Thoughts on life after the PhD
This week is “Going to the Doctor” week in my intensive Japanese class (which bills itself as advanced but really isn’t, at least not for anyone who’s lived in Japan for more than a year or two). We’ve spent the past several days going over every imaginable ailment and how to describe it in Japanese, as well as examining the custom of kaishain kenkou shindan (annual company health checkups) and Japanese kokumin hoken (national health insurance). The whole experience has been remarkably unpleasant. People have been sullen and more silent than usual in class. Initially I wondered if it was just because the topic was dull, but then I started to realize that health care, particularly for Americans who aren’t monumentally wealthy, is always an unpleasant topic.
Unlike the uncuth idiots who’ve been disrupting town hall meetings across the country recently, I and millions of other Americans actually have good reason to be afraid. Even if we’ve got health insurance, there’s no guarantee that it’ll cover us when we get genuinely sick (or expensively sick). Grad students are better off than most–we usually get health coverage through our university–but the quality of the plans varies wildly. When I got food poisoning last year and ended up spending the night in the hospital, I paid more than $1500 out of pocket for the privilege. The total charges levied by the hospital were close to $30,000–I’m not sure if my insurance company actually paid this amount or if the hospital inflated the charges because they knew the insurance company wouldn’t pay the full amount. Over the summer I have no health coverage unless I pay an extra $150–not a lot, but I always end up failing to pay it and just hoping that I don’t get sick. And of course this summer I did get sick–sick enough to need some lab tests and medications. Thankfully the health center let me pay the fee and get my treatment, but I’d seriously considered not seeking treatment just to save money. Which could have, in this case, made me a lot sicker. Not good.
This is what has come to boggle my mind about the U.S. health care system. Somewhere along the way, we became convinced that a) hospitals are expensive, so we’d better just pray that we don’t get sick, b) health care fees, no matter how high, are predominantly the responsibility of the patient, and c) it’s perfectly acceptable for the government to give millions of taxpayer dollars to corporations so that they can avoid bankruptcy, but not to give said money to individuals so that they can avoid bankruptcy (and sometimes death). Years of fear-mongering have managed to convince us that we don’t deserve affordable, high-quality health care. We hear about situations in other countries where people are able to take months off for maternity leave, where patients can choose their own doctors and hospitals, where getting treatment for breast cancer doesn’t involve mountains of paperwork and weeks of waiting for approval from the insurance company, and we’re amazed. Or more likely, we convince ourselves that there’s a huge catch–that such countries bleed their citizens dry with higher taxes, that the quality of care is sub-par, and that patients wait in line for hours to see a doctor for only a few minutes.
To which I respond–even if this is true, how is it any worse than our current system? I may not pay an exorbitant tax to cover a national health care plan, but last year I paid close to $2000 in medical fees (and I’m pretty healthy). If I go to a public hospital I may wait as long as six hours to see a doctor. And while I don’t worry too much about the quality of my care, I do worry a lot about a system that forces doctors to inflate prices, order unnecessary tests, and flat-out lie in order to appease insurance companies and stay afloat.
Lately I’ve become so depressed by the seemingly limitless power of insurance companies to intimidate and mislead that I’m beginning to lose hope. The idea of a system where, as one senator recently put it, only the healthy are covered by health insurance is horrifying. I often wonder if those who make a practice of denying expensive care to the grievously ill have come to see those individuals purely as numbers. In a way I hope that’s the case, because the alternative would be that they are truly evil. And yet, as Hannah Arendt reminds us, evil is banal–it rests on the ability of the masses to “normalize” even the most heinous acts. In the case of health care, we all have blood on our hands.
I honestly don’t know what the best course of action is now. I wonder if, in my lifetime, I will see even a dent made in the prison that insurance companies, pharmaceutical companies, and those in their pockets have built around us all. Watching the insurance company-funded outbursts at town hall meetings–and watching the media report them as genuine expressions of fear and rage–should make me laugh. Instead, it makes me shake my head in defeat. In the face of so much greed and ingnorance, or at least in the face of a small group of greedy individuals who hold so much power over so many, I feel powerless.
But I’m not. None of us are. I may not know what the best course of action is, but for the time being I’m staying informed, calling my senator, calling my news outlets, and demanding what’s rightfully mine. The fight is going to be long and brutal, but with so much at stake surrender isn’t an option. I’ll be damned if I’m going to spend the rest of my life living in constant fear of getting sick.
writing•translation•scholarship on Japan (and a few other things)
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