08 July 2007

The Personal IS Political

Back in 1974, as a high school junior, I had to research and write a term paper for my English class. I chose to investigate comprehensive medical care, and my Canadian father helped by mailing envelopes bursting with information on Canada’s medical system. I also learned about England’s system. And I read story after scary story about the abuses of medicine for profit, e.g. doctors performing unnecessary hysterectomies on poor women of color. I became 100% convinced: we needed to remove the profit motive from medicine.

Call me old-fashioned; call me naïve -- I probably am. But naïveté speaks of a good heart, and I’d rather be hopeful than cynical (although cynical comes pretty easy these days). I believe that government’s function is to provide for the general welfare of its populace, that we elect representatives to take on the job of seeing to those needs that affect us all. Health care affects us all. And the cost of health care has become unbearable.

Count me among the millions of America’s uninsured citizens. As a self-employed single woman, I cannot begin to afford medical insurance. Up until now, I’ve found my way around this obstacle; I live a reasonably healthy lifestyle, and get what medical care I need through the local health clinic at sliding-scale fees. Even paying cash for dentists and eye care, I spend far less than I would on private-pay health insurance. By the graces of good health and state-funded health programs, I scrape by.

Until yesterday, when I went to the pharmacy. Ah, the heartbreak of psoriasis; a plague on my skin for pushing 30 years now. The only thing I’ve ever found to help was a synthetic Vitamin D brand-named Dovonex, sold through Bristol-Myers. For many years, Dovonex was available through a program that some pharmaceutical companies provide for those of us floating in limbo: too poor for health insurance and too wealthy for public assistance. But a couple of years ago, Bristol-Myers discontinued offering Dovonex this way. I dug deep and paid for a couple of bottles of scalp solution, which I’ve eked out over time, along with the cream I still had from the “free” days. But my supply is running low, so my doctor called in a new prescription for me. Yesterday I went to pick up the drugs, only to learn that I couldn’t afford them. They had gone up in price to over $200 EACH, five times more than I had anticipated, based on my (sketchy) memory. Ouch. I told the pharmacy clerk to restock the meds; I will have to do without them. (I also had the small-town joy of saying this in front of a former client, who was standing at the counter at the time.)

There is no good reason that this product, which has been out for years and would have recouped its research-and-development costs long ago, should cost so much. Except for greed. I doubt the higher echelon of Bristol-Myers ever has to worry about how to pay for their medicine, let alone how to afford medical insurance. (In his 5/19 review of Sicko in Time, Richard Corliss notes that “HMOs and pharmaceutical companies have made billions while Americans have health care below the standard of other industrialized countries, and pay more for it.”) So here’s my idealism again: tax the rich. Skim the financial cream off the obscene excesses of the rich – those who keep getting richer while the poor get poorer – and pool the money into funds that provide for the general well-being of all, including comprehensive medical care. It’s a bloody sin that the executives of pharmaceutical companies are swimming in wealth while I (and people like me) can’t afford medicine.

I realize that this is a simplistic answer to a complicated problem, and that creating a government-funded medical insurance program that works is challenging. Hopefully the Democrats will manage to institute a sensible and successful program. (Okay, I’m being a dreamer again.) All I know is that we need comprehensive medical care. Of course, after presenting my mounds of research and resulting thesis to this effect years ago (as the oral presentation part of my project), Mrs. Hastings’ response was a snide “You realize you’re proposing socialism, don’t you?”

I never wrote the paper.