Congressional leaders competing with anecdotes of tragedy during the healthcare debate last week reminded me of the way I viewed this issue before embarking on the Recession Roadtrip. It was only after six months of listening to the aspirations and anxieties of people across the country that I began to recognize how deeply the employer-based insurance system impacts our cultural identity and the nation's prospects for future prosperity.
For the Brothers Tartamella in Brooklyn, their excitement to become green business entrepreneurs is tainted only by fear of health insurance complications. Two encounters with non-Hodgkins lymphoma a decade ago drove James Tartamella to bankruptcy--despite the full insurance coverage he had at the time. Even though he and his brother, Joe, view their foray into green industry as a partnership, it's a necessarily unofficial one because James has that bankruptcy on his credit record.
Surviving cancer made him "uninsurable" by private insurance industry standards, but James qualifies for Medicare and disability because of the lingering effects from debilitating stem cell treatments. If he wanted, James could sit on his butt indefinitely, cashing government disability checks to subsidize his cannoli habit. But James--crediting the work ethic taught by his Italian immigrant father--has too much ambition for that, though pursuing the new opportunity will mean surrendering the security of Medicare. A small business of less than five employees can't afford health insurance, particularly not for a double cancer survivor, so James has accepted that he will soon join the uninsured--"unless Obama gets his thing passed," he told me.
James's comment reiterated ones made by Darwin Moore in northern Indiana, who also expressed a hopeful desperation for Obama's healthcare agenda to pass quickly. Like James, Darwin and his wife, Laura, are accepting extreme personal risk in exchange for the opportunity to pursue their dream of small business ownership. Darwin is "uninsurable" because he survived a brain aneurysm last year. Though his doctor has scheduled follow-up exams to monitor the status of his aneurysm, Darwin won't be able to accept that care because his family can't afford thousands out-of-pocket for the necessary brain scans. Laura told me that prayer would have to be the main means of health insurance for her husband "until Obama fixes the system." I worry that if the fixes don't come soon enough, Laura could end up running their small business alone.
For most of his adult life Shawn Burke has known he could never hope to start his own small business. More than twenty years ago an insurer stuck Shawn with over $750,000 in medical bills after ruling that his policy's fine-print clause about problem pregnancies absolved the company of responsibility for paying the expenses of his prematurely-born son. (I saw another family profiled in the news last week going through a nearly identical situation.) "That f*cked up my entire life," Shawn told me. As a result, the 48-year-old has never even been able to secure a credit card.
Specific experiences such as the above make it fairly easy to illustrate how the business practices of a for-profit health insurance industry can create roadblocks that hinder entrepreneurship. I find it a greater challenge to convey the more profound detrimental impact the current status quo has on individual ambition, freedom, and the pursuit of happiness. Turns of tragedy have solid facts to report, while chronicles of unexploited potential rest on the demise of ephemeral aspirations.