Uninsured

I've known my husband, Matt, since I was in the seventh grade. (For those keeping score, that's about 21 years ago.) We were friends for a long time before we became a couple, and I've known much of his family for almost as long as I've known my own.

At this time of year, my thoughts always turn to Matt's godmother, whom we affectionately referred to as "Aunt Purple." Not a relative by blood, as his parents' best friend she was nevertheless his favorite aunt and they were very close. I first met her at Matt's brother's wedding, and she and I hit it off immediately and spent the reception dancing together and having a blast -- she was one of the most fun people I'd ever met.

One year, almost half my life ago, she and Matt and I began a tradition of getting together every year for St. Patrick's Day. We would dress all in green, including green false eyelashes, temporary tattoos, mardi gras beads, glow sticks, etc, and we'd go out to eat, drink, dance and laugh, usually at our local Bennigan's. Every year I looked forward to our get-together. It was my favorite holiday tradition, and the only one that truly felt like my own -- no obligations, just fun.

Over the years, I got to know Aunt Purple better, and we became very close. One of the things I loved and admired most about her was her ability to truly be herself in every situation. She knew who she was and she never compromised herself in order to fit in -- and you couldn't help but love her. She adopted me as her goddaughter, and when I had Jacob, she couldn't have loved him more if he'd been her own grandson.

Her early life had been quite difficult. Her birth mother died while Aunt P was still a baby, and her father remarried, then he died a few years later. She was raised by her stepmother and older stepsisters, who never truly accepted her as their sister. Like me, she married young, and also like me, struggled with infertility before finally becoming a mother (she and her husband adopted a baby boy.) Like me, she made the decision to forgo outside work and make her home and family the center of her world.

But unlike me, Aunt Purple had an abusive husband who eventually broke her heart and left her emotionally and financially devastated. For many years she struggled to find a steady job that would pay her bills, but her lack of education and a changing economy made that very difficult. She was frequently out of work, and the jobs that she was able to find didn't pay well and had little or no benefits. Her ex-husband gained sole custody of their son and, without his mother's influence, he became as abusive and self-serving as his father, only calling his mother when he wanted something from her. One day, she tripped and fell on her front step and shattered both of her feet. It took a long time to heal from the injuries, and she missed a lot of work as her medical bills piled up. Eventually, she lost her home and had to move into a cramped one-bedroom apartment.

In the spring of 2002, Aunt P was out of work once again and receiving unemployment, which was barely enough to scrape by. One day, she had what she believed to be a heart attack. A friend took her to the ER, and was admitted for tests, but a few days later they sent her home and told her that she hadn't had a heart attack. The hospital bills began coming in immediately, and she decided to try to apply for medical assistance. They told her she made too much money (with unemployment) to qualify. "How much is too much?" she asked. She made $20 a month over the limit for medical assistance. Aunt P reached into her wallet, pulled out a $20 bill, and laid it on the table. "Now, do I qualify?" The answer was no.

In the days that followed, she had dizzy spells and trouble breathing, and she went to yet another ER. She was admitted to this hospital and seen by a doctor who blamed her problems on her excess weight, and once again she was sent home, where she continued to have dizzy spells and trouble breathing. She drew up a living will and named Matt her executor, although he and I both told her we were sure she would be just fine.

A few weeks later, one of Aunt P's close friends, panicked by the fact that she hadn't answered her phone all day, went over to the apartment, let herself in with her key, and found Aunt P's body on the floor. She immediately called Matt, and he and I were both shocked and completely devastated. We requested that an autopsy be done, and when we got the coroner's report, it said that the cause of death was suffocation due to scar tissue that had been caused by a heart attack. Yes, the very same heart attack she'd supposedly never had. She was only 54 years old.

Whenever I hear anyone dismissing the idea of universal health coverage, I wonder if they've ever had the opportunity to watch a person that they loved die due to a lack of health care, simply because they didn't have or couldn't afford coverage. After all, it's not an uncommon thing in the USA -- the only wealthy, industrialized nation which refuses to provide its citizens with this most basic of human needs: across the country in 2006, twice as many people died from lack of health insurance as died from homicide. 11.3% of Pennsylvanians are uninsured, and an average of two working-age Pennsylvanians die every day because they lack coverage. Uninsured people have to forgo routine health screenings, and they wait longer to see a doctor, and so they are more likely to be diagnosed with diseases in their advanced stages. Uninsured people have a 25% higher rate of premature death than those with private insurance, and lack of insurance is the third-leading cause of death for people aged 55-64. Uninsured people also pay more for care, because they don't have insurance companies negotiating lower costs for them. (These statistics are from familiesusa.org).

I'm very fortunate, as a full-time mom who chooses not to work outside the home, that I have excellent coverage through Matt's job. Still, a roll of the dice and I could have easily been in Aunt P's shoes (and to be honest, so could any of us.) She was a wonderful, vibrant human being who was taken far too soon, and her death was completely preventable. For me, the national health care debate will always be deeply, profoundly personal.