On a long drive back from Nevada, I listened to the radio and heard about a function being given in a small town to support a young man who had been severely injured.  The money was going to pay for his medical expenses.  Two nights later, I saw on the news another function to raise money for an injured man who was in a wheelchair, who looked to me, a former neurologist, quadriplegic.

I’ve seen thousands of jars of coins in my lifetime to support children with leukemia, young boys vegetative after football injuries, or a young girl in a hospital after a retaining wall fell on her at a national park.  Quads?  Yes, them, too.  Awful.  Terrible. Unfair.  Devastating.

These functions, these jars, these attempts are futile.  Yes, futile. The amount of money they collect is minuscule compared to even one day in a hospital, let alone the fees charged by a surgeon, anesthesiologist, and the consultants that are part of everyday medical care. Go Fund Me will, for a 5% fee, allow crowd sourcing to help families of victims get money.  Even right wing sheriffs in Arizona used it, despite their past opposition to the Affordable Care Act, about as ironic as it comes.  We don’t have Go Fund Me pages for the millions of people who need medical care and can’t get it.  They can’t get it because we don’t have a national system of medical care that covers catastrophic as well as basic care.  We’re better than we used to be, despite 60-odd attempts to repeal the Affordable Care Act, but we have a long way to go.

Go Fund Me works for those who have connections with others who have money.  For those with identical medical issues without such connections, and that would be far more people, there is no recourse.  That is why we need a system that covers catastrophic and basic care, so everybody has a fair chance to get necessary treatment.  Ideal and equal?  Nope.  But it would be more fair and help many more people.

Another irony is that small town America votes Republican.  The Congressman representing this town voted against taxes, he voted against the Affordable Care Act, the passage of which may have given him his seat.  Despite the fact that the ACA has insured millions of Americans and has been a success, both in decreasing bankruptcies and improving the percentage of people who consider themselves healthy, that insurance isn’t enough.  And while the ACA is starting to cost more money, that is not bad, because it means people are finally getting care for things they once let slide, like diabetes, hypertension, Pap smears, skin checks, colonoscopies.

A national health plan covering catastrophic and basic medical care would raise taxes, but it would end the practice of saddling ordinary people with hundreds of thousands of dollars of debt they can’t possibly repay.  It would help hospitals and doctors, too, both groups delivering free care.  I did as a practitioner, and the hospital for which I was medical director did, too.  The problem with Go Fund Me is that some get help and some don’t, the help not proportionate to the medical need.  Pass out leaflets instead of jars, leaflets supporting the Democratic candidate who will work to bring health care reform to the entire nation, and we would see an end of the bankruptcies occurring because of catastrophic medical expenses. Medicare’s overhead is less than Go Fund Me.  While taxes would rise, medical costs paid out in personal budgets would fall.  I can’t put a price tag on the lack of worry whether a medical condition would have to be lived with, because the cost to get care was prohibitive.

Yes, it is you in rural America who ought to start supporting Democrats who vote for things you need.  The Democrats are not coming to take your guns, your liberty, and your land.  The first two have never happened, and as for “your land,” we the American people own it, you and us, and that includes a guy like me. who enters it, doesn’t trash it, shoot up road signs, foul the water, run an ATV across fragile parts, cut down trees, and despoil what should not be despoiled.  The American people own the Owyhee, we all own the Grand Canyon, the national forests, the parks and lands held in trust for us which we must hold in trust for those whose lives are yet to begin.

We cannot realistically help everybody deal with medical bills by crowd source fund raising.  You want to help?  Then vote in legislators who will give us national health insurance so that basic and needed care will be paid for by the people of this land, because each of us is one bacterium, one virus, one plugged vessel, one leaking vessel, one drunk driver away from medical bills that may lead to bankruptcy.  I am frankly less at risk than most, because I have Medicare and can afford my supplementals.  I have social security, which I don’t need and I am near the end of my life, older than 90% of the rest of you.

I am willing to vote and have voted against my economic self-interest to pay for what is needed nationally.  What I don’t understand is why so many in rural America support those who have more than 60 times voted to repeal the ACA, and if given a chance will take away Medicare and other safety nets.

Everybody deserves a chance to have freedom from fear–fear of choosing between medical care and food, fear of bankruptcy, fear of wondering what delaying care for oneself or one’s child might mean. There are many things to be afraid of in this world, but this fear we can and should address.

We’ll be a better nation and people for doing so.

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