THE BLOG

Health Care Conundrum: Worth The Fight

04/14/2014 12:43 pm ET | Updated Jun 14, 2014

As a mother of two grown sons, a sister to nine and an aunt to 21, things can become blurred. When it comes to our "children" there's a tacit agreement between us: They are priority one. So when my phone rang in late February and I heard the tightness in my sisters' voice, I listened intently. Her only child, her adult son, had been diagnosed with cancer. Since that call and this post, he has visited two oncologists, gone through imaging studies, surgery and is now in the care of his physicians as he heals and awaits outcomes. This is a vital, incredibly talented and smart young man with two beautiful children. He is the second of my sibling's (now) adult children to face a serious illness. In my niece's case, a diagnosis of AML came as she turned the corner of her 20th birthday. Covered at that time by her dad's employer sponsored plan, she faced multiple hospitalizations, a bone marrow transplant and the interruption of the beginning of her college education. A hard won scholastic scholarship had gained her entry into Amherst College. Fast forward 10 years, and she is in medical school. That up close and personal brush with her own mortality will be of great use when she embarks on her healing work as a physician. The thing about serious illness, however, is you have to wait for outcomes, and you have to fight through difficult days. You have to allow others to help you, and you have to challenge your thinking. Being diagnosed is just the beginning. So when an individual has health care, they focus on the task at hand: getting well.

Now we have been offered the opportunity to enroll in health care as singular individuals. If my nephew had not enrolled, he would likely not have seen a doctor in the first place. When he did get covered, he headed off to see his primary care doctor. It had been a couple of years since he had coverage, so he wanted to check in and make sure all was well. Had it not been for the looming deadline to enroll in health care he may have ignored that. He is so busy working three jobs that he rarely stops to care for himself. As statistics are shot back and forth like a wild west gun battle over whether the Affordable Care Act and the enrollment of an estimated seven million Americans will be worth it, I raise my hand. Yes, it is a success. It is a game changer. One may consider is one person's life really that important? That would depend in part on how you define life and worth. Is it worth years of vitriol and contention that has focused on overturning decades old laws with the outcry of "it's a life, not a choice"? Screams of support for the unborn have gone on for years. I contend that there should be equal concern and support for the people who are here right now, presently. I am satisfied that a decision was made and the process of insuring people has finally begun. It's so overdue that the implementation itself has been anticlimactic. The outcomes are being measured with the same yardstick that alternately gives us high unemployment numbers one day and the next the measurement may be questionable because the actual people that are unemployed "are hard to quantify"? Please let me know how these polls are conducted because I'm in touch with many people on a daily basis that are quantifiable. They are working like my nephew, part time jobs with full time school, or part time jobs and entrepreneurial work. Some are pulling themselves up with weak arms at the deep end of the pool, having survived the long swim from job loss, home foreclosure, and deep depression to rejoin the living and redefine their status quo. No matter how they are feeling, I can assure any poll person that they are indeed quantifiable.

I have worked with employee benefit plans for years. I was in high school when Richard Nixon signed the Health Maintenance Organization Act in 1973. We were so much like the youth that I love today. Disillusioned as we watched another costly and unnecessary war wind down, too young to be fully engaged with the world at large, we were gathering up steam to figure out our lives. A decade later, and I was fully engaged as I was working for a large company and we were about to have an open enrollment that would include an HMO option. Many thought the HMO plan concept would never work; people would not be satisfied with having to go to physicians that were in a network. There was conjecture about the participating physicians and the fact that they would likely not be quality doctors. There was conjecture about disproportionate numbers of migration to the HMO plan creating the illusion of adverse selection. I understand the big picture and the complexities that have to be figured into profits and performance and I even understand the fear of change. It has never stopped me from making a hard decision, though, because that state of inaction is crippling. The single most effective way to block change is to create an atmosphere of fear. Conversely, if you educate people and allow them to choose, they will do what is best for them. Healthcare is not a frivolous giveaway. Without health care, my nephew would not have gone to his doctor as soon as he did. He went to "check in" and was met with some really unexpected news. If only our elected government officials were as pragmatic and committed to values as this young man that works hard and pays their salaries is. When we cut through the morass of web failure, false starts, and subjective statistics, I thank those that did not give up before they saw this enacted. I am an advocate of social justice. Not Socialism, social justice and doing the right thing. Now my nephew can work on getting well. He has a lot to do.