Tuesday, July 08, 2008

"The Office" (workstation series) 102 (roots of revolution edition)

Let's talk about health care for a minute. Today was my annual exam. Dharmonia and I have a primary-care physician we really like (anecdotal evidence of the fucked-up state of health care in this country: in a town that is the principal medical locus for 5 hours in any direction, we had to change doctors 4 times in 4 years, as they left their practices, relocated, or retired). One of the reasons we like the current doc is that she is simultaneously matter-of-fact and an ass-kicker: when you need to bring your blood pressure or cholesterol down, or your muscle mass up, she just tells you, and leaves it at that: radiates the presumption that you are an adult who is capable of making constructive health decisions--or of consciously deciding to make bad ones.

But here's the ball-buster: Dharmonia and I work for a university system in a medical town, and as tenured/tenure-track faculty we have access to both excellent health plans and a wide range of top-notch caregivers. But there are neighborhoods in this town--mostly to the east and north of "the good sections"--where people don't have the same access: either their employers don't offer health plans, or are ramping down their coverage, or the plans are becoming more and more ruinously expensive. And more and more people, even as the cost of health care skyrockets, are simply having to do without any health insurance.

I remember this. We were poor for a long time, and I remember occasions when we went to the free neighborhood clinic in North Cambridge (a Portuguese and Vietnamese ghetto, by then) because that was all we could afford. And I remember lots more occasions when I simply didn't go--when the cost of paying up-front for health care was so overwhelming that I'd live with the flu, or the sprains or infections, or with my hurting, because we couldn't afford mitigation. I went without dental care for about 12 years because of this, and the only reason I still have any teeth in my head at all is because of the luck of the genetic draw.

This morning, as a result of the university-paid health plan we're on, I had a full annual exam, bloodwork, other vitals, consultation with doctor, gentleman-of-a-certain-age gland checks, and script for the thyroid condition that I, like so many others, only developed after moving here and being constantly exposed to the herbicides in the air and groundwater.

The co-pay--that is, the amount that I have to pay personally in order to "match" the costs paid by the employee health plan--was $20.

Twenty dollars.

Less than 3 hours' work, even at minimum wage.

Less than Dharmonia and I pay for our weekly Sunday-brunch indulgence.

This is profoundly, profoundly unjust. I have enough education and a high-enough income that, statistically, I am far less prone to health issues than someone older, with less education, or a lower income. And yet I pay a fraction (a small fraction) of what such a person, without health insurance, would have to pay. Assuming that s/he decided to go to the clinic, rather than simply put up with the health risks or pain. $20 to me is a brunch, or a stack of used paperbacks, or a bottle of cheap rum. To a single parent trying to raise multiple kids on minimum wage, it's nearly half a day's pay.

What kind of country do we live in, that the poor have to suffer and get sick, while the rich pay chump change to stay healthy? I make enough money that I should (because I could) pay a hell of a lot more than $20 a visit. Why can't we live in a nation where everyone pays the same, income-adjusted rate?

The answer is that we could. But powerful corporate interests don't want us to. So, instead, Dharmonia and I take large chunks of that money we don't pay for health care and donate it to initiatives on behalf of kids and animals.

The roots of revolution lie in suffering. If the system is screwing you, why wouldn't you want to overthrow it?


T said...

The world we live in preaches tolerance to the point that poor people are afraid to speak their minds, to stand up for the rights granted to them by the Constitution of the United States (which is being "reinvented" by the rich and powerful every day). The poor are afraid to oppose. In a world that preaches tolerance, there's no room for revolution. Quite frankly, the poor are too busy working their asses off, and too damn tired as a result, to fight a losing battle.

I enjoy reading your blog. I don't agree with everything you say, but you make many interesting points.

CJS said...

Thanks for the comment. I would go further, though, and posit that part of the reason that tolerance is preached to the poor (as are materialism, chauvinism, and nationalism) are because all of these "isms" are ways of keeping poor people satiated and distracted from the actual exploitation they are being subjected to. In our culture, I'd put forth that it's not so much *religion* which is the "opiate of the masses", but rather materialism, chauvinism (e.g., fear of the outside world) and so on.

Thanks again.

Thunderboot said...

I don't know anyone that $20 would be nearly half a days pay, that's just insane. I have to question that. I would go to the nearest woods and live off the land before I would except that type of job.
I'm not sure though letting the government take of things like this will help though, we'll wind up all paying more than we are, in more ways than just money. :)

CJS said...

Thunderboot: thanks for your comments. Here are a few responses:

You say "I don't know anyone that $20 would be nearly half a days pay, that's just insane."

US minimum wage is $5.85 hour (http://en.wikipedia.org/wiki/List_of_minimum_wages_by_country#cite_note-38)
It's less in certain jobs, such as wait-staff and for under-21's and seniors. It's not insane, it's the reality for a lot of people.

You say "I would go to the nearest woods and live off the land before I would except that type of job." Lots of people don't have a choice, either to "go to the nearest woods" or whether to "accept" a given job. Urban unemployment rates are steadily rising, especially among the poor. Which "woods" would you suggest a single parent with a couple of kids in school should move to?

You say: "I'm not sure though letting the government take of things like this will help though, we'll wind up all paying more than we are"

The vast majority of tax dollars go toward the defense budget and to agribusiness. The Iraq war is expected to cost somewhere between 1 and 3 *trillion* dollars; one *thousandth* of that cost could fund universal health care in this country.

Wouldn't you think that the cost of becoming a nation who tortures and starts wars to protect its addiction to oil is *already* too high a cost to pay?


CJS said...

Sorry: I should add, for the sake of clarification, that I completely *agree* that 5.85/hour is insane, and that we need to make fundamental changes in our priorities if we're going to avoid becoming a nation where 90% of the population toils to support the lifestyles of 10%

Thanks again for your comments.