Open Letter on Health Care Reform

The following is an open letter to my fellow Americans, and to our representatives in both houses of the legislature. I have sent this to my congresspersons and senators individually, and I post it here for the benefit of my readers. It is distributed under a Creative Commons 1license, so feel free to use it or pass it on with attribution2.

The rallying cry for so-called health care "reform" goes something like this: Think of the uninsured! Think of the small businesses! Think of the single mothers! Think of the children! Anything must be better than what we have. This is effective only as long as we blindly accept that anything is better, making it pointless to evaluate what is really being offered.

As an uninsured, small business employed, single mother concerned for the health and well-being of her six-year-old child, I feel compelled to tell the side of the story being most ignored -- that of the people this legislation promises to help. The uninsured in America face a number of challenges in obtaining adequate health care -- to these natural barriers, proponents of health care "reform" seek to add punitive taxes on those who cannot afford or do not want what the government thinks is the "right" health insurance, and unprecedented government control over how and when care is provided. These proposed changes evidence a despicable assault on poor and working-class Americans by their own public servants, obfuscated in thousand-page policy tracts not fully understood by even their sponsors.

I face the following barriers to obtaining adequate health care: the unpredictability of health care needs; caregivers loathe to lay out for patients exactly what a diagnostic, consultation, or treatment will cost; the prohibitive cost3 of comprehensive no-deductible health insurance -- the all-encompassing type "reformers" are pushing; and the fact that even comprehensive coverage will not cover all of our care needs, such as ongoing supplemental speech therapy for my son.

Ironically, until the "reform" debate began, I thought that my only choice was between impossibly expensive comprehensive insurance or nothing. I almost bought the "health care crisis" FUD4. However, with a little research, I learned that there were already alternatives that I could make work for my family. I'll be putting about $250 per month aside for health care expenses. About $120 of that will pay for high-deductible health insurance -- the kind that kicks in if some injury or illness drives up high medical bills, provides vaccinations and annual check-ups, and gives me $20k of life insurance. The other $130/month goes into a tax-free Health Savings Account, or HSA.

The HSA money pays for any health care expenses I choose to use it on -- it's my money. No one can tell me which doctors to spend it with, or tell my doctor what treatments he or she may prescribe. I can reap the financial benefits of seeing a nurse practitioner instead of a doctor for my strep test, and no one at all for a cold. I can go straight to my specialist if my allergies suddenly effect me differently. *I* get to decide whether the cost savings of glasses is preferable to the quality of life gains of corrective surgery, or not. I'm more motivated to spend the money to take martial arts classes because I know that getting back in shape will save me money on health care -- if I don't stick with it, I'll pay for that, too.

Yes, $250/month is a lot for me right now -- however it is less than any version of "reform" I've seen will cost me, and I get to decide how most of that money will be spent. True, wealthier people will have better health care than I will. That will be true no matter what -- just like wealthy Canadians come to the US to get health care their state-run system won't buy them, wealthy Americans will always be able to buy the best, here or abroad. I'm okay with that. I don't want to get everyone worse care because I don't have the best -- I want to get my family better care!

Proponents of "reform" plans insist that the government doesn't want to control health care. I can't figure out whether they are lying or just impossibly naive. Already Medicare and Medicaid have forced an electronic prescription database on health care providers -- and I got stuck with it. I work in computers, I know exactly how insecure such a system is, and I do not want my information on it. However, because the federal government required it of any provider wishing to see Medicare or Medicaid payments, no provider could afford not to use it.

Would we prefer that our health care costs skyrocket to cover the costs of people who choose to use heroine, the helicopter mom who takes all three kids to a pediatrician every time one of them sniffles or scratches, and the consequences of a poorly performed sex change operation, or would we instead be told that we won't receive care for a broken arm because it was sustained during the "risky" act of backpacking Mt. Ranier with the family, a daughter's birth won't be covered because her mother chose a non-standard birthing position, and a son's speech therapy won't be covered because he needs more of it than they can afford to cover for everyone? Either the government doesn't ration care and regulate our lifestyles, causing taxes and the deficit to explode as consequence-free health care costs spin out of control, or government does ration care, and underpaid bureaucrats take over life, death, and quality of life choices that we should be free to make for ourselves. Ration, don't ration -- either way, we all lose.

 The next time someone tells you to think of the uninsured, the small businesses, the single mothers, and the children, think about my family. Ask the "reform" pushers how punishing those with no health insurance, or the "wrong" health insurance gives Americans better health care. Ask how wresting control from all Americans and giving it to the government gives us more choices. Ask whether they want you to pay for others' habits, or let the government decide who gets care. Ask if there is a single "reform" plan they are committed to, and see if they try to avoid analysis of their offering by saying that one bill hasn't been chosen yet. Ask whether they have read whichever health care bill they advocate cover to cover -- and what is in it.

Demand answers, and watch as their arguments crumble, leaving only the false assumption that anything at all is better, and empty appeals to guilt and fear. The health care "reform" argument just doesn't stand up to reason.

1. 1. This work is licensed under the Creative Commons Attribution-Share Alike 3.0 United States License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/us/ or send a letter to Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA.
2. 2. Please acknowledge my work with my name, Susan Stewart, and a link to this article.
3. 3. about 1/3 of my income to cover my son and I
4. 4. Fear, Uncertainty, and Doubt -- seeded to provoke an emotional response and avoid reasoned argument.