To Choose or Not To Choose

I've been trying to write a post regarding my feelings on the whole public health care debate. I've been gathering information and listening to opinions, wading through the foul swamps of rants and deliberate distractions and I keep coming back to the same spot: We need reform and we need options.

When my sister was 18 she needed surgery to remove some cysts. We were out of the house and sharing an apartment and she was too old for my parent’s job-provided health care coverage. She was going to community college and only working part-time for minimum wage at a pizza restaurant but still made $100 too much per month to qualify for the Oregon Health Plan. If only she had gotten knocked up in high school so she had a dependent or two she would have then qualified and been covered completely. Instead, she was left to pay for the entire surgery herself, making payments to the doctor and the hospital for the next seven years - all because she was one year too old and a $100 too rich.

When I was pregnant with Adam we were fortunate enough to be covered by the health insurance through my employer. It was very good insurance that covered all but 10% (which still amounted to around $2000 for us for a very normal, easy pregnancy) of doctor and delivery fees. I wanted more than anything to quit work and stay home with Adam. We looked at every possible angle, even talking to a financial counselor on how to make it work, but it just didn’t pencil out. The biggest hang up was insurance. I had great insurance but it meant that I had to keep working. Damonn’s employer paid for his insurance, but it would cost us $700 a month to add me and Adam onto the policy. We might have managed without my salary, but just couldn’t swing the extra cost of insurance on top of it. Instead of paying an additional $700 a month we contemplated just paying the bills ourselves as they came up. That’s a great idea until you get a $800 bill for a single middle-of-the-night visit to the ER for an ear infection. A visit that included only the use of a thermometer, a look in the ear and a dose of Tylenol. You suddenly understand the actual size of the financial cliff you could be confronted with should something catastrophic happen. So I went back to work and the kids went to daycare. We seem no worse for the wear, but how many other families are faced with the same dilemma of a dad that provides the better salary and the mom that provides the better insurance? How many other moms or dads would be home with their kids if they had a choice?

And what about the man at my work who has an epileptic daughter? What will happen if he is laid off and has to purchase independent insurance (if he can afford it) that won’t cover her pre-existing condition? Or the lady at my work with Lupus? The usual drugs used to keep this disease in check make her sick, but her insurance won’t cover the other drug because it is too experimental.

And as the debate rages on I hear people screaming about freedom and choice, about death panels and denied coverage and I think, are these people independently wealthy or just clueless? Do we have any real choice now? Is a choice between what your employer provides (if anything) and paying for the bills yourself really a choice? Or maybe it is the choice between choosing medical treatment and choosing groceries that they are so adamantly refusing to give up. Which, by the way, is a very real decision for some families. Do they not realize that the insurance companies already tell us what doctor we can see and what medicines they will pay for all the while raking in enough cash to pay for box seats and bonuses?

I am under no illusions that a public option (emphasis on the option) provided by the government will be perfect. What is? But how can your argument against a public option be based on freedom and choice when that is exactly what you will be getting. . . . another choice and the freedom to choose. There are no easy answers here and I’m sure we won’t get it right the first time around, but doesn’t it deserve a fair and rational conversation? A conversation without shrieking and insults and threats of secession? We need reform and we need options and those are most likely not going to come from those with the loudest voices. So let’s turn off the Pelosi’s and the Limbaugh’s, put down our picket signs and and get to work. This is important.