You may doubt that some of the stories I’m going to relate are true, but they are. Every one.
My wife grew up in rural Arizona, where doctors were far away and ranchers don’t offer insurance to their hired hands. One day when she was a kid, her little brother clomped her over the head with a hoe while playing outside. Blood flowed. Her father, a ranch hand, came running and knew she needed stitches. So he did what he had to do. He intertwined her left and right pony tails, pulled tight, tied them together with string, and told her not to get her head dirty until the scabs healed.
Recently I was talking with a store clerk I’ve seen a few times. Her voice that day was hoarse and rough. I asked her if she was going to be able to take it easy once she got off work. She laughed (sort of) and said after work she’d be going to her other job. I asked her, “you don’t have any health insurance, do you?” She laughed again. “I haven’t been to a doctor in four years,” she said. Three days later I saw her again. “How are you doing?” I asked. “Better,” she said, but only because she was embarrassed to tell the truth. She was not better. Still working, though.
When my own kids were growing up money was tight. When you have eleven children money is always tight. Our insurance was one of those high deductible policies, which is about the same as not having insurance. But my wife’s rural background helped a lot. She knew which veterinary medicines were good replacements for prescription drugs, and which ones weren’t. Veterinary drugs are a lot cheaper, if you know what you’re doing. Most don’t, but she did. I’m not proud of it, but we knocked down a few infections with livestock drugs when we needed to, for about one-fourth the price.
When I retired in late 2016, I was still a few months from getting on Medicare. So I rolled the dice. Almost got away with it, but I caught the flu. It flattened me like a coin on a railroad track. When my wife got scared we went to the doctor. My temp was 104. The visit was $125, the prescription for Tamiflu, without insurance, was also $125.
Fortunately I was able to write the check. But I know some people who would have just gone to the ER now and ignored the bills later. They wouldn’t feel good about it, but desperation can lead you to do degrading things.
It’s really great that unemployment is so low and nearly everyone has a job. Or two. Or three. But having a job doesn’t mean you can get sick. In 2005 less than one in ten Americans was an “independent contractor,” which is oldspeak for today’s more trendy term: gig work. Today giggers make up 34% of the work force. By 2020 it will be 43%. As a rule, gig jobs don’t offer insurance.
By the way, I asked the gal with no voice if she’d ever had insurance. “Sure, once” she said, “but it was one of those Obamacare policies that didn’t pay anything until you reached the $6,500 deductible.” I thought she was just making that number up. She wasn’t.
Is there a point to all this? Just that we are the only—repeat, the only—industrialized nation on earth that hasn’t figured out how to get reasonably affordable health care to all (or even most) of its citizens. To those of you with good insurance, you’re probably wondering what all this fuss is about. I hope, sincerely, that you never have to wake up in a panic every time you hear a child cough in the night, and feel sinking desperation when someone you love starts running a temperature.
But if you get in a jam, you can always tie your hair together to avoid stitches. That’s a joke, mostly. But it’s also the way we have to do things occasionally here in the US of A. Call it Yankee ingenuity if you like. I have another name for it.