In Memory of 9/11: Towards a Healthier USA

As I write this, on the eve of September 11, the events of that fateful day in 2001 seem to have taken place a long, long time ago. I never thought that would be the case. But it’s eight years now, and the world, both internally and externally, has changed significantly. Internally, I have been living four years already outside the City, exactly half the time since 9/11/01, when ashes dropped onto our stoop and we lost neighbors, friends and just about every member of every fire department within miles; I have become father to a second child who will be turning five before the year is out; I have written books, and some have even been published; our family has built a house and survived the turmoil; I’ve become an American citizen and an elected official; and along with my older son Campbell, who turns 14 this weekend, I’ve become a committed Burner. Things haven’t always been smooth but, unlike the innocent victims of 9/11, I’m still here, still making the most of it, still trying to prove you can get through life following your heart and not just by succumbing to the rat race.

Externally, the changes have been greater. And the most significant one, it occurs to me as I attempt to make sense of things during this especially hectic week (back from the Burn, back to work, back to school, or, as Soul II Soul so poetically put it, “back to life, back to reality”), is that this September 11 will be the first anniversary of the Attacks with Barack Obama as our President. For seven consecutive 9/11s, we had to endure Bush, Cheney, Giuliani and co. claiming everything about the tragedy (except responsibility) as their own – or, as one particularly eloquent protest banner put it a few years back, “The Bush Administration hijacked our grief and flew it into Iraq.” Now, post-Bush, we New Yorkers, Americans, world citizens alike, have a right to take this grief back and return it to its natural resting ground, to the physical locations where the planes crashed and to the emotional depositories in our hearts.

I have yet to look and see how President Obama will be commemorating 9/11. However he chooses to do so, Fox News and the conservative talk shows will criticize him for doing so, as will their legions of conspiratorial followers. Fortunately, the events of the last couple of weeks have convinced me that he will ride out these potshots and continue to lead this country back in the right direction. For if we want to talk about the security and safety of the United States of America, we have to ensure that the conversation extends wider than just the fight against terrorism. The health of our nation is just that: the health of our nation. And we are not, in any way, shape or form, as healthy as we could be.

Before I went away to Burning Man, I wanted to write something profound about the Health Care debate. I didn’t have the time, and I couldn’t really find the words. I tweeted regularly my support for health care reform; I talked about it with friends. It upset me that a generation of youth that had seemed so eager to elect Obama to office, on a platform that placed health care reform square and center, seemed unwilling to defend that goal, seemed willing to cede ground on the issue of health care, and in the process, on the whole political landscape. As the rabid dogs of the Reactionary Right Wing used Town Hall meetings to heckle and shout down their democratically elected leaders; as they dared to compare America’s first black President to Adolph Hitler; as they spread their malicious lies about death panels and government-sponsored abortions, so it seemed that Obama’s noble intent to actually live up to his electoral promises might find itself stymied within his first year of office. It happened, after all, to President Clinton, and over the very same issue.

As regular readers know, I believe the USA to be a great country. Leaving aside its leadership in so many fields, leaving aside its spirit of independence and entrepreneurship, the official separation of Church of State and the guarantee of free speech embedded into its constitution, it’s a country full of people that care. I see kindness and compassion and general decency on a daily basis and it warms my heart. I see people volunteer with their time and their energy and often their money. I live in a community where residents do all they can to prevent their neighbors from falling into bankruptcy, and frequently I see those residents come together with dinners, concerts, garden parties, yard sales, whatever it takes to help pull those neighbors back out of the financial hole.

And yet all too often, probably in nine cases out of ten, the very thing that is dragging these families towards financial devastation to begin with is the cost of their health care. Someone in the family gets sick – truly sick, life-threateningly sick – and suddenly their insurance company (assuming they could afford insurance to begin with) no longer agrees to cover them, and they find themselves paying for consultancies, specialists, operations and medications out of their own pocket. Savings dissolve overnight, bank accounts empty out, cars and luxuries are sold off, and it’s left to the local community to come together and try and raise a meager few thousand dollars as a show of support when the cost of the medication and treatment runs into the six figures and will surely keep growing. A young family can be left to decide, literally, over the care of a very sick child or the roof over their head, and that’s no choice at all. An older person can easily figure it’s less stress on everyone around them to give up the ghost than to keep fighting for their health and be left with nothing to enjoy it with, and that, too, is not a choice anyone should have to face.

Such scenarios are fundamentally wrong. It goes against every principle of human rights that the only people who get excellent health care – especially in times of crisis – are those who can afford it to begin with. Indeed, if there’s any one reason I would choose to live in a different country than the USA it would be because of the cost of that health care – or the absence of a universal health care system to begin with.

As has been regularly noted in the ongoing “debate,” the actual quality of available health care is not really the issue in the States. We have some of the best surgeons, doctors, nurses, hospitals and equipment in the world. When I was diagnosed with a hernia at the start of this decade, I was successfully operated on and back home again within a week. When our younger son was born with some potentially dangerous internal organ deformations, he was successfully operated on at fifteen months of age. (He was also put on a continuous dose of anti-biotics from the age of 3-18 months and we are now fairly certain that played a considerable role in his Pervasive Developmental Disorder. That ties into a greater concern about our society’s dependency on medications.)

These are the success stories. My two ski accidents, on the other hand (both of which I take personal responsibility for) revealed the greed at the heart of a system that encourages, even rewards unnecessary procedures. The first of them, in 2006, I shattered my shoulder: having no health insurance at the time, I spent $300 for 30 minutes with a specialist in New York, who told me that my shoulder wasn’t worth operating on, and that it would cost me $10,000 to “replace it,” making it sound much like a broken alternator or worn-out exhaust. Given that we were on the eve of moving back to England for six months, I decided to spend another $300 flying home that very night, where I spent nine painful hours in the dilapidated emergency waiting room of my childhood South London teaching hospital – and yet was operated on that very same night, by a visiting American neuro-surgeon ironically enough, and without question as to my means of paying. (The operation was a complete success; I had rods in my arms for weeks, and much painful therapy, but I regained complete use of my shoulder. I did not feel guilt about using the NHS as I’d paid taxes for many years in the UK without ever needing medical treatment of any kind.)

My second accident, in 2006, found me insured – but that didn’t necessarily find me properly treated. The orthopedic practice I wanted to use in Kingston was in the midst of a dispute with my insurance company, and refused to see me. The alternate practice that would take my insurance put me through an expensive MRI for my injured knee, and then scheduled an even more expensive operation to repair what the radiologist had read as a torn ACL. But it was not torn, something the doctor would have known had he actually examined me rather than look to make a quick buck. Fortunately, when I demanded a second opinion, I found myself back at the Kingston practice I’d originally hoped for (their dispute having now been solved), where the orthopedic doctor flatly denied that I had a torn meniscus, let alone torn ACL. “If you’d torn your ACL, you wouldn’t have been able to walk in here,” he assured me, as he put me up on the table and wrenched my leg in several directions. Instead, he sent me off for physical therapy for an injury that, as he suspected, turned out to be nothing more than bad scar tissue. His integrity saved both me and my insurance company from a $20-$30,000 operation that would have put me on crutches for months – and might have prevented me ever running again.

My examples are not atypical. We need a system that reduces these unnecessary procedures, that stops the sort of squabbles between insurance companies and private practices that see the likes of me sent 50 miles in every different direction, that enables those who can’t afford top-notch health insurance to be guaranteed at least some kind of health care. And we need a system that, as the President has repeatedly pointed out, does not allow insurance companies to drop patients because of “pre-existing conditions” or because, god forbid, they get ill and start actually relying on their insurance.

For all these reasons, I’m thrilled that President Obama has rediscovered the fighting spirit that brought him through the long Primary and Presidential Campaigns and all the way to the White House. He made a mistake in rushing into health care reform, and failing to articulate his plans as clearly as he could have done, or to have anticipated the sheer ferocity of the attacks that would inevitably come his way. (Perhaps his Secretary of State could have clued him into that one?) But I’ve figured him for infallible. I know he can’t be perfect; no politician ever can. But I think he’s the right man for our difficult times, an honest, devoted, intelligent, compassionate, practical and supremely healthy individual who deserves our continued support. And so, I appreciated that his White House set up its own web sites to counter the health care lies put out by his opponents in big business and the Republican Party; I appreciated, as I went off to Burning Man, that he was finally seeking out the same kind of grass roots support on health care as brought him to the Presidency to begin with; and I especially appreciated, as I waited at Reno Airport after eight days in the wilderness, that he was on the airport TV screens (broadcast by Fox News, who have cleverly sought to become the channel of choice for domestic air travelers), that he was using the opportunity of a Labor Day speech to rally the troops, so to speak, on this most central of issues.

His speech Wednesday night to Congress was an attempt to regain the high ground, to take back the debate, to return the conversation to the core values of compassion and equality that brought him to office. He may have been too demanding for some on the right, too full of compromise for some on the left. That’s the nature of politics. What he demonstrated to the rest of was his refusal to back down on this most important of issues. He showed that, while he recognizes he can’t get everything he wants, he is not prepared to settle for the status quo: “Not this time. Not now.”

In every election in my memory, health care reform has been a central platform with at least one of the key candidates, and with the exception of Bill Clinton’s miserable attempts in 1993, nobody has sought to do anything about it. As a father of two, I can’t afford to do without health insurance. And yet I can’t afford the health insurance either. It costs us $7300 a year for basic, high-deductible insurance. We take the risk of low-cost, high deductible insurance because we are, essentially, and despite Noel’s earlier problems, an extraordinarily healthy family: we eat well, we exercise, we don’t have weight problems, high blood pressure or cholesterol or any of the other key causes of strokes, heart attacks and cancer. (Obama’s necessary focus on health insurance has taken the conversation away from preventive care – whereby our society looks after itself by diet and exercise, minimizing the need for all these hospital treatments to begin with. That’s a conversation we can continue to have, especially in our school lunchrooms.) But all we need is one unexpected illness, one calamity, and we’ll paying those high deductibles, out of pocket, until we’re out of cash and hoping our neighbors will organize a community benefit to gather up some token small change.

For these reasons, and for all the others I’ve listed, I believe in health care reform. I believe that reform requires what is being called a Public Option – but I also believe that if you like your own health insurance, you’re welcome to keep it. I’m not looking for a revolution here; that’s for the terrorists and warmongers. But I voted for change last November, and I want to see that change come to fruition. Seven years of post-9/11 Bushism did not make our country happier, healthier, or wealthier. And so, while we can’t bring back the people who were killed on 9/11, nor in the wars that followed overseas afterwards, we can honor their memory by making America a better place. Ensuring and insuring our individual and collective health is a damn good way to start.

More at iJamming! on 9/11

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