting folks, and I sometime dream of escape from it all.

At the US Social Forum, the potential to gather many voices and many forces together to move toward healthcare justice in this nation may or may not fully materialize. Sometimes the voices at the microphone calling for transformative health reform are as controlling and power-hungry as those who run the for-profit, medical-industrial complex. The loudest voices speak with officious verbiage and self-righteous certainty that can squeeze out the meek or those without the required activist pedigrees. In many movements for social change, there is an intricate power structure that can be hard to understand and even harder to accept.

Those of us who believe that the for-profit health care system – not just the for-profit health insurance industry – must be broken apart to save lives, to save homes, to save families and to save this nation, must get to the point where swimming to the other side of this profit-powered river of healthcare delivery and finally changing this awful, brutal mess means so much to us that we are willing to let it be a people’s movement not its own hierarchical system of political ineffectiveness. The mission must be getting to healthcare for everyone and not who gets us there. We have to throw it all in together if we are ever to change it.

The power of the medical-industrial complex in this nation is that the thieves stay in bed with each other against all forces that would break up their game. Providers simultaneously speak ill of insurance giants but then court the best contracts with them. Even providers who claim to want to see transformative change in the system sue patients into bankruptcy to collect deductibles after those lucrative contracts negotiated with insurance carriers leave some portion of the bill unpaid. It isn’t just their money and raw greed that buys influence over the system of political power, it’s also their intense loyalty to one another and codependence on the sources of their profit margins -- not unlike how the mob operates. Break out of the fold, and they’ll break your knees.

And, sadly, thousands and thousands of those who even support single-payer reform in their non-working hours are beholden to the system for their healthy incomes and lifestyles many patients will never attain. It’s hard to trust someone whose collection agency is garnishing your wages when they try to say they aren’t an inside player in this mess with a vested interest in making changes that protect the money they must have to protect the style of living to which they have become so accustomed.

Too often in movements for huge social change – like the health reform movement – we get tied up in the process and who is running the show, which expert is expert enough and who is at the microphone speaking to the lowly, less articulate minions instead of hanging together against the forces that we seek to overthrow. This tragedy is a people’s tragedy, a patients’ tragedy, a least-among-us tragedy. If we won’t even value those voices in the process – if we believe the stories and the pain no longer matters – then we do not believe in the basic human right to anything.

I am not sure we can transform the healthcare system in this nation unless we first stand at the edge of the river looking over to healthcare as a basic human right on the other side and share deeply enough the rage and the pain and the frustration of our sisters and our brothers who have been hurting for so long. We must then become united against all forces that would divide us against the primary goal of achieving healthcare for all. We have to rage together against a system that has ravaged so many lives and robbed us of so much human potential along the way – and we must not rage against one another for not having the perfect approach or the perfect pedigree or the perfect PhD or MD or JD.

The river and a bridge are all that physically separate me today from healthcare as a basic human right and the travesty of healthcare as a privilege of the sufficiently privileged. But the river of social and political change that separates me from healthcare as a basic human right is potentially much more difficult to bridge, unless we embrace and lift all voices. Raising millions of voices for change requires valuing what those voices have to offer to the chorus. All voices in, no voices out.

I am sick to death of fighting this terrible system to secure healthcare for my husband and myself. That struggle has consumed much beyond our health and our meager wealth. I don’t ever again want to glance across the way and see relief and know it could have been ours in this nation if only we’d fought the right enemy.

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