The politics that surround health policy and care are intimately linked with any individual patient’s quality, and even duration, of life. Sadly, these topics are incredibly emotionally and politically charged these days. I have therefore always avoided writing on such overtly political topics in this space. I have no desire to alienate fellow patients from either end of the political spectrum, and indeed I have friends and family whose views span everything from the conservative to the socialist. And yet, every now and again I have to shake the metaphorical bars of my metaphorical cage, and ask what I did to deserve being so thoroughly, thoroughly screwed by my country’s medical system.
As far as I can see through the rhetoric that obfuscates the issue, those who oppose health care reform fall into two camps. There are those who dislike the health care reform bill that was passed by the current administration, and then there are those who staunchly resist health care reform in any way, shape or form. To the former I have nothing to say. The health care bill is riddled with imperfections. It is nobody’s ideal. I don’t think anybody is really happy with it, but that’s how politics tend to warp plans and ideas, and is a topic for another person in another forum. But to the latter, those who firmly resist change of any kind, I ask again, “What did I do wrong?” Why do I deserve to have no choice in insurance carriers, have to wait months to see any specialist, and not be able to go to the ER when my doctor orders me to do so? Why do I deserve to have such poor insurance that, by the end of 2011, I will have spent half of the year with no form of prescription coverage? This is not an academic question; it’s my life. As such, I present my situation as an example of how I feel that our system is a broken one.
One of the dirty little secrets about biomedical research is that it is largely performed by students and post-docs. Graduate students in the biomedical sciences are highly skilled employees often working at, or below, minimum wage. We are full-time researchers, and work long and irregular hours. Our performance and pay is not linked, and we make no bonuses or overtime. We make far less money, and have far poorer benefits, than full-time staff members, whether they be cleaning staff or administrative assistants. I do not have a problem with the fact that graduate research or teaching assistants make so little money; that is a trade-off we consciously accept when we decide to go to graduate school. We trade a real salary for the opportunity to earn a degree. I do have a problem, however, believing that in a supposedly merit-based society we don’t deserve the health care coverage granted to other employees of our institution. I don’t believe that graduate students should be forced to make the choice between forgoing important medical treatments and finishing our degree.
I have no particular political axe to grind, and I recognize and acknowledge that there are many people whose situations are far worse than mine. But I do have to ask under what system of ethics, meritocracy, or even simple human rights is my situation just or fair? I am highly educated, highly skilled, and employed full-time. I work the job, rather than the clock, which means that even my so-called vacations are filled with work assignments. I did nothing to earn my health problems, and in fact have always followed a much healthier lifestyle than the average citizen. And yet, once again here I am, staring at my list of prescriptions, and deciding which ones “merely” improve my quality of life, and must therefore be eliminated. Once again I must figure out which drugs I must continue to take, or risk a spiraling flare of my disease which could literally be fatal. After spending the past ten years learning how to understand diseases, immune systems, and the science behind drug design, I am once again bereft of any kind of insurance coverage that might help me pay for the very drugs I study. To those who believe that the status quo is fair and merit-based, I ask once again, "What did I do wrong to deserve this?"