That hopey changey stuff
I couldn’t bear to watch the end of the healthcare debate last night. When I went to sleep at 11pm, it was still going on, and it continued to midnight. I couldn’t bear to check US newspapers this morning either, so I heard the good news from a more distant source, the BBC Today show. It was the first headline Justin Webb read out: “Barack Obama’s landmark healthcare reforms have finally been approved by Congress.”
There was a hint of bemusement in US correspondent’s Mark Mardell‘s voice as he reported. This is what landmark means: “Nearly every American will have to take out insurance, or face a fine, and insurance companies will be stopped from refusing to insure sick people, or dropping them when they get ill.”
Bewilderment of some sort would be justified. To anyone outside the US who lives in the developed world, the healthcare bill introduces measures that are elementary, basic, almost a bare human right.
This in itself isn’t news to anyone who’s been following the bizarre healthcare debate, but some of the provisions are truly telling. They show just how bad the situation has been.
The most striking today was this factlet, reported in the Wall Street Journal: From 2010 onwards, insurance companies will be “barred from denying coverage to children with pre-existing illness.” What? What??!! I thought, when I read this. Clearly up until now it had been entirely legal for insurers to deny coverage to sick children. Given the wild costs of healthcare in the US, many kids must simply have had to do without. It seems unimaginable.
Also shocking was news of the turmoil at Capital Hill. On Saturday anti-bill demonstrators hurled racist slurs at African-American senators entering the House. Oh, and spat on them. Nancy Pelosi linked arms with John Lewis, an African-American congressman from Atlanta Georgia, to show her support. Lewis said the protests reminded him of his days as a civil rights activist in the 1960s. “There’s something loose in the land which has created this climate,” he said, adding, “I don’t any ill-feeling or malice towards people who use the ‘n -‘ word, the individuals that spat on my colleague … Our responsibility is to create a greater sense of community.”
But … I just don’t understand. How does healthcare relate to race? The madness that unfurled during this debate seems randomly to blend specific anger about government activities with a free-floating racist rage. It says a lot about America.
I’ve lived in the US for under two years. It’s impossible for anybody here to go unscathed by the maelstrom of awfulness that is the US medical system. Whether you’re rich or poor, uninsured like me (well, we’ll see how travel insurance works!) or even insured, the system gets you down. Just the other day Cary Tennis, the advice columnist at Salon.com, who is receiving treatment for cancer, wrote that his insurance company had denied a request to pay for the treatment doctors said he needed. After he hired “a professional medical advocate” and asked Salon.com readers to lobby his insurance company, his treatment was approved.
“Thanks to everyone who has worked on my behalf, the medical reviewers at Blue Cross have taken a second look at the case for proton beam radiation therapy and have approved my treatment,” Tennis wrote today.
He later said: “I do fear for the fate of sick people who lack the communication skills, the research skills, access to media and the resources to call upon the necessary specialists to make sure that their cases get the scrutiny they deserve.”
Hmm. Should a cancer patient need to hire an advocate and establish an internet campaign, just to get care for his illness? Note: this was someone who had insurance. If you don’t have it, you go bankrupt; or simply forego treatment.
On a personal level I’ve had some deeply unpleasant encounters with the US medical system, which I chose not to blog about because they were just too depressing. The most amusing, though, was when I had a shouting match with my elderly pharmacist.
Towards the end of my period of insurance as a student, I went to my doctor to get one or two extra prescriptions to tide me over while I figured out what to do next. When I went to the chemist, the prescriptions wouldn’t go through because I had maxed out my limit, according to my insurance company’s records (this couldn’t have been true, the company just knew I was near the end-date of coverage). I was upset and struggled to understand what was happening. Somehow the grey-haired pharmacist took my questions amiss, and we ended up in a row. “It’ll be worse when Obama gets his way!” the old man yelled at me. “It couldn’t get any worse!” was my reply.
Today I received an email from Barack Obama entitled “Thank you, Frieda” (I don’t quite know what I did but I’m on his mailing list). “For the first time in our nation’s history, Congress has passed comprehensive health care reform. America waited a hundred years and fought for decades to reach this moment. Tonight, thanks to you, we are finally here,” Mr. Obama wrote.
“We have shared moments of tremendous hope, and we’ve faced setbacks and doubt. We have all been forced to ask if our politics had simply become too polarized and too short-sighted to meet the pressing challenges of our time. This struggle became a test of whether the American people could still rally together when the cause was right — and actually create the change we believe in,” he went on.
Yet it’s been those who rallied together against the bill that have really been notable over the past year.
Still, what Sarah Palin called “that hopey changey stuff” has come back to life again. Although it rained all day today and it’s dark now, the world somehow feels a sunnier place.
Update: For another instance of someone WITH insurance being screwed by the system, see Nicholas Kristof in last weekend’s New York Times, where he asks if insurance companies cover any illness at all.
Update 2 (April 1 but it’s not a joke): Certain insurance companies have made women pay more for coverage than men, even men who smoke, arguing that women are more likely to avail themselves of it. For this and more insalubrious info. about health insurance sexism see NYT, March 29 2010, “Being a woman is no longer a pre-existing condition.”