Der Tagesspiegel (Germany): an American tragedy — a system

Millions of Americans have no health insurance. Here and Rebecca wood had to choose to be treated or to treat a daughter.

Spring 2015 Rebecca wood had to make a decision — not the first time. Her lower left canine broken, and the nerve in the tooth is inflamed. It was necessary to treat the root of the tooth, but this required to pay to the insurance of $ 2000. And she has not been paid by the speech therapist daughter Charlie. Charlie is more important.

It tells Rebecca in a few days her face swelled and her breathing became difficult. “I drove the car to the hospital to save the ambulance”.

Three days later she underwent surgery under local anesthesia, because General anesthesia was too expensive. “First they ripped out my tooth, then another nearby, then a third, then the teeth around it, and then do all the bottom row,” — says the woman.

“They pulled all my teeth”

However, the inflammation is spread throughout the oral cavity, and the attending physician called for help a colleague. “In the end, they removed all my teeth. And scraped part of the jaw”. As Rebecca said, the pandemic in the fashion industry, she feels just like another critical situation.

41-year-old Rebecca wood suffers from a severe form of asthma, and also from a rare autoimmune disease like lupus. It is, among other things, weakens the lungs. Eight years ago her daughter Charlie was born three and a half months premature. A girl suffering from disorders of the neuro-muscular system, called cerebral palsy.

But the main reason why the family of Rebecca wood had over the years to move so much suffering, not that. The problem in the health care system of the United States.

Rebecca is lucky to have her in the kitchen, a huge window. From the fifth floor she can see very far. In clear weather is visible in the distance, the Maurice Tobin bridge, a gigantic structure, spreading across the Mystic river in Boston. “Actually, kind of wonderful,” says Rebecca.

But the closer she stares into the surrounding world, the more frightening she looks. When Rebecca looks down at the sidewalk, she sees people without masks. Runners who do not observe social distance. Construction workers.

And when she decides to go down to the lobby of his house to get the mail, and there, according to her, is always one neighbor and prevent it to pass. “Get out!” — she yelled at him a couple of times in past weeks. But he allegedly did not understand.

Most of the reform, but the resistance is large

Since the beginning of the pandemic coronavirus in the United States died from the infection more than 100 thousand people. This was announced on Wednesday evening, the University named Johns Hopkins in Baltimore.

Relative to the overall population is more than in all EU member States. There average from the effects of coronavirus infection dies of 27.5 persons per 100 thousand inhabitants in the US was 30.3.

Rebecca wood belongs to the group of highest risk. As she says, coronavirus infection with a high degree of probability will threaten her life. “What will happen to Charlie if I die?” Charlie long was fed through a gastric tube and was held for several different courses of therapy. “I would like to live at least until the moment when Charlie will become independent,” says Rebecca.

When we first talked to Rebecca wood on 6 March, the virus was only one of many issues. “The coronavirus has shown how badly needed Medicare for All (eng. “health for all”),” — says Rebecca. She is referring to draft Bernie Sanders (Bernie Sanders), who at that time was still a presidential candidate from the Democratic party.

Medicare for All was to expand the existing Medicare program, which insured the elderly and people with disabilities, and at the same time to replace all private health insurance companies. It was supposed to be United and financed by taxes, the health insurance system, such as those that exist in many countries.

It would be one of the greatest social reforms in US history, supported, according to polls, the majority of the population. But resistance to reform is huge. HMOs insist on keeping the current status quo, as well as the pharmaceutical industry, private hospitals, lobbying groups such as the American medical Association, the Republican party and Joe Biden, now the only remaining presidential candidate from the Democrats.

30 million US citizens have no health insurance

The US health care system is a giant, largely unregulated and opaque market where competing 900 insurance companies. In terms of the US health care system is estimated at 3.3 trillion euros — 18% of GDP. More than any other country in the Western world.

Even before the crisis, with a cov of about 30 million people in the U.S. lacked health insurance. One in three Americans has debts to medical institutions is the most common cause of bankruptcy of individuals. Scientists at Harvard University found in 2009 that 45 thousand Americans die each year from “shortcomings of the health system”.

Rebecca wood and her daughter live in the small town of Revere, Massachusetts, just outside Boston. A couple of minutes drive to the Atlantic ocean. Charlie goes to an elementary school in the first grade. Mother works in Mass-Care, an organization advocating for the introduction of universal health insurance. Before the pandemic, she was making $ 400 a week, now she’s reduced working hours.

The more she learned over the years about politics in healthcare, the more it became her wish this policy to change. On the phone she said that at the end of March should give a speech on the forum in defense of Medicare for All not far from Boston — “to attract to our side more people.”

Four days later, on March 10, she wrote that the conference was canceled. School Charlie also closed. By that time in Massachusetts was registered 93 cases of infection with coronavirus. On this day, the state Governor, Republican Charlie Baker declared a state of emergency. For Rebecca and her daughters first day of isolation.

From one emergency situation to another

The story that Rebecca usually talks like this, that is its own story, both unusual and mundane. Unusual because Rebecca years to get out of one of the emergency and goes to another and asks herself why she have to face such misfortune. Everyday, because in such a situation millions of Americans.

The struggle Rebecca began in 2012 after the premature birth of her daughter. She lived at the time in South Riding, Virginia, with her husband, a computer programmer by profession, which is now divorced. In the 24th week of pregnancy, she developed preeclampsia, a life-threatening condition leading to fluid accumulation in the tissues of the body and increase blood pressure.

Two weeks later when she almost had kidney failure, the doctors had to do something to save the mother’s life. May 29, 2012 she underwent a caesarean section and took Charlie. Until the end of term was three and a half months, the baby weighed 800 grams. “She was the size of my palm,” recalls Rebecca.

Charlie stayed in the intensive care unit for newborns twelve weeks. Rebecca could not hold back tears, telling about that time. “Excuse me,” she says, ” but it seems to me that the trauma I have experienced.”

Many Americans do not seek treatment due to fear of cost

In the US, even people with health insurance tend not to go to the doctors. In a survey made by the Institute “West health” 14 percent of Americans polled said that if you experience typical symptoms of infection by the coronavirus will not go to the doctor for fear of costs. 9% will not go to the doctor, even if they have a clear suspicion on disease by a virus covid-19.

The vast majority of insurances cover only certain services. Certain hospitals and certain doctors only accept certain insurance. What a human insurance, depends, as a rule, from the employer. The fact that 40 million Americans because of the coronavirus have lost their jobs means, among other things, that many millions of people were left without medical care.

Our second telephone conversation with Rebecca took place on March 17, after a week of isolation. “Two small rooms is not much for two people,” he says, laughing, Rebecca. According to her, Charlie was all right. She reads a lot, practices with his guitar, watching videos of his favorite band Dispatch.

“News and tweeting infuriates me,” says Rebecca. President trump, who has long denied the risk of virus and still opposes the adoption of effective measures now agreed with the definition of “pandemic”. In such large cities as new York, will soon be impacted by the availability of the ventilator. “I don’t know what Rebecca said. — But I’m sure it will be bad”.

She told her story, Bernie Sanders stood up for her

Rebecca tells how many specialists she had to see for Charlie: a physical therapist, an occupational therapist, dietitian, speech therapist, optometrist, gastroenterologist. She describes how for weeks traveled to Virginia to get to the doctors that the family could afford — in Upperville, Harrisonburg, Winchester, Fairfax, Charlottesville.

She explains that Medicaid, the state program for people with low incomes, are allowed to hold many types of therapy for Charlie, however each time you visit a doctor still had to pay $ 40. “It took all our money.” According to Rebecca, because of financial reasons she has to choose between their health and the health of his daughter.

When Rebecca first told her story in an open forum in September 2017, Bernie Sanders stood behind her and quizzically shook his head. The Senator from Vermont gathered that day, a press conference to present his plan to create Medicare for All.

How then told Sanders, it’s just a shame that the US does not guarantee its citizens health coverage. “While insurance companies and drug manufacturers are allowed each year to hundreds of billions in profits,” said Sanders.

“I am grateful to Bernie for his courage,” says Rebecca, sitting at the end of March in my kitchen. It’s her first interview on video. Her gray t-shirt, blond hair in a braid.

She didn’t understand why the Governor of Massachusetts imposed a regime of isolation. After all, other States have urged their residents to stay home. She understands that the more people infected with the virus, the longer it will have to stay in the apartment.

Goes on demonstrations with a picture of your daughter

Rebecca grew up in Roanoke city, Virginia, with perhaps 100 thousand inhabitants. Parents are devout Catholics in the family, except for her five children. According to her, she didn’t know what profession to choose, he studied chemistry and social work, worked as a Manager at the restaurant, and later, the delivery service UberEats food. Not interested in politics. Before the election of 2016.

Trump even during the election campaign said he will abolish the Law on the patient protection and affordable care (Affordable Care Act/ACA), passed in 2010 and known to most people as Obamacare. Many millions of Americans after the reform got insurance, the health insurance companies had to follow strict rules. Although its main promise is to provide health insurance to all citizens — Obama has not fulfilled.

“The ACA has many flaws, but this law helped Charlie, Rebecca said. — But suddenly everything hung in the balance”.

In January of 2017 in front of the Capitol in Richmond, capital of Virginia, a demonstration was held in defense of AC. Rebecca decided to go and brought a poster. “Without medical protection she had no chance at life”, was written over a picture of Charlie. “People did not realize that the girl on the poster is the same that runs nearby.”

After the vote was crying from happiness

In late July of 2017, the U.S. Senate held a vote on the future of Obamacare. “I then worked at a music festival and all the time staring at the phone”. According to Rebecca, she felt as if she was watching the execution.

When late night came the news that the majority of the Senate voted for Obamacare, that is, trump lost, she was crying from happiness. But the relief was short-lived. “It was clear to me that ASA is only crumbs that we need more: health insurance for all,” she says.

Then came April, the United States became the country with the largest number of cases of coronavirus. The last days were hard, says Rebecca. She decided that Charlie would be better to have her former husband in Virginia, because there is a garden. “He’ll pick it up in a couple of days, she says. — Children should not be permanently locked in four walls.”

“Tomorrow we will nakrasit nails?” asks Charlie, Bouncing somewhere behind. “Tomorrow’s my birthday,” says Rebecca, when Charlie disappears into the other room and looks like tears.

Singulair, symbicort, plaquenil, famotidine, prednisone

The following weeks were marked by Rebecca the UPS and downs of mood. According to her, sometimes waking up, she thinks, today, simply to survive. She coughs and says, joints hurt, stomach hurts, hard to concentrate. Turns on the TV but not really watching. Thinking about the beach that misses. At low tide, says Rebecca, the rocks look good.

In better days she teaches Spanish, talking on the phone with friends, doing yoga and reading books. Finally she has time for herself — for the first time after the birth of Charlie. “I don’t need to go to work, I have an apartment. I’m still in a privileged position”.

Then she gets her medication from the Cabinet. Pills for asthma, pills for lupus capsules from stomach pain, cortisone sprays, inhalers. She says to spell the names of medications: singulair, symbicort, plaquenil, famotidine, prednisone

Insurance covers part of the costs, the Rebecca spends for drugs $ 200 per month.

On April 19 she sent a TEXT message: “Tomorrow will break the quarantine. Or you’ll go crazy.”

But the next day she returns from a walk upset even more than before. “So many people that don’t consider others as idiots,” she says. — Some masks are worn around the neck, if it’s a fashion accessory”.

At the end of may in the US were 1.7 million cases of infection with coronavirus. Massachusetts is the number infected at the fourth place among the States. With a population of 6.9 million people it was 90 thousand cases.

According to Rebecca wood, a couple of months ago she had hoped that in November the presidency will be elected, the person acting for the state health insurance system for all citizens. But since Sanders dropped out of the race, and with him disappeared the hope for Medicare for All, to keep optimistic has become even more difficult, says Rebecca. “I’m afraid that trump will win again. I know that Joe Biden leave everything as is.”

A couple of days ago my daughter came back to her. They decided to take a walk on the beach. As Rebecca said, this spring she has the same feelings as after the birth of Charlie, when she was in the ICU. A few months of fear, and who knows how it ends.