LOS ANGELES – Michael Moore is right— maybe not about everything, but about most things— in his hysterically funny new movie, Sicko.
And Rudy Giuliani is wrong— maybe not about everything, but about most things— in his opposition to extending health coverage for children and his limited and largely irrelevant response to the health care crisis in America.
Michael Moore’s movie extols the health care available to everyone in Canada, France and England. The truth is that I don’t want to move to any of those places, not for health care or anything else; I have no desire to trade the doctors who return my calls, email me at night, get me in within a day of calling, and are determined to provide me and my family the best health care money can buy for a state-run system in which doctors see more patients, make less money, and aren’t free to provide that kind of service, or do every last test.
Yes, I fight with insurance companies sometime to get tests covered, and get stuck with hefty co-pays, but I’m still one of the lucky ones, who gets the best, knows how to fight, and can afford to pay for what I have to.
My guess is, so is Rudy, who can afford it more easily than I can, and probably gets treated even better. The difference between us is that I know just how few of us get that kind of health care in America, and how few can actually afford it, and from the way he’s talking, my guess is that he doesn’t have a clue what it’s like to have lousy insurance or none at all, and not be able to afford it or get it.
When I worked in politics, I used to meet families on the campaign trail all the time who weren’t poor enough to qualify for Medicare and weren’t rich enough to buy insurance on their own. They worked for companies that didn’t provide it; I met people working two jobs to make ends meet, and neither of them provided insurance. But Rudy and most of the Republicans have always opposed employer mandates, which means forcing everyone who employs more than five or 15 or 25 people to provide group insurance to their employees.
The “nanny state,” they say. So in these families, kids aren’t allowed to play Little League or football because they might hurt themselves, and no one goes to the doctor unless it’s an emergency, which means they get sicker and die younger than the rest of us, and the care they finally get, in hospital emergency rooms who can’t turn them away, or at least aren’t supposed to, costs more than it would to prevent their illness or treat it an earlier stage in the doctor’s office.
Rudy’s answer to these folks is that they should buy private health insurance on their own. He’s even offering a $15,000 tax credit, which is a give-away to private insurers by another name, a tax expenditure of billions of dollars, potentially, to help people do it.
There are two problems with Rudy’s solution. First of all, a tax credit is useless unless you pay that much in taxes. To Rudy and me, $15,000 off the top of our taxes is a very nice handout; to a family headed by someone in a low wage job, it’s more than they pay in taxes anyway.
Besides, what are they supposed to do with it?
Try buying private health insurance for someone who doesn’t have it. Has Rudy ever done that?
When my babysitter’s son was still a minor living at home, it was impossible to insure the boy. He has epilepsy; we went down a long list of insurers and the answer every time was no. It’s easier to get homeowners insurance if you live in a fire area through the state than it is to get individual health insurance from a private company if you’ve got a sick kid.
When her son grew up and moved out, I decided to try again. In the 17 years she’s worked for me, I can count on one hand the number of days she’s missed work due to illness. Knock on wood. So I applied for Blue Cross; I was willing to pay whatever it cost. Nothing doing: she was rejected because her medical history said she had gastritis.
Gastritis? Stomach aches? Find me a woman who doesn’t.
I finally found an HMO that would take a woman in her fifties with gastritis, albeit with high deductibles and co-pays, for more than a few thousand a year. She couldn’t have afforded it; I could. Problem is, the care isn’t great; the co-pays are way too high ($900 for a colonoscopy) and she’s embarrassed about putting them on my credit card. So we tried blue cross again. No chance. She’s on medication to fight osteoporosis now (like most of my friends); that’s even worse than gastritis. As another friend with allergies explained to me, the minute they find out you are a chronic user of prescription drugs (who over 50 isn’t?) they don’t want you anymore.
So we’re back to trying to at least get her on a better, and more expensive, plan with the HMO she’s with now.
I don’t mind paying more, actually I’m trying to; the problem is you have to fill out a new application form, with all the things you’ve been diagnosed with and all the medicines you take, and while the lady who advised her about the better plan told her that the fewer things she put down, the more likely she was to be accepted, the truth is that all they have to do is look at her medical records to find out that while she’s doing well for her age, she’s not the bionic woman.
That’s the reason one doctor friend of mine who tests for the breast cancer gene does it anonymously; that way, it doesn’t become part of your official records, which would make you uninsurable. The only people who can get insurance are the ones who don’t need it, but if they ever do, at that point they’ll be uninsurable.
This is not, I would guess, a problem Rudy has ever faced. Nor have his children, or mine. They’re covered through our group plans. Not so for the millions of children of the working poor in this country. If they’re sick, it doesn’t matter what the parent is willing to do; no one wants them. And if they’re not sick?
Ideally, the parents would have enough money to buy some kind of coverage for their kids. But many of them just can’t afford it. And yes, some who can don’t. So should we punish the children for that? Let them get sick and stay sick until they’re ready to keel over and land in an emergency room? This isn’t about whether we’re a nanny state, but whether there’s any compassion left at all.
Rudy Giuliani, with his attacks on the Democrats, and his Republican colleagues in the Senate, who have refused to support expanded health insurance programs for the children of the working poor, aren’t trying to solve the health care crisis that faces over 40 million Americans, not to mention the gaps in coverage and the inadequate care received by many who have some form of insurance.
If they were, they wouldn’t be proposing more tax breaks. What they’re trying to do is use the health care issue to score ideological points, to rail against big government and establish conservative purity. But when you’re sick, it doesn’t matter if you’re a Republican or Democrat, or if the doctor is. When you’re sick you need help, and that is precisely what the Republicans aren’t willing to provide.
I thank my lucky stars every day that they don’t have that kind of power over me. But isn’t that how it always is? It’s not us middle-aged middle-class well-insured voters who pay the price for the posturing, but the sick kids who don’t qualify and the parents who can’t afford it.
Susan Estrich is the Robert Kingsley Professor of Law and Political Science at the University of Southern California. She was Professor of Law at Harvard Law School and the first woman President of the Harvard Law Review. She is a columnist for Creators Syndicate and has written for USA Today and the Los Angeles Times.
Estrich's books include the just published “Soulless,” “The Case for Hillary Clinton,” “How to Get Into Law School,” “Sex & Power,” “Real Rape,” “Getting Away with Murder: How Politics Is Destroying the Criminal Justice System” and "Making the Case for Yourself: A Diet Book for Smart Women.”
She served as campaign manager for Michael Dukakis' presidential bid, becoming the first woman to head a U.S. presidential campaign. Estrich appears regularly on the FOX News Channel, in addition to writing the “Blue Streak” column for FOXNews.com.