Thursday, August 13, 2009

The Struggle for Health Care in the U.S. Today: A Personal Statement

It occurs to me to accompany the postings I’ve been making about the health care debacle and town hall meetings with some first-hand testimony about my own struggle with the American system of health-care provision. For readers who have followed this blog for some time now, these stories won’t be new. But for those who log in only occasionally or may be new readers, the personal angle I bring to my analysis of the health care debates may not be apparent.

Warning: personal testimony to follow. For readers who do not welcome such personally revelatory statements, please be forewarned that what follows is written from personal experience and from the heart, without a great deal of intellectual baggage to cover over the emotional depths the narrative discloses.

I write about these issues—and it’s important to acknowledge this—as one of millions of Americans who have no health insurance, and who, as a consequence, live in constant anxiety about what might happen if we need medical treatment. As those living in the U.S. know, having health insurance depends absolutely on having a job.

I don’t have a job—not a full-time paying job, that is. I have been out of work since the summer of 2007, when my job as the academic vice-president of a United Methodist university in Florida ended precipitously and unhappily, through no fault of my own.

Through no fault of my own: that’s an important qualifier to make here, one that applies to me as well as to millions of others who are out of work. There is a tendency among those who have secure jobs—a tendency rooted in the Puritan theological substratum that so powerfully informs the American imagination—to presuppose that those without jobs and health coverage deserve to be where we are. We haven’t worked hard enough. We haven’t tried. We can’t keep a job due to our lack of a strong work ethic and lack of righteousness. (We're black, we're lazy, we're immoral, we want to sponge off other hard-working Americans.)

I resist those judgments, though the leader of the United Methodist university that has put me in my current situation has sought to make several of them (e.g., the charge that I did not work hard and am incompetent) stick in my case. I resist them because they are untrue and I know they are untrue. People sometimes lose their jobs through no fault of their own, because of gross injustice, because of the malfeasance and lack of integrity of their supervisors. Or because of prejudice, simply because of who they happen to be. Not because they have failed to work hard and have not excelled at their work.

And when they lose their jobs, they lose health coverage—effectively speaking, in almost all cases—in the United States. It is hard for my European and Canadian friends even to imagine what happens to someone in the U.S. who is without a full-time job. The systems of almost every other developed nation in the world assure that for someone without work, the added anxiety and burden of not being able to seek medical treatment will, at least, be lifted from one’s shoulders as one copes with the indignity and pain of unemployment.

I happen to know the Canadian system, since I lived in Canada for six years as a graduate student and qualified—solely because I was a human being and happened to be living in that country on a student visa—for national medical coverage during my years as a graduate student in Canada. I did not pay a penny for this coverage. I could ill afford to pay for any medical treatment I received in Canada, in any case, because, like many other graduate students, I lived on a shoestring budget during my years of study.

I can say from first-hand knowledge what a relief it was during my years of study in Canada to be able to go to a doctor, knowing I would be seen and treated when I needed medical help, without anxiety about how I would pay. I never paid a single doctor’s bill in my years in Canada, though I had good, ongoing care all the years I was there. I did not pay for any medicine I took in those years.

That system spared me, as it spares millions of people in other developed nations, the kind of anxiety I now face on a daily basis while I am unemployed. Because Steve and I simply cannot afford for me to buy any health insurance on his salary—because, as I have noted previously, we are now saddled with mortgage payments for a house we bought in Florida solely because the “friend” who ended our jobs there in 2007 with specious and unjust reasons for her actions had promised us jobs up to our retirement—I live without health insurance.

Like many gay couples around the country, we live in an area in which few employers provide partner benefits. So I am unable to qualify for health insurance under the plan that covers Steve as a full-time employee.

The upshot is that I do anything possible to avoid seeing a doctor. In the two years I have been without health insurance, I have been to see a doctor twice, to the best of my recollection. Those were occasions on which I simply could not defer seeking medical treatment. I paid out of pocket on both occasions, and when one of those visits required me to fill a prescription for an antibiotic, I found that the pills were astronomically, prohibitively expensive. But I had no choice except to pay for them, out of my pocket.

I have been to the dentist twice in the same period, again, because I simply could not avoid going. I put off regular dental check-ups, and I have ignored calls reminding me of my need for a colonoscopy, as part of the ongoing care my previous doctor recommended for me as a man nearing 60, who suffers from mild high blood pressure and is at the borderline of diabetes. I cannot begin to think of paying for the kind of routine, ongoing exams men of my age need. I just don’t have them done. I pray a lot.

I’m told that, if some emergency did come up, I could surely obtain treatment at an emergency room. I like to think that’s probable. I’m also aware that anyone going to the emergency room at many American hospitals is likely to encounter all sorts of obstacles, and can also sometimes receive less than optimal treatment from the over-worked ER staff who do not know those they’re treating, and who haven’t followed the particular needs of these particular patients.

I’m also aware—and I live in great fear of this—that ongoing medical treatment, if I’m in a situation of calamity, could simply wipe out all of my savings, take my house, and destroy me financially. Again, my Canadian and European friends are baffled when I tell them this is possible. They cannot imagine sane, healthy societies in which such possibilities, such dire no-win options, can confront human beings.

I am not complaining. I am explaining, or trying to do so. I have, in some respects, a richer life than do many of the millions without health insurance. I at least have a house in which to live, though it's not yet paid for. I occasionally travel, when I can use my frequent-flyer miles and have invitations to stay with hosts who kindly offer me hospitality.

I am privileged, in that I am white and male. I do not share in all the privilege many white men take for granted, because I also happen to be gay. But I am aware that my pigmentation and my gender do play a role in my privilege, and I would be dishonest if I did not admit that society accords unwarranted power and privilege to people on the basis of skin color and gender—and so many of the millions of Americans without health coverage struggle with even more difficult burdens than those confronting me, simply because of their race and/or gender.

I am also aware that my education places me in a separate category from many of those who have no health coverage. Many of those without health insurance do not have the benefit of tools available to me simply because I have an education, or the status accorded to me in some circles because I have an education.

Even so, in the final analysis, I hope my story will also convince some readers that just about anything is possible, when it comes to finding and keeping a job and having access to medical treatment in the U.S. I’m a Ph.D. nearing 60 who has simply been unable to find full-time work that in any way fits my credentials and background, for two years now.

And I’ve tried hard. I’ve networked. I’ve sent out countless letters of inquiry. Admittedly, my own background makes it difficult to find a job that fits, since my education is in the field of theology, hardly a field for which employers are breaking down the door. And jobs for people in academic administration are extremely limited in number, and even harder to find when one ends a previous job under a cloud created by an unscrupulous, but powerful, supervisor.

I have good friends assisting me, and I appreciate their assistance. I’m aware that I could perhaps take a job flipping hamburgers at a fast-food restaurant, and as some readers might point out, if I were really desperate to have health coverage, I ought to consider such an option.

I have avoided that path so far not because I feel myself superior to any kind of honest labor. A saying drilled into me by my parents as I grew up is that all labor is worthy labor, if it is honest labor. I have avoided taking that path primarily because I think my talents—what I have to offer as a human being—lie in other directions. And I would hope to find work that uses those talents and allows others to benefit from them.

So this is the story of one American who has worked very hard all his life, who happens to have earned a Ph.D. and two M.A. degrees, who has written some four or five books and countless articles, who has excelled at teaching and scholarship, who has been urged to undertake administrative work in higher education against his own instincts because he was told that he has a talent for interacting with many kinds of people and getting them to work effectively together.

And who cannot now find a job, as he nears 60. And who, as a result, is unable to afford the kind of ongoing monitoring of his health that is recommended for a man his age, or even to purchase medical treatment except in situations of imperative need.

And, of course, who does also happen to be gay—and that fact has undeniably played a very strong role in placing me in the situation in which I now find myself. Employers—faith-based employers included, and perhaps predominantly—still find it possible in many parts of the U.S. to use sexual orientation as a convenient way to dismiss good workers who have, for whatever reason, run afoul of their bosses. And they are upheld in these actions by the legal systems in much of the country, and by the churches that sponsor the institutions they run.

In the final analysis, it has not really given me much joy to read recently that both of the church-owned colleges/universities at which Steve and I have experienced gross, life-altering injustice now find themselves in hot water due to their long track records of grossly discriminatory behavior. As I have read about what is happening at both of these institutions, one in North Carolina and one in Florida, I am not really heartened. I feel no Schadenfreude.

I feel, rather, disgust that people can continue behaving so badly, and be kept in power for years as they hurt first one person after another, while church leaders look on with blind eyes. I feel great sadness that people who treat others as objects, who engage in persistently immoral, unjust, and even illegal behavior, are not only frequently maintained in their positions of power in church institutions, but that they learn nothing—absolutely nothing—over the years.

As the Catholic school in North Carolina booted me out, it began a rumor campaign to destroy my reputation by insinuating that 1) I was gay (I had not yet come out of the closet at work), and 2) I was pro-abortion. I am, of course, gay and I chose to respond to that insinuation by battering down the closet door, thereby taking a moral high road that the Catholic institution had forfeited by its lying and rumor-mongering. They did me a favor by creating the conditions in which I could finally be open and public about myself, though taking that step ended my career as a theologian working in Catholic institutions.

The rumor about my being pro-abortion was simply baffling, since I had never taught or published a single thing on that subject up to this point in my career. It was, I realized, simply how this Catholic institution liked to deal with people it chose to destroy. The worst possible charge that the old boys running that institution, other than the charge that one was gay, was that one was an abortion promoter.

So it really does not give me much satisfaction to read now, as this school is faced with public (and legal) censure for its well-entrenched patterns of discrimination, that it is using precisely those same insinuations to destroy the career of yet another faculty member, more than fifteen years after it did this to me. And, even though the school may well suffer some legal penalties for this behavior, it knows it can still get away with such behavior in the powerful, rich right-wing Catholic circles it inhabits. In fact, the school and its old boys' network count on this behavior to earn them good publicity and perks in the right-wing Catholic world. Even as I write this, the school is being lionized in the media of those circles, as a martyr for Catholic values experiencing unjust persecution for its fidelity to the magisterium.

And the other school? Same story in another church context. Same replication of utterly dysfunctional patterns by a wretchedly incompetent and morally challenged leader whose legacy has come to be consistent, every place she goes, because she is incapable of seeing those with whom she works and those who work for her as more than objects in some bizarre psychodrama going on inside her own mind. At her previous school, when she left, people rejoiced openly, and spoke of her as someone who leaves a trail of bloody bodies everywhere she walks.

The same pattern is now emerging at her next school, where she continues to be kept in power, even as things fall apart and she does precisely—almost as if she is following a script—what she did at her previous school, actions that led to her censure by an academic watchdog body and are now being discussed negatively in national scholarly publications about academic freedom.

Sad, how little we learn. Sad, how those who cannot learn and whose corruption leads them to damage others, can be kept in power even while they destroy the institutions they lead and the lives of many who work for them. Sad, how the churches in which some of these academic leaders find shelter continue to provide safe haven for them, even as they harm one person after another. Sad, that one of the constant patterns in these stories in church-related institutions is the willingness of churches to empower and give the benefit of the doubt, in particular, to known gay bashers.

And sad that for many of us who are their victims, and for many who are victims of incompetent and immoral bosses in other settings, or whose jobs have been cut for financial reasons, or who have lost employment due to a myriad of other factors beyond their control, there is the tremendous challenge of living without access to basic, ongoing health care even as we search for jobs. And sad beyond belief that many Americans are unable to see that leaving huge numbers of their fellow citizens in that boat affects all of us.