A couple of weeks ago, I submitted my ballot. Because I am afflicted with a weird case of mild obsessive-compulsive disorder/anxiety, I checked and double-checked and then checked again that I had filled in the ovals by the names and choices I supported. A friend of mine happened to be in the town office at the same time, and I actually had her check my ballot to make sure I hadn’t accidentally voted for the wrong person. (Tune in tomorrow for the spin-off Stupid Question!) She was happy to confirm that I’d voted for the people I’d wanted, though she left before I could have her confirm my “yes” vote on Question 1. (Predictably, I am now slightly anxious that I somehow accidentally voted “no,” despite my having quadruple-checked it before I put it in the envelope.)
Thus, I can state with happy confidence that I voted for Barack Obama, just like I did four years ago. (I am not, however, taking Election Day off to volunteer for the GOTV effort like I did last time, largely because I didn’t vote straight-ticket Democratic and don’t want to have to canvass in support of a Senate candidate I don’t want to win.)
The title of this post is slightly misleading. I have lots of reasons for voting in favor of a second term for the President. He has come out in favor of my right to get married. His party doesn’t have a distressingly-high number of office-seekers making disqualifying statements about rape and pregnancy. I find the mendacity of his opponent appalling, and the flagrant, gleeful obstructionism of the Republicans in Congress borderline seditious. I trust him far more on foreign policy. Etc.
But I have another salient reason, similar to but distinct from Tod’s. It has to do with a conversation I overheard a few years ago.
As I’ve disclosed, I live in Maine. For five years I worked in a practice there, before leaving that area and taking my current job in Massachusetts a couple of years ago. In that office, my computer station was behind the front desk, but hidden behind a partial wall. Even though I couldn’t see people as they checked in and out, I could hear their conversations.
One evening a mother with several children in our practice was checking out and the woman at the desk told her what the charge for the visit would be. It was much more than she could afford. For reasons I do not recall well now, her family had lost its insurance coverage through her husband’s job, but they still made too much to qualify for the state’s Medicaid program. So they were newly part of our large “self-pay” population. And the bill for the visit was higher than she thought it should be, and more than they could afford.
Of course, I felt terrible overhearing this. I had nothing to do with setting the rates for the office visits, and had billed the appropriate amount for the complexity of the care delivered. Technically I could have revised the billing code downward upon hearing that the family lacked insurance, but doing so would have been fraudulent. (Doctors can get into oodles of trouble if they bill different patients different amounts based upon insurance status.) I had essentially nothing to offer to mitigate the expense, but felt responsible for the hardship it had created for this woman and her family nonetheless.
I now work in a state where patients are universally covered. Indeed, this state of affairs is in large part due to the efforts of one Mitt Romney, quondam governor of Massachusetts. It means I never have to worry that charging patients for my services means they won’t have money for their food or utilities or rent. I worried about this all the time in my last job, and I do not miss it now.
That mother in Maine was not unique. She was not unique to our practice, not unique to that state, and not unique in her circumstances. And neither was I unique in my worry for her. I want that worry to disappear for everyone everywhere.
Do I think the Affordable Care Act is perfect? No. I will admit that I do not think I even understand it fully, with its mass and complexity. At best, it solves only part of the problem, the part dealing with individual patient coverage. It does little to control costs, which is the conversation nobody wants to have. I am under no illusions that it is flawless.
But it is a start, and a good framework on which to build further reforms. And, put bluntly, I have no confidence that the GOP has any intention of either meeting that challenge, or (if met) doing so in a way that will safeguard the interests of the people most in need of help from the state. Between half a solution and no hope of a solution, I’ll take the former.
Like Tod, I admire the political courage it took to keep pressing for the ACA, despite its shaky popularity. Unlike Tod, I am a supporter of the bill, albeit a tepid one. Because I never want to overhear another conversation like that one I heard in Maine, I was happy to fill in the oval next to the President’s name.