My younger brother died a couple of weeks ago. For the past few years he'd suffered a series of serious illnesses. When he died, however, his condition was chronic--not terminal--and could be managed with medical care. And, my brother had access to good medical care and pharmaceuticals. To be precise, he had access so long as he could write checks for the services he received at the doctor's office, the imaging lab, the hospital, and the pharmacy. He had no insurance. Yes, he'd had insurance once. When the company he'd worked for closed its doors he did Cobra. When that ran out, he discovered that insurance companies had a variety of tricks for refusing to cover him. At any price. Yet, he managed for the next few years.
My brother managed because he sold his home--in essence cashed in his 30 year investment--before the market collapsed. He was long divorced, and the two kids were close to finishing their undergraduate years. He downscaled dramatically and, at 53, believed he could "live simple" and survive. He'd always been a saver, always been thrifty, and had no debt. His largest cost was the pending expense of graduate school for his two children. When it came to his health, he began the wearying process of bargaining with some health care providers (turns out doctors hate insurance forms and love cash), crossed the border periodically to buy cheaper medicines, and sometimes just gritted it out. In a very real sense, managing his health, and healthcare costs, became his avocation, if not his new profession. How many times did I hear him say, "I just hope I can hold on until I'm 65 and Medicare kicks in"? Too many to count. He was incredibly buoyed by the election of President Obama and the possibility that--finally--healthcare reform might make insurance simply available, let alone affordable.
Then came the current "debate" on healthcare reform. Then came the Tea Baggers, and the Town Hall Screamers, and the Death Panel Conspiracy Nuts, and, well...you know. Then came Charles Grassley and the bipartisan head fake. Then too, came Max Baucus and the Blue Dogs with their hand wringing about costs and deficits even as they poured oceans of cash into the accounts of banks and insurance companies and agribusiness and defense contractors.
My brother watched all this with growing disbelief. He simply couldn't comprehend how a conversation about reform could be so thoroughly hijacked by demagogues and their spittle-rage followers. He couldn't believe that the real crisis in our healthcare system could be so marginalized by fear, misinformation, disinformation, propaganda, and outright lies. He couldn't believe that the "discourse" of rage, and fear, and--yes--racism, so thoroughly occupied the media that marginal voices were grossly magnified and given legitimacy. He couldn't believe that so many "leaders" who really knew better could succumb to the fear of the willfully ignorant and concientiously misinformed. He couldn't believe that so many "leaders" would so cravenly abandon intellectual honesty as they pandered to the mob. He couldn't believe that so many "leaders" were so transparently concerned, not with the needs of their constituents, but with their own Machiavellian power equations. He couldn't believe that something so critical, so serious, so existential, as the future of healthcare in the country, could be so derailed, so trivialized.
He was sick, and then--recently--he began slipping into depression. In his mind, he believed any meaningful reform was slipping away. He was sick, he was exhausted, and he was losing hope. Yes, we told him to turn off the television. Yes, we told him this would pass. Yes, we affirmed our love and support.
But, my brother knew that hundreds of thousands of uninsured and under-insured American families slip into bankruptcy every year as they struggle to pay bloated medical bills. He knew he was in danger of doing just that. Indeed, he was in very real danger of losing all the savings it had taken him a lifetime of working, scrimping, saving, clipping coupons, and often simply going without, to accumulate. He knew that he might not be able to fulfill what he considered an almost sacred promise to his children, that they would be able to complete their graduate studies without accumulating a mountain of debt. Day by day, he saw his resources dwindling, just as he believed he saw--day by day--meaningful reform slipping away. Then, he made the decision to simply let himself slip away as well.
Was it the right, or rational, decision? For those of us left behind, of course not. Is my family devastated? Deeply. Would I trade all I have, all I'll ever have, for five more minutes with my brother? Instantly. Do I know how I'll find a way to be light-hearted again? No. Am I angry that my only sibling is forever gone? Yes. Am I angry at him for his choice? It comes and goes. Am I angry with my brother because hopelessness overwhelmed him? No. Did my brother increasingly see the current debate through a gravely distorted lense? Perhaps. Was my brother trapped in an American system of health insurance and healthcare that is deeply cruel? Yes. Did the "debate" kill him? I simply can't say.
Was his decision directly tied to his reading of the current "debate" on healthcare? Honestly, I don't know. I'll never know, and I'm not willing to lay blame. I'm not willing to use his death as a political indictment. But what I do know is my brother slipped deeper into hopelessness and despair as he watched this vile debate unfold. I know that the screeching voices on the airwaves, the feral behavior at town hall meetings, the "leaders" who stoke the rage, and the good people who believe that it's happening somewhere else to someone else, aid and abet this coarse debate. I know too, that my brother was not alone in his despair and fear. I know that down too many streets, in every town and city, in every state and region, people like my brother--and their families--are in the same desperate spot. I know that millions of us wonder if this country can find the political will to do the right thing. I wonder what will happen to so many of us if it does not.