Why The ACA Matters to Me
Over on her site, author Kameron Hurley tells the story of how she almost died because she didn’t have enough money to manage her adult-onset Type 1 diabetes. It wasn’t that she wasn’t working — First she worked for a company through which she had (crappy) insurance, and later she was hustling as hard as she could as a freelance writer. It was because the way insurance has been handled in the US made it very difficult for her to get insured, stay insured and to afford to be insured — and the alternative to being insured here in the US is so much worse that it simply beggars description.
Thing is: Kameron’s story? Not unusual for writers in the US. I don’t have enough fingers and toes on my body to count off the writers in my own personal sphere who are hardworking, who are hustling as much as they can with their work, who had the medical boom dropped on them by life and were screwed because they didn’t have health insurance, or couldn’t get health insurance was even remotely within their financial means. I can’t tell you the number of writers I know personally who have gone begging online or to family and friends to cover a catastrophic medical issue. Not to mention musicians, artists, actors, and any other sort of creative people.
Or anyone else, for that matter, who doesn’t live in the magical bubble of work that carries benefits. I was at the store the other week, listening to the woman in front of me in the checkout line cough like her lungs were trying to escape through her throat, and heard her friend admonish her for not going to the doctor. And the coughing lady gave her a look, and it was a look I knew really well from days of old, the one that said, and just how am I going to afford that, do you think?
In my professional life, I’ve been fortunate. I’ve always had good health insurance, either through my employer or through my wife’s, and the one brief time I paid full freight for our health insurance, I was able to afford it (although I had to incorporate, hire my wife and then attach myself and our child as dependents on her policy, because it was massively cheaper that way — which also points out the stupidity of how health insurance is done in the US). I’m also aware how fortunate I have been for someone in my field; I am one of the few self-employed writers I know who doesn’t have a health insurance tale of woe.
I’m also aware how many of how many people I know — not just writers but people in general, among friends and family — who have no margin of error when it comes to their health. If they get sick, their most rational option is take some Tylenol and hope it goes away. Because they can hardly afford to go to the doctor and even if they do, what is the doctor going to do? Give them a prescription for something they really can’t afford, or send them along to a specialist they also can’t afford, or tell them they have some problem or issue they can’t afford to fix. Out comes the Tylenol. Out comes the look the woman in the checkout line gave her friend.
Now, here comes the Affordable Care Act, and its various marketplaces for insurance. God knows it’s not the perfect system — it’s really not — but for the first time in my adult memory it means that people can find an insurance plan with decent coverage, including the basic preventative care that can address so many problems early and much more cheaply than if people wait until they find themselves in an emergency room, for a price scaled to their income and their ability to pay. It means all the people whose previous rational options for health care consisted of being sick because it was cheaper than getting well have a better option, both for themselves and for the rest of us (you didn’t think those ER visits came for free, do you? Oh, we pay for them, my friends).
And of course some people oppose it. They give all sorts of financial and economic reasons, which don’t hold up to scrutiny, particularly over the long term, as the benefits of a healthier population and throttling of expanding costs come into play. In the end, a lot of the opposition stems from the fact that the United States still has a thick layer of angry Calvinism to it, the sort that suggests that if you are poor, or sick, that you did something to deserve it and that you should just have to deal with it because after all it is your fault. Well, I’m looking real hard to see how Kameron Hurley deserved to get adult-onset Type 1 diabetes. I’m coming up with a blank. They only thing she can be blamed for — and to be clear, blame is hardly the accurate word for it — is handling her illness in the way that the circumstances of her life dictated, first with her (bad) insurance and then later with none. Yes, sometimes people do foolish things, and get sick or hurt. But lots of people don’t do foolish things, and get sick or hurt anyway. In the real world, this angry Calvinism is nonsense (and even people who do foolish things should have affordable health care).
I know too many people — too many people who work hard — for whom the ACA is a lifechanger, a way for them to finally be able to not have to choose between health care for themselves and their families and all the other bills they have to pay. When I see the Congresspeople who shut down the government as a way to stop the ACA, among all the other problems I have with them is the fact that I see a group of people who are, essentially, looking at people I know and care about and saying to them, just fucking die, already.
I’m not inclined to look kindly on the people wishing my friends and family dead. I’m going to remember the ones who did. I am also going to remember the ones who instead chose to help them.