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What No One Tells You: The Shame

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Audrey's got advanced degrees and owns a mental health care practice. We got together last week to drink some good red wine. Inevitably, last month's "Going Rogue: Kiss It, Kaiser" blog came up -- the one about how I snapped and politely told my health insurance carrier to kiss my naked backside.

Somewhere in the midst of enjoying our respective second rounds of Pinot, she put her head in her hand, stared into her glass and said, "I haven't been insured in two years. I couldn't afford it anymore; not if I want to keep the house." We both stared at our reflections in the bar's mirror.

Then there's the Ph.D.-holding, award-winning classical music composer and conductor I've known for more than 20 years. He launched a music teaching program that has won awards. He emailed me that he's been living uninsured for more than a year. "I can eat, or I can go to the doctor," he emailed. "I chose food."

My neighbor is 27 years old and working around the clock to complete an IT degree to financially better his family that includes 18-month-old twins. "Even the school's policy costs too much," he said, helping me schlep a trash bin.

I'm not one lick surprised to learn of others' non-medical-insurance conditions. I fully expected to hear of those who finally threw in the towel, as did I, after my carrier raised its premiums (despite my self-propagated, excellent health) from $400 a month to more than $1,000 a month within the last few years -- simply because they could.

What I didn't see coming, what I did not expect, was how ashamed everyone is about their lack of coverage. I've been caught off guard, these last weeks, when friends and acquaintances have cornered me and whispered of their own non-insured situations.

No one told me of the outright embarrassment that perfectly responsible, 50-hour-a-week working folk suffer as they quietly, reluctantly and often painfully relinquish the financial protection they originally sought in having their medical bills financially covered.

All this collective shame seems terribly wrong. Along with all the other pains that presently accompany the United States' health care crisis, now comes yet another layer of burden: that of added mental and emotional despair.

Some might judge the non-insured. It's easy, assessing those who might well go bankrupt should medical crisis strike. It's tempting to say that they (which includes me) should have planned better.

Accusation and admonishment are aplenty.

That's pure hogwash. If you need a roof and you need food and you need to get to work and school and keep the kids' feet in decent shoes, survival comes first. If you work your tail off and live a good life and the income can't absorb ever-increasing health insurance premiums, premiums that currently surpass many a monthly mortgage payment (as did mine), self-insuring can and often is the only thing left.

An M.D. reacted to the blog about walking away from insurance costs running amuck like this:

"It would take millions more (people) to walk away so that insurance companies and, yes, the government wake up to the truth ... I don't believe health care is a free enterprise commodity. I think it should be a right under the Constitution because without it, there cannot be life, liberty or any happiness. Eighty percent of health care cost is medico-legal issues. If we solve this, we can resolve the health care issue and will be able to afford health care for all."

I don't know the correct emotion to this crisis: shame, embarrassment, helplessness or anger. Maybe there is no correct emotion.

I do know that last year a visiting house guest fell while on a walk, suffered a head injury and, even when she grew drowsy, found enough presence of mind to say (in a concussion-infused panic), "Don't you dare call an ambulance. I can't afford it. I don't have insurance."

It was a mortifying moment for us all.

If you've spent any time in a third-world country, you know that there's no place like home. America the beautiful is where anyone can be anything -- a black man can be elected to president, twice. Openly gay and bisexual people can serve in the armed forces, the Senate and beyond.

We just can't be sick.

To hell with the shame. Like the black, the homosexual, and the bisexual visionaries who refused to live as second-class citizens and who now look to make law, there's a synergistic dissatisfaction, a rumble in the country's soul. The U.S. can and should address this exigency.

Because a family dealt the blow of a child with cancer should not also be forced to endure a crippling bankruptcy in the treatment of that child.

Allowing such conditions? We should all be ashamed.

For more by Cathie Beck, click here.

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