The gift of health

I am late to this wedding celebration, and for that I sincerely apologize.  I have struggled a little bit to create this gift and wrap it just so for the lovely couple and for the entire group of blushing brides.  I have previously been loathe to address political and social issues on my blog, but I am finding myself drawn to these subjects as of late.  Perhaps it is the realization that I am bringing up two young girls, bringing them into a world that is not a friendly and happy place for all of its inhabitants.  I want to ensure they can help to make the world a better place, by learning through example (from me, from you, and from all of the people who will touch their lives).

Anyway, enough with the apologies, and on to the order of the day.

The social justice issue that I am most passionate about is healthcare. 

Article 25 of the Universal Declaration of Human Rights, as established and promoted by the Office of the United Nations High Commissioner for Human Rights, states the following:

1. Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
2. Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

I have a personal interest in a fair and equitable healthcare system for the United States, due to a rare disease that requires me to receive an exorbitantly expensive treatment once a month.  For life.  A treatment which I literally could not afford without my health insurance.

But I am one of the fortunate ones in this country.  I have excellent insurance, partially subsidized by my employer, and a plan that covers me and my family.  We are able to choose our providers to a large extent.  We do not have to worry about referrals.  We have not been refused treatment.  We do not have a lifetime cap on costs which would require us to switch insurance companies and possibly be denied coverage due to preexisting conditions.

Many, many individuals and families in the United States are not so fortunate. 

Sometimes people have to "float" without coverage for days, weeks, or months before their new coverage kicks in.  They must hope and pray that they will not get sick enough to require treatment, or that they will not suffer from an accident or injury that will require hospitalization.

Or families can be denied health insurance altogether.

Sometimes emergency rooms refuse treatment to individuals because the doctors don't think a patient's insurance will sufficiently cover their services.  People have to sell off all their worldly possessions to pay for medical treatment, or must incur serious debt to pay off medical bills. 

And heart-breakingly, insurance sometimes doe not cover treatment even in the most desperate of circumstances.

You might have assumed that many of the United States' uninsured are the poor and/or unemployed citizens and residents of this country.  But there are some sobering statistics about America's healthcare system and who exactly are the nation's uninsured.  In a fascinating article on this subject, Dr. Mike Magee of "Health Politics"* breaks down the numbers:

(*note: I have the link to this resource, but did not provide it because it seems to have been temporarily hijacked by a Canadian pharmaceutical copany -- I'll restore the link when the site returns to normal)

There are approximately 290 million U.S. citizens, [of which] 244 million, or 84%, have health insurance, and approximately 46 million, or 16%, are uninsured.

[The] 46 million number pertaining to the uninsured is somewhat misleading... First, it includes only those without insurance for 12 months. If you count all who went without for at least 1 month in 2005, the number jumps to 64 million uninsured. Second, it says nothing about quality of the insurance. And as insurers and employers are rushing to embrace consumer-directed health plans with high deductibles and health savings accounts, the risk of losing it all is rising for the American family. Third, the number doesn’t include an estimated 7 to 10 million illegal immigrants who function in the U.S. under the radar screen, arriving at the nation’s emergency rooms when they’re sick and desperate.

So many people and families without insurance.  Avoiding the doctor's office or hospital until they are close to death's door, and then wondering how they will foot the bill.  Worrying about family members who suffer through illness and injury untreated.

And the issues faced by individuals and families that DO have insurance are still too numerous to count.  For most Americans, health insurance is inextricably tied to one's employment.  It is not designed to be portable as individuals move from one job to another.  So a person losing his job often suffers a double whammy: loss of income due to unemployment and loss of insurance due to the severing of their healthcare. 

America's health care system seems to be reactive rather than proactive.  It's not uncommon for emergency rooms to treat the heart attack victim repeatedly, rather than set the person up with a mandatory series of wellness visits to ensure that the individual is following a recommended dietary and exercise regimen.  Proactive health management can address glaring problems in the community, addressing issues such as poor nutrition, lack of exercise, and mental health screening to detect depression and other issues before they become a crisis -- but it's still not widely utilized or accepted.

Conditions for medical professionals continue to be an issue, which impacts the quality of healthcare provided.  An ongoing nursing shortage in this country has left the nation's nursing core overworked and burned out, and subject to leaving the profession behind entirely to find a less demanding career.  Medical malpractice costs have crippled physicians and affected insurance costs. 

Workers everywhere struggle with not having enough sick leave or family leave.  Many hourly wage earners get no sick days, so they must carefully weigh the impact of a day's wages lost against going to work while they are under the weather.  If they work when they are sick, they run the risk of infecting others, but if they don't work they lose that valuable paycheck.  Even salaried workers who get an annual allotment of leave to use for medical issues struggle with having enough.  New moms who have just returned from work after a period of maternity leave (frequently not enough time off to begin with) spend months or years trying to have enough leave to take a day off for themselves when they are feeling badly -- often, most of the leave they've managed to save up gets squandered immediately due to sick children, and moms must suffer through their own illnesses in silence.  (Dads, too).

These are just some of the issues that we face with respect to healthcare and insurance in the United States today.

This is a huge and complex problem, and I'm not going to pretend I have all of the answers for you.  I am not sure anyone does.  However, it helps if we can try to understand the problem and all its dimensions, so that we can be informed consumers and work toward bringing about a better solution for the nation.

Some good sources of information on this subject:

Families USA is a nonprofit, non-partisan organization that strives to achieve better healthcare. It addresses issues regarding the uninsured, prescription drugs, and Medicaid.

Patient Advocacy Resources: this site includes an online guide for patients and their families, which tells consumers what they need to know from their doctors about their health, including lists of questions people should ask before surgery and regular check-ups. Also explains the rights people have as patients and as human beings.

Universal Health Care Action Network (UHCAN) is a nationwide network that promotes comprehensive health care for all through education, strategy development and advocacy.

The American Medical Student Association's page on Universal Health Care features a number of resources, including a helpful overview of health policy.

Read.  Become informed.  Come back and discuss.

And congratulations to Jen and Mad.  Now, who's got the champagne?

Comments

[jen]

ahh. nancy. a topic so close to my heart too....

and the thing about this one is it is completely solveable...we can do better. we can be less greedy.

it is solveable.

[carole]

I also feel very passionately about this subject. My mother in her last 48 hours of life was forced into a nursing facility which involved an excruciating transport due to cancer breaking her bones with the slightest movement because a stupid clause in my father's private health insurance denied her further treatment at the hospital or home hospice. It makes me furious to this day that our system would fail someone in the most desperate of times and make a family endure such added trauma to the inevitable horror of losing someone to cancer.

[Heather]

Having grown up in the great white north, it would frighten me to think of worrying about the cost of something while en route to the doctor/hospital. Those are thoughts I've never had and the stories about families going bankrupt paying for someone's medical care scare me. If my family had been living in a place without socalized medicine after my mother was in a serious car accident I have no doubt we would have grown up destitute and homeless.

[Mom101]

This is a great public service you're doing here. I've got a lot of soapbox issues (as you know), and I'm definitely with you on this one. For some reason, there's a misperception amongst a certain segment of our population, that believes that the uninsured for some reason are not deserving of insurance - that they're lazy or stupid or just poor (meaning they're lazy or stupid). I don't know anyone who can look at a child in particular and not believe that it's all of our collective responsibility to make sure she's taken care of.

[V-Grrrl]

Since moving to Belgium, I've been using their healthcare system, and in my experience it's been far superior to the U.S. Not only does Belgium have universal healthcare, it also seems to have doctors and nurses who are far less stressed than the overworked, malpractice-fearing professionals at home.

New mothers spend days in the hospital, get SIX months paid maternity leave if they want it, and receive periodic visits from a nurse at home. Daycare is also provided by the communities for the youngest children.

However, all these benefits come with a steep price tag. The sales tax her is 22 percent; income tax is at least 50 percent BUT people get the care they need, and I think good health, above all, enhances quality of life.

[MotherPie]

I'm glad you wrote about this as I, too, think this is one of the most important issues facing our country and as a mother,I care about the health and well-being of others, especially the children and families and those who can't afford it.

It is in all of our best interests to work for this.

Wonderful post.

[mayberry]

Great post. It's scary--and completely unacceptable--how so many of us are just one layoff away from potential disaster, and how many more are already there.

[Mad Hatter]

Yeah, Nancy is writing, Nancy is writing!!!

Thanks for this important gift. There are more people in the US without health insurance than there are in the entire country of Canada period.

As you know, we have universal health care up here but the system is severely cracked. Politicians feeling corporate pressure and pressure from American HMOs flirt dangerously with dismantling the system. Just lask week a private emergency room opened in Vancouver. With the Tory gov't in place there is no indication that anyone will crack down on this joint for standing in contradiction of the Canada Health Act. Bingo: two-tiered health. It infuriates me.

What we still have going for us in Canada is two generations of people who have only ever known universal health-care. Time and again, health-care is the #1 election issue. When the CBC did a cheesy reality show last year called "The Greatest Canadian," Tommy Douglas the founder of universal health care in Canada was easily voted as our country's greatest person of all time.

I fear what the loss of universal health care would mean to those who live on the margins of society. As it is, dentists and optomotrists will often refuse care to the homeless. To not have medical care? That would be unthinkable here. I am sorry that it is happening in the richest nation on earth.