A Final Defiance Against GOP’s Affordable Care Act Repeal Strategy: Suicide

I hate writing this. I hate thinking this. I hate that I am even having these conversations. But, I also know that I am not the only one.

We’re going to lose the ACA as we know it. We’re going back to profitable death insurance. Whatever comes next will undoubtedly result in less early detection, less preventative care, less (or no) coverage, unattainable pricing, and yes, death.

There’s no grand replacement that’s being discussed seriously. The GOP had six years of voting to repeal the ACA to come up with an alternative, there is none. (Well, there is, it’s called Medicare for all, but that ain’t gonna happen.)

Whether it ends up being completely demolished, or just broken for most, or unattainable, the ACA is going to be changed.

Congressional leadership has vowed this.

The President-elect has cheered it:

Inspired by Xeni’s heartbreaking, but important, tweetstorm about her cancer story (read every word of it), I feel I must share this with you.

Prior to the ACA, you could find countless stories of individuals losing their house, selling everything they had just to stay alive. And many did not make it. Many went broke dying. As if that is not tragic enough, understand that their families also suffered the same fate while trying to save a family member. Homes sold or mortgaged to default, savings and retirements depleted, keepsakes pawned, lost years of children missing education, jobs lost forever.

A silent destruction of generational progress.

Get it straight, these tragedies did not happen because they were sick, they happened because they couldn’t pay the price to get well. But Americans are a resilient sort; and even if the odds are long, we will do anything to win a battle.

Some made it. Some died. But in either case, the financial ruin would be the same.

My uncle made it, for a while. He lost homes, sold his business, depleted what savings were left after the Great Recession, and struggled to survive. In an attempt to save some semblance of life, he moved to Texas where the oxygen and humidity allowed him to function without an oxygen tank. The other reason? He was able to go over the border to Mexico and get affordable meds.

Then came the ACA. He would no longer have to live in the healthcare shadows for fear of preexisting conditions, he could get on Medicaid, his meds would be expensive, but doable. In short, he would be able to live out his life, see his grandchildren born and grow up. But Texas valued “freedom” over Medicaid expansion, so he had to travel to Colorado - back and forth — for doctor’s care.

Some of this was illegal, I am sure. But here he was, a man who lived a healthy life, in his late 50s, doing all he could, eviscerating all that he had built in his lifetime just to survive. I’d pick him up from the airport to drive him to his doctor, he walked with a stroller that held his oxygen. He barely had use of his left leg from a stroke in his spine caused by a surgery gone wrong. He had constant dry mouth from the opioids, his eyesight had worsened. He looked sicker each time. But he smiled through it, so happy to see me. The trip, the altitude, airports, it all took it out of him.

Not to mention the rash of shit he received at each TSA stop for his very powerful medical narcotics. I saw his literal pain as they would constantly pull him aside and rifle through his med bag, disassemble his stroller to check for some phantom bomb, all while he struggled to stand. I saw his embarrassment as they inspected the pain pump surgically implanted under his skin into his spine. He’d wince with pain, and then crack a joke thanking them for keeping the country safe. And he meant it. He was a patriot, a businessman, a guitarist. A good fucking guy.

I say “was” because he died about two years ago. The meds attacked his liver, his pancreas, and his mind. He did see his grandchildren’s birth, but he would not see them grow up. I treasure the time of my life spent taking care of his.

He had a shot to live a much longer life. Maybe had Texas simply allowed the federal expansion of Medicaid, or if the ACA been passed sooner, maybe, just maybe, he could have enjoyed some health and longer life. But honestly, the cost of keeping him alive was a great drain on his immediate family. As I said, businesses, houses, savings, land, were all drained to secure a hope of some semblance of life.

Now, I’ve had the unfortunate honor of having dealt with much sickness and death in my family. Almost all of them are gone. My father died far too early. All my grandparents, cousins, great aunts and uncles. In almost all of those circumstances, there is a tragic healthcare cost story that goes with it. I know that I am not the exception. It is the reason why health care and insurance has been such a hot issue for as long as I can remember — Ted Kennedy, Hillary Clinton, Obama. Obviously, the argument has always been around health and better outcomes, but the ACA also sought to attempt solving the financial ruin problem that has long, silently plagued this country.

Which brings me to what I want to share with you. I’m having many conversations with people who have what would be considered terminal illnesses if they did not have affordable care. There are also some who have not been able to participate in full health care coverage yet who are sick. I’m sure you know some too. People who would have to pay $8,000 — $10,000 per chemo shot, coupled with other thousand-dollar-per-month prescriptions, in addition to co-pays, scans, surgery, countless visits, paperwork, blood tests, etc.

If the ACA is repealed, not only is death certain, but so is financial ruin for who is left behind.

We don’t have much more to lose. There are no more houses to lose, no more savings to drain.

It is because of this that there are serious discussions surrounding Death by Dignity.

Hold up, “Death with Dignity? Isn’t that suicide?” Yes.

Technically no, but yes, it is choosing when and how you die.

Now, I know your (and most people’s) first impression might be, “Suicide is never the answer.” I get that, I agree. I am not a suicidal person, neither are any of the people I am talking about, or with. They have families, they have homes, some even have businesses and a bright future. But many have seen what unregulated, profit-driven healthcare does. It kills. It maims. It steals.

Now, I know, you’re also going to want to be that American who believes they can fight and win any battle. But at what cost? And what does “winning” look like? That’s the question being discussed right now. Even if you are able to cobble together enough cash to live, it’s going to be to the detriment of your family. Granted, this is a sacrifice any family will gladly make. It’s how we are built. But, you are most likely too sick to earn more ever again, and therefore, the future built for kids or family in general, will be ripped from this earth…just before you are, or soon after.

Is that future worth it? Should congresspersons be enriched by health insurance company campaign donations, so that you can merely survive? Should the chairman of a leading health insurance company make more bonuses for “cost control and profit” in addition to his $10,000,000 a year salary, because you sold your house and raided the kids’ college fund just to stay alive and sick?

For some, the answer is yes. I get it. If you’ve never gone through it, you probably think it would be worth anything just to survive. And for you, it may be.

But for many others, the answer is no. For most, the answer is, there’s no way in hell they could even attempt to pay that much for life saving care. Sell everything, charge all the cards, pawn it all, and they’d maybe get one month of care. So, they will live as long as they can with no care, often in pain.

So, your options are 1. Die from disease or illness because you can’t afford care, 2. Go kind of personally broke trying to not die, but dying earlier than you might anyway, 3. Go broke and bankrupt your entire family, ruining a generation after you of any chance at success and you live to see the struggle.

But there is another option. As macabre and antithetical as it may seem to you or your belief system, there is another way.

Assisted suicide. Death by Dignity.

I live in Colorado where we just passed a Death with Dignity law. We join Oregon, Washington, Vermont, California, and Montana in having these laws. Now, I am not going to get too deep into all the particulars, such as, how many doctors must agree, or state citizen requirements, etc. But, I can tell you it costs about $400–600.

You can research it for yourself here: Death with Dignity

This last week, I have had at least three separate conversations about end of life planning in advance of the ACA being repealed. Obviously, there are only 5 states where this sort of thing is legal, but there are many in other states who are considering whatever options they have open to them, legal or not. Understand there are huge implications affecting life insurance, estate planning, and even custody, where suicide is involved. So, it takes planning, forethought. It takes having these heart-wrenching discussions with family and friends, BEFORE it’s too late.

Again, this is not the preferred option. In a perfect world, ACA would be improved and expanded. In a perfect world, medication or life-saving care would be as important to the safety of this country as say, a $13 billion dollar aircraft carrier meant for war and killing enemies. But that’s not reality.

None of these people are wishing to die or hoping to die to escape the pain they live with. They wish the ACA would be strengthened. They hoped that the people of America, having seen the net good it has done firsthand would not install a leader who would demolish it.

They all watched in confounded horror, some while literally in the hospital, while people HATED Obamacare, but loved a lot about the ACA.

They all watched as this most unusual election delivered results that all but surely doomed them to a march to slow death.

The ACA wasn’t perfect, it wasn’t even fully implemented. It was fought by states and politicos and news orgs, and was still very young in its purpose. Certainly some people have paid more, some people have lost their doctors (mostly because their doctors aren’t participating in exchanges), and yes, some have paid more in taxes.All valid concerns to tune a law that affects one financially.

But let’s get something straight. No one is fucking tragically dying BECAUSE more people have health insurance and care.

The people I’ve been talking to are Republicans and Democrats, it’s not about party. In fact, some strong advocates of the 2nd amendment feel more at ease knowing they have a solution because of that right. Basically, it’s “defending yourself,” they’ve said.

Let me share some of the quotes:

“I already lost a house and all of my savings for my husband’s illness, I’ll be damned if I will be the reason my kids and grandchildren have no future.”

“Let’s see, pay those fucking health insurance executive vampires and pharma capitalists $10,000 a month until I die eating tuna, or spend my last $3,000 on a final vacation? Pretty easy choice”

“I don’t want to die. But I do not have enough strength to fight cancer while fighting the bank over my house, and the insurance companies over billing, and the pharmacy over drugs. I’d rather just give my kids my house, so they at least have a shot.”

“As a musician, I got healthcare for the first time in my life in my 40s under Obamacare. Found out how sick I was, and I was able to slowly get better, but it left very little for my kid’s future. But if it’s taken away, there’s no way I make it. None. I’ll just record my last record and hope I get a hit so there’s some royalties for my kids.”

“Just had a grandchild. I’d do anything for that kid. My parents taught me that we must do everything for our kids to do better than we did. I’ve tried with my kids, but the economy is rough for them. So, if I’m not able to help my grandchild, she has no chance. I’ve had my time. If I lose my health coverage, I have to think of her first.”

“Look, if enough of us that get chemo treatments decide to just ride it out and not pay for it, then maybe they will go broke too. Maybe if the people start deciding not to pay for it, they’ll go out of business and won’t be able to hurt people like us in the future.”

So, it has come to this. Conversations about end of life planning because some of the country, perhaps as low as 25% of it, ‘don’t want no obummercare.’

I’m not here to persuade you to kill yourself if it comes to it. I’m also not here to judge, if that’s the decision you make. I AM here to be honest with you about what’s going on in conversations off that news channel you watch with anchors who have employer-based healthcare (not just health insurance), this is what’s being discussed right now that you won’t read in your favorite political blog.

These conversations have illuminated something very tragic. For every family bankrupted by health insurance and health care costs, there’s a health insurance company thriving and worried about increased profits for the next quarter. For every family’s future that has been spent on drugs that numb pain or slow the advancement of killer cells, there’s a drug company thriving and hoping to get approval for that next one. There is a direct relation to how much money one spends on saving their life to how much money someone makes by charging for it.

Killing yourself might just be the last act of defiance against a GOP that would trade tax breaks, votes, and profit, for the health and well-being of America’s citizens and future.