The Inhumanity of “Affordable Care”

public-opinion-supports-new-proposal-in-health-care-reform_largeA few days ago, the distraction of actual governance in Washington was the report on Employment, the economy, and the effect of the Affordable Care Act published by the Congressional Budget Office (CBO). As usual, the talking head of Washington, Republicans and the Democratic White House included, missed the point.

“It confirms what we’ve known all along: The health care law is having a tremendously negative impact on economic growth,” said Sen. Bob Corker (R – Tenn).

“At the beginning of this year, we noted that as part of this new day in health care, Americans would no longer be trapped in a job just to provide coverage for their families, and would have the opportunity to pursue their dreams. This CBO report bears that out, and the Republican plan to repeal the ACA would strip those hard-working Americans of that opportunity.” – White House Press Secretary.

The point missed by both sides, and it happens all the time, so often that many of us have become numb to it, is that they are talking exclusively in numbers of a system which is just as well, if not better, described by the lives of the people they serve.

An analogy:
I had cause to take my friend Sharon to a dermatologist she had never visited before. It was an emergency visit. Sharon had been in and out of the hospital for a few months, and one day, at home, her arm blew up. Her slender arm, where she had a pic-line for IV fluids she had to take at home, suddenly, within hours, inflated almost beyond recognition. She called her nurse, and she called me. What I saw was a Thanksgiving’s Day Parade version of her left arm. We took a picture and sent it to her doctor – anything to avoid going to the hospital, which she had already seen too much of. The doctor called ahead to this dermatologist to take a closer look.

I took Sharon there. She filled out the paperwork. Along with Benadryl, ice, and then heat, the doctor diagnosed her with an allergy to the adhesive of her bandages. After two hours, Sharon was all better; tired, but better. We stopped at the office counter on the way out, so that Sharon could make whatever co-pay was needed. The office accountant happily announced, “Your insurance said that you’ve already met your deductible; isn’t that great!”

I’m sure that the woman meant to say something positive at the end of the long visit. She probably didn’t realize that a fulfilled deductible also meant an exhausting road of illness. How could she know all that Sharon had already endured, and that this was just one more stop in pursuit of better health?

Sharon set her straight, “Do you know how sick I’ve been before I reached the deductible? It’s not worth the savings.”

doctor-photoThe Washington Post points out that the CBO was less partisan in its actual findings:

“In its assessment of the law’s impact on the job market, the agency had bad news for both political parties. In an implicit rebuke of GOP talking points, the CBO said that there was little evidence the health-care law is affecting employment and that businesses are not expected to significantly reduce head count or hours as a result of the law.
But the report also contained a setback for the White House. The CBO predicts that the economy will have the equivalent of 2.3 million fewer full-time workers by 2021 as a result of the law — nearly three times previous estimates.

After obtaining coverage under the health-care law, some workers will choose to forgo employment, the report said, while others will voluntarily reduce their hours. That is because insurance subsidies under the law become less generous as income rises, so workers will have less incentive to work more or at all.”

Just as the secretary at the dermatologist’s office spoke to Sharon with only an eye to dollars spent or saved (which really required high expenditures first), so it is when politicians speak about Health Care, as if the care we are speaking about is not about people at all.

I take for granted that both sides, liberals and conservatives, are arguing not about whether or not health care is important. They (ultimately, at least) are arguing about how we should go about providing it. Either because of the political climate and the need to score-or-punish, or, the abstraction of talking about the systems underling funding, both sides have lost the language of human value which underlies the necessity of a government caring for people – real people, such as Sharon.

A parallel exists between the health care debate and the Tower of Babel story.The_Tower_of_Babel
What did God see at the Tower of Babel that was so infuriating? The Torah never tells us, but it was so bad that God could not allow this first Biblical community to continue. Our sages suggest that it was not the building of tower itself, but rather HOW the people went about building the tower that drew God’s ire. The people were so focused on building the tower, they forgot their humanity.

“The tower was built with steps on the east side and on the west. Single-file, each person would climb up on the east side, place the brick, and descend on the west side. When a person would fall from the great height, they people of Babel would lament, “How long will it be until someone can bring up a brick to replace the one that was just dropped?”

As we continue to discuss the affordability of healthcare, I suggest that we, and the leaders we elect into office, have in mind real people in our lives who have been in need of great care. My hunch is that over the next decade or so, we will indeed develop better cost structures in health care. What we can’t afford is losing our humanity along the way.

 

Posted on February 11, 2014

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