Not Rich, But Rich Enough
Readers that have been with me for awhile know that I’m a two-time cancer survivor. In 2003 I was diagnosed with ocular melanoma. More recently, my thyroid gland proved to be cancerous, possibly as a result of the radiation that treated the first cancer. I have lost the vision in one eye and my thyroid hormone now come out of a bottle, which provokes other problems, and I’ll be at risk for metastatic cancer for the rest of my life, but on the whole I have been very, very lucky.
I use the word luck because I have had access to insurance for the entire period of my illness, and the access to regular medical treatment that it provides has repeatedly saved my life. Both of my cancers were largely asymptomatic. In both cases, they were discovered by doctors before they could spread far beyond the original site of corruption, and that makes all the difference between life and death in cancer cases. In November, 2003, I discovered a tiny speck in my vision. I was very tempted to ignore it–it was only an annoyance, they happen for benign reasons–and if a visit to the doctor was an expense beyond a co-pay, perhaps I would have. But I could afford to have it investigated and so I did. The speck was blood coming off of the tumor, one easily seen by the doctor–but the key decision was that I asked him to look. Had I waited, had I needed to hoard some money before I went for what is called “preventative care,” I would have been a dead man, riddled with a cancer for which there is little in the way of treatment.
Since my original cancer, I have been forced to spend a great deal of time in various doctors’ offices being screened for that metastatic cancer risk. I am regularly scanned for lung and liver cancer–these are the organs where melanoma likes to hide. My bad eye is checked to make sure that the original tumor stays dead and my good eye is checked because it is at some risk of going the way the bad one went. My lymph nodes and thyroid levels must be checked. I see eye specialists, radiologists, oncologists, endocrinologists. It is all very expensive, but because I have insurance, my wife and I don’t have to bear the full brunt of it.
I have little doubt that the insurance company would drop me if they could. I’m a loser for them. But look at what the consequences would be. My thyroid cancer was discovered accidentally, showing up as the result of a test related to my original cancer. Without follow-up care, I would have missed it. Access is everything.
The tangle of our economic and health care problems are difficult and apparently beyond people smarter and more educated than I am, and even when someone suggests a program that makes sense to me, someone has a counterargument for why it won’t work, why we will sink into a morass of debt. All I know is that whatever we do, there has to be a more humane solution than the present system. Every day there are people like me dying, people who had diseases that, with timely intervention, didn’t have to kill them. You can frame the imperative to get those people care in any number of ways–moral, economic (chucking away adults in the prime of life is damaging to productivity) — I don’t really care what premise you use. All I know is that we are killing people through a kind of quiet negligence.
Every day that the health care debate goes on, I am painfully aware of my good fortune. I am by no means wealthy, but I am rich in the one thing that matters. In this country we argue a lot about the right to life, but we have yet to secure the right to live. That shouldn’t be something you have to be able to afford, but something we provide to each other as a society.
March 2nd, 2010 at 12:49 pm
Steve:
There is no way to read your post and not think, “Yeah, this system is WAY sub-optimal.” 30 (or 45) million uninsured is just lousy any way you slice it. The fact that most of these uninsured are young and healthy doesn’t change the fact that 1) some aren’t and 2) you can go from young and healthy to young and deathly ill in a blink.
So when you suggest universal health insurance as a moral imperative, I sympathize. My problem is that, just as nine years ago President Bush enshrined massive tax relief without asking for any sacrifice in return, today President Obama is suggesting the creation of a new entitlement with absolutely no sacrifice save from our kids and grandkids who are, again, being asked to foot the bill.
If the President really wanted to lead, he would couple a more modest (and thus affordable) expansion in health insurance with an increase in the retirement age, means testing, re-adjustic COLAs and other elements of an entitlement reform package that could actually make a dent in our overall budgetary outlook.
But to pass this bill absent major fiscal reforms and actual cost-cutting remedies for health spending instead of the President’s gimmickry is unjust, because it consigns our kids to the modern equivalent of debtor’s prison.
I feel you, Steve, truly I do. Lord knows a world with fewer Steve Goldmans is barely worth contemplating. Can we just do it right, though?
March 3rd, 2010 at 6:19 pm
No, Ian, we can’t.
We won’t adjust entitlement spending-voters are too stupid and selfish to do that.
And we can’t do modest health reform. Modest doesn’t work. You can’t limit preexisting conditions without universal coverage-no one would carry insurance until they get sick.