Celestial Lands The Religious Crossroads of Politics, Power, and Theology

Please put the Government between me and my Health Care!

I have been debating whether or not to talk about this, because in one respect it is a little embarrassing. No one wants to admit that there are times in their lives where they were living not only paycheck to paycheck, but sometimes day to day… and even with that to remember that they were still financially better off than many others.

But as this health care debate has continued, and as the idea of a public option has been debated (and single-payer unfortunately dismissed), I have thought of how my own life and story highlight both the need for a social responsibility for healthcare and how someone might end up without insurance.

I grew up in the U.S. Army, and so as a child health care was not a matter of insurance, it was a matter of socialized medicine. Though there is a managed care program in the military, it is managed quite well, and it was mostly during the last administration that the military run program began seeming more like civilian insurance, to its detriment. As a child, if I needed to see a doctor, my mother called the military clinic or hospital and made an appointment. My being registered as a military dependant was enough. When my cousin hit me in the face with a rock, I went to the emergency room and got stitches. When a neighbor-child hit me in the back with a boat oar, I went to the emergency room and got x-rays. When I was diagnosed with a congenital double hernia, I was admitted to the hospital and had surgery within a week. It was accessible, available, and professional.

When my father got out of the military, all of that went away. Though I do not know for certain, I believe our family went through a few years without medical coverage, or at least without comprehensive coverage. Dad was looking for a job in his field and was selling cars to make ends meet. When one of us kids needed to see a doctor, we would go to one of the walk-in medical clinics, and my parents would pay cash. Money was very tight, and so those visits were traumatic to our family’s budget. As a child, one of the things I most noticed about the transition to civilian life was that the health care seemed so much worse. We were no longer cared for members of the community… we were now consumers.

Dad eventually went to work for the State of Tennessee, and through my high school years we were back on a government managed health care plan. Though it was by no means as easy, as professional, or as clear cut as the military system, it was better than pure civilian health care had been. I had also reached the time in the life of many teenage boys and young men where I was “invincible”… I did not need a doctor unless I wanted out of school.

When I joined the Army at 18, it was back to a health care system that actually seemed to care for us. The military realized thousands of years ago that healthy soldiers are better soldiers. In the last century it realized that soldiers with healthy families are better soldiers. Decisions about care in the military “socialized medicine” system are made by doctors. In my many years of involvement with military service health care, I do not ever remember speaking to a bureaucrat about my care, other than making an appointment or handing them my military ID card.

When I fell out of a helicopter in rappelling training and broke my tailbone, the first person I saw when I arrived in the back of a humvee at the post hospital was a doctor, sending me right to x-ray. When I had a car accident in the Republic of Panama, I spent three hours in a local Panamanian clinic before an ambulance picked me up and took me to the military hospital, where the first thing I saw (besides my team making fun of me) was a doctor and an x-ray tec taking me to see if I was paralyzed.

In the countless visits to troop medical clinics for everything from the flu to a stress fractured ankle, in the visits to the emergency room for a serious concussion and shock to my spine to a broken tailbone, I never once saw a bureaucrat about how I was going to pay, I never once had to spend hours on the phone with my insurance company arguing about why I needed the care, I never once had to argue with the doctor that I could not afford the prescriptions. I needed health care and the health system provided it. It is funny to think that those who argue against “socialized” medicine would not dare argue against caring for troops… but that is exactly what they are implying. In recent years, there have been proposals and recommendations to “reform” the military health care system by privatizing it. That has to some degree already happened with dependent dental care. Ask a military family what they think about that… I dare you.

Healthy soldiers are better, more productive soldiers. Healthy military families are more stable, more supportive military families. If this is true, then it is not a leap to think that healthy citizens are more productive citizens, and that healthy civilian families are more stable, supportive civilian families.

When I got out of the military, I simply was not prepared for the cost of health care. I had planned on my cost for tuition, for rent and food, for car and gas… but not for health care. The university heath care was very limited, and my new wife and I could not afford any additional coverage. Looking back, I think that my inability to provide the kind of health care she had before from her parents was a part of what led to our eventual divorce. After a year of college, I found myself divorced and back in the Army.

When I got out the second time, home from Bosnia, I was a mess. I did not have any health care insurance, and I was deeply emotionally and psychologically troubled by what I had experienced in Bosnia. It was not on the civilian economy that I found the help I needed, but through another “socialized medicine” system, the VA; specifically, through the Veteran’s Centers. Once again, I needed care, and a socialized health care system provided it. If I had needed to find a way to pay for it, that care would never have happened. Much of what I was emotionally going through prevented me from earning the money necessary to pay for such help. My part-time employer did not offer insurance to “college kids” and the very limited campus health care (basically colds and immunizations) had no idea what to do with a soldier walking the edge of PTSD.

For the next five years, I did not have health care insurance. I could not afford it. I tried several times to set up such insurance with employers. In one case, my asking the question about getting onto the health care insurance placed me in line to be let go as soon as it could be justified. In another case, the coverage I got was so inadequate it would not pay for, well, for anything. I was paying each month for a card that said I had insurance when in reality I did not. Another employer made sure to keep my hours just under the level that would have moved me to full-time, just to be sure that I did not qualify for health care. With each of those employers (save one), the process to obtaining the insurance was difficult to nearly impossible.

When I would normally have seen a doctor, I stayed home. I used every homeopathic and over the counter remedy I could find out about for ear infections, for colds and the flu. I even reset a slightly broken finger myself (Army combat lifesaver training). When I had to go to a doctor, I went to a walk in medical clinic with many of the undocumented workers on Galveston Island, and I paid cash. I never went to an emergency room and received care, because I was too ashamed about not having insurance. Through all of this, my wife had insurance through her school, but it would not cover me.

When I moved to Chicago, I bought temporary insurance to meet the school’s requirements. When my wife was hired at a good, union job, we enrolled in their health care plan. After all these years, I thought I finally had adequate health care… And yet…

My wife still has to wait months for an appointment. Several times, the issue she made the appointment about no longer applied by the time the appointment came around. Several times, she became so frustrated by the wait she cancelled the appointment. When I had an eye infection and could barely see, I called the bureaucrats at our insurance, and asked to be allowed to go to the emergency room. They argued with me for an hour that I really did not need to see for the week it would take to see my primary care physician (whom I’ve never been able to meet, just a name on a paper). When they grudgingly said I could go to the ER, I sat around for 3 hours before becoming so frustrated I left, and went back to using the same homeopathic remedies I depended on when I did not have insurance. Left to my own devices, I was better in two days… so I actually could have “seen” my doctor the following week, but why?

As far as I’m concerned, the only useful part to having civilian health insurance is to cover emergencies. The system is too broken for much else. Best health care in the world? Only if you can afford it.

I’m telling this story so I can simply say this. Please, please, please put the government back between me and my health care! One of the reasons my wife and I are asking for Active Duty Military Chaplaincy, even though it will mean more deployments to combat zones, is so that we can get back to having government-run health care. When my wife requested that we be an active-duty family, it was so that she and our eventual children would have that level of care while I was gone… and not be dependent upon the civilian health care system.

Yours in Faith,

David

5 Thoughts on “Please put the Government between me and my Health Care!

  1. VA health care shows the pluses and pitfalls of Government run health care. It’s an integrated system, leverages computer technology, uniformly delivers care, and the huge pitfall is Government a total failure at Capital Planning. The VA’s Capital Structure doesn’t move where the Veterans move. It is horribly imbalanced and next to impossible to rebalance because of the stakeholders of Unions, Communities, and Medical Schools.

    When it comes to capital investment, the government can’t do it very well.

    Another classic is the Illinois Health Planning Board, the board Hospitals must go to for approval on Capital Investments. It was the root of corruption for our last Gov and the source of his undoing when one brave Hospital Administrator stood up to the blackmail and wore a wire for the FBI which was the start of Gov Blagojevich’s down fall.

    Much of life is about power and you concentrate vast power over health care in one institution, we’re going to have very bad outcomes.

    I’ve done consulting with the National Health Service in the UK on waits and delays, and always amazed at how they have these weird inefficiencies, and the Doc in charge told me each sub ministry had it’s own budget, completely independent of patient needs (like convenient location)… the Ministries all had their power structures and stakeholders and patients low on the list.

    Stick with TriCare…

  2. Thanks for this great post, David!

  3. Well said, David.

    Our experiences with the Chicago HMO were mostly positive, especially when Brandon was hospitalized for a major asthma attack for three days, but sometimes the bureaucracy was definitely in the way. Now we’re on the UUA plan, and we have had to argue over every single claim to get it paid correctly, and our out of pocket expenses are significant. I actually miss the HMO at this point.

    We did not have coverage for a time when Brandon was a baby, and I remember his pediatrician’s office administrator “suggesting” that we go elsewhere for his care when we tried to negotiate payment arrangements. Talk about humiliating.

    It’s so frustrating to be discouraged about going to the doctor when one really needs to, in anticipation of the later bureaucratic nightmare of getting things paid for or approved or whatever they’ve decided to require at that particular moment. What gets me about the current health care “debate” is that many of the lawmakers making most of the noise have been on government run healthcare plans for so long that they have no idea what the private sector actually looks like in practice.

  4. David–

    Your story is a compelling. You should find a way to share it widely.

    From a geezer who hasn’t had health insurance for nearly four years and whose medical plan is: 1) Don’t get sick or injured 2) Die suddenly.

  5. What a great posting! I will link to it from my blog.

    The conviction that we cannot do national health care well is a failure of nerve and imagination on the part of the well-paid hacks who are working against it.

    Peoole who don’t believe that health care is a human right find specious arguments against having the government manage our health care. I wonder where are the corporations they think so highly of? The ones that apparently do it right.

    Do those corporations insure people with pre-existing conditions? Do they welcome underwriting care for people who need innovative treatment? Do they let your doctor prescribe what she believes you need or do they reject some drugs just out of hand? In heavens name, which are these wonderful corporations? I have been paying attention to the insurance industry for 40 years (and my father and grandfather were in the business) and I can’t guess what corporations they are.

    I have been lucky as I got older in being married to a partner at a prospering law firm. I have gold-plated insurance … and in fact, I have also been fortunate that my husband has been willing to remain married to me, even though we’ve been separated for ten years, so I could maintain that gold-plated coverage. I do not delude myself that my fortunate situation is within a hundred miles of the American norm.

    It’s fascinating to hear these people who go on about how our health care is the best in the world (without acknowledging that this wonderful program covers the select few) and who downgrade national health care systems in e.g. the U.K. and Canada. If we Americans are so darn smart, why can’t we improve on what they do in other countries?

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