Wednesday, July 8, 2009

"If you go there, you are preparing to die."

We Share Our Mother's Health - The Knife (mp3)
Doctor! Doctor! - The Thompson Twins (mp3)

My view of health care is a little skewed.

As we drove through Nairobi on our way out of the city in the summer of 2007, I found myself mesmerized by the easy comparisons and contrasts between what I was seeing and my Traditional American Notion of a city.

Heavily-trafficked streets that aren't streets so much as bumpy surfaces similar to the surface of the moon, except brown. Rows of one-story shack-like buildings painted a variety of over-bright colors dimmed by mud and time that serve as their own version of shopping plazas. Nice hotels where security guards armed with automatic weaponry use long poles with mirrors to ensure there is no bomb strapped under your car before allowing you into the entryway.

One of the more telling moments about just how far out of Kansas we really were occurred when we passed one of Nairobi's hospitals. (For all I know, it was the ONLY hospital.) The building was a maroonish color and went up at least six or seven stories, and it looked more like a large prison complex than my notion of a hospital. When our driver pointed it out, I said something to that effect, and his response was, "It is a bad place."

"The hospital? Is a bad place?" I asked.

"If you must go to the hospital, you are preparing to die."

Being dim, I needed clarification. "Are you saying that you don't go to the hospital if you're just, sort of, sick?"

"No no. If you go to the hospital, you are close to death. You don't go there unless you have no other hope."

When it comes to health care, this experience is the health care equivalent of your mother's "There are starving children in Africa" speech. I've seen starving children in Africa, and I've seen hospitals in Africa. More importantly, I've seen the public opinion of hospitals and health care in Africa, and it ain't pretty.

Amongst my in-laws, I'm pretty much the lone voice of liberal dissent. My politically vociferous in-laws range from Ann Coulter and Neil Boortz to Sean Hannity and John Stossel (That's the one who's a Libertarian in Republican's clothing). There might be an albino Walter E. Williams in there as well. But there's nothing so reasonable as a David Brooks or George Will amongst them.

Anyway, because everyone needs a common enemy, I'm constantly CC'd on their email exchanges regarding politics, and once in a while I take the bait and engage in smart-assed or sincere disagreement with them. Lately, every day seems to include a handful of email exchanges from these Righties about health care. Being Righties, they insist that Obama's plan will obliterate all private insurance companies and leave us with a system even more incompetent than that stupid wacky Canadian system.

Disclosure: I know jack and shit about health care. (And, as Ash from the Evil Dead series would say, "Jack just left town.")

I've read plenty, but I don't really know anything beyond personal experience. But here's two things I know with absolute certainty: (1) The rising cost of insurance has virtually obliterated every penny of my salary increase for the past eight years; (2) Ain't nothing about health care in 2009, when compared to 2001, has gotten better where me and my family are involved, at least not nearly enough to explain sucking away virtually every cent of my pay raises.*

* -- Note to rich people: I'm in education. Three percent of shit is a mere teensy dingleberry, cash-wise. So the fact that my insurance increases leapfrogs my pay probably means little to you in your fancy mansions on the hills.




I don't know whether Obama's plan will do any good. It's entirely possible it could have the scare-mongering effect conservatives claim, although I doubt it. But all this conservative talk about how free markets correct themselves and would lower costs and be more efficient... well, that clearly ain't happening in the world of health care. And all the spinning in the world ain't gonna make it so.

And compared to Kenya, I know we're lucky to have the system we have, flaws and all.

But I believe deeply that what we're getting for what we're paying is, in no uncertain terms, a racket. It's a sham. A complicated Ponzi Scheme of payments going to lawyers and insurance companies and drug reps and God-only-knows who else. I believe, without equivocation, that health care and insurance shouldn't have to be this expensive. I believe the system has proven itself incapable of fixing its own problems. I believe our government, unfortunately, is the last option at trying to force those wheels to set in motion.

Until powers from the Right -- or some insurance companies -- prove they can make wheels turn in a different direction with promising results, then I'm forced to back the only cards I see getting played. Inaction seems to have proven a failed option.

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