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Tuesday, June 19, 2012

Disability and Health Care: Michael Berube Rules

Over the weekend Michael Berube published an outstanding article, "Our Great Healthcare Denial" in Salon. See http://www.salon.com/writer/michael_berube/. Berube makes many astute observations about healthcare and disability. The most stunning and accurate observation was: "We simply do not think about disability when we talk about health care".  This silence affects liberals and conservatives alike. So the issue become why, why do we not talk about disability and healthcare? In a word denial. When I read this I stopped dead in my tracks. Wow, can the controversy over healthcare really be that basic? I do not know but Berube was persuasive. He wrote:


"if you stopped for a moment and shuddered at the thought that you or a loved one might lose your faculties, physical or cognitive, then that’s probably a good indicator of what’s going on here: Individually and collectively, we are in denial. And in a sense we have to be. No one of sound mind and body can wake up every day with a visceral awareness that their soundness of mind and body is a happy accident. None of us wants to start up the car in the knowledge that a random patch of ice can put us or our children into comas, and none of us wants to make our retirement plans on the assumption that we will be too infirm to enjoy it."


Berube goes on to note that when we think of the uninsured the first person that pops into our collective thought is a healthy young man or woman in their 20s, the picture of perfect health. The thinking goes, these people do not need healthcare and hence go without. The logic Berube describes is as follows:


"Americans think of health insurance as a personal calculation, like putting only just so much change in parking meters. You make that gamble, you leave your car too long, you get a ticket, it’s your problem. Or you make that decision, you go without insurance, you get sick, fine, you knew the risks. You pays your money and you takes your chances, and don’t come around here looking for a handout when you lose your shirt. Quite apart from the cruelty of this devil-take-the-hindmost approach to health care, what’s really stunning is how profoundly foolish it is. Sure, people know (or know that they have to pretend not to know) the risks of smoking, or drinking heavily, or eating bacon double cheeseburgers, or riding their motorcycle without a helmet. But most disabilities don’t work that way. They’re not the result of calculations and risk management."


I love the line "most disabilities don't work that way". Amen. Looking back to the first time I got sick I had no clue nor did my parents of how my life would be radically altered. I did nothing wrong. I woke up like any other day, a child interested in Sunday morning cartoons. People do not plan to become paralyzed. People do not plan on becoming disabled in the myriad of ways it is possible for this to happen. It is not supposed to be part of the life process. Well, I am living proof as are many others of the folly that disability is not relevant or part of life. In fact, if you live long enough the odds are very good one will age into a disability, physical or cognitive or perhaps both. To me, Berube is tapping into the American ideal of fierce independence. We are in control of our own destiny. This is utter nonsense to me. None of us are independent entities but rather a complex result of a multitude of social factors. Berube wrote:


"Once you’re born, health care and health insurance is a personal matter, and your encounters with nature’s mishaps are nobody’s business but your own. That’s why you haven’t heard from any American conservatives with the honesty or integrity to admit that the Affordable Care Act, known derisively in some (or all) quarters as “Obamacare,” prohibits insurance companies from denying coverage to disabled children under 19. Or that starting in 2014, the law will prevent insurers from excluding anyone from coverage or charging higher premiums for any pre-existing condition — including a disability."


This is the sort of discussion I would love to engage in. I would like to discuss why the Supreme Court controls the near and long term future of my son's health care. I would like discuss why I am effectively barred from comprehensive insurance until 2014--assuming healthcare reform moves forward (this is no sure thing). I would like to know how insurance companies justify charging me as  paralyzed man a higher premium than a man who is bipedal. So much for the notion of being equal. How about we talk about disability? How about having a civil discussion. Instead we get Rick Santorum and Sarah Palin who use their disabled children to forward their political platforms and sway voters with empty emotional rhetoric: "Liberals want to kill our babies". This makes a great headline but has no semblance to the reality people with a disability live. Let's talk about healthcare bills being the leading cause of bankruptcy in America. Let's talk about misleading insurance policies. Let's talk about the people who are forced into nursing homes because of the institutional bias. Let's talk about the politicians we elect who ignore the views of those who voted them into office and instead cater to insurance lobbyists. These subjects are worthy of intense discussion. 

1 comment:

city said...

nice posting.. thanks for sharing.