BEYOND THE HEALTH CARE DISCUSSION
I met two little boys about a month ago — ages 6 months and 4 years. Their mother came to the place I work seeking help for her bipolar disorder with both kids in tow. The first thing I do, as a therapist, is to gather as much information as I can about the person in order to determine the proper course of treatment. It is called an intake, or an assessment. Usually these are conducted with just the client him or herself and me. But this woman had no one to watch her boys that morning, so there they sat in my office while their mother told me of her life. Here’s the essence of what I learned…
She is 26 years old. Her parents are both deceased. She is not in touch with any close relatives. She is unemployed. She has been suffering from severe mood swings since her late teenage years. That’s the nature of bipolar, severe mood swings. It used to be called manic-depression: suicidal at 9 a.m., cleaning the floor obsessively at 9:08 a.m., and on and on.
As her infant slept in an old child car seat and her toddler tugged at her torn clothes, she informed me that she had no insurance. The bureaucracy and glacial pace of Medicaid, she reported, kept her from receiving basic health care needs. Thus, at the time of intake, she was ineligible for almost all of the essential behavioral health care services we could provide, including individual and group therapy, case management, housing, etc.; not to mention her lack of coverage of all other health care services. I told her this as I watched her baby sleep and her toddler fuss in my tiny office in inner city Detroit. I did inform her that there is a General Fund from the State of Michigan that would cover her prescription medications for the mood disorder…her look…as if I handed her a million bucks.
We continued. She told me that when she was 3 years old, her mother allowed men to have sex with her in exchange for drugs. This lasted until she was 10, when protective services finally removed her from her mother’s life. She did not cry, quiver, divert her eyes or lower her voice when sharing. She simply reported it. Think about the last time you told something to someone without any emotion and in a matter of fact manner — like that. She stated she has never been to prison and does not use drugs or drink alcohol. Then she corrected herself: “I drank alcohol when I was 17 but didn’t like the taste, or the feeling I got from it. Plus my parents drank and did drugs. And I do not want to be like either of them.” She went on to say that she has a 9th grade education and has worked fast food and janitorial jobs. This, along with a whole host of other details, she described during the hour and a half that I was with her.
But the thing that I have left to the end of her story, and of which she did not tell me until I asked of her current living situation is this: she is homeless. She is homeless. She washes her children with water she gets from a hose at the house next to the abandoned one that she and the boys reside. Her days consist of walking to the store to buy food and formula and taking it back to their home that has no door, broken windows, no electricity, water or heat and, in turn, eating at a table that was left behind by the previous squatters. She rides buses with the kids to stay warm and as entertainment for her 4 year old. “He loves looking at all the big buildings in Detroit,” she said. She has been doing this for the last 4 months after getting evicted from her apartment for back rent. Later that day, I received a phone call from her telling me that the shelter I had contacted earlier, while she was in my office, had accepted her and her two boys for 3 months and that she was grateful. I have not seen or talked to her since.
Now, we are all aware of the current healthcare debate in this country. Liberals and conservatives, democrats and republicans and all the pundits regularly use this issue as red meat for their constituents. My friends on the left and my friends on the right continue to post pictures, quote past presidents they claim as their own, and pay, for the most part, disrespect to each other in a, largely, ill-informed manner on Facebook over who should receive health care, who should pay for it and what to write in order to be seen as the all-wise anchor of the thread.
But here’s what I really think: Not every individual in this country receives quality health care, still. Some of us have lost the quality of our health care that we enjoyed over the years. Others of us are now getting coverage we haven’t had in years or have never enjoyed. Some people continue to receive the same exact coverage they’ve always enjoyed. Some doctors have turned to “concierge type practices,” whereby they charge patients out of pocket fees each year, bypassing the whole system. If ya can afford it, it’s certainly worth looking into. Most of us will not be able to afford that type of Cadillac of care. Other doctors continue to stay in their current situation and work within the framework provided them. And every single one of us will need some type of medical care again before we die. I’m almost certain of that.
So my question is just this: If a person is in physical or mental pain, should they have access to health care beyond the emergency room? See, if you break your neck, have the flu, or have been hearing voices since you were a teen, you have a problem. There are people in this country of who can help you. When we see others as ourselves, there is no discussion. There is no need for Rush (Limbaugh) or Rachel (Maddow) to advocate for your side. Because it’s pain we’re talking about here. We all know about that. So, they get what they need…these people of whom I describe. They qualify for the neck brace and the surgery. They get to take the antibiotics for their infection. And the Zyprexa is ready for them on time so that their hallucinations can subside.
When health problems strike our own (those we love), we do not want to hear about money, insurance companies, Obamacare, the republican’s plan, etc. We just want them to get the care that is out there. If you are a seven figure earner, you can contract HIV. If you are on the streets with your kids, you can contract HIV. Depression and alcoholism are diagnosed daily unto those who are pro-choice and those who are pro-life. Cancer has no preference as to the color of your skin, how you define God, or who you believe to be attractive. If you inhale nicotine or are around it for long periods of time in your life, if you eat poorly, live in stressful conditions (including abandoned homes and board rooms), or have parents who have or had cancer, you are at risk of getting it.
We want to figure out this health care problem, for certain. At least that seems to be the current discussion in this country at the moment. But we are attempting to create, shift and edit policy regarding this without looking at the true source of the problem.
And that is this: Too many Americans do not believe that all persons in this nation are deserving of their concern and well-being when it comes to health care benefits.
Members of the NAACP and Tea Party activists are probably not going to lunch with one another anytime soon to discuss their aches and pains and the fact that they both have had, more than likely, similar physical and mental health problems. When a child needs surgery in this country, we do not question their belief system. We put them in a room with educated people who are trained to heal them. Why? Because who in their sane mind would deny an infant or child health care? None of us on this list, I’m fairly sure.
The question, as I see it, is not — Should we provide health care for all Americans? The question, I believe, is — Is it okay for some to suffer without health care based on our beliefs about them?
The little boys in my office have no idea about any of these things here. What they know is that their mom is not always “there” for them. When she is down, they do not get what they need. Running water, heat and even a hug are unavailable because her illness is not being treated. Yes, it is that direct.
When “the other side or way of life” is as important to us as “our side or way of life” when it comes to providing relief of physical and mental pain, we will end the discussion about WHO should get health care and begin to address the real HOW of it.
Until then, the generational welfare recipient and the greedy CEO will continue to hold us hostage to our own emotional short comings.