Thoughts On Presidential Candidates (And Their Healthcare Plans)

Just to get this out of the way first: I'm voting for Barack Obama. I'm aware that he is a politician (and all that entails), but in all my reading and research so far, his ideas, proposals, and plans sound a lot more coherent and inclusive than McCain's.

I don't begrudge those who want to vote for a third-party or write-in candidate the right to follow their conscience and principles by not picking either a Democrat or a Republican (and my own cognitive discomfort with adhering to ideologies is the main reason I'm registered independent¹ rather than with a party), but realistically, we are going to end up with either Obama or McCain, and I personally would really prefer Obama in office.

I am not going to list all the detailed reasons here as to why I've decided to vote for Obama, because (a) I know no amount of arguing for my preferred candidate will have any effect on people who've already decided he's the Antichrist or something similar, and (b) because there's plenty of information out there on the Web anyone can find if they want to know the candidates' positions and get a sense of who they might want to vote for.

However, I will say that healthcare has been a big factor in swaying me toward the Obama camp -- I am actually literally scared of what might happen to the healthcare options for me and people I care about under a McCain presidency. I am in no way equipped to cite or critique statistic-based statements about what sorts of plans would actually result in more people getting quality healthcare when they need it, so I fully admit that when it comes to healthcare policy proposals I plan on voting based on how I think certain plans (and the philosophies behind them) are likely to impact me and people I care about.

My parents got me a subscription to a financial magazine last year (Kiplinger's) due to my longstanding difficulty understanding large-scale economic stuff. (I have exactly one talent when it comes to money, and that is the ability to save it -- meanwhile I have only the barest inkling of what a "stock" is, and still think of credit as being largely meaningless and fake even though I now have a credit card; I just never use it for anything I don't already have the money to back up.)

I often can't make head or tail of what Kiplinger's is saying in most of its articles (and they seem mainly directed toward people with massive amounts of unacknowledged privilege), but every so often something will catch my eye. And in a recent issue of Kiplinger's, there was an article comparing Obama's and McCain's healthcare plans. As far as I could tell, the thrust of McCain's plan was toward less distributed coverage (i.e., coverage that would apply to more people by default) and toward things like...people getting tax credits that they could use to go out and find their own private coverage. Whereas Obama's plan seemed more geared toward making sure more people had coverage.

That is, of course, a grand oversimplification -- but again I am not going to repeat here in detail things like candidates' healthcare policy proposals, because you can read detailed analyses of both Obama's and McCain's healthcare plans elsewhere, as well as the material on the candidates' own websites.

For me, though, I come to this matter of healthcare informed by my experiences being uninsured and unable to get coverage. I am insured now through my employer -- but back when I first graduated from college, I was hired initially as a subcontractor. Which meant that if I wanted healthcare, I had to get it privately. I applied to self-insure, as I was making enough money to afford a basic plan -- but was rejected. I appealed, and was rejected again. The reason? "Pre-Existing Conditions".

I still don't know exactly what pre-existing conditions they were rejecting me on the basis of, as I've never had anything life-threatening.

I have had:

- A partial thyroidectomy when I was fifteen to remove a benign growth (with no complications afterward, and no need to take supplemental thyroid hormone as the remaining portion of the gland "took over" functionality for the missing portion, and this has been verified by numerous blood tests)

- A back injury in college (for which the treatment was ice, ibuprofen, and no heavy lifting for a few months)

- A record of seeing various therapists for brain-related stuff since before preschool.

...so I'm guessing it was probably one or more of those things.

I don't think any of the above "conditions" make me any more of a "risk" than average, but even if I did have something that made my health more actually precarious (and there are people I care about very much who I worry about often due to the even more extreme lack of good options for them), you'd think that there should be a better option than, "Oh well, you're on your own -- even though you could probably benefit greatly from having a safety net, you can't have one because you might actually be likely to use it!"

Or at least I'd think there should be a better option.

Anyway, though, after being rejected for the second time I just sort of hung on for dear life (that is, hoping I didn't get sick or injured) until I got hired on as a permanent employee who could receive group coverage benefits.²

And I do use these benefits.

I use them in order to maintain access to prescription medications, to get checkups for female-oriented stuff, and to (when necessary) get counseling and other forms of assistance. These benefits are not perfect but my quality of life is immensely higher with them than without them. And I know that if some plan came into effect wherein I couldn't even get group coverage through my employer, I would be in a much worse position than I am now.

There's a factor in health coverage and accessibility even beyond the financial that I don't see talked about much, but which affects me (and probably others) greatly. I still have no clue if I'd have been able to get coverage anywhere, or find affordable doctors who would take me, prior to getting insured through my employer -- I could not, when it would have been most helpful, locate the information or the necessary procedures by which to identify resources I could actually use. I tried, but none of the available information made sense to me and I didn't even know how to formulate the questions to ask for help.

If it turned out to be necessary for me to go to a different state to get health coverage, I might not be at a financial loss, but I would almost certainly be at a logistical loss. The complexity involved in doing that kind of thing would likely mean I'd never do it, which would mean I'd be stuck forever with the "don't get sick plan". And somehow I hope that I don't live in a world where having that kind of cognitive difficulty means people like me are simply going to be considered "too stupid to deserve to live".

I can very clearly do interesting (and, dare I say, useful) things with my brain -- but one reason I use an HMO (actually a primary reason) is because there is so much less in the way of paperwork and other barriers to actually getting needed care than there would be with a private system. Even something like a PPO (which my employer also offers) would be an accessibility nightmare for me.

I realize that I am exceedingly lucky in the first place that I live in a society where certain things are available to me that would not have been generations ago, and would not be if I lived in a different country -- so this is not about me feeling "entitled" to stuff, but rather about describing a non-financial reason as to why I would probably be way worse off under a McCain-like plan.

A lot of people are focusing on how much X or Y plan would cost, and who would bear the brunt of that cost, but frankly cost is a secondary concern to me. I don't know if this is very common in autistic people in particular or what, but in my case I seem to run into far more in the way of logistical barriers than money barriers; e.g., I am the kind of person who (if I didn't have people like my partner reminding me to eat actual food) could starve with $100K in the bank.

And I am sure I'm not alone in this.

The times when I've had the best quality of life healthcare-wise have been when I've had access to systems where I can pretty much just make an appointment or walk in and get what I need with minimal paperwork and phone calls -- having HMO coverage permits this, and I had something similar (albeit more limited) in school because my college had a decent health center, but when I was working but uninsured (and uninsurable) I was in an extremely, viscerally vulnerable position.

I realize some people reading this might just decide I'm an ignorant idiot and that my whole position here is based on misconceptions on how things would actually pan out if Obama or McCain (or someone like either of them) were elected, and that's fine; you're entitled to your opinion, and I don't keep a blog for the purpose of trying to show off to the world how smart I think I am. I may not be very smart in certain areas, and effectively navigating a more market-driven healthcare environment is one of those areas. But does simply wanting there to be options other than "survival of the fittest" open to people like me make me unforgivably selfish? I'd certainly hope not.

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1: Note that "independent" is NOT, by any stretch of the imagination, the same thing as American Independent. The American Independent party is an actual (albeit "third") party. A very scary ultra-right-wing party. Not one you would ever see me joining!

2: Mind you, I never once felt "entitled" to these benefits. I have a weird thing about "entitlement" wherein I tend to feel very strongly that things ought to exist in general for people who need them, but that when it comes to me personally, I am really, when it comes down to it, on my own in what amounts to a "state of nature".

That is, I think certain safety nets ought to be a fundamental component of any society that wants to call itself civilized -- but this is NOT because I somehow think money or resources come out of nowhere, or because I believe I can actually ever rely on any sort of "safety net" myself the way I can rely on things like the existence of solid objects. I really do see "benefits", even from an employer, as being gifts -- that is, things that I do not fundamentally "deserve" from the universe, but things I've fortuitously been able to access for reasons that have way more to do with luck and privilege than with personal effort on my part.

And in acknowledging that, I see it as reasonable for me to put forth opinions along the lines of, "We as a society should, on the basis of ethics and common decency, decide to create certain universally-accessible (or as close to it as possible) resources for our citizens."

Also: I do think effort plays a part in where people end up in life, and I would never disdain that, but I also realize that a person has to have a certain amount of starting advantage in order for any amount of hard work to do much for them. I've worked my proverbial arse off in some ways, for sure, and I am proud of that, but I do not think for a moment that there is some direct, linear correlation between (say) my present access to healthcare and the fact that I tried really hard in college. I had a lot of logistical support in college from my parents and others, not to mention some accommodations without which I probably could not have graduated, and even with all that I still rate getting through school as the absolute most difficult thing I've ever done.

Hopefully that makes sense -- I am often reluctant to talk about healthcare stuff publicly because I've had some bad experiences with people assuming that because I think it would be nice for people in a supposedly civilized society to decide that their neighbor's lives are worth more than another 3 vacation homes and a gold-encrusted yacht, I am an evil coercive redistributionist who simply wants an excuse to lead a "slothy lifestyle" while "productive people" work themselves into exhaustion for my sake.

And that is absolutely not my position.

I don't think the world works that way to begin with, I don't think there is any basis right now to say that there simply "aren't enough resources" to keep even poor and variously disabled people alive, and I believe that there are actually tons and tons of people making lots of tremendous contributions to the world around them without being employed by corporations. And yes, I am saying this as someone who IS presently employed by a corporation, so this should not be taken to mean I think it's always bad to be employed as such, or that there's moral superiority in not being employed as such.