My Little Family

In the car at 26th and Hiawatha, in extremely premature labor, I thought "I wonder if there is anything they can do with the baby; if we can donate it to research or something. I wonder if anything good can come of this." Then I thought "I wonder if our health insurance will cover this. We can't afford this."

After he was born and he was stabilized, I had a chance to revisit my nervousness about money. I called my health insurance representative from my hospital room. They said we were 100% covered. I asked again. "What about the baby?" "100 %" the voice said. I didn't really believe it, but I was relieved.

This was going to be expensive.

As I wound my way through my son's hospitalization and the statements started rolling in; as I learned more about prematurity and read up on the statistics, I started to wonder about other people. Sure, we are fine, but if other people are not, are we really fine?

According to The March of Dimes, in 2006, 12.8% of babies (542,893) were born preterm--an increase of 16 percent over ten years. Furthermore, "during 2004-2006 in the United States, preterm birth rates were highest for black infants (18.3%), followed by Native Americans (14.1%), Hispanics (12.1%), whites (11.6%) and Asians (10.7%)." The associated economic cost in 2005 was $26.2 billion. Preterm birth rates are highest for women over 40 and women under 20. Everything I heard from doctors was that they "don't really know" what causes it in most cases.

If you add in health insurance statistics, it becomes pretty likely that many of these preterm babies are born to women who do not have health insurance: 19.8% of women of childbearing age are uninsured; Hispanic women of childbearing age are twice as likely to be uninsured; Native American and African American women are also more likely to be uninsured; and 40.7% of all births were covered under Medicaid in 2002. Apparently, the care for one baby like mine could pay for the care of 12 "healthy births." To sharpen the focus: 40 percent of preterm births in 2005 were covered by Medicaid (1).

I am not uninsured. I am fortunate that my employer provides excellent benefits, and I would not choose a public option at this point. But what would happen if I lost my job, which is likely due to funding cuts? What would happen if I could not find another job that also provided benefits? Well, in my case, I could go on my husband's insurance. But he works for the same public entity as I, and his job could go away, too.

What would this little family do then?

My baby cost $20,482.62 to be born and another $355,316.80 before he could come home, and he had no complications. What if, like many of the mothers of premature babies, I had no health insurance? If it's not a "right," then is it just too bad, so sad about my tiny baby? After all, he has never worked a day in his life. What happens to the little family? That baby will be cared for, and someone will have to pay. Maybe it will be medical assistance. Maybe it will be the little family, for the rest of its life and beyond, most likely putting them onto, or keeping them on, some sort of public aid. For the rest of their lives. And beyond. Someone will have to pay.

Someone always has to pay.

Do I benefit from the despair of others? Do I benefit when fellow citizens are sinking under economic pressures, many of which are caused by health care expenses? In my mind, we all suffer. We none of us live in a vacuum; our society is only as strong as our most marginalized people, and we will sink or swim together, in the end. Someone always has to pay.

It's pretty obvious where I stand on this issue. I believe that health care is a right, not a privilege. I think that tying health insurance to employment does little more, in many circumstances, than keep people in unsatisfying jobs, often thwarting creativity and ingenuity in favor of very real concerns about the household bottom line. I do not believe that "the market" is the appropriate place to put our health and our lives. I do not believe that "the market" has our best interests at heart. I believe that "the market" cares most about "the market," and allowing it more license and access will not make it more responsible to real human needs. When profit is allowed into our health, I think our health suffers. I do not understand why people put so much trust in "the market." And yes, given the choice, I trust the government more. At the very least, the government has an agreed upon charter in The United States Constitution. "The market" has no such responsibility to the public trust.

I believe that Republicans are exploiting libertarians and marginalized people for their own gain, much as they exploited Christian fundamentalists. They use fear and negative emotion to get people on their side, people who--in the end--will not benefit from their policies or their platform. This is not to take a paternalistic view of the American voter who is Not Me. Emotion is a powerful tool, and politicians have always known that. It is the most successful politician who can exploit emotions to his or her own gain. If done in a positive sense, then both participants can gain from the relationship; if done negatively, people line up to participate willingly and loudly in their own demise to the benefit of those in power. I believe that many of the people against health care reform are benefiting or have benefited from some form of government assistance, even as they loudly decry it.

I believe that the current "debate" around the subject of health care reform, while not outside the bounds of historical, American political discourse, is dangerous and deplorable because of its disregard for the ideals of a civil government, its exploitation of fear, and its subtle (and not-so-subtle) manipulation of racism in order to gain a political end of dubious value.

I believe that dissent is essential in a republic in order to create balance and foster healthy disagreement and informed dialogue, but I believe that the current climate is precisely the opposite. I believe that protest from either side should be respected only when it behaves respectfully, and I do not believe that the current protests fit the bill. I believe that the lies being disseminated by the instigators of the opposition are an insult to the intelligence of our nation and are also, in their continuous use of Nationalsocialist comparisons and echoes of the Holocaust, an affront to the many different groups who did suffer cruelly and wrongfully in the 1930's and 40's in Europe.

I believe in this country's ability to eventually rise above this morass of hateful invective, but perhaps not before we can effect real change in how we go about taking care of one another. I believe that everyone who has heard the lies and who agrees with the need for a public option for health care coverage needs to speak out and be heard.

Because I believe that our numbers are larger.

1 Preterm birth By Richard E. Behrman, Adrienne Stith Butler, Institute of Medicine (U.S.).

Committee on Understanding Premature Birth and Assuring Healthy Outcomes.