President Barack Obama's Supreme Court victory in June saved his health care plan for the needy but also had a deep and rarely noted personal meaning: Obama's own mother, Ann Dunham Sutoro, suffered and died from cancer while unable to pay her medical and other bills.
It seems that quietly, Obama had sent a message to his mother in heaven saying: "Mom. No one will have to suffer and die as you did, unable to pay for basic medical care.
Sutoro, then remarried to an Indonesian man, was working as an anthropologist on literacy and micro-credit programs for the U.S. foreign aid agency USAID in Indonesia. But she held a contractor's job, which offered no benefits such as medical insurance.
So when she began to feel bad, the local Indonesian public health system offered treatment that was far below the U.S. standard. Her illness, according to her friend Kay Ikranagara, interviewed by phone in Jakarta in 2009 when I worked for USAID in Washington, soon spread and was untreatable.
Sutoro moved back to Hawaii in 1994 where Obama had been living with her parents. But she had no way to pay the extensive medical bills as doctors tried and failed to save her life.
His mother would certainly have benefitted from the Affordable Care Act (ACA) - pejoratively dubbed Obamacare by Republican opponents of the bill.
My mother Dr. Miriam Barber had also been disgusted by the pay-to-play medical system in New York City, when she set up her pediatrician's practice in our apartment after we moved to the U.S. from England in 1948.
"I can't stand to take money from the parents - they have no money and they reach into their pockets for a crumpled five dollar bill. I don't want to take their money," she said to me.
She also said she wanted to send patients for an x-ray or blood tests and couldn't do it because it meant sending the family with a sick baby on the bus or subway to a lab where they have to pay more of the money they don't have.
A few years later my mom joined the first HMO in the country - the New York Health Insurance Plan or HIP - and joined their pediatric clinic at Montefiore Hospital. By showing their membership card, families - mainly from police, fire and teachers unions-- could get everything done in the same building - pediatrics, radiology, blood work, specialists--at no cost.
That system enabled my mother to give top treatment to people regardless of their wealth. It did not however help millions of Americans who lacked any medical insurance-- until Obama's health care plan was passed by Congress and subsequently got a fresh bill of health from the Court.
Until the advent of ACA, Sutoro's fate was the fate of many Americans. Those with money or with jobs that provide benefits could get treatment covered. So can those with no money who are entitled to Medicaid.
Those in between like Obama's mother are left to suffer, often destroying all the elements of middle class life such as their home, car, credit and possessions to pay for medicine.
Only yesterday I heard from a friend caught in the same bind: he contracted Hepatitis C decades ago and now needs new medication that costs $1,000 per day for three months - about $100,000 for the cure. This is far beyond his means unless he sells his small farmhouse and the few acres of land around it.
So the tragedy of Obama's mother is symbolic of millions of ordinary Americans facing pain and suffering - unable to take their sick or even dying children to a doctor; or to have their infected tooth treated.
The tragic treatment of Sutoro in her final months is compounded by the selfless life she lived serving U.S. aid programs and helping the world's poortest peoples.
She spent more than 20 years in Indoneisa working on projects for USAID, The Ford Foundation, the World Bank and other orgnizations.
"Like me, Ann was a child of the '60s who ended up in Indonesia, ready to take up challenges," said Ikranagara from Jakarta in a telephone interview with me when I was editor of the USAID newsletter FrontLines. Sutoro was "an earthy person and an anthropologist--at home in the villages. She had a wide variety of friends beside the ex-pats," Ikranagara told me.
IN 2009, Obama told the National Prayer Breakfast that his mother" was the kindest, most spiritual person I've ever known. She was the one who taught me as a child to love, and to understand, and to do unto others as I would want done," he said.