After reading that "the overwhelming majority of Americans are satisfied with their health care," Ann Weaver Hart noted that those were general comments but she hadn’t actually heard many people say they loved their health care plans. She posed a question to Gather members to see how they would respond when asked how pleased they were with their specific plans. You can read her post and the over 200 responses here.
A seemingly polite, health-conscious, young (if the icon is him) man responded with,
“Very satisfied. Hardly use it. I go for a yearly routine check. My dental, I am less satisfied with. The out-of-pocket costs are too high. But I hardly use it too. What I do do, is eat extremely healthy. Compared to what I hear people out there eat and do, I consider my diet extremely healthy. There is not a week in the year where I don't do some form of high intensity workout 3 times (running at 6mph, weight lifting, swimming, ...). People need to take care of themselves and medical costs could be lowered. Nobody wants to tell anyone how to live their lives however. Free to be fat, free to eat unhealthy, free to smoke, free to drink, then they want our tax dollars to pay for their medical cares.”
I typed the following but, before hitting the send button, decided to expand it into this post instead.
What about the person who eats extremely healthy (a subjective analysis that we will have to trust dietitians would approve since we don’t know what he actually eats and the lab values of his body) but has a genetic problem that still causes illness? What about the person whose high-intensity workout causes joint damage and requires replacements? What about the person who is on his healthy 6mph run when a car veers off the road and hits him? The guy who is swimming and a shark takes his arm for lunch? The weight lifter who is in the wrong place at the wrong time and gets shot in the face?
These people took care of themselves. They were free to do all the wrong things, chose not to do them, and still ended up in need of medical care. It is possible that these people did not have insurance or finances to cover the costs of these things that happened to them regardless of how diligent they were in taking care of themselves. Nothing they could have done would have lowered the cost of medical care. They just might be one of the many people who need assistance, through no fault of their own.
You say, they want our tax dollars, as though you aren’t one of them, and the tax dollars can’t possibly be theirs. If you aren’t willing to buy, “We’re all in this together,” you must understand that any day your life could change and make you one of them. Having a tragic change of circumstances would be bad enough - what a shame if you had to add hoof-in-mouth disease as a complication.
Exhibit A – ME
I was born healthy. Perfect size, no problems, home in three days, adjusted well. I’m older than dirt so I experienced the usual childhood measles, mumps, and chicken pox without complications and before I started school. I didn’t get colds or flus. I was naturally thin and extremely strong for my build. Aside from routine visits for school check-ups, my elementary visits with the doctor were for aching knees and a tumble down the stairs at school. He diagnosed growing pains and that seemed apt, since I was taller than most children my age.
In my early adulthood, I walked faster than your 6mph runs, and could walk ten miles without breaking a sweat or taking a break. I parked four blocks from work, covered an eight-story building several times a day and seldom used an elevator. I was a tall, thin, muscular, exercise fanatic. I ate healthy – extremely healthy – by any dietician’s standards. I breezed through a pregnancy, dropped out a baby after three hours of almost painless labor, went home in size 5 jeans, and danced at a party the following weekend.
Everyone I worked under would tell you I was one of the most productive employees they’ve known. Most of them replaced me with two or more employees. People I did not work for would tell you they made terrific offers to try to lure me away from my employers. I loved my work and, more importantly, I loved knowing that I had done the best job I could possibly do and that I could support my family.
I worked a full time job while going to school and, at times, I worked more than one job. I did not miss a day of pay in twenty-five years, I had the best insurance money could buy, and provided the same for my family.
It turned out those were not growing pains. The pain worsened after I stopped growing. I was diagnosed with juvenile rheumatoid arthritis in my early thirties, multiple sclerosis in my early fifties, and a long list of other diagnoses in the years between. Doctors urged me to go on disability ten years before I did. I loved my life and refused to give it up until I was so exhausted I could not function. Even then, I went out fighting – taking temporary jobs, doing what I could from home - anything to delay the inevitable.
I don’t want your tax dollars for me. I’m doing fine with the social security and Medicare that I earned those twenty-five years I worked.
I’m eternally grateful that I supported our “socialized” system long before I knew I would not be able to continue working and giving to others, and that I gave generously to others while I could – even to people who didn’t want or couldn’t find the strength to do what I did. That is what enables me to hold my head high during this healthcare discussion and demand your tax dollars for people who aren’t as fortunate as I am.
It happened to me and it could happen to you. I’m fighting this battle for you, and all the others who still think in terms of they and our.
Exhibit B – My Father
My father joined the service straight out of high school and was a veteran of the Korean War. He returned and worked a federal job until he retired at age fifty-five. He saw doctors for routine check-ups and, in later years, for allergy shots - his only routine medication before age fifty-seven.
He was active, he didn’t smoke, he was a less-than-social drinker, and a healthy eater. He gave blood as often as permitted and his weight and blood pressure were never outside normal range. When he retired, he had missed fewer than ten sick days, and cashed in a lifetime of sick pay. His gray hair was the only thing that hinted at his age. He spent the first two years of his retirement building – his hobby - an addition on a house and a garage, almost single-handedly.
At fifty-seven, he went into the hospital for the first time in his life. He was diagnosed with cancer and died two weeks after his sixtieth birthday.
I can’t think of anything he might have done to live healthier and lower the cost of medical care in this country. There are many people just like him, who do the right things and still get sick, and many of them do not have jobs or insurance.
We cannot condemn people like my father, or even people who could have made better choices, to early or painful death because it’s easier to think they could have done something to change their fate or the cost of health care. Funny, that’s what obstructionists are accusing President Obama of wanting to do when, in fact, it is they who wish to let others suffer and die rather than spend tax dollars helping them.


Comments: 65
You wanna force people who eat poorly to pay more for health insurance, so you can pay less? Many people who eat poorly do so because it's that or starvation. But even those who eat poorly by choice are not taking any more risks with their health than your average, sanctimonius, sprout-eating douche. We have the technology to monitor who is driving a car and talking on a phone at the same time. Doing so is just as likely to lead to auto accident-related injury as driving 'legally impaired'. So, it's only fair that if we're going to monitor who eats what, and financially punish those who don't eat the officially 'approved' diet, then we should monitor everyone who engages in any kind of behavior which can increase the statistical probability of a negative health outcome for themselves or anyone else.
You want to charge people who smoke more for their health insurance? Stress contributes just as much to health problems and early death as smoking does. We'd have to monitor the smokers' tobacco consumption, in order to figure out how much they owe for their premiums (self-reporting is notoriously inaccurate and too easy to cheat). So, it's only fair that we monitor everyone's stress levels as well. How about a point system, where every time you yell at your kids or argue with your wife, you get points? We could schedule required rest periods every so many hours, and penalize those who skip them. We could make play time a requirement, and charge people for non-compliance. Every time you snap at someone, you get a point. Every time you worry about something, more points.
You want to charge people for not exercising? You'd have to monitor everyone's physical activity in order to figure out who to charge, and how much they owe. I hope you're not staking a big chunk of your income on the assumption that jogging, bike riding and working out regularly makes you more physically active than me. You'd have to do 3 hours a day of combined jogging, biking and working out to get as much physical activity as I do just working at my job. We'd have to count the number of cars which pass you when you're biking, because breathing their exhaust is bad for your health. So, good luck with that.
But even those who eat poorly by choice are not taking any more risks with their health than your average, sanctimonius, sprout-eating douche. And these aren't so bad, either. That part of your comment reminded me of a girl who used to lecture me about smoking. She was s/p gastric bypass and still over 400 pounds. I could run cross country track without breaking a sweat and she couldn't get across the room without taking a break. But, there were probably others around us who were thin and did not smoke yet carried greater genetic health risks or stress levels (thanks for mentioning that) than either of us. None of us had a right to point a finger (or a "sin" tax) at the other. I speak with some practical experience since part of my job was to risk rate patients.
The dirty truth is that statistics can't tell you very much of a conclusive nature about an individual, but they can assign probable outcomes to groups of people--the larger the group, the more accurate the prediction. The other, dirtier truth is that statistics are almost useless when they're used to examine only one of many factors. You can't learn a damned thing about how behavior affects health by looking only at diet, or by limiting your range to diet and exercise. You only get truly useful information when you look at all human behaviors, individual and group, and study how each one of them and every possible combination of two or more of them affects health... both for the individual or group engaging in the behavior and for those who do not but are indirectly affected by it.
What I'm saying is that setting health insurance premium rates based on behavior is a fatally flawed idea, unless you apply the concept to all behaviors which have an effect of any kind on anyone. People who claim otherwise always have some egotistical and completely false idea of how their own behaviors compare to the behaviors of others.
And, as another commenter mentioned already, what about heredity? If your paternal grandfather died of a heart attack, you may or may not die the same way. But people who have a relative with heart disease, as a group, have a higher incidence of heart disease themselves than people whose relatives have no incidence of heart disease. So, do we start charging people more for the health issues of their relatives which have a genetic component? Even if heredity is only one of many components in determining whether you will develop the same illness? How many components are there? How do we weight the significance of each component?
What I'm saying is that all these statistics are great for figuring out how to treat and prevent illness. But to use them as a basis for determining levels of access to care, and the costs of that access, is insane.
By the way: "We have the technology to monitor who is driving a car and talking on a phone at the same time. Doing so is just as likely to lead to auto accident-related injury as driving 'legally impaired'. So, it's only fair that if we're going to monitor who eats what, and financially punish those who don't eat the officially 'approved' diet, then we should monitor everyone who engages in any kind of behavior which can increase the statistical probability of a negative health outcome for themselves or anyone else."
I'm all for an automotive i-chip (like the v-chip, except for Idiots) that will kill the signal of a cell phone within a certain proximity of the steering wheel. I'm not in favor of protecting these driving-and-texting morons from themselves, since that's natural selection at its finest, but I don't want them to be able to affect the rest of us.
Kris, thanks so much for this perfect example of how ridiculously complicated this could all get: Should I be charged a higher premium for my parents' "mistake"? Should you be charged the higher premium, or allowed to sue your parents for giving you life? How do I get anything out of the grandmother who passed these genes on to me? She's dead now and didn't have anything when she was alive.
And I love this. Sure, but you'd better also charge the people whose parents are both card-carrying Republicans, as are they, a higher tax rate to fund the unnecessary war for which they all three voted. Maybe we do need to have everyone choose a political party and tax them accordingly. They can pay for their wars, and we can give up any freedom the Iraqis threaten to take away from us. We'll pay for healthcare and they'll just have to take the "felix" plan of self-treating and dying when that doesn't work.
First of all, how do we identify the deserving?
Second, who's to say that some people who take horrible care of their bodies don't contribute much more to society than some people who are exemplary in their pursuit of good health?
Third, what about people with hereditary problems?
Then there's the question that may not be obvious to some people: What's the benefit to society of providing health care for the "undeserving?" I think there's an obvious benefit. It means we're not trying to abrogate the social contract whenever we feel like it. Folks, we're all in this together.
Simple, Nippy. Me and mine are deserving. Forget everybody else.
Second, who's to say that some people who take horrible care of their bodies don't contribute much more to society than some people who are exemplary in their pursuit of good health?
Bite your tongue! (Do frogs have teeth?) Contributions to society don't matter unless they are tithes.
In my job, I work with families who have children with developmental disabilities or delays. If we do not meet the medical needs of these youngest and vulnerable people in our society who were born with issues through no fault of their own, they will not be able to be a productive part of the world to the best of their ability.
I would like to see my tax dollars go to being sure others needs are met.
We are all in this together. When we take care of each other, we all benefit.
You said it. The way some people mouth this particular kind of line reminds me of the laypeople who think they can disprove the theory of relativity, regardless of the fact that they don't fully understand it in the first place.
Excellent article Sandy, very well written and effective.
Exactly, Wanda. This is why I refuse to shy away from or apologize for the term "socialized" - we are a society, we should be sociable.
Wouldn't we have to 'judge' others in order to determine worthiness? We can write strict criteria to cover qualified, but not worthy.
When I was told I had high blood pressure a year or so ago by a dentist, then a clinic doctor, I thought they were joking. No, I didn't have double vision or dizziness or headaches or any of the other symptoms they asked about. I am totally asymptomatic, as was my grandmother, which leads me to wonder if 10-15 points high is my "normal." I feel no different on medication than when I go without except on it I'm slightly dizzy all the time, which I find to be somewhat pleasant.
What I can't control is the genetic factors that are at play, the little aches and pains of growing older, and activities other people may engage in that put me at risk, such as speeding or shooting at your girlfriend because she is a skanky ho.
I cannot promise that I will never have a serious medical crisis or an accident that will leave me needing care. I can promise to take care of myself, avoid risk (not trying any of those stunts I've seen on Jackass), and not to freak out about every little change my body throws at me just because I have access to a doctor. I can also promise to pay for any health care I may need, to the best of my ability.
I'm not asking for free health care, but damn, let me in door. Don't tell me I live in a country with the "best" medical care in the world when I don't have access to it. The US may also produce the best trips to the moon, but it's highly unlikely I'll be vacationing there. Why does health care have to be in the same league as a lunar getaway weekend?
Even if we were to postulate that "costs" equal actual monetary exchange, there are far more costs to denying affordable healthcare for a population than the outlay on the bottom line. The reason the free market (so-called) doesn't work is because it is based on short-sighted profit/loss and not on the actual work needed by the populace. If we were to devise a national attitude toward providing healthcare based on the true goals of optimizing the health of the people while assuring their freedoms of choice, the ultimate result could well be far less costly in the bottom line sense, while tremendously value generating in the larger sense.
The President of the United States makes a fraction of what some capitalists get as a bonus to their already outrageous salaries. That alone should tell us that socialized medicine would 'cost' less, and that's what we need to save us at this point. The details of the plan can be worked out later, with medical professionals advising.
The complaints we see in these discussions, by people who may or may not understand the medical side of things, should have little bearing on whether or not we provide a government option for health care.
Maybe you, Kris, EmJay, Lisa, and anyone else who wants can add exhibits C, D, E, F, G . . . and we can send this to our reps.
You want sketchy medical treatment? Try looking at the mental health area! In 20 years of counseling, I've had two really good counselors. In the same period of time, I've had four decent psychiatrists (and you generally get a new one every 6 months). Talk about insurance companies being obstructive? I once called for an appointment, telling them I was suicidal. They gave me an appointment 2 months away. What did my depressed mind interpret that as? "You don't matter, and we're hoping you improve the world by killing yourself before we have to actually DO something for you."
When you are least able to fight, is when you have to fight the hardest (I see this in other illnesses, too). It shouldn't be like that. When a person finally gets up the nerve to tell someone they are depressed, what they need is help not hindrance, and our current system is all about hindrance. I think insurance companies play a part, but I think general attitudes play a part, too.
And I really hate having this diagnosis in my file, because it's almost impossible to get an MD to consider what I say. They see "depression" and discount everything I say as hysteria. No, you don't have allergies or need to deal with your sinuses. It's all in your head (ha ha) because you're depressed. I had one doctor tell me to "take up a hobby" ... I suppose running the science fiction club, the ferret club, participating in an amateur acting group, writing and going to a writer's group ... while working a full time job, training a dog, being married, taking care of four children AND making jewelry for fun wasn't enough to keep me busy. WTF?
Mental illness is one of those "you just can't understand until you've felt it" sorts of things. Just like young, healthy people who can jog for miles have problems understanding how it couldn't be your fault that you have RA (and that it freaking hurts), lots of otherwise kind and caring people can't believe depression isn't a choice.
If I could choose to wake up every morning feeling light-hearted, you better believe I'd do it!
There is an attitude in the US (I don't know if it exists elsewhere, as I've never been elsewhere) that any poor health (mental or physical) is at least partially your fault. Diabetic? Oh, you must have binged on sweets! It's your own fault. This goes for many other problems. I've often wished I could trade the depression for a broken leg ... at least people could see it and believe it hurt. And if the drugs don't help (or fix you completely as in my case) it must be because you're not compliant, self-medicating, "using" something, or wallowing in self-pity.
And of all the illnesses a person can get, I think mental illness should be one of the more aggressively treated problems. People with RA are not known to take a rifle and climb a bell tower. Diabetics don't have the very real potential of driving head-on into a bus. People with mental illness can be *dangerous* and need to be treated ... but the worst cases are ignored, kicked out onto the streets, told their money has run out, etc. Of all the social problems we've dealt with poorly, mental illness is one of the biggest failures. It's also one of the last to be funded and one of the first to be dropped.
This line hit a raw nerve with me: Mental illness is one of those "you just can't understand until you've felt it" sorts of things.
(I've said the same about fatigue). I'm one of those people who can shake it off and laugh about it - no matter how bad it is - almost immediately. If I'm upset, the hobbies will turn me around. I didn't understand that it wasn't so for everyone, and used to try my best to "cheer up" a friend who was chronically depressed. When I finally understood, I felt so terrible for all the times I had suggested everything I could possibly think of to make her "get over it". My intentions were good, but I wasn't helping. I apologized - too little, too late, I'm sure.
Add your exhibit if you want.
I do think that healthcare for everyone should be a given in such a rich place as the US. The only reason to withhold it is greed, short-sightedness and downright meanness. [well, from my point of view anyway]
http://en.wikipedia.org/wiki/Universal_health_care
Makes us look not so civilized or progressive. What's weird is that the people who fight against this are mostly the same people who keep repeating, "We are the greatest."
We have used tax policy for several generations now to influence behavior. In the past few decades we have taxed cigarettes hugely in order to discourage smoking. And it has worked. With that background, I'm not sure we can take higher premiums for the morbidly obese off the table. I sympathize with those who say they have a medical or physiological condition that makes them fat, but in reality what they have is a food addiction.
Oh, now that they've taxed cigarettes to the point of ridiculous - I won't be happy until they impose the same taxes on fast food and fatty foods, and foods with peanuts, and foods with wheat and dairy, and hairspray and cleaning products - and everything else anyone is allergic to. And sports because you can't imagine the sports injuries I've seen. Another employment tax would be nice because jobs are stressful and stress jacks up the cost of health care tremendously . . .
And I think you are probably right - most of the people who are satisfied with their insurance have not had to use it - and most of them were not satisfied before we elected President Obama and they thought it was cool to pretend they are.
as a common tax free benefit when the number was
hardly worth noticing: say $3.50 to $4.00 a paycheck.
Social Security Administration did the same thing
with the Social Security deduction, At one point,
that deduction was a couple of bucks. Medicare
was added. It went along like that for a
while. Then, the regular increases started. And,
did they ever increase.
The thespians who made so much noise at
town hall health care meetings (and I hope
readers don't not object to the term, because,
in my mind, that is just what they are: actors.
Unless you wish to believe they are "patriots"
concerned about the growth of government,
(right), have one thing in common: none have
ever gone into their own pockets for any
medical procedure, appointment, or treatment,
in their entire lives.