Fight of Your Life
Patient centered health care.
Freedom of choice.
Freedom from government intrusion.
These are great soundbites.
These soundbites have benefitted Republicans over the last seven years, but the reality is much different. Our health care cannot be explained, described, or fixed in soundbites. A choice between safeguarding health or not, hardly seems like a choice at all. There are those in Washington D.C. who want you to believe that it is not only a choice but central to your freedom as an American citizen.
The choice to forgo or obtain minimal health care coverage is no luxury. It’s no realization of the great American dream. The response to this is often that the government should not be involved in health care or force you to buy it. I guess we are supposed to believe that it is personally empowering to deal directly with insurance companies. That haggling over every bill, arguing for every ounce of coverage is the realization of life, liberty, and the pursuit of happiness.
The idea that my freedom as a person is tied to my ability to interface with insurance companies falls more than a little flat to me. My parents did this for most of their lives and I can tell you, it’s no kind of freedom.
One of the lasting memories I have of my dad is him spending every Sunday on the phone with our insurance company. He worked for Illinois Bell, which was bought out by SBC, and then finally by AT&T. He was employed there for thirty years, he had a pension, insurance — a rare story of long-term employment that you don’t hear much about anymore. During that time our insurance coverage switched providers and plans on multiple occasions. There was a good chunk of time in the mid-90s where we went from an Health Maintenance Organization (HMO) to a Preferred Provider Organization (PPO) and then back to an HMO. The PPO days of the Ayres house were heady days indeed.
My father was a rare specimen of human who relished in haggling over the cost of things, health care procedures being one of them. That’s what I figured as a child anyway. I didn’t think that the constant fight over cost was informed by my families battle to maintain at least the appearance of financial solvency.
We were a fairly large family, seven of us in total. Alana and I were born prematurely. Both of us were given life-saving medications which, while crucial at the time, had other unintended health consequences. Born with developmental delays, my brother and twin sister saw a specialist in the field of neurology regularly. Specialist care was not one of the areas of coverage our insurance provider enthusiastically covered. Much of this care came out of pocket. Still, some would argue you could anticipate those expenses. Once you knew that specialist care would be an ongoing cost, you budget for it. Simple as that.
There were always those expenses we couldn’t anticipate as a family. I know there are those who may read this story and think, ‘Ah well, if they would have just worked harder, considered their costs more carefully…’
But my parents did. My mom went back to work as soon as she conceivably could after my twin and I were born. My dad took every extra hour his job would give him. On the weekends, my dad and I would go through the Sunday adverts and clip coupons. It was fun for me. I loved sitting there with them, the table covered in a mess of coupons. I know now that for my parents it was necessary, a desire to save as much money as possible. When we went shopping we took advantage of every sale. We didn’t order food or eat out without a coupon. My older brother and sister both worked as teenagers, often the maximum amount of hours the law would allow, and sometimes even more. In short. We tried.
Illness and injury sprang up in our home the way they do for so anyone during the course of living a life. It was always a kind of Whac-A-Mole when it came to medical and home expenses. One crisis would end while another bubbled to the surface.
A crisis could be anything from an extra filling, to an unexpected x-ray or new prescription. Perhaps a plumber had to be called or a new mirror had to be put on the car. These costs put us in the red each month. Of course these were our small ‘c’ crisis. We also had the big ones. The costs you simply can’t imagine, can’t plan for no matter how enterprising you are.
One morning my mom woke-up sick. Extremely sick. She was throwing up, she couldn’t see. Her head hurt. We had to call 9–1–1. But before doing so, my dad’s first thought was ‘will this be covered by our insurance?’ He knew that ambulance rides cost a lot of money. My older sister yelled at him, told him to just dial 9–1–1, so he did. My mom had a brain aneurysm. Against the odds, she survived.
A few years later my dad had his first heart attack. A few years later he had another one, this one required a quadruple bypass. He had the large vein in his leg placed in his heart. More recovery, more time off work, more bills. Still, you go on, you find a way to live, even if it means living outside of your means. Perhaps my family could have sold our home and moved into a smaller one. I’m sure we could have forgone a family vacation or two and lived in a way that would have been tenable to fiscally conservative Republicans. In a country that values work, work among anything else, you cling to the rare moments where you allow yourself to enjoy your life.
It’s in those hours where you don’t feel the oppressive weight of finances bearing down on you, informing every choice, every move. And most of the time, it doesn’t even matter if it’s financed on credit or simply a delusion you allow yourself to believe. Because it is in these rare moments you feel free — happy.
You allow yourself the breathing room to enjoy your child’s laughter. You watch them eat french toast or swim in a pool, even if it means opening up yet another credit card. These fleeting moments make the 60–100 hour work-weeks survivable. Despite what your life has been, you cling to the belief that it will be better for your children. Maybe if you show them joy when and while you can and provide them with as much as you are able to, maybe they will have it easier than you.
That I was able to find and experience joy in the space between my parents illness, between the battles for care and coverage is thanks to them. My parents carved out happiness not because of insurance, but perhaps in spite of it. That we had health insurance at all was pure luck. Luck that my father worked where he did, when he did. That we could finance our bills on a credit card or take equity out of our home (twice) to pay bills meant that we were already better off than most Americans.
And yet somehow I’m supposed to believe that this scenario is better. That the endless hours my parents spent dealing with insurance companies is a closer realization of the American dream than anything else offered.
There are few guarantees we have in life but our health care system has always come with at least one — you will fight it. You will be engaged in an unyielding battle. Our system of care has never been set up to serve individuals, it has always advantaged the insurance providers.
Obtaining health care, maintaining care is isolating work. We spend hours alone reading documents, bills, and codes we can’t or lack the tools to fully understand. We search for answers online or call our providers asking for clarification on matters that never quite seem to be any clearer by the end of the call.
Then there are the quiet hours alone where we wonder if we are really sick? How bad is the cough? Is it worth going to the doctor this time or can it wait? How long can it be put off? We don’t want to be that person, the one always going to the doctor. The one our representatives warn against on primetime TV. The ones who take advantage and cost tax payers money. Could you convince someone you were sick enough?
For some of us, the embarrassment and shame of having to prove you are poor in order to receive 20% off your doctor’s visit is too much anyway. The question can wait, can’t it? It’s probably just a stomach flu, take some medicine, use your inhaler. The doctor’s office never seems to have time for you anyway. They always seem to be annoyed when you call. And who were you supposed to contact for insurance again? Which part of the company, there were two divisions… Nah, not worth the hassle. Not to tonight anyway. Tonight you are tired.
And as you walk up your stairs a thought flashes through your head, one you rarely allow yourself because you hate self-pity. But there it is all the same, was it always meant to be so hard?
You sent your kids to college, you buried your husband, your parents, and somehow, you were still able to set aside some money for retirement. But this. The American dream? It’s impossible. At least for today. At least right now. So tonight, maybe you’ll just go to bed. You can think about it tomorrow. Tomorrow you’ll feel better. Tomorrow you’ll be ready to fight again.
But this time, you never wake up.
