It’s personal

Health care reform, with a single payer system like that in Great Britain and Canada – or at least, a public option for health care that’s affordable for all Americans regardless of income – is vital.

Fifty million Americans are without medical insurance in this country. Many millions more are a mere paycheck or layoff away from losing their health insurance. Individual insurance is so inordinately expensive that many people simply can’t afford to buy it. Many of those who can are denied because of pre-existing conditions.

This really has got to change.

As some of you already know, I’ve had rheumatoid arthritis since I was 28 years old. For almost 15 years I suffered frequent, painful flare-ups of the disease that often rendered me temporarily disabled. One day it would be my hands; the next an ankle; the one after that a hip. I even had it in my jaw. Each flare lasted anywhere from 24 hours to five days. Sometimes there would be a brief reprieve between flares; more often there was no reprieve at all.

For a great portion of that time I was under the care of an internal medicine doctor – the nearest rheumatologist was a four-hour drive away. We tried just about everything available to the Army medical system at the time – NSAIDs, injected gold, malarial drugs, aspirin and Tylenol. None of them had any effect at all on the RA, though a lot of them came with bad side-effects. To ease the pain when the flares were unbearable, I was given opiate painkillers in limited amounts. I was even hospitalized once. Eventually, no longer believing that modern medicine could do anything to help me, and fearful of adverse side-effects, I stopped taking any RA drugs – except the opiate painkillers, which were the only ones that worked even a little. They had no effect on the disease, but at least they muffled the pain.

Eventually the RA flares became less frequent. Then they stopped. I was normal again. I could walk without limping and gimping. I could use my arms freely, twist caps off jars and open doors without first steeling myself against the inevitable pain. And oh, I was glad. The RA was in “remission.” I went backpacking, fishing and camping. I hiked. I lived without wondering each morning when I got up which of my joints would plague me that day. And after a while, I started forgetting how it had been.

But rheumatoid arthritis is incurable. For its own mysterious reasons, it sometimes does go into remission, often for many years. It’s a disease of the autoimmune system – the body actually turns against itself, attacking the synovial fluid between the joints and causing inflammation and pain. And it attacks different individuals in different ways. One person might have it for years and years with only minor pain and little or no disability. Another will contract it and be wheelchair-bound, unable to walk, within a couple of years. Some people end up with twisted, gnarled wrists, hands and fingers. RA can also attack the body’s internal organs, like the lungs, the heart, or the vascular system. It can cause blindness.

I lived flare-free for almost ten more years. Then, in 2007, my hands started flaring again.

I was unemployed. I couldn’t afford individual health insurance. Fortunately, I’m a veteran, and although I had to wait nearly a year before I was destitute enough to qualify, I was able to get medical care through the Veterans Administration.

Today I’m being treated for RA by a VA rheumatologist. I’m back on RA meds. I’ve been lucky so far – while my hands ache and twinge nearly every day, they’ve not got so bad I couldn’t use them. Not yet. And so far, beyond a few, thankfully transient twinges here and there, no other joints have been affected.

There are new drugs available now that weren’t the first time I went through a period of “active” RA. The ones I’m taking can slow the progression of the disease, which at least buys me some time. But there is still no cure. It means that I’ll be taking these drugs under the care of rheumatologist for the rest of my life. In time I may, even with the drugs, become permanently disabled because of it.

I have a dear friend who’s been very ill for some years now, plagued by a cascading series of serious ailments, from diabetes to uterine cancer. She’s survived, but she’s bed-bound, no longer able to walk. Her days are spent fighting over the phone with employees of the health insurance company that continues to cover her only reluctantly and which frequently denies care ordered by her doctors. She’s constantly having to appeal the insurance company’s decisions; the appeals take weeks and months, and her condition worsens before resolution can be achieved. She lives in mortal fear of being dropped from their insurance roles – and she is covered by her husband’s medical insurance. He’s a doctor.

In today’s society, with so many pre-existing conditions, my friend could never find new insurance, even for the highest of premiums. Her care has depleted their life savings already; they couldn’t afford individual care for her now, anyway.

And here’s the worst of it. If her insurance company drops her, without affordable care she’ll probably die within a year.

We need to reform health care in this country. Not just for me and my friend, but for the millions of Americans who face potential devastation or catastrophe simply because they fall ill. Please write or call your Congressperson and tell them that Americans must have a public option for health care. That without it, we condemn millions of our fellow citizens to bankruptcy, poverty, untreated illness and even death.

It’s that important.

Note: Jonathan Alter of Newsweek asks “What’s Not to Like?” about America’s health care status quo. Do read.

h/t: Lance

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