It will take you about four minutes to find out what this topic has to do with voting, although at this point there is no secret about how I plan to vote.
It would be possible for everyone in this country to have access to quality affordable healthcare. But we have to want it.
In 1998 I was diagnosed with diabetes, at age 38.
I was working out regularly and trying to get in shape. I’ll never forget the day I stepped on the scale at the gym and saw “114”. I’m 5’6” so 114 pounds is skinny. I thought to myself “wow, the exercise must be working”. But that only lasted a moment, because what I thought deep down was “holy shit something is wrong with me.” And then when the worried and worrying comments came from my family – “wow, you’ve lost weight, are you OK?”, I really started to pay attention. I went in to see the doctor and described the classic symptoms – rapid weight loss, extreme fatigue, excessive thirst. She checked my blood glucose and the meter in the office couldn’t register a number – it was that high. I asked wishfully “maybe it was just the brownie I ate last night, huh?” Yeah, no.
Of course I asked my doctor why this happened to me. She didn’t hesitate. “Bad luck.” I was looking for an actual reason, though I’m not sure I really wanted one. Maybe in my soul I wanted to know if it was my fault or not – genetics (not my fault), I ate too much sugar (my fault), I didn’t eat enough fiber (my fault), environment (not my fault) too much stress (my job’s fault), not enough yoga, whatever.
And now when I tell people I’m diabetic (which is not that often), to a person they almost always say something like “wow, I never would have guessed”, or “why did YOU get it”, or “it must be in your family?”
In my head I translate those well-meaning comments into something like “wow I’m surprised you got diabetes because you seem so healthy.”
In other words, I didn’t do anything to cause it. So I must not deserve it either.
I start to squirm.
If I was visibly overweight, with a noticeably unhealthy diet, or if I made other less than ideal “lifestyle” choices, did I cause my disease, and therefore did I “deserve” it somehow?
No one honestly thinks that you deserve the disease you get, right?
When people around us are diagnosed with an illness, we ask why. It’s a natural question. We want there to be a cause we can pin-point. I do it too. We want to tell ourselves that if we don’t do the same things that the sick or diseased person did to get there, then we can avoid it. If I live a healthy life – eat right, exercise, don’t smoke, stop eating gluten, start drinking coffee (which is truly the miracle food) – I can control my destiny.
Which is partly true, but it’s partly bull-shit.
I believe in science, and I believe in cause and effect. And I believe that disease and illness can be attributed to environment, or lifestyle, or stress, or genetics, or a host of other things. I’m not anti-science.
But I also know non-smokers who got lung cancer, overweight and sedentary people who never got diabetes, and alcoholics who appear to have perfectly functioning livers.
We need to live healthy lives. And living healthy helps stave off illness and disease. I think my own (mostly) healthy lifestyle has helped me to manage my illness.
But let’s be careful when we talk about (or even consider at a subconscious level) who caused their own disease, or who might have done something to “deserve” it.
Why? Because we all have one thing in common. A body. A body that when it works perfectly carries us through our day while we are oblivious to its beautiful, mystical, complicated, harmonious inner-workings. Our body is like one of those Rube Goldberg machines that sends a marble down a chute which sets off a fountain which dribbles down a gutter which weighs just so and kicks off another marble, which lands on a see-saw and rolls down and bang, down goes a long row of dominoes, and the last domino flips a switch and turns on a lamp.
But if your cat decides it wants a drink from the fountain, it throws the whole machine off.
Roxane Gay, a brilliant and funny writer, talks about having an “unruly body”*, and I guess I have an unruly pancreas. Blood sugar is a moving target of too high, too low, what’s your number, what can I eat, what can’t I eat. When your pancreas works, it’s a beautifully choreographed dance. You eat what you want (within reason of course), your pancreas gives you the insulin your body needs, your liver does it’s thing, it’s all good. When it’s not working, you can die. If your blood sugar goes too low, you can go into a hypoglycemic seizure and die, which happened to me twice. (The seizures, not the dying.)
If it goes too high for an extended period, you can go into a diabetic coma and die, like happened to Alec Smith, a 26 year old man from Minneapolis who couldn’t afford his insulin, started rationing it, and died.**
Which brings us to the voting part.
Mostly we have some control about how we “manage” our conditions. If you get in an accident and break your arm, you have to go to physical therapy. If you have a knee replaced, you need to do the exercises. You need to take your medicines. Of course you have a role in your own health.
But you don’t deserve what happened to you.
Of course, no one really thinks that do they? No one is that hard-hearted are they? No one actually thinks that some of us deserve illness?
Umm, let’s think about that.
In America we believe in hard work, taking care of ourselves, not being lazy, or relying too much on government, and pulling ourselves up by our bootstraps. “Entitlements” is now a dirty word. We believe that successful people have worked hard to deserve their success, and those who aren’t successful must not have worked hard enough. This is the DNA of our country’s unruly body.
And this is part of the reason we’ve never been able to figure out a healthcare system that takes care of everyone. We do not believe that healthcare is a human right. And we place high value on taking care of yourself, and mostly just yourself. And while we don’t like to admit it, we may not care that much about other people.
Some believe that if we all just live healthy lives, work hard, maybe pray a little (or a lot), you’ll be fine. And that you need to “earn” your right to health and healthcare.
I try to fathom, though it seems unfathomable, whether the same people who don’t think you deserve healthcare, never get sick themselves, or never have gotten sick, or will never get sick sometime in the future? Can they honestly not relate, or empathize, with people whose bodies are broken?
We need to change how we think about healthcare in this country.
It’s time to think of health care as a human right.
Government (our government, yes you, USA) has not only a role, but an obligation, to ensure that all of it’s citizens have access to quality affordable healthcare. In fact, government is the only entity that is positioned to make this happen.
Churches will not pay your million dollar bill when your baby is born prematurely and with multiple complications. Charities will not pay for your chemo treatments if you get cancer. Emergency rooms will not treat your diabetes. Insurance companies have little interest in making sure your premiums are affordable. Drug companies will not ensure that the drugs you need (in some cases, to survive) will be affordable.
We cannot frame the healthcare conversation around who has “earned it”, because we have created a system that makes earning it impossible for many, and very expensive for everyone else.
There can be no more “yeah buts” to the question “Can I get affordable quality healthcare in the U.S.?”
Yeah, but you have to have a job, a very good job.
Yeah, but you may have to choose between food stamps and healthcare.
Yeah, but you can’t start that business you’ve always dreamed of because you won’t be able to afford the premiums for yourself or your employees.
Yeah, but you can’t have a pre-existing condition because insurance companies care about risk, and you’re too risky because you had cancer (or a baby, or arthritis, or fill in the blank).
Yeah, but you really can’t work for that small business because they can’t afford to cover you.
Yeah, but your Medicaid benefit requires you to work even though the reason you’re on Medicaid in the first place is that you can’t work.
Everyone deserves quality, accessible, affordable health care, don’t you agree? If you don’t agree, think about who doesn’t deserve it and please get back to me.
If there’s a litmus test it must be simple – “Do you have a body?” “Yes, I do.” “OK, you’re covered, and here’s how it works.” Anything else leads us down the slippery slope of deserving vs not deserving.
If you have a body, what you deserve is not blaming or shaming, but healthcare. All of the reasons, the circumstances, the things that you have done or not done, do not matter. You are a human with a body that hopefully works well most of the time, but some day it may not, some day it will not. You cannot work your way out of illness. You cannot pay or pray your way out of illness. You cannot avoid all accidents. You cannot exercise or eat your way to perfect health. You cannot not get old.
The healthcare system may not be broken for you, but in this country people go bankrupt or die because our healthcare system is broken for them.
You may have health insurance through your employer, and premiums which are conveniently deducted from your pay check, but you’re still paying through the roof.
You may have an insurance card in your wallet, but deductibles so high that basically you’re uninsured.
You may have health insurance, but your insurance company refuses to cover the treatment you need, so you are left with inferior care, or no care.
You may have health insurance but require drugs that are not covered, or are so expensive that you can’t afford them.
You may have access to public healthcare services but you don’t know about them because you are just trying to make ends meet and don’t have time to navigate our complicated system.
Or you may not have any insurance at all, which means you could be one accident or serious illness away from financial disaster, and crossing your fingers that the GoFundMe campaign comes through for you.
And now we actually get to the voting part.
“We all do better when we all do better.” The social contract that the American government has with the American people needs to include ensuring that everyone has access to quality affordable healthcare. It’s time. The Government needs to do this. There is no other way. The free market won’t do it, because they are driven by profit. Churches and charities can’t do it. Those options have been tried, and they failed.
Republicans have controlled all branches of government for two years, but even while Obama was president, they tried repeatedly to the repeal the ACA, the only major progress we’ve made on healthcare in decades. The Republicans tried again last year to repeal it, and failed. But they didn’t actually fail. They have been chipping away at it’s provisions, and will continue to do so until there is nothing left, until we are back to pre-2010, the “yeah-but” era. As part of the 2017 tax bill for the wealthy and corporations, they repealed the individual mandate, which makes the ACA less financially viable, and increases the risk of premium hikes. They are threatening to repeal protections for pre-existing conditions. Some states have cruelly refused to take advantage of Medicaid expansion. Senate Republicans (namely Mitch McConnell) are threatening to try again to repeal the ACA, and cut Medicare and Social Security (to pay for the deficit that they created by the gazillion dollar tax cut by the way. But that’s another story)
In short, the GOP does not believe that healthcare is a human right, not even close. They don’t care if you die because you can’t afford to pay for it yourself. It’s harsh, I know. But look at the facts. It’s in their record.
The only candidates I know who are committed to healthcare as a human right are Democrats. The Democrats may not succeed in getting us to a place where everyone has quality, affordable, and accessible healthcare, but they are the only ones who have committed to trying. This problem can be solved. There are options on the table such as single-payer, public options, “Medicare for All” (or could we even just have “Medicare for Many” or “Medicare for Most”??), and negotiating lower prescription costs with drug companies. We’re smart, let’s do it.
I’m voting Democrat straight down the ticket, for the candidates who recognize what a big deal it was that the ACA provided healthcare to millions who never had it before, who know that we can still do better, and who will work to find solutions for all of us. All of us. Because we all have bodies.
(The photo is of a sculpture by Jesus F Contreras, titled “Malgre Tout La Pesar de Todo” or “Despite Everything”. I recently visited Mexico City and saw this sculpture at the National Art Museum)
©Rebecca Larson 2018