Differing Perspectives: Health Care Take Two

I had two very different medical appointments today. The first was a birth control consult at Planned Parenthood so I could get another pack of birth control to see me through to my annual check up appointment. The second was with my mom’s dermatologist to look at my problematic underarm mole. She had written to him to ask if he would be willing to see me and give me an estimate on costs so I could save up and self-pay for his services.

In the morning I saw a nurse practitioner at Planned Parenthood. She went over my paperwork, advised me to get a mammogram, or at least a full breast exam, and agreed to give me one more pack of pills to tide me over until my appointment. Even though my paper work made it clear, she asked me if I had insurance. I said, “No, I work in daycare.” I say this because I think society ought to know that most of the people who care for our children do not have insurance, and isn’t that shameful? Her response was to suggest that perhaps I get job training so I could get a better job.

Wow.

So many different things ran through my mind. First, that daycare work is not something someone would do voluntarily, which in turn implies that only the desperate, and uneducated would do child care. That implies that I am desperate and uneducated, and while I resent that assumption, I am more resentful and appalled by what that attitude says about how we should care for our children—only the uneducated and desperate should care for young children. Didn’t she realize how important early child care education is? How important caring, knowledgeable, skilled, and effective daycare is for babies and toddlers? How quality daycare forms the building blocks of school success or failure, and thus of adult success or failure, and how that impacts us all when those little children grow up? Apparently not.

This topic is so large and complex that I couldn’t think up a quick response. Instead, all I said was, “I have a Master’s degree. I have plenty of education. And experience. Beside, I like the work and I’m good at it.” She backed off, saying something about how I must have it all thought out, another comment showing she didn’t get it. Then she suggested that I at least buy catastrophic medical insurance which would pay for any large medical crisis that I might have. She said that was what she had and it was cheap.

“What does cheap mean?” I asked, and she answered that she paid only one hundred and fifty dollars a month. “That’s not cheap,” I said. Again, she backed off, but her tone implied that I was being irresponsible in not buying insurance. After all, I was getting free care from Planned Parenthood, wasn’t I?

I shouldn’t be surprised. Our system is flush with the attitude of blame the victim. Of course it is my fault that the insurance system is failing. It is because people like me don’t do our share and pay big chunks of our barely-making-it-as-it-is-paychecks for insurance that doesn’t even cover moderate medical problems, let alone small medical needs. I would be crazy to buy catastrophic medical insurance. Even as healthy as I am, I need that $150 a month to pay for my own minor and moderate medical care needs out of pocket.

For example, take my second medical appointment of the day. The doctor looked at my mole, and did a check for other problematic moles. He told me that he didn’t like the look of one on my arm, and though they probably both were benign, it would be irresponsible of him not to take them off. He told me that, since I was self-pay, he could waive his fees for the office visit and the procedure, but he would have to charge me for the lab tests since that was done out of office. He asked if that was OK with me, and I agreed.

Without further ado, he numbed up the moles, cut them out, and sent them off for testing. He and his assistant chatted with me amiably, keeping me distracted and comfortable. When he was done, he shook my hand, told me the results would be back in a week, and thanked me for coming in. I was in and out in a half an hour.

I walked away from this encounter feeling like a proud fellow professional. His attitude towards my work was not one of charity, but of doing his part for the community by keeping me healthy, as I was doing my part by taking care of the children. My earlier appointment left me feeling like I was a leach for doing work beneath me and that I was taking advantage of the system to support my lazy ass.

Once again I circle back to hierarchical dualism, the dominance paradigm that rules our society, a world view which is based on fear. Our insurance companies have grown bloated and fat off of this fear. Avarice, conceit, and their own fear-based world view have allowed health insurance companies to become billion dollar businesses; businesses that feed off of the pain, suffering and fear of others. They keep health care limited, a scarce commodity, and use our fear of not getting what we need to keep us separated. Divided, we can do nothing, and, thus, nothing changes.

And yet, there is hope. Within this world of fear, there are pockets of resistance. People like the dermatologist I saw today, who value working together to make the world a better, not a scarier, place. Only by working together will we be able to reach across the divide of fear and begin to weave a world of care and abundance. It is slow, hard work, and we often go unnoticed and unappreciated. And yet it is the only way to truly transform the world. In my book, that makes it worth the price.