It’s Not About Health Care, It’s Health Coverage

This debate is not really about health care.  There are issues in the medical system, and they need to be addressed.  But this is about health coverage—how we pay for and how we get access to care—not about the care itself.

My job situation is increasingly uncomfortable. I have a difficult relationship with my boss, and ideally I would look for other work.  Unfortunately, I had a brush with cancer last January, and I’m supposed to have checkups every three months for two years.  If I drop my health insurance, the cancer becomes a pre-existing condition and does not have to be covered by any subsequent insurance.

I cannot afford to be without health insurance for even a day, so I am trapped in my job until I can find another with benefits.

Or am I?  There are always options.

Option one:  I can choose to live without insurance.  I would have to accept the consequences—no further checkups.  I’m clear right now, and the type of cancer is extremely unlikely to recur.  So my risk is pretty low.  I can probably do without the hormones now—they were only supposed to help me through the initial transition anyway.  My pain medication is available over the counter.  So maybe I can do without affordable access to doctors.

Option two:  I can choose to deal with the stress and tension of working in difficult circumstances.  My supervisor has insecurities that affect how we work together, and I have been told the job will end in a year.  Looking for the next job takes time, which my current situation doesn’t provide.  Staying in the job obligates me to do the work as directed and as well as I can.  So I can choose live with the work, the tension, the stress—and the health insurance.

For the moment I’m sticking with option two, even though I realize that living under stress is not exactly a healthy choice.  I may find that option one is actually better for me in terms of actual health.  But it does feel like I have to choose between false security in my job benefits and the false danger of living without coverage.  I have to choose between fears.

Why does our health coverage system force choices like these?  I’m not unique—there are many others with similar situations, many far more difficult than mine.  There are people who should be resting, cutting back on hours, who can’t afford to do that without losing both the job and insurance.  There are people who literally could not live without the medical care that the insurance promises to pay for.
Right now, both access and affordability are, for the most part, tied to traditional employment.  Only the very rich, the very poor, and those over 65 are not bound into having a job with benefits in order to access the health care system.  Those of us with no job-related insurance, or with non-standard working lives, have to choose between work we love and affordable access to the health system.

Not a healthy choice at all.