Here A Ration, There A Ration

A temporary free clinic in Houston, TX.

There’s a giant fear running around out there that a government-run health care system is going to create the rationing of health care. Americans needn’t be afraid because, guess what? Rationing already exists in our current healthcare system.

What is a life worth? And are some worth more than others?

The National Association of Free Clinics recently set up a temporary clinic in New Orleans to offer health care for those without insurance. Ninety percent of the patients who came through the clinic had two or more diagnoses. Eighty-two percent had a life-threatening condition such as cardiovascular disease, diabetes, or hypertension. Some hadn’t seen a doctor in a decade. One woman went home without a referral, choosing not to treat the stage-four breast cancer that had gone undetected because of her lack of insurance. This picture of people in need of serious care is just one example of the rationing that’s happening all over the country.

A study was just released by Harvard University showing that uninsured Americans are more likely to die in the Emergency Room than those who are insured. Experts in the field say that patients without insurance are often transferred to “financially strapped” hospitals with less equipment and less staffing. Hmm…some people getting to stay at the hospital that has more life-saving equipment and staff, and others being sent away. Sounds an awful lot like rationing to me.

Add up an employer-based health insurance system and more than 2 million jobs lost already in 2009, and you get a whole lot of people without access to health care. Tell those people you’re worried about health care rationing and they will laugh in your face (or possibly hit you).

It’s clear that rationing has to happen in some regard – Peter Singer points out in his New York Times article “Why We Must Ration Health Care” that if you believe there is any limit whatsoever on the price that should be paid to keep a person alive for any amount of time, then you believe in rationed health care (including, as he points out, 1 million dollars to extend a person’s life by 6 months). The truth of the matter is that for all of us to be able to visit the doctor when our bones break or when illness strikes, something has to give. It seems that we’re very willing to talk about a few cancer patients who are being denied expensive life-extending medication, but are unwilling to broach the subject of the 45,000 Americans who die every year because of their lack of health insurance.

Perhaps what people mean when they say “I don’t want the government to ration health care” is “I don’t want the government to ration my health care.” Isn’t it about time we thought about the greater good on this one? Or is that just an antiquated socialistic notion.

Don't worry, little lady -- we'll take care of you later. Honest.

I just can’t let go of this “abortion coverage in health care reform” issue. The more I learn, the more commentaries I read, the more enraged I get. Let me count the ways:

Quite apart from the abortion question, the reform bill passed by the House omits basic preventive care for women. Not one of the bills emerging from the House and Senate requires insurers to cover all the elements of a standard gynecological "well visit." This means the basic health care that most women need – and use, thereby helping us avoid more serious illness and disease – such as pelvic exams, domestic violence screening, counseling about sexually transmitted diseases, and, oh yes, birth control, will be off the list of basic benefits all insurers must cover. Mind you, laboratory testing of our PAP smears will probably be covered, but not the visit to the doctor who performs the test. How’s that again? Yep: be sure to send the sample to the lab, but I guess you’ll have to learn to take the sample yourself.

But back to the abortion question. Will someone please explain to me why religious organizations and ideologues get to decide what care will be covered by my insurance plan? I know, there will always be some things not covered. But how did my uterus become a bargaining chip? And why are women being castigated for ‘insisting on the perfect plan when reform is necessary’ just because we want to be able to make choices about our bodies, and have the most basic care? I know, we’re only 51% of the population, so maybe we’re just another silly special interest group, but . . . no, we’re 51% of the population, and we’re neither silly nor a special interest group. What’s more, we are really tired of being asked to ‘take one for the team’, as Katha Pollitt has said.

And let's be clear: The Stupidak (sic) ban would prohibit millions of women from using their own money to buy private health insurance that provides comprehensive health care benefits.

Not only that, but why is it that my taxes must pay for things I abhor (war, tax exemptions for religious organizations that engage in electoral politics but deny they do, obscene agribusiness subsidies) yet other people’s abhorrences are codified into federal law? There’s something fundamentally wrong there. (Pun intended.)

I know it’s an old cliché (are there such things as new clichés?) but really: just tell me, Bill Clinton and Al Franken and E.J. Dionne and all the rest of you Y chromosome people yammering about how we just have to hold our noses and accept this bill – how about if instead we preclude coverage for prostate cancer screening and treatment, vasectomies, and erectile dysfunction? You can buy a rider for those. If you can find one. And you can afford it.

Don't stand for this. Please tell your senator to STRIP THE STUPAK BAN from the Senate version of the health care bill.

Got a soapbox? Use it wisely.

Look at this horrible, horrible advice.

A woman is raped by her boss on a business trip, decides to have the baby, her husband leaves her. Years later she wants to reconnect with her ex, and writes to Lesley Garner (an advice columnist for the UK’s Daily Telegraph) for guidance.

Garner’s reply: You weren’t raped, you should’ve had an abortion, and your husband’s awful reaction is completely understandable.

Seriously?

Writers with access to large audiences have a responsibility to talk about women’s issues in a way that makes sense and doesn’t reinforce hundreds of years worth of oppression and stereotypes.

An advice columnist is uniquely positioned to A. set a graceful example for handling tough situations by showing a true grasp of what someone is going through, and B. make an important introduction that feminists have advocated for decades – “Hello, Personal, I’d like you to meet Political – I think you’ll find you have a lot in common!” There’s an opportunity in this column to bring awareness to all kinds of political issues (workplace harassment and assault, a woman’s right to choose, single motherhood...), but what does Lesley Garner do? Blame, scold and shame the victim.

Ignoring the bad apple for a moment, I’d like to point out some people using their soapboxes for good, not evil: The Sexist , who tipped me off to Garner’s faux pas. Also, Bitch Magazine (especially in a recent article pondering what the world would be like if we reacted to rape the way we are to H1N1.)

If you’d like to advise Lesley Garner on better ways to use her column, you can contact the Daily Telegraph here and comment on the original article here.

Here’s an opportunity that hasn’t yet been missed: The Seattle Times recently covered a story about a man who disappeared suddenly last year. (He was found sometime later living in another state under another name.) The article points out the extraordinary attention the case garnered – anonymous tipsters called in with their theories, guesses, and offers to assist.

How often do you see a “woman goes missing” story get that kind of response? I think it’s a point that deserves to be raised in a public forum by a reader. Original article here if you’d like to comment.

Photo credit: visual.dichotomy

More Hand-Washing Won’t Protect Family Economic Security

How many of you know someone who has been sick in the past month?

If we were standing in a room together, chances are, every single person would have his or her hand up. This week alone, in my son’s classroom of 29 kids, 14 were out sick – as well as the teacher. Nationally, at least 600 schools have had temporarily closures – including 351 schools last week alone, affecting 126,000 students in 19 states.

The sensible advice, of course, is to keep your sick child home – or to stay home if you yourself are sick. But what if your family cannot afford for you to do so?

Consider these facts:

• Only 61% of private sector employees have access to sick pay for their own illness or injury, and nearly half (47%) of working women in the private sector (approximately 21 million) are not able to take a paid sick day when they are ill.


• The lower a worker’s wage, the less likely she or he is to have access to paid sick leave. (See chart here.) More than half (59%) of minimum wage workers are women.


• Industries with some of the most public contact – retail trade, accommodations and food service (which are also the industries that employ the most women) – are also the least likely to offer paid sick days. More than half (55%) of retail workers and (78%) of accommodations and food service workers lack paid sick days.


• Even when workers have access to sick leave, they may not be able to use it to care for their family member’s illness. (In Washington State, the Family Care Act does allow workers with available paid sick leave or other paid time off to use that leave to care for sick children, and, in certain limited circumstances, also for other ill family members.)

It’s a Catch-22 for working families: either (1) go to work sick (and send your kids to school sick) and spread illness, or (2) don’t go to work and lose pay – or worse, your job.

Legislation such as the Healthy Families Act, which would provide seven sick days a year to workers in companies with 15 or more employees, would help eliminate this economic insecurity. The Obama Administration recently announced its support for this federal bill.

No longer having to worry that your food service worker is spreading H1N1, because she couldn’t afford to stay home? Helping sick kids get better, without their parents having to risk their jobs? This kind of policy sounds like just what the doctor ordered.

If you have faced a conflict between your work and family responsibilities because of H1N1 or other illness, please tell us your story.

Score: Religious Bigots and Indifferent Congress -- 1. Women's Needs and Rights -- 0.

Remember that scene in the first Harry Potter book and movie, where Ron Weasley directs a chess game with Harry and Hermione taking the place of chess pieces so Harry can proceed to the next obstacle in recovering the Sorcerer’s Stone? Well, that’s how I – and hundreds of thousands of women – feel in the health care debate right now. Except my side isn’t winning the game.

Nope – we’re just pawns, our health care needs and rights at the mercy of a) the Catholic Conference of Bishops; b) members of Congress, who have the best health care coverage in the country and a seeming indifference to the life realities of the rest of us; c) so-called “blue dog” Democrats, who couldn’t care less about the well-being of the people as long as their importance is honored; d) the wimpy Republicans who have forgotten what it means to keep government out of people’s lives – or that it was ever a central tenet of their party; e) President Obama, who needs to stand up for the rights of all women – including his daughters.

I want health care reform just as deeply and passionately as you do. But I also want, and I deserve, to be treated equally and fairly. The bill passed by the House of Representatives yesterday not only freezes into law the horrific Hyde Amendment prohibiting government from providing funds for abortion, it goes further, limiting coverage even for women paying for their abortion without government subsidies. That’s right, folks: according to The Washington Post, if this bill becomes law, thousands of women won’t be able to use their own money to get health care they are constitutionally entitled to obtain.

The Catholic Conference (which to its credit has long pushed for universal health care) won the day in the House yesterday. “We think that providing health care is itself a pro-life thing, and we think that, by and large, providing better health coverage to women could reduce abortions,” said Richard M. Doerflinger, a spokesman for the anti-abortion division of the Catholic Conference. (Just curious: why do they label it the ‘anti-abortion division of the Conference’? Isn’t that redundant?)

“But we don’t make these decisions statistically, and to get to that good we cannot do something seriously evil.”

Right back atcha, Mr. Doerflinger: what you have done is impose your religious views on me, my nieces, cousins and hundreds of thousands of women. And in our constitutional system, which is supposed to guarantee freedom of and freedom from religion, that’s another kind of evil.


P.S. Don’t be thinking it’s just health care. Good news from last week: the Senate lifted most of the long-standing restrictions on use of non-federal funds for legal services activities. Bad news: it specifically left in place restrictions on assisting clients with legal issues related to abortion.

The Polarizing Effect of Politics

I’ve lived on or near Capitol Hill for some time now. I often refer to it as “the hill,” though I’m clear on the fact that there are 7 different hills here in Seattle. It’s just the only one that matters...to me.

Sometimes it’s tempting to wrap ourselves in our own little world, surrounded by those who think just like we do. Remember 2004 when you didn’t know a single person who voted for George Bush and wondered how on earth the man got elected?! (King County went nearly 65% for Kerry) Immediately following the election we began to see vivid maps of blue coasts and the red heartland, accompanied by half-hearted threats of secession from blue-staters. I remember feeling so far removed from the thought process of someone who believed that four more years of what we’d experienced was a good idea.

Looking at the results—by county—of Washington’s Referendum 71 battle, gives me this same feeling of dismay (and makes me realize why my partner and I spend the majority of our time in the northwest corner of the state). East of the mountains, it seems there was very little support for domestic partnership rights, with some counties rejecting R-71 at rates of 60 and 70 percent. As the Seattle Times points out in an article posted today, “Part of the challenge facing gay-equality supporters, both here and across the country, is that not many gay families and individuals live in rural areas and smaller towns, many preferring urban centers where they feel more comfortable and have more legal protections.” But there’s another way to look at these statistics: If 60% of people voted down domestic partnership rights in Spokane County, that leaves 40% who voted for them. And we mustn’t forget that there are still 35% of people in King County who disagree with equal rights for gays and lesbians. (Ruby, of the “Are We Married?” blog talks about this notion in her recent post “What I Learned At Wendy’s: An Accidental Meeting with Small-Town Gay America")

"There's two sets of values in Washington.” Says Larry Stickney of Protect Marriage Washington. “There's values in Seattle, and there's the rest of us." I think it’s easy to buy into the color-coding of values. But are we really that different? Do we actually live inside of these red/blue dichotomies? Or is our reality closer to a shade of purple.

In any case, it’s vital that we talk to everyone, everywhere about the importance of equal rights. Whether you’re in the presumably safe haven of a Capitol Hill coffee shop or in the middle of nowhere .