I have no health insurance.  I have to worry about getting a cold, getting a flu, getting food poisoning, or some other unfortunate ill.  Heaven forbid I do, I have no way to go and see a doctor for any sort of treatment.  In the back of my head, I worry every time I step out off the curb into the crosswalk, worry that some crazed taxi driver will gun his engine and inadvertently take me out.  In that case, I hope I go quickly and painlessly, and not have to end up in a hospital and drive my family into bankruptcy.  That is my prayer, in the supposed land of freedom and opportunity.

I, along with many of my peers, went to college and are pursuing further grad work.  I, along with many of my peers, are in debt up to our eyeballs.  Cornell Arts and Sciences costs something in the order of $40K, though I was in Cornell’s College of Human Ecology, a measly $20K as a New York State resident.  Meanwhile, I just Googled the tuition cost to attend the University of Cambridge in England and here is what it said:

“In 2009, the University of Cambridge will charge tuition fees of £3,145 (plus a small inflationary rise to be determined by the DIUS) per year for all courses, as outlined in our Access Agreement, which has been approved by the Office for Fair Access (OFFA).” (http://www.cam.ac.uk/admissions/undergraduate/finance/tuition.html).  That’s $4654.  Per year.  At one of the world’s premier universities.  In order to succeed in the land of freedom and opportunity [the United States] you must be willing to fork over an arm and a leg, in addition to your firstborn.  This is the mantra that the country continues to chant.

So getting back to my story.  I have no health insurance, and I’m signing loan after loan to pay my way through school.  Theoretically, I have only another…5 more years of school to go before I get a steady paycheck.  After that, maybe another thirty years before I pay off my loans.  Even if I didn’t take my double-masters detour from medical school, I would still be paying off loans well into my child’s teen years.

I have tried to find a job, but finding a job in itself is a hassle.  I finally got one, after 6 to 7 months of searching (not including the tutoring position I currently have).  Other friends, though, are still in the job-hunting game, with little to no success.  Most, if not all, are from top-tier universities around the country.  Even if they’re not, they are certainly smart and capable, yet they are all being denied.  Welcome to the United States, the land of freedom and opportunity.

Why have we failed our own people?

Part of the problem is we are still operating in an exclusively capitalistic mindset.  Privatize this and that so that the brunt of the cost falls on the individual and the group is spared.  Leave it to market forces, because the market will cure all.  We have no concern for the group, just the individual, whose health and future is put in the hands of the market.  This is the equivalent of leaving them in the hands of a temperamental child, easily swayed, and never entirely stable.  Inflation is only driving costs up.  While, in the case of healthcare, Medicaid and Medicare do exist and for education, there is state and federal financial aid, they are imperfect solutions.

Medicaid remains a often-abused and neglected system.  Millions, if not billions of dollars, are being spent because clinicians are billing the system fraudulently, exploiting loopholes in the system that have yet to be resolved.  If they aren’t inappropriately billing the system, they are less likely to treat patients on Medicaid, and those hospitals and clinics that do accept Medicaid are notorious for being sub-par in comparison to their private counterparts.  While Medicaid targets those who are often well-below the poverty line, and private insurance takes care of people in the upper brackets, there is still a whole set of people who are neither poor but are neither capable of shelling out money for private insurance that are left without health insurance.  There are no resources for these people.

“Give me your poor, your tired, your huddled masses…” unless they’re above this income bracket and below another.  In that case, you’re on your own.

Yet even if you can pay for private health insurance, you are probably out of luck if you were to end up with a major medical condition.  While routine checkups and most lab tests are covered by most health insurance plans, the more complex procedures are oftentimes not covered.  So regardless of your status, in terms of health insurance coverage, there are problems just waiting to happen from which no one can effectively bail you out.  Russian Roulette, if you will.

Welcome to the United State, the land of freedom and opportunity.

If someone wants to have enough money, not just to pay off health insurance, but to have a decent quality of life, they need an education.  Education, especially in recent years, has become prohibitively expensive.  People who would otherwise be capable of getting into an Ivy League are stopped short by the costs, and have to go somewhere else (which may not necessarily be a bad thing, refer to my earlier post).  Inflation is driving up university costs at astronomical rates, and greater pressures are being put on colleges to construct new buildings and upgrade what they already have, adding to the cost.  Why do we have to be restricted from attending some of the nation’s finest universities by something like cost?  We have become a society of debtors, in part due to this phenomenon.  Don’t even get me started on the fact that, despite the fact that we pay through our (insert orefice of choice here) for a halfway decent education, we lag behind most of the world, especially in science and mathematics.  That’s for another post.

The irony is that I want to be a doctor with a few grad degrees aside from my MD, and currently I neither have health insurance nor a sound way of even paying for one grad degree, let alone medical school.

Welcome to the United States, land of freedom and opportunity.

Dear President-elect Obama: Do you hear the the death moans of a nation once at the pinnacle of greatness, now reduced to a society of forgotten people, languishing in their own physical and financial sickness?  You spoke of healthcare for everyone, where even the poorest person can have the same healthcare as a United States Senator.  Coming from a distinguished background, you know the pain students go through to get a decent education, just to enjoy some of the benefits that you have.  I will bite my tongue and pay my loans off as best as I can, dutifully carry around my bottle of Purrell in an effort to stave off illnesses for the time being, and look both ways before I cross the street (in a very anti-New Yorker fashion) but at some point this needs to stop.  I need to stop worrying about how I’m going to pay for my education and I need to stop worrying about whether my next step could land me in a hospital.  More importantly, though, my younger brother shouldn’t have to worry about which college he can afford to go to, or how he’ll be able to get healthcare once he’s older.  My parents shelled out a lot just to see me enjoy opportunities that in some cases, they had to forgo.  Now that the second one is lining up for his turn, I don’t want to see them struggle anymore.

Can you bring meaning back to the phrase “Welcome to the United States, the land of freedom and opportunity,” and not leave it sounding sarcastic and empty?  Can you fix it?