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Health Care at Last

March 22, 2010

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I watched the House pass the health care bill earlier tonight. The talking heads all claimed it had the votes to pass, but I still found myself a case of nerves as the numbers piled up oh-so-slowly. The feeling of relief when the count hit 216 was palpable.

A great night for Obama, for the Democrats, for America.

Is it a perfect piece of legislation? By no means. It’s deeply flawed. What we really need in this country is a single payer system, like Canada and Australia. Failing that, a viable public option. But the political realities being what they are, we could not get either of them. This small, hesitant, deeply flawed bill is nonetheless an important first step on the road that will, one hopes, eventually take this country to where the rest of the western democracies arrived several generations ago.

Pelosi and Obama both spoke about politics being personal. So true, especially where health care is concerned. Let me tell you a few of my own experiences.

I’ve been a full-time freelance writer since 1979, and I’ve been fortunate enough to do very well at it, thank you. As a result, I have health insurance. But even for me, it hasn’t been easy. I remember, when I first moved to Santa Fe and went full time as a writer, I was coming off three years teaching college, when my health insurance had been covered by my job. Now I had to find my own. I was young and healthy back then… even slim and fit, believe it or not… but I didn’t have a lot of money, and when I went looking for an individual policy, everything I found cost way more than I could afford and covered way less than my group insurance with the college had. To get affordable insurance, I had to join a group: the Santa Fe Chamber of Commerce. As a “small business,” I joined the CofC and signed up for their group coverage. It was not great insurance, by any means, but it gave me some protection for a few years. But that was in 1980 or so. In a more recent decade, when the Writer’s Guild policy that had covered me during my Hollywood years expired, I tried the same dodge… only to discover that while I could still join the Chamber of Commerce as a sole proprietorship, I could no longer get their health insurance. That was now available only to members who had two full-time employees. The insurance company had… you guessed it… changed the rules.

From 1997-1998 I served as vice-president of SFWA, the Science Fiction Writers of America, in the administration of Michael Capobianco, one of SFWA’s most outstanding leaders. A LOT of freelance writers had no health insurance, and Capo did what no other president before him had been able to do: find a decent, affordable group policy for SFWA members. It was through Aetna, and while it wasn’t as good as some other policies — the WGA policy was much better –it was good enough, and certainly both cheaper and better than anything any writer could find as an individual. I signed up, as did a couple hundred other SFWAns, and for a couple of years we had the peace of mind that having such insurance brings.

And then Aetna dropped us. No particular reason was ever given. Guess we weren’t profitable enough for them. They just cancelled the entire group. That wasn’t allowed in New York State, where state laws required them to continue insuring policy holders resident in that state. But those of us in the other forty-nine states were out of luck. Nor were SFWA’s officers (Capo and I were out of office by that time) able to find ANY other insurance company willing to step in and take Aetna’s place. We were a group with fourteen hundred members, a couple hundred of whom had showed themselves willing and able to purchase group insurance (the rest, presumably, had policies from day jobs or through spouses, or were unable to afford any insurance whatsover)… and yet no one would insure us.

Like I said, I am one of the lucky ones. I was able to go back to the WGA for a few years, and from them to COBRA, and thanks to our state laws in New Mexico, I could purchase insurance through the New Mexico Health Insurance Alliance coming off COBRA without fear of being refused for pre-existing conditions. So I’m covered.

But I have a lot of friends who are not nearly so fortunate.

Many of you reading this blog today are presumably science fiction and fantasy fans. It would probably shock you to know how many of your favorite writers have no health insurance whatsover. Most midlist writers struggle to get by even at the best of times; lean times can be lean indeed. For a self-employed individual, even one who can afford the premiums, insurance can be very hard to find and obscenely expensive when you do find it… and god help you if you have a pre-existing condition, because the insurance companies sure won’t.

This has all been brought home to me forcefully these past few years. A couple years back, one of my dearest friends, a great writer and a great guy, almost died of a heart attack. He had to have a quintuple bypass, and had a very difficult time recovering from it. No insurance. No money, either. Only the fact that he was a veteran saved him. He was able to get help from the VA. More recently, another old friend of mine got sick. Another fine writer, natch. No insurance, natch. No money, natch. Like the first friend, like a LOT of writers, he was just getting by. So when he started feeling sick he did not go to see a doc, no. Couldn’t afford it. Took over the counter stuff, rested at home, drank liquids, got sicker and sicker. Finally went to the hospital, where he almost died. Two surgeries and three weeks later, he’s finally been discharged. He’s not a veteran, so the VA won’t he coming to the rescue here. His surgeries, his ICU stay, those three weeks in the hospital, they will doubtless add up to about ten years of his annual earnings. Maybe more. He’s going to face bankruptcy. “Well, he should have had insurance,” I can hear some right wing asshole out there saying. Yeah, he shoulda. Except, even if he’d had the money to buy a policy, no insurance company would ever have issued one for him. He’s had a pre-existing condition since childhood.

It is worth pointing out that if either of my friends had lived in Canada, or Australia, or France, or England, or any country with that old vile “socialized medicine” the right wing likes to denounce, they would never have gotten so sick. They would have seen a doctor much earlier, early enough so that their medical problems could have been diagnosed, treated, and perhaps cured or ameliorated before they required major surgery. But no, they couldn’t afford doctors, and they didn’t feel THAT bad… not at first… so they did what millions of Americans have done, and ignored their symptoms until it was almost too late.

So, yes, I was thrilled by what I witnessed tonight. This is something this country desperately needs. Health care is a basic human right, something every other major western democracy recognized decades ago.

Now I just hope the Senate does not screw it up.

One last thing. I think the extreme polarization of contemporary politics is both unfortunate and frightening (read some history of the Third Republic if you want to learn where such extremism can lead). Obama’s efforts to reach across the aisle and make these reforms bi-partisan may have been fruitless, even misguided, but they were also heroic. And the utter rejection of those efforts by the GOP is both depressing and infuriating. I have been a Democrat more often than I have been a Republican in my life, sure, but the Republican Party that I grew up with, the party of Lincoln and Teddy Roosevelt (the first president to propose a national health program), of Clifford Case and Nelson Rockefeller, of Everett Dirksen and John Lindsay and Chuck Percy and Dwight D. Eisenhower… that party is now dead, it has become clear. The nasty campaign of fear and misinformation and outright lies that the right has waged against “Obamacare,” complete with odious comparisons to Hitler (!) certainly drove that point home… though perhaps one might cling to some hope that those people were just the lunatic fringe.

But no. The fact that NOT ONE SINGLE REPUBLICAN voted against the party line is damning (more than thirty Democrats crossed the other way, by comparison). Today’s GOP has abandoned all pretense of serving the people or attempting to redress the country’s problems. Today’s GOP belongs to the religious fundamentalists, the loonies and the haters, the lobbyists for the banks and corporations, and the very military industrial complex that Eisenhower warned against in his farewell speech. They proved that tonight.

Shame on them.

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