Health care is an ethical issue, not a political one, not a spending one, not a fairness one, not a “who has earned it?” issue.

ETHICS, MORALS, RESPONSIBILITY, JUSTICE. That’s what we’re talking about.

This one has been brewing for a while. I’ve been trying to come up with a fair assessment of health care. With some new found friends from Canada (how have I never known that not all Canadians say “aboot?”) and experiencing health care in a “2nd world” country, I think I have a better handle on things than I did having only lived in the United States. Watching any news outside of the US is interesting. After having just been to Greece over the winter break, I felt connected to the workers riots in the streets, but then found that my parents and grandparents who accompanied us, had heard nothing of the riots on the US news. The same thing happened in Bangkok, I reassured my parents we would be okay with the Red Shirt rallies, they hadn’t heard anything about them until it turned deadly after we got back. The news about US healthcare is laughed at a bit overseas. The US seems out-of-date, low on grace, and full of squabblers. Here’s my opinion, for what it is worth.

I’ll equate health care to a couple of different issues; education and nutrition. These are both issues that one could  view as “rights” and as “earned privileges.” It is only those making an income well above the poverty line that are shopping at “Whole Foods,” paying for preschools, and sending their kids off to enriching camps or workshops. But I think most people would agree that it would be Unethical, Unjust, and Irresponsible to deny people of these three basic necessities. I struggled with this a bit when I first moved to Oregon. I was teaching a lot of illegal immigrants. If there was an ICE rumor in the community, a bunch of students wouldn’t show up at school. I remember thinking, out loud, that I shouldn’t be paying taxes for these kids to go to school. They weren’t citizens, their parents were breaking the law. But a wise middle school band director (Jaimie Hall, I think of you often) set me straight. With some very straightforward language, and probably a few choice words, without even knowing it he convinced me that it really was in EVERYONE’s best interest that these students came to us. They had a brighter future, they spoke and wrote the language, they would be employable and contributing citizens eventually. Truly every dollar spent to educate illegal students was a dollar well spent, it would pay off in dividends, and would eventually make society better. I’m sure many fall through the cracks, but these students would not be desperate, homeless, criminals with the education we were giving them. We also fed them breakfast and lunch. Because of the large number of students living below the poverty line, every student in my first school received government subsidized lunch tickets. It was such a small amount of money, even with 100 or more students eating two meals a day, for what it meant to those kids. For many of them, eating fruit, veggies, and meat at school would be the difference between growing up underfed, obese, relying on fast food and a healthy childhood. I’m sure this saves oodles of money in energy consumption and health care (uh oh, we’re circling back). Before we totally circle back, I’m convinced that education and nutrition, while both could be considered something to always strive for better, really are RIGHTS in a 1st world country. If we are allowing anyone in the borders of the US to go without proper nutrition or grow up illiterate, we are shooting ourselves in the foot. “Let’s shut down those soup kitchens, they haven’t earned a meal.”  “Those 4 year olds don’t speak English, we shouldn’t waste our time teaching them to read.” It just sounds crazy. I believe there are very similar statements in health care. “He doesn’t have a job, he shouldn’t get health insurance” and “You already had that problem before you signed up for insurance” are both just as insane to me, but those two statements especially get a lot of mindless nods.

Here’s a big part of the problem: When you deny people health insurance, you deny them care. Maybe they can show up at the ER, and they won’t be turned away, but they won’t really be taken care of, they won’t be able to take care of themselves, and as a nation, we will end up worse off than if we had just helped them out in the first place.

Well, here’s my situation. I am currently a hardworking American, I’ve filed taxes since I was 17 (10 years, holy cow!), I paid way too much for health insurance when I was only considered 90% of full time at my first job, and I’m about to have a baby! Right now I live outside of the US and I benefit from a national health care system in Kuwait and additional private health insurance paid for by my employer. Unfortunately, there is a bit of a gap in my current health insurance; it only covers emergencies in the United States and, although it would completely pay for prenatal care and childbirth in Kuwait, that does not extend to the United States and I will be in the US for my due date. I am uninsured and seemingly uninsurable in the United States. It would have been dumb to pick up private health insurance to cover maternity before I was pregnant, I have both public and private care in Kuwait, and now, I have a pre-existing condition that would not be covered by a new health plan if I applied today. I’m not attempting to fleece any system in the United States, and I’ve really never taken any benefit from any other large social system in the US outside of the education, library, and public safety systems.

I find myself in the gap and truly, good health care is barely an option for me without health insurance. What if something goes wrong? I can imagine carrying a debt of $7,000-12,000 for the birth if I end up paying cash, but not $100,000 or $500,000 if something goes wrong. Especially if what goes wrong ends up with me, or the baby, or both, not coming home. Do I not deserve to go to a hospital with experts trained in maternity and birthing care because I am uninsured? Do I not deserve health insurance because the insurance companies with definitely pay out on me? Is it okay to just leave the helpless to “hope for the best” and cross their fingers? If I take the high road and show up to a hospital and am 100% honest with them that I cannot pay, I will end up negotiating what kind of debt I am able to take on and what the hospital’s lowest price really is. It won’t be in chickens, I hope.

Again it seems a question of what is Ethical, Just, and Responsible. If I am in the US, the only ethical option for the hospital is to treat me, and they are required to do so . . to a point. “Contractions 2 minutes apart, baby’s heart rate down, oh, no insurance, sorry, take it outside.” Fortunately, that won’t happen, but I believe we’re not far. The only just thing to do is to help out everyone, whether they have earned it or not. This is done currently, the hospitals really don’t turn anyone away, but I would get a different kind of care. Just imagine you were in a freak accident, maybe out of the country, that wasn’t covered by your car insurance. You’ll be able to get your car fixed, but you’ll go to “Shady McGee’s Car Repair” and make sure that your car is just running well enough to keep you going until you can afford to buy a new one. Just think, some people do this with their health care. Why do we require people to have car insurance, but we can’t handle that if it is health insurance?

Now here’s where we get to the hard part, the responsible thing, it to help me and my unborn child get the best care possible, to help us on our way to a better future than our currently uninsured one.

So here are the choices I face. I can be the responsible mother that I am in Kuwait with my health care here, I can go in for my monthly visit, meet with my obstetrician, visit the nurses at the birthing center and end up paying thousands out of pocket for a normal birth. OR, I can show up at the emergency room when my water breaks, tell them I have no health insurance and then never pay the bill. Truly, what is better for the country? What is a better use of your tax dollars? Helping me be responsible or forcing me to use my last option? Health insurance legislation in the US must view responsible health care as something everyone must have, a RIGHT, just like nutrition and education, or we all turn to desperate criminals.

If I make the ETHICAL, RESPONSIBLE decision to tell the hospital that I am uninsured then why can’t we make the decision in our country to truly treat everyone ETHICALLY and RESPONSIBLY?