Seeing Health Care from Both Sides as a Native American
I hate going to the doctor. I don’t know exactly why. Maybe it’s just that I see it as an inconvenience of sorts and would rather spend my time playing a video game or watching TV.
I don’t like having to keep up with appointments, and I really prefer not to have my blood drawn. But the part of going to the doctor I detest the most is the billing and payments phase of the appointment. It is easily more painful than having a needle shoved into my foot to relieve a swollen tendon—and that needle was huge.
The payment process for medical expenses is convoluted and confusing—and often, quite costly. Understanding your financial obligation is hard to figure out and can also be a surprise, but not in a good way. It is a painful and often futile exercise that, in my view, is totally unnecessary.
I’m no expert on medical, legal, or political matters, but as a Cherokee citizen, I am an American with the benefit of a perspective on different modes of healthcare delivery that most Americans do not have. So no matter what your views on the whole topic of health care in the United States is, please indulge me for a moment to share my thoughts.
The Problem with Employer-Based Insurance
I have not ever in my life had any health care provider or insurance policy that lasted any length of time. I’m pretty sure my car loans have outlasted most insurance providers.
I have always struggled with being content in my professional life and am always looking for the next best thing. Sometimes, this is a disadvantage, while in other times, it has served me well. This is a trait I seem to share with my dad, who worked in a number of professional roles that I can recall growing up. This isn’t because we have trouble holding onto jobs or end up bouncing around from place to place due to our own shortcomings as employees but more to do with the fact we prefer smaller companies over corporate environments, and the opportunities for upward mobility and growth in these spaces are sparse.
If you are reading this from the United States, then you know that your ability to see a doctor is too often tied directly to employment. The way this system is set up means that for many American workers prioritizing opportunities and quality of life over choosing a job strictly for benefits, regular medical care often suffers.
Under this system, switching jobs means switching doctors or going without health care altogether, and working for small businesses often means foregoing coverage completely. Seeking a career move to better your position in life can even lead to catastrophic financial burdens from unforeseeable accidents or disease. This means that if you have difficult medical issues that require costly medications or regular check-ins, you may as well count out being self-employed or starting your own business.
Seeing Both Sides
Another thing that I get from my father is Native American heritage, although most would never guess by my red hair, blue eyes, and distinctly pale complexion that I am a member of the Cherokee Nation of Oklahoma. As determined by the Dawes Commission of 1893, my blood quantum stands as 1/16th Cherokee. I am only 1/16th of a Native American. The rest of me is as white and European as an aged block of Gouda.
What this means in terms of health care is that I am entitled to avail myself of services provided by the Indian Health Service through the Bureau of Indian Affairs. I know most Americans have no access to the IHS and that this experience gives me a somewhat unique perspective to talk about health care delivery in this country.
The IHS was established in 1955 to provide medical care for Native Americans from a dedicated agency with its own staff and facilities. Care had previously been provided from other agencies within the government. The IHS provides services that are 100% government funded through employees of the federal government in government-owned facilities and are free at the point of delivery.
Because of this, I have had access to socialized medicine throughout my life. I have never seen a bill from the IHS, nor do I know how much any of the services I have received cost. And I am afforded this all through a complete happenstance of circumstances that I was born into Cherokee ancestry. Short of being born, I did nothing to earn this entitlement. While Veterans Health Administration medical services are also socialized, they are a benefit given to those who voluntarily served in the U.S. armed forces.
Only in the last few years after the full implementation of the Affordable Care Act have I enjoyed regular, full coverage health insurance. Under the ACA subsidies, because of my Native ancestry, I am eligible for Blue Cross Blue Shield with zero premiums and zero copays for everything.
While the amount I pay is the same as it’s always been, the difference is that now I am able to view the cost of my medical care, and it is absurd.
The True Cost of U.S. Health Care
Last month, I filled prescriptions that would retail for over $1200!! Who can afford that? Even with my $450 subsidy from Obamacare, someone is losing money. But it is not the insurance company losing the money, though.
It is all of us.
Everyone living in the United States pays into this system one way or another, even those who aren’t paying taxes. That’s because taxes, wages, and even retail prices are all impacted by our United States healthcare system. It all comes out of everyone’s pockets, and those costs get distributed in highly unequal ways.
Some people receive minimal health care at public facilities. Some people get no copays at top hospitals. Some people go broke paying their portion of insured care at crowded private clinics.
And then there are those who make too much for Medicaid but too little to pay out of pocket for their healthcare costs. Those are the folks that just die.
They die when they don’t have to.
Often, it’s those untreated health conditions that prevent them from making more money in the first place, a churning cycle of suffering and misery that continues until the inevitable happens.
There are also those who remain tied to a job they absolutely detest because they know it is the only thing literally keeping them alive, and that even to switch jobs could lead to a break in coverage and the loss of ability to buy life-preserving medicine. It is a sad state of affairs.
What About Wait Times?
As a Native, I have seen firsthand how a government-run facility works using government employed physicians and staff. It isn’t perfect. But the idea that any system should be flawless overlooks how complex healthcare is and how deeply flawed private insurance is.
One of the recurrent debate points against universal healthcare is that wait times are out of control under government-run healthcare, while private healthcare gets you in right away. But it certainly hasn’t played out that way in my comparative experience.
Here are a couple of examples:
Specialists: To see a podiatrist at the Indian Hospital, I had to wait three weeks, whereas my wait time to see an ENT at a private facility was eight weeks. My wife waited a whopping nine months to see a rheumatologist with her private insurance.
Emergency Care: I’ve waited up to eight hours in a private ER, and I’ve waited as little as 30 minutes in the Indian ER.
It Starts With the Will to Change
Government medicine can work if it has the funding and, importantly, the desire to make it work. Anyone who advocates against it has never left a hospital without visiting the billing department. Believe me, it is freeing. Having access to affordable healthcare is a huge peace-of-mind issue.
Lack of access to health care is a struggle Americans face that doesn’t exist in pretty much every other developed country. Unfortunately, it’s hard to see how much it’s hurting our nation because so many have not had the benefit of access to good medical care that isn’t costly or tied to our jobs.
Ultimately, health care is just one more way powerful corporations have leverage over average Americans. If our employers held no power over our health, U.S. workers could be much more free to pursue entrepreneurial endeavors, giving our country a significant economic advantage.
The idea that starting a business could threaten your health or accepting a better position could mean skipping a month or more of needed medicine hurts Americans individually and as a whole. In the post-pandemic world, the freedom to change jobs is more important than ever.
Good health is also fundamental to thriving families, a cornerstone of a strong nation. Poor health of a parent or child can rob kids of a fulfilling childhood and reinforce generational poverty. The stress of juggling medical expenses with everyday expenses can zap the life out of parents, leaving less quality time for the kids. Furthermore, paying for prescriptions and doctors can lead to fewer fun family nights out or even having enough decent food to eat.
We could have the benefits and freedoms afforded by access to health care today but collectively lack the political will to go against the status quo. People are fearful of change, but change is good and often necessary for society to progress.
And we have many case studies to prove it:
- Abolishing slavery was a radical change that made society better in countless ways and eventually leading to the United States becoming the world’s second-largest industrial power.
- Allowing women to vote and hold office has improved our governance, with studies linking women’s suffrage to a 15% dip in the child mortality rate, increase in school enrollment, and increases in school spending.
- Accepting LGBT people for who they are has made our society kinder, more generous, and less bigoted while reaping numerous economic and public health benefits.
I am convinced if more people could experience a world in which disease does not equate to bankruptcy, they would be more accepting of universal health care. I genuinely wish everyone could experience the access to healthcare I’ve enjoyed, but you’d need a CDIB card for access, and they don’t give them out to just anyone. While two of my kids get the benefit of IHS, my wife and adopted son are at the mercy of whatever private insurance we’re able to currently access.
Unfortunately, too many folks who do not wish to have the government “making decisions for them” are perfectly fine with having an unaccountable corporation making the same decisions. Health insurance companies are responsible for countless stories of misery and suffering for people just fighting to not die. At least you can vote for leaders in government. You don’t vote for CEO.
Everyone needs health care, even those who protest, “But I’m healthy!” Believe me, if you don’t need it now, it’s only a matter of time, and if you don’t have coverage when that time comes, it’s going to cost everyone else.
We have plenty of resources to cover everyone in this country. We just have to make that a priority. In the meantime, you can learn more about the true costs of healthcare here.
Further reading and video about health care: