Health Care Access: Two Stories

health care handsHealth insurance exchanges launch next week.  To honor the occasion, a couple stories feel like they need to be told.  One was a story I heard on NPR about a Yale University professor.  She cut her hand in a freak accident when cleaning a glass bowl.  She told the Yale hospital emergency room physician treating her that she was a knitter, and that fine motor control was important to her.  He assured her he knew what he was doing and she would be fine.  Unexpectedly, one of her students interning in the emergency room happened by and exclaimed, “Professor, what are you doing here?”  Her attending physician stood rigid.  “You’re a Yale professor?” he asked.  When she affirmed she was, he stopped and called in a surgical hand specialist.

Moral of the story:  We don’t have equal access to health care.  Even the affluent.

The other story I heard last night in jail.  An inmate was a passenger in a car wreck six months ago.  She was rushed to the nearest emergency room where surgeons operated on her right hand.  She needed more surgery, but she didn’t have insurance.  The day after the accident, doctors amputated mid-forearm.  The following day, she was discharged with 30 pain pills.

Nothing hurls someone recovering from addiction into relapse like fresh trauma.  That’s the arc of this story.  Traumatized by the accident and in excruciating pain, she turned to drugs.  She was arrested on a drug charge two months later.  It was in jail that her cast, bandages and stitches were removed, revealing her stump to her for the first time.  She shed a grateful tear when describing the officers’ care for her in jail.

Moral of the story:  We don’t have equal access to health care.  Especially the uninsured.

Lest we be tempted to disregard this as an isolated case affecting only the poorest, let’s look at the numbers.  It’s a sad fact that Texas inmates receive better health care than the 26% of Texans who lack insurance.  Uninsured Texans outnumber the entire population of Yale’s home state, Connecticut, by a factor of almost 2.  One in 4 Texans could reasonably expect this level of care.  Only because the woman became incarcerated did a caseworker recognize her need for additional medical care, trauma counseling and rehabilitation to help her learn things like writing with her left hand, buttoning her pants, and slicing a bell pepper.

That’s a bright spot, I guess, but I have to add, time and time again I see people in jail who wouldn’t be there if they had access to health or mental health care.  The lack of access puts a terrible strain on jails, to speak nothing of the strain on people falling through the cracks and landing in jail.  And for the cold hearted out there unmoved by the human toll (you know who you are), our de facto jail-as-a-last-resort system costs taxpayers more than access to appropriate care in the first place.  Would a surgical hand specialist have saved this woman’s hand?  I don’t know.  What I do know is recovery in jail costs more than recovery at home, and now she qualifies for disability for the rest of her life.

Access to health care will never be equal.  Some will always have more.  I don’t begrudge them that.  Here’s the salient point: starting next week, no one else has to live this inmate’s story.  That’s a relief.

Join the conversation.  Where do you draw the line between a person’s responsibility for his own health and our responsibility for each other?

Copyright 2013 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

Banality of Evil: Take Two

let them eat cakeThe “Let them eat cake” celebration by House Republicans marking today’s passage of yet another bill to defund healthcare for the uninsured and continuing the sequester is unseemly.  The New York Times called their glee “grotesque.”  Having just separated millions of people from public housing subsidies, Head Start, and unemployment  benefits, and coming as it did on the heels of ending food stamps for almost 4 million people, one might expect a somber tone.  Celebrating the sequester… who wudda thunk?

Rather comically, the Majority Whip took pains to emphasize, repeatedly, the vote was bipartisan.  Perhaps being math challenged is part of the House’s problem.  Two of 190 Democrats voted for it.  I would call that 99% along party lines, but, hey, that’s just me.   Majority Leader Eric Cantor, who pushed yesterday’s food stamps vote, shared the podium.  The provisions of that bill would impact those with an average yearly income of $2,500 or less, truly the poorest of the poor. One commenter poignantly wondered what Cantor prayed for on Yom Kippur.  Could it have been to take even more away from those at the bottom?

The juxtaposition of such harsh treatment of the poor happening the week following the highest Holy Day of the Jewish year, the Day of Atonement, is difficult to reconcile, even for non-Jews like me.  The Jewish path to Atonement with God requires t’fillah, teshuvah, and tzedakah.  These translate roughly to prayer, repentance for wrongs, and the charity that justice demands.  Charity is a particularly bad translation for tzedakah.  In many ways, they’re opposites.  Charity is optional, at the discretion of the giver, and something to which the recipient is not entitled.  Tzedakah is commanded of each and every individual, regardless of wealth, and in the Jewish tradition, recipients are entitled to tzedakah.

The Jewish tradition doesn’t try to equalize income or wealth.  While it t recognizes vast gulfs between the haves and have-nots, it also recognizes a sense of fairness.  Food, clean drinking water, a safe place to sleep and other essentials for survival are things every human is entitled to, for the sake of social justice.  Even those who receive tzedakah are required to give it.  They may render aid rather than material provision.  The Jewish way of engaging with those in need is full of dignity, on all sides.  Dignity is what seems to be sorely lacking in the US House of Representatives this week, but today especially.

The specter of powerful politicians usurping the powerless is not the worst of it.  What gives me greater pause are the millions of Americans drinking the Kool-Aid and voting against their own economic interest.  It calls to mind Hannah Arendt’s landmark book chronicling the trial of a Nazi war criminal.  In it she coins the term “banality of evil” and argues the Holocaust (and indeed, all the great evils in history) resulted not so much from the actions of evil people as from ordinary people blindly accepting and participating in evil behaviors promoted as “normal” by the state.  About the criminal she concludes, “…everybody could see that this man was not a ‘monster,’ but it was difficult indeed not to suspect that he was a clown.”

While it may be tempting to describe our elected representatives as clowns this week, the consequences of their clownery is costing real people real lives.  Who represents them?

Join the conversation.  Why do so many Americans participate in the anti-healthcare, anti-poor rhetoric?

Copyright 2013 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

Looking for Cover

Jerry McClure/Dallas Morning News Special Contributor

Jerry McClure/Dallas Morning News Special Contributor

My local paper had this photo of scantily clad revelers on its main page most of last week. Unusual? Hardly.  The Dallas Morning News served a steady diet of bikini pics throughout the summer.  I ask, when did wearing skimpy bathing suits to public events become a good idea? Never mind. It was never a good idea. Perhaps the more salient question is:  When did it become a cultural norm?

I’m seeing more skin in mainstream media. I think it started with “news” coverage of celebrities lacking coverage. Recently, it extended to pornography personalities. Six months ago, I couldn’t name a single porn star. Now I can, thanks to Huffington Post main page headlines. I’m not sure when porn stars became mainstream. I’m more concerned about when wearing bikinis to public events became mainstream.  Are they related?

I can shake my head at the 20-somethings in the photos, but my three teenage daughters can’t. They have to process media messaging somehow.  As a teen unhappy with her body, the models in Elle, Seventeen and clothing catalogs tormented me. But those models were clothed. My daughters are pelted with images of unclothed women, and like it or not, that media messaging establishes cultural norms and expectations. Teenage boys have always wanted to see skin (so I’m told), but now they expect to see it. Teenage girls feel expected to show it, and they do—both the girls with bodies that conform to cultural ideals and those whose bodies do not. Feeling pressured by (and moreover, complying with) cultural expectations damages self-esteem when the message is showing skin counts more than showing intellect or showing heart.

My daughters span a wide range of changing shapes and sizes. In May, one decided to avoid swimsuits all summer. She was relatively successful, even with a beach vacation. Where highs reached the low 70’s, lounging under a beach umbrella in shorts and a t-shirt was not only comfortable but also common among the fair skinned. More difficult was avoiding our sailing club.  Kids wear life jackets by law when sailing, so that wasn’t as problematic as the club pool (where adult behavior isn’t always at its best). When the others wanted to go, she dug in her heals or went to a friend’s instead.  Consequently, our family sailed less this summer.

Her plan broke down at her evangelical Christian camp, of all places. Although the camp went to lengths to protect girls’ modesty—no spaghetti straps, shorts less than fingertip length or 2-piece swimsuits—water sports could not be avoided. She survived, maybe by wearing t-shirts over her swimsuit, or maybe because it’s a place where showing heart counts more than showing skin.

Her quandary made me ponder covered women in the Islamic tradition. Several of my Duke Summer Institute classmates spent years in community with covered women. What my classmates relayed, and what Muslim women at the local mosque expressed, was a deep sense of freedom. Ironically, the burka westerners view as oppressive Muslim women view as liberating. They feel free to be themselves and to express themselves without being judged by appearances. They are utterly aghast at the pressures American women must resist to maintain their dignity, and they can’t fathom women presenting themselves as sex objects by choice. Conversely, covered women feel respected by men who don’t expect them to show skin for male attention, and they feel protected by a culture that doesn’t prize appearance above all else.

Join the conversation. Who’s more exploited—the ones choosing bikinis or burkas?

Copyright 2013 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com