The High Cost of Not Caring

Margaret Atkins MunroLet's Talk About MoneyLeave a Comment

My thoughts have been occupied this week by a public drama and a personal tragedy. It may seem odd to connect the death of my mother-in-law in Glasgow, Scotland on New Year’s Day with the shooting approximately six thousand miles away in Tucson, Arizona, where a mentally disturbed Jared Loughner killed six and wounded fourteen, including Congresswoman Gabrielle Giffords. But the more I think about the two disparate events, the more I am convinced that there are lessons in the personal that can enlighten the public.

The Tucson tragedy has played out on our screens, as we watch the news updates and the running commentary, each of us examining what might have been done differently to avert it. Many are pointing to inflammatory political rhetoric, while others will cite lax gun control laws. What no one is discussing is the crucial role played by the lack of adequate healthcare, which could have prevented the massacre.

The challenge facing the American healthcare delivery system at the moment is a case study in the haves and the have nots, and rarely has the inherent irony been so ably displayed. In this situation, a congresswoman with gold plated health insurance was critically injured and is receiving exemplary emergency health care as a direct result of the actions of a young man who had inadequate or no mental health care coverage.

Compare the events in Arizona with my family’s personal situation in Scotland, where despite the diagnosis of a terminal cancer, my mother-in-law received timely and appropriate care from her government-funded and controlled health care system. Her cancer was detected in late September; from mid-October through Christmas Eve, she was fully involved in chemotherapy and radiotherapy treatments at a state-of-the-art cancer center in Glasgow. Her hospitalizations were mostly in private rooms; for outpatient appointments, transportation was provided to the hospital and back by the health service. When I saw her on Christmas Eve, her hair was styled, her hands were manicured, and she’d had a massage, all courtesy of the hospital. Given what I was expecting, she looked well – and she was able to participate in all the Christmas festivities.

My mother-in-law did not wait, nor was she ever billed, for any of the myriad services she received; all of her care, which covered the full spectrum of her medical needs, was provided by the National Health Service.

Socioeconomically, my mother-in-law had far more in common with Mr. Loughner than with Congresswoman Giffords. She was a working-class Scot who lived a modest life. She never went to college, never worked at a professional job, and she got her news from tabloid newspapers and the television. But during her lifetime, she received medical services of a caliber similar to those currently being provided to the Congresswoman.

The status quo in this country is scheduled to change over the next seven years as health care reform continues its gradual phase-in; whether the full scope of the phase-in will be allowed to happen is becoming increasingly unclear. The newly-constituted House of Representatives would like to repeal health care reform in its entirety, despite assurances from both the Senate and the President that their actions in this regard will only result in increased divisiveness. The House evidently wishes to end mandatory health insurance for children, state insurance exchanges, and the prohibition against insurance companies denying coverage for preexisting conditions. This, despite the savings that the non-partisan Congressional Budget Office says are built into this law, which are currently projected at approximately $230 billion over ten years. Of course, these are estimates only; there is no certainty regarding the eventual cost of reform, the adequacy of the revenue raisers written into the law to pay for the anticipated costs, and whether or not reform will actually change the size of the federal deficit. There is so much that is not known, and those who throw around precise numbers as facts merely parade their ignorance for the world to marvel at.

No one will dispute the significant healthcare costs that my mother-in-law incurred during her lifetime, and especially throughout the course of her final illness. But the costs of not providing Mr. Loughner the care he so desperately needed are much greater still; the final tally of his acts, immeasurable.

Much has been made of the poisonous rhetoric surrounding American politics, and the role this may have played in Arizona. No one has looked at the failure and inaccessibility of the American healthcare system, which arguably contributed more to the firing of those shots than words ever could. Perhaps Congress should take a good hard look at what happened in Tucson, and why, before they attempt to dismantle reforms to something so clearly in need of repair.

As to my mother-in-law, who will be sorely missed, she was an ordinary person who received extraordinary care and the dignified departure from this world that she so richly deserved.