Health Care

(Note: usually, I leave this sort of stuff out of this particular blog because it's political, and I try to keep that sort of thing out of here. But this really is related to The Boy, as it's my experience.)

In the car at 26th and Hiawatha, 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 vaccuum; our society is only as strong as our most marginalized people, and we will sink or swim together, in the end.

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. "The market" cares most about "the market," and allowing it more license and access will not make it more responsible. 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.

Do we really want the nation's health in the hands of the people who handled our mortgages?

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

Committee on Understanding Premature Birth and Assuring Healthy Outcomes