Friday, September 25, 2009

Personal perspective on problems with our privatized health care system

Many of the debates surrounding health care seem to dwell in the realm of ideology and polemics, and fail to address the way in which this issue meaningfully intersects with people's lives. I have had numerous exchanges with a good friend of mine on this issue, and we find ourselves in disagreement over it. However, this is an issue that did directly affect me over the past year, and I think it's important to discuss that in order to change the tone of debate.

About 15 months ago, I was dismissed from my position as a teacher in a public high school. I'm not going to go into details regarding that dismissal, other than to say that it was likely due to personality conflicts more than my performance as an aggregate over the entire year, from start to finish. I had invested a good portion of myself in that job, regularly putting in an additional 25-30 hours per week outside what I spent in the classroom, so when the district administration essentially let me know that my efforts were not valued nor appreciated, it affected me quite significantly. I had to eventually seek counseling in order to maintain my state of mind while working in a less-than-hospitable environment.

When the fall came and I was still unemployed, and my family was facing great financial difficulty as a result, I slipped into the depths of a depression that I just could not get out of. By depression I am not talking about just feeling a "little down," I am talking of being consumed with thoughts for significant lengths of time on how to hang myself down in my basement, or to simply speed up my car and swerve into a bridge abutment, and so forth. I'm not kidding in the least -- it got that bad. I probably was not that far from actually acting on these impulses, a thought that sends chills down my spine today when I think about how it would have affected my wife and young daughter.

When my wife finally confronted me on this and basically told me that I had to get some kind of help, I figured that the best place to turn would be the counselor I saw at the end of the previous school year since we already had an established relationship. I needed help immediately, so I scheduled an appointment and resumed counseling.

Since I had lost my job, we also lost the health insurance policy we had used the previous year and had to switch to my wife's plan. Not to worry my counselor told me, he was a participant in my new plan, so all I had to do was to make the co-pays. Except after a few sessions, I started receiving statements from my wife's insurance demonstrating that my counselor was NOT a participating provider, so the services were not covered, and instead of paying a $30 co-pay for the appointments I would have to cover $120 per visit!

As it turned out, the provider we had (and still have) has a myriad of different plans. While my counselor was a participating provider on most or all of the other plans, he was not a participating provider on the specific plan that we had. Fortunately for me, he was willing to drop the fee from $120 to $60 per visit, and I was able to keep seeing him. Eventually, after going on medication for a period of time, I was able to gain the perspective on my illness and overcome it. However, this experience certainly gave me a personal perspective on our health care system as it currently is, and how it needs fixed.

First of all, one of the common refrains heard in opposition to any kind of government-run system is that "decisions should be left between a doctor and patient, not put in the hands of some government bureaucrat." Funny thing is, under our for-profit system, decisions were NOT in the hands of my provider and myself. They were subject to corporate decisions.

Secondly, losing one's job and the inability to get another one is one of the most traumatic experiences that a person can go through -- especially a man in our society. When I was not able to work, I felt that I could not make any contributions to my family -- primarily because the way our society measures a person's worth to their family is the financial income they contribute. I was lucky in that my wife has a successful career that provides us health insurance. Given the current state of our economy, what about the millions of others who may be in similar situations but are not fortunate enough to have a "Plan B" like we had? Where do they turn in our for-profit system that ties health insurance to employment status? Answer: there is NOWHERE for them to turn.

Thirdly, when I lost my job an additional $30 (or $60) per week in counseling expenses was one that we really could not afford on our already-strained budget. When you don't have income, a medical co-pay can be something that strains your home finances past the breaking point. However, given my state of mind at the time, forgoing professional help was not really an option. Lucky for us, my parents stepped in and paid for the services. But regardless of our good fortune in this regard, what are those who are not lucky enough to have outside support like us supposed to do? Where are they to turn under our current for-profit system? Answer: there is NOWHERE for them to turn. It is undoubtedly situations like mine (and more dire than mine) that are the reason that medical costs are the #1 reason for bankruptcy filings in our nation over the past several years.

Now, the self-interested way of looking at this scenario might be for me to simply say that I was able to get through it and make it work, therefore other people should do the same. However, I cannot do that when I think of others who could be going through similar (or worse) circumstances and do not have the outside support to get the help they need. This is why I support, at a minimum, a public option in our health care system. I would rather see a single-payer system, because I believe it would completely circumvent many of the problems that I encountered. However, a public option would ensure that those who find themselves unemployed, underemployed, or in other difficult circumstances would not be simply left out in the cold.

At the heart of the matter, our health care is a MORAL ISSUE. It speaks to who we are as a society. It is way past due to listen to the better angels of our nature, and show ourselves to be a society that promotes the common welfare rather than self-interest. It is past time to institute a viable public option that will allow the government to use its volume to negotiate for lower prescription drug and service costs. It is past time to ensure that people have access to services WHEN THEY NEED THEM, and not tie that access to present employment status in an economic downturn.

I support a government takeover of our healthcare system because, based on my own experience and the mountains of evidence available, our current for-profit system has failed too many of those who needed health care. It is well past time for them to step aside. The kind of thinking and approach that got us into our current predicament is not going to get us out of it.