The Non-Reason of Health Care Debates

I doubt she planned on being in this chair!

I have not come to praise Obamacare. I’m on record many times as saying there should be no such thing as for-profit medical care in America–­health should be a human right. But given that this Congress is more likely to abolish gravity than advance public health, I can’t bring myself to bury Obamacare either. We can debate this, but would it be too much to ask that we insist that that discussion rest upon something more substantive than Straw Men?

There are two in particular that have been so endlessly recycled that they even get trotted out on NPR, the closest thing we have to meaty mainstream media here in ‘Merica. The first is that too much money is “squandered” on end-of-life elders; the second is that among the “losers” of health care reform will be younger workers. If ever the adage that foolishness repeated eventually becomes reality holds true, these two cinch the case.

It stands to reason that more money is spent toward the end of one’s life–healthy people tend not to die until they first shed their (apparently) annoying lack of illness. I suppose one could make the case that it makes little sense to approve a heart transplant for a 75-year-old man. Or does it? What if that man was your father? Now how do you feel about it? No doubt about it—the elderly cost more to maintain. We could do what some peoples north of Arctic Circle do; that is, when the elderly become burdensome, abandon them on the tundra until the cold, wolves, or bears finish them off. But spare us pious nonsense about spending too much on old people until you’ve booked tundra passage for your parents and your name appears on a future manifest. Until then, shut up and help pay for hospice care, morphine, and nursing care that eases the passage of elders, lest you appear an idiot, a monster, or both. Let’s call picking up the tab the least we can do for a person who once valued his or her life (and bank account) as much as you value your own.

If you’re young and healthy, be thankful not selfish. I nearly spewed when I heard an October 23 NPR story that repeated the line that the young and healthy stood to be “losers” in health care reform because they would end up “paying” for those who are “sick.” Well, duh! What’s the point of insurance other than to have it when needed? What does age have to do with it? Nobody plans or wishes to get sick. I know; I’ve been there. When I was barely in my 30s, I experienced very severe back pain of mysterious origin. I was running every day, ate a healthy diet, wasn’t overweight, and had not injured myself. It took a battery of tests to locate the problem: a bladder tumor pressing against sensitive nerves. It had to be removed and tested–cancer. I was extremely lucky in that it was tiny, completely excisable, and had not spread. An outpatient procedure fixed me, though healing my psychological anxiety took a tad longer.

The moral? What turned out to be a very minor incident wracked up around $40,000 in medical bills before it was said and done. Because I had insurance, I was out for just several hundred dollars of various copayments. Consider this before mounting your prancing young pony and extolling your rosy-cheeked youthfulness–unless you just happen to have forty grand lying around the house for which you have no better use. Human bodies are like cars and houses–use them long enough and things wear out or break. You’ll never know when this will happen. When I go the gym I observe shoulder and knee surgery scars, ugly marks that once held the staples for post-op open heart procedures, and external reminders of hip replacements. Sometimes these bodies are old, but often they are far younger than my own. You just never know…. Insurance protects us from what we can’t  predict, not what we can. If you don’t have it, you’re playing Russian roulette with your future. And, in a very indirect way, you’re also asking me to pay for your gambling habits. If you go broke, who pays your Medicaid bills?

We certainly need a health care debate in this country. Too bad we spend our time knocking over Straw Men instead of dealing with the heart (and knees, shoulders, hips, etc.) of the problem.  Obamacare? It’s little more than a notched stick in the hands of a one-legged man. But in lieu of anything else, the man is glad to have it.