Morality, Luck and the Price of Peace of Mind

Tuesday, March 16, 2010
Inspired last night by a conversation with the Smart Man and a thought provoking post this morning by Seth over at Fighting Commies for Health Insurance, today I'm examining my own attitude about health care in this country.

When I was growing up, we always had access to health care, including optometrists and dentists. My parents were negatively affected by Colorado's energy bust in the early '80's, but they had planned well enough and had enough financial savvy to ensure we were always covered. I'm sure it was challenging for them, but I never had to think about it. Typical entitled middle-class white kid, and I was fortunate that my parents were in a position to ensure I never had to worry.

Right after high school I joined the military, which really is the epitome of socialized medicine. If I had a problem, I went to medical for "sick call," and I was treated. As a teenager, the Navy kept after me to ensure I went to the dentist, to the GYN, to my annual check-ups.

When I got pregnant with the Smart Twins, the Navy took amazing care of all three of us. I had to have an emergency C-Section at Balboa Naval Hospital, and then I was in the hospital for a week thereafter. The Smart Twins had to stay in Neonatal Intensive Care for 5 weeks after their birth, and had we been privy to the cost of that care, there's no doubt it would have come in at $500,000.00 or more. Our cost was essentially the cost of their "food" while they were hospitalized on a per day rate. I believe it was about $750.00. For a 35 day hospital stay in an intensive care unit for two people. Again, I didn't have to worry about it, due to socialized medicine.

After I left the Navy, I continued to enjoy full health care benefits either by being married to an active duty member or because I had a civilian job that offered fabulous benefits.* I chose Kaiser Permanente as the health care provider for me and the Smart Twins (and later for the Smart Man), which includes the following co-pays:
  • Primary Care: $20.00
  • Specialty Care: $30.00
  • Preventive: $10.00
  • After Hours: $25.00
  • Emergency: $75.00
  • Hospital: $250.00/Admit
  • Rx: $10/$20
In addition to these fees, my out of pocket cost for our family's health care (four adults) is $231.00 a month. I pay additional fees for dental and vision care, but the entire thing costs us less than $300.00 a month. FOR FOUR ADULTS.

Yes, I'm a lucky, lucky human being, and by association, my kids are, too. None of us have ever had to worry about health coverage, or blowing our entire financial future because someone broke a bone, or got sick, or needed surgery. I fully realize how very lucky we are. We have peace of mind, and it costs us less than $300.00 a month in predictable expenses, and completely manageable one-time costs for visits and treatments.

And here's what I don't get. I've never had to stay in a crappy job because the health coverage kept me in handcuffs I had to accept for the good of my family. I've never had to compromise my dreams to ensure my wife and baby had the care they needed. I've never had to choose between feeding my kids and getting them the vaccinations they need. In my mind, the fact that I've never had to make those decisions makes me STUNNINGLY UNQUALIFIED to tell people who MUST make those decisions what the best choice is for fixing our health care system. The fact that I've never had to sacrifice for my family's health care doesn't make me morally superior, or in a position to tell those who struggle to "work harder" or "pull themselves up by the boot straps" or some other gag-inducing rhetoric. The answer is, I'm simply lucky. My access to health care isn't a reflection on my quality as a human being - it's a reflection of my status as a member of the Armed Forces (go, socialized medicine), or my status as someone's wife, or my status as a member of an industry that traditionally has offered great health care benefits.

Health care reform is a question of MORALITY. It's morally reprehensible to deny people the ability to be healthy and get the care they need simply because they don't have a decent education, or their parents can't find a job that offers decent benefits, or because they're members of the 10% of folks who are currently unemployed in this country.

As health care reform continues to struggle in our legislative branch and people scream and shout about reconciliation and other red herrings, I'd like to point out (again) that this issue is one of morality. Can't we please address it from that point of view?


*Make no mistake - one of the reasons my company is a good place to work is because they offer FABULOUS BENEFITS.

10 comments:

vince said...

I don't think those screaming most about health care and teh evil gummint understand morals about as well ss Glen Beck does.

This whole debate reminds me of a scene in the Mel Brook's film "History of the World: Part 1" where the Roman Senate is in session:

Leader of Senate: All fellow members of the Roman senate hear me. Shall we continue to build palace after palace for the rich? Or shall we aspire to a more noble purpose and build decent housing for the poor? How does the senate vote?
Entire Senate: FUCK THE POOR!

Eric said...

For many, maybe most critics of health care reform, it is a moral issue. They come from a moral system in which people are rewarded or punished in this world for their virtue or lack thereof. To these people, implicitly (some wouldn't say it aloud) or explicitly (some are honest about their feelings), the fact that somebody is unemployed is a sign of laziness, many of those who are ill are sick as a consequence of their own behavior (be it promiscuous sex or a failure to stop smoking or to eat well or exercise enough), poverty is the result of poor choices or perhaps simply not being right with God.

There are two virulent schema at play. One is a libertarian work ethic that says that a person is what he makes of himself--any man who is willing to make the most of himself shall be rewarded. The other is the descendant of the Puritanical ethic--if you are a godly person (and hard work and self-discipline are marks of godliness), the Divine Hand of Providence will give you what is yours by right (and if you are ungodly--immersed in any one of the Seven Deadly Sins, for a start--God will surely punish you as surely here as He will in the hereafter). (The toxic intersection of these two threads, the fiscally conservative with the socially conservative, is the burgeoning "prosperity gospel" movement; God will, as the song asks, buy you that Mercedes-Benz, and if He doesn't it's your own damn fault for disappointing Him.)

I find these moralities reprehensible and vile. First, they obviously don't consider the role of blind, stupid chance. The guy who just got run over by an airplane didn't deserve it, neither did his two kids who lost their dad. That's not so much a healthcare example as it is just one more illustration of the sheer whatthefuckery the universe throws at us by chance or design (choose at your pleasure). Hard work isn't always rewarded or vice punished, sometimes it's just a cosmic die roll somewhere.

But maybe the worst thing about these moralities is that, while ostensibly about a sort of free-will and self-empowerment, what they're really about is entitlement. The subscribers of these particular conservative moral "modes" aren't really working from "work hard-->reward," they're working backwards from "reward" to say that they're not lucky, they're better than other people and must deserve what they have. People who work it the other way, who start with "work hard" and see where it gets them (instead of trying to justify what they already have, whether it's earned or not) generally wind up with the experience to understand that sometimes hard work pans out and sometimes life just sucks, and them's the breaks. (That's not to say that hard work will make you a liberal--but it will make you a realist, whatever ideology you wind up with.)

I guess the point of all of this is that the healthcare debate is already a moral debate, implicitly if not explicitly. If some opponents prefer to keep the debate implicit, well--it's probably too much to expect anyone to honestly say "We all get what we deserve and I deserve what I have" instead of speaking in code about what it will cost them.

My two cents, anyway.

kimby said...

While I live in a country that does have health care, I also grew up not having any form of benefits. My parent's employers never offered any kind of benefits, so we had what was covered by OHIP. While I am thankful that we had what we had (and I am sure that my parents are as well, since both kid brother and I were accident prone and had more than our fair share of broken bones and ER visits) all dental, scripts and eye care were out of pocket.
As an parent, I know now how much my parent must have worried. I am one of those people who have taken a job to make sure that we are not on the street. I am lucky that now I have benefits..and not one that makes you pay first and wait for reinbursement. Up until now, the only thing that we MADE SURE happened was eye care, since all of us wear glasses, and even then, the only ones who were up to date are the children.
We are lucky, as now employment, however sucky will allow me to get things like medicine, if needed. It also means no more food banks, or going without.
If the gov't wants to change health care, it needs to listen to those who need it the most. They are the ones who KNOW what it is like. Not some rich senate member who at the end of the day goes home to have his cook whip up his dinner, and his personal secretary pick up his prescriptions at the pharmacy.
Yes there needs to be reform. One of the things that needs to be reformed is who is doing the reformation.

(sorry Janiece, I am feeling a little ranty today)

Vagabond said...

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
-John F. Kennedy

To my mind the greatest moral issue facing us with the debate on health care reform or any other political debate in the present day, is the surrender of independent thought. We have become a nation of "sheople," herded this way and that by pundits whose words are more crooked that the shepherds staff.
Instead of charting our own course, we blindly react to external stimuli that seldom exist in the threatened form. We, as a society, have devolved into a scary and very partisan "groupthink" that's little better than a rioting mob where reason is concerned. There is something eerily Orwellian about the willingness of the American public to be blindly swayed by opinion solely based on the end of the political spectrum from which it originates.
Ask 10 acquaintances to explain the reasons why they are for or against health care reform and try to get an informed answer. My guess is that your experience will be much like mine and you will receive party line slogans and platitudes from the great majority of those you query. See if anyone can tell you what the ACTUAL effect would be on their family in terms of increased or decreased care and cost.
How does one fight against voluntary and blissful ignorance? The fact that frightens me most is that the majority of Americans have no desire to explore and debate issues or form an independent opinion. They simply want to follow the rest of the herd.

Anne C. said...

Vagabond, I find it ironic that you post a statement against blind partisanship and "sheople" on the blog of a woman who I consider the very antithesis of unthinking partisanship. In fact, were I to take up your challenge and ask my friends about their opinions on health care, most of them would answer similarly to Janiece, with many anecdotes of their own experiences (like the time that I had to get a root canal at the end of a three year uncovered-by-dental-insurance period of my own life) and few references to party sound-bites. In fact, her whole appeal is for people to really Think about the issue and not just dwell on one aspect of it.

So welcome, but you're preaching to the choir. We adore independent thought here!

Janiece said...

Rant away, Hot Chicks and Smart Men. That's why we're here.

Anne, I think you were working crazy hours from hell when I introduced Vagabond, also known as Matt. He's an old friend of mine from the Navy, and knows me very well, indeed. I think he was giving the finger to those who don't value independent thought. As we all know, they're out there. *cough*tea party*cough*

Anne C. said...

Ah. Sarcasm. Sorry! It's hard to spot without context.

Juan Federico said...

You're mixing Morality in with Power, Politics and, Cash????

That's a bad drink there barkeep.

Janiece said...

John, I never claimed to be an accomplished drink mixer. Which is why I stick to malt beverages...

Vagabond said...

Hi to Anne and other readers! Vagabond here once again! Rest assured, Anne that I was leaping to agree with Hot Chicks premise, and trying to add some food for thought by commenting on the abysmal state of political discourse and issues specific knowledge in this country. By the way, I didn't suggest asking ten FRIENDS to explain their position vis a vis health care reform. I suggested asking ten acquaintances, people with whom you are not intimate friends. I'll readily grant that those of us in Hot Chick's orbit tend to be a cut above average and are, therefore, a bit more educated on issues (as the high quality of posts on HCDSM indicates). I also concede that like minds tend to group together, and so your friends are likely to be as educated as you. I also still believe that a sample taken from those outside your inner circle will generate some rather alarming results.