Where's Jacob Riis when we need him?

Harry Bliss touches a nerve on the eve of my annual physical.

Kind of funny: When I called to make the appointment, the woman at the doctor's office pulled up my records and was trying to schedule me for next month. I said that I had a prescription that needed to be renewed now, however, and that the doctor would probably want to see me before doing that.

"You're not due until November," she said, "so you'd have to pay for it yourself."

"I"m going to have to pay for it myself anyway," I said.

She paused and, I'm guessing, took another look at the screen. "Do you have insurance?"

"No."

"Oh, well then," she brightened. "You can come in any time! How about Friday ..." and she went on to schedule the appointment.

It's been a little more than half a dozen years since I had decent health insurance, three since I had any at all, and, while we didn't have a $7,500 deductible at my last two jobs, it was very near that figure.

Some things were covered, some things weren't, and, as someone pointed out on Facebook the other day, even the stuff that is covered still leaves you paying about a third.

When I started freelancing, I looked into some catastrophic health coverage, just something that would kick in if I found I had cancer or some other critical health crisis. I forget the numbers, but the monthly premiums were in four figures and represented about 60% of my gross income. And would only cover me once I'd met something like a $7,500 deductible.

And then the spigot would shut off again at a figure I knew wouldn't get me through a long stretch of chemo or repeated surgeries to try to remove tumors and suchlike. 

This blog has readers all around the world who ought to be sitting slack-jawed in disbelieving horror as they read this. However, we overwhelm them with so much of our TV and other cultural offerings that I suppose they've heard all this before.

But as the plutocrats natter on about health care, I wonder if any of them know anything about real life, about what it's like down here in the trenches.

You're right, Mitt: We don't deny people health care when they have a heart attack. As you say, we take them to the ER and they get treatment.

Which everyone else pays for through higher insurance premiums and higher taxes.

But we routinely deny them health care before they have a heart attack, and, whether or not that is humane, it's fiscally irresponsible.

This isn't some semi-abstract conceptual thing, like the idea that, if we built more schools, we wouldn't have to build so many prisons. This is just nickels-and-dimes common sense, as old as the expression "Penny wise and pound foolish."

You paint your house so the wood doesn't rot. You put oil in your car so it doesn't throw a rod. Preventive care saves more than it costs.

Come on, you know that.

Let's be clear: I'm not whining about my own situation. If this were unique to freelancers, well, we simply wouldn't freelance, except at night, unless we were married to someone with a straight job and decent coverage.

This is about a whole lot of other people, including many who, unlike we artistes, have not voluntarily chosen to place themselves at the bottom of the pile.

I'd like it to be changed.

But, more than that, goddammit, I'd like it to be acknowledged.

Because, first of all, we haven't all "chosen" this lifestyle and I'm sick of hearing rhetoric based on the idea that people can just put on their shoes and go find a job that pays $60,000 with benefits, if only they'd show some initiative.

Second, because we're not at the bottom of the pile. I don't qualify for any assistance and there are any number of people in this same bracket. We can get by, as long as the car doesn't break down, as long as nobody gets sick, as long as the rent stays the same. As long as we're not expected to save for retirement, emergencies or, god help us, vacations.

But there are people a few rungs down the ladder from us who aren't so fortunate, who aren't so resourceful, and to think that the current level of government assistance is making their lives bearable is wrong. To think, further, that it makes their lives comfortable is ignorance inspired by heartless arrogance.

I'm nowhere near where they are in life, but I can see it from here, a vantage point for which I consider myself blessed.

It's been 45 years since Bobby Kennedy visited the Mississippi Delta, and I wonder if any of those comfortable, self-assured bastards in the Beltway, airily prescribing their confident solutions, have any concept of how the other half lives?

And before Bobby, there was Jacob Riis. It's been nearly 125 years since he began trundling his photographic equipment through the slums of New York to show a callous America "How The Other Half Lives," and his work, along with that of the other muckrakers and reformers who sprang up in that era, stunned the nation out of its lethargic apathy.

For a while.

We got over it.

Comments

[Mat]

I could only watch so much of the debate before slipping into a rage-induced coma from BS overdose.

However, what got me about the debate was Romney's discussion of shopping around for insurance plans, as though that were a feasible alternative. Right now, I have my workplace's insurance plan, which is expensive (even for a group plan) and covers very little. I don't have any alternative, unless I want to strike out on my own, pay the same and get less.

There's also the fact that competition somehow makes things better for everyone. Yet, my own medical bills are expensive for minor things. Bloodwork from a physical still costs me several hundred dollars after the insurance pays a scant amount of money. My girlfriend's mom had a stroke and a preventative doctor's visit after the fact is UNCOVERED. Let me repeat that: A doctor's visit, to prevent further strokes, is UNCOVERED by her insurance.

To suggest that there's anything efficient or excellent about private, for-profit insurance is to believe that everyone has > $1 million in the bank and can buy whatever primo insurance exists.

As an aside, I noticed that the debate was focusing very intently on taxes. Everyone was talking about taxes. Maybe I just don't make enough, but the tax rate someone is paying seems to be a rich man's problem. When I talk to people around my age (20s-30s), they aren't bitching about their taxes. They're bitching about low pay, job-induced depression and the lack of any quality employment.

Shoot, I need a vacation.

[Dave from Phila]

We are, once again, seeing the vestiges of Reagan's "southern strategy" ~ convincing people on food stamps and without health insurance to vote Republican against their own economic interests. Turns all economic theory upside down. If the American people vote in this member of the ruling class, they get what they deserve.

[Geoffrey Cubbage]

I have to explain this patiently to my fellow 20-somethings who've opted for safe, white-collar desk jobs at large corporate firms more often than I'd like.

People who aren't working for, say, a major software company or a law firm or a bank just don't have access to health insurance that actually "insures" in any effective way. It's not available to us, at least not for a price anyone can pay month in and month out.

And as this post points out -- big credit for doing so -- some of us (me) chose to go live a freewheeling, bohemian, artistic life with all its attendant risks. But a lot of people didn't make that choice and still don't have access to the kinds of safe, boring jobs that come with functional insurance.

So yeah, the bloggers and writers and artists are at risk here. But so is basically every wage employee you meet day to day, from your waiter to the guy that pumps your gas (ha! kidding. no one pumps gas for you anymore.) to the guy that delivers your newspaper (again, ha! kidding. no one reads newspapers anymore.).

And that's not a good system. Like the comment above mine says, us young, just-getting-started types aren't worried about going broke paying our taxes. We're worried about going broke if we slip and crack a rib, or catch anything more serious than a cold.

[Nostalgic]

When i hear about "shopping" for insurance, i risk popping a blood vessel. It's swell for any commodity in which you're a customer they want to attract. Health insurance is an industry that wants young, healthy low risk customers, and emphatically does not want the rest of us. When you're 50+, their forms and premiums make it clear that the point is to get you to go away.

Anybody who knows me is aware, this is a biggie for my family, and having just placed orders for both myself and daughter with an online pharmacy that, of course, can't possibly be in Canada because that would be illegal, i can only be grateful that we have problems meds can help with. In-person treatment, not so much.

[Dan]

Nothing is perfect but what do you want? You want it free so that people still die but at least the government bought them some band aids.

I went online 5 minutes ago to check. Granted this is in Texas so maybe we get better rates since by comparison our state government is not so prolific with our taxpayer's money.

First hit for insurance.
51 year old male.
No smoking
No health issues.
$143 per month
$10,000 deductible
Sure that is high. But not the Hundreds that others are screaming about.
If you need insurance because you broke a leg that is stupid. Do you need insurance when your shoes wear out? It is for catastrophic problems. Do you have a fever and need to go to the doctor then go to the doctor! You should not rely on insurance for this crap.
The reason it is so damn high is that we think someone else needs to pay for it.
Most on this blog want everyone we to pay for their crappy healthcare through even more taxes on everyone else.
What gets my goat is that I can get most every service done for half price if I was not insured. Do you want a cat scan? Go price them and see. With insurance vs without. Huge difference in price. When you get the nanny state or big insurance involved, it costs more. Those of you that think government healthcare would be so much better are living in a fantasy land. If you want improvements do away with the vast majority of both. But you cannot be sue the doctor happy at he same time.

[Mat]

"Do you want a cat scan? Go price them and see."

Medical professionals don't give the prices out on procedures and operations. Myself and my girlfriend have both spoken with different medical professionals on these matters and invariably, no one in the office knows the price of anything. They rely on the administration of service providers (office, lab, hospital, etc) to provide the price after the procedure is done.

"Sure that is high. But not the Hundreds that others are screaming about.
If you need insurance because you broke a leg that is stupid. Do you need insurance when your shoes wear out? It is for catastrophic problems. Do you have a fever and need to go to the doctor then go to the doctor! You should not rely on insurance for this crap."

I think most people would consider a broken limb fairly problematic. It can be pretty catastrophic if you break your limb someplace away from civilization. A broken limb 60 miles away from a city can be a fairly catastrophic problem.

Moreover, unless you don't realize it, doctor's visits are EXPENSIVE, insurance or no. When I was younger, I had to get a basic checkup to get an internship (unpaid, obviously). As I was uninsured, I had to pay it all out of pocket, which came to a bit over $200 for 15 minutes worth a doctor's time. A couple years ago, I got a simple physical and bloodwork test for things like cholesterol, blood sugar. The doctor's visit and the cost of bloodwork was probably around $1200, and mitigated to a few hundred dollars after my insurance.

This is basic preventative care that most experts (including insurance companies) suggest you engage in on a consistent, regular basis, but it's still prohibitively expensive for a lot of people. Whether or not you agree, most people procure insurance to mitigate the costs of these visits.

Moreover, you certainly have a quote above, but you haven't really described what things it covers, how much it will cover, etc. Just because I have health insurance doesn't mean that I'm completely covered. Most of the time, my insurance takes a marginal quantity of costs and leaves with fairly high bills anyways. My mom had insurance outside of a group plan probably similar to the one you cited. It provided very insubstantial quantities of money for doctor's visits and operations. Moreover, insurance companies have the discretion to deny you coverage for insurance anyways. Older people being denied coverage is a very real problem.

[Mike Peterson]

Mat's pretty much covered it. I went on-line to try to find a quote for my area, but gave up after way too many attempts to just get some numbers instead of opportunities to have a salesman call me within 24 hours. I'm not in line with your logic on health coverage, but your Google skills are impressive.

Still, I've never heard of a $10K deductible. Most "catastrophic" coverage pegs it at half that.

Mat's scarin' me with the blood work price tag, because I had some done this morning and I haven't seen the bill. On the other hand, I had it done before and it wasn't so bad, which is the point -- health care costs vary widely and maybe Texas does offer really cheap coverage. Not finding it here in New Hampshire, though the temptation to move a few miles to the People's Republic of Vermont sure is tempting.

But here's something you missed, Dan: Only the Republicans are asking taxpayers to pick up the tab for other people's coverage. Under the Affordable Care Act, the cost of coverage is born by everyone -- not just the middleclass taxpayers, and not just the people who, by virtue of their stage in life, need health coverage, but by the young, healthy people. If everyone is in the pool, nobody has to pay an inordinate amount, and we all share the burden.

Under the current system, the people who have insurance pay extra to cover the people who don't. That's not fair, but it's what the GOP is pushing.

[Jack-knife Gypsy]

Without a Communist state, it is impossible to provide health care for 400,000,000 people. That may be what you all want in the end, to have all the basics in life 'covered' so that any income you derive from any activity is yours to do with as you please. That seems to be the direction we are heading towards and for how that will turn out, we will have to wait and see, but it's safe to say that the health care issue is masking a much much greater catastrophe: the increasingly rapid decline of the middle classes.

The current slide is evident to the tens of millions who have either lost their jobs, careers, and incomes or have had to take substantial reductions in pay and benefits to continue working. The future is only going to get dramatically worse. Those who are making it a partisan issue are so misguided that it is pathetic, the level of ignorance out there in the public domain.

The GOP this, the DNC that....what total b/s.

Until it is recognized that the United States is too large to govern with any semblance of competence, we will continue to muddle along like the 3rd world country we are becoming due to one single solitary fact: NO JOBS that pay a decent wage, that employ the increasingly irrelevant skills our people possess (or do not).

That is the crux of the matter and health care, social security, food, housing, and every other thing on the planet one would consider necessary for a decdently led life is contingent on greater employment opportunities for an ever growing national and global population increase.

Can anyone honestly argue that a sudden decrease in population on the macro or micro scale, wouldn't immediately make the remaining population more "valuable" to employers?

Anyone?