Bitter Pill

     I spent a classic Friday the 13th in the ER, where I had a few unexpected hours free to ponder healthcare reform. I'm fine; it was just one of those odd things that we elderly folk are prone to called "pill esophagitis", which triggered a cascade in the sympathetic nervous system, mimicking a heart attack.  It was first terrifying, then mostly embarrassing and painful, then time-sucking and boring. Because I wasn't able to breathe properly and my DH was being careful, I got the full treatment, bumpy ambulance ride and all.

      Once I figured out I was going to live, I got interested in seeing what a big city hospital ER looked like on Friday the 13th in the middle of a flu epidemic. It was really quiet and surprisingly empty in the waiting room, just a handful of people. My doctor was apparently fifteen and probably a movie star, so it was all worthwhile in the end. Who wouldn't want to be treated by a gorgeous child prodigy? Essentially for free. Paid for by you, the taxpayer.

     Thanks to my DH's military career, we have terrific Tricare health insurance. It can often be no-frills, it won't cover non-essentials, and there aren't many providers in most towns, but it's been more than adequate for us so far. And the drug benefits are unbeatable at an average of $9.00 per script.  When I turn sixty-five, Tricare For Life kicks in as my automatic secondary to Medicare. I could tell you some horror stories about treatment for military dependents in S. Korea, or about trying to get admitted to deliver a baby at a crowded military OB clinic on a full-moon night, but they'd be nothing compared to the stories I've heard from the under-insured or uninsured, so I can't complain. It's reliable insurance. It pays for treatment. I wish you had it, too.

     As a provider of mental health treatment, I've watched even the well-insured suffer from the standard policies of commercial insurance companies. Because they feared the pre-existing condition clause, patients would sometimes deny symptoms, drop out of treatment when diagnosis was discussed, or wait until they were in need of inpatient care before they showed up for outpatient care. I've seen patients dropped from insurance enrollment for having the temerity to be seriously mentally ill. And, too many times to count, I've watched patients try to manage without medications they desperately needed, because they couldn't afford them. For a person with a chronic, but common, problem like anxiety or depression, a job change can be a traumatizing risk or an impossible luxury due to insurance issues. Cobra can be a Hydra to these folks. Three or four such stories a day, on an average day in my office, would break your heart.

     I don't have answers; only opinions. If a "public option" could resemble my insurance and Congress could find a way to pay for it without turning us into a third world country, I'd be all over it. I wonder what it would cost for everyone to have the kind of insurance that military families and federal employees have? It couldn't be that hard to do the math, since we have decades of data on those populations to extrapolate from. I'm really hoping that somebody is doing their homework.

     About all I suffered yesterday was a sore throat and a few hours lost. I listened to the stories emerging from the other curtain-icles near me (there's no privacy in an emergency room), and worried  whether financial disaster was in the making for the storytellers. Or whether your dollars were paying for both their treatment and mine, one way or another.

     Later on, free at last, I scrolled around the news channels on my daughter's TV. It was hard to find anything that resembled news. I watched two very attractive female anchors flirt with each other while mutually bashing Sarah.  Wolf Blitzer was standing in for Larry King. Three guys were yelling at and interrupting each other over where to try the 9/11 terrorists; if the trials are any less decisive or any more slapstick than this display, we're all going to feel furiously cheated of justice. Worst of all, I saw Congressman Shadegg exploit an infant to make his point about healthcare reform.  Now, I feel sick.  I think I'll make a contribution to the closest National Public Television news broadcast I can find, because they may be the only people who still occasionally offer news in a form I can recognize.

     The healthcare issue is personal.  There's no one who isn't affected, no one who's neutral, no one who should be.  It's going to take a couple of decades, or more, to work the kinks out of whatever we decide on.  And, since neither the science of medicine, nor the context in which it's practiced, ever stands still, our great-great-grandchildren will still be tweaking the laws we pass.  In the end, it's all about the personal stories.  What's your healthcare story?  Scroll on down and post a while.