Friday, February 27, 2009


Some weeks at work are worse then others. The weeks when things are due are busy, and the weeks when multiple things are due? Oh yeah-- those are fun. This week was in fact one of the fun weeks, and next one is promising to be only marginally better. I am not exactly whining here, because I actually do like what I do, and daymn if it's not one fine-looking assignment we put out today,-- more like explaining why it only fully registered with me that the President was giving the speech that any other year would be called the State of the Union on the actual day of the speech, but more importantly why it's taken me since Tuesday to write of the thing that has been burning me since that night. (And why I am still behind on my blogs-- really hoping to fix that over the weekend.)

The thing bugging me? Predictably perhaps it was the Republican response, delivered by Governor Bobby Jindal of Louisiana. Perhaps less predictable is why. Oh, sure I bristled at a lot of it, seeing as I prefer my logic left to do its thing rather than twisted into a pretzel and baked, whatever seasonings are involved. But believe it or not, I only yelled at the TV once during the speech. It was early on, in the section of the speech probably designated in the draft stage as "setting the mood." And let me tell you-- my mood was set, to fuming. As I still haven't simmered down (and as more professional people than I have pulled apart the meat of the speech, and as the good Governor was today forced to retract his personal involvement in the central anecdote of the speech), you get to read about my take on Governor Jindal's field of vision. Aren't you lucky? (Cue maniacal laughter.)

Here, without further ado, is Governor Jindal's birth story, in his own words:

Like the president's father, my own parents came to this country from a distant land. When they arrived in Baton Rouge, my mother was already 4-½-months pregnant. I was what folks in the insurance industry now call a "pre-existing condition." To find work, my dad picked up the yellow pages and started calling local businesses. Even after landing a job, he could still not afford to pay for my delivery, so he worked out an installment plan with the doctor. Fortunately for me, he never missed a payment.

Governor Jindal is without a doubt a very fortunate man. So fortunate, in fact, that he doesn't even begin to know where his fortune lies. His father never missing a payment wasn't his lucky break. That was perseverance, responsibility, determination. But determination and perseverance only carry you this far, and, sometimes, they don't carry you at all. A funneling cervix doesn't give a crap how determined you are not to have the baby until you reach full term. Curiously enough, pre-eclampsia doesn't seem moved by anyone's tale of perseverance, though it has been known to negotiate with magnesium on occasion. Pre-term labor happens, no matter how responsible you've been in your pregnancy, no matter how wanted the baby. You see where I am going now, don't you?

It's not his father meeting his fiscal obligations that was fortunate for Mr. Jindal. It was his mother not developing pre-eclampsia, not having an incompetent cervix, not going into pre-term labor, not having her membranes rupture prematurely, not having placenta previa, complete with a hospital bed rest and a c-section, or even just not needing any old regular c-section. Now that-- THAT was all extremely fortunate for the future Governor. As was not being born prematurely or with any condition that would've required developing a close relationship with a team of specialists. Or heck, not developing anything as minor and usually completely devoid of long-term consequences, but still requiring a short NICU stay, as, say, transient tachypnea of the newborn.

The funny thing is that the Governor is a poster child for the veil of ignorance concept, but he's been too fortunate in his life to realize that. I have to admit that because I was not a philosophy or government major, the first I heard of this concept was on The West Wing. Having now spent some time googling around for a concise explanation, I still like the one from the show better. "Imagine before you're born you don't know anything about who you'll be, your abilities, or your position. Now design a tax system."* Substitute health care for tax above, and you get my feelings exactly.

Health care is a human right. It just is.

The Cub started out in NICU. He was there for less than eight days, a short stay as these things go. And yet, if we had to pay out of pocket, I am not sure we would still have our home now, installment plan or not. We didn't, because we have great insurance. Shouldn't that be enough of an argument? Shouldn't we, as a matter of conscience, decide that no parent should ever worry both about their child's health and about how to pay for it? Shouldn't we decide that no child should ever worry about being a burden on the family, that no child should ever have to worry about the cost of their medication, or about whether the family can afford their trip to the ER?

I think we should. And I think that Governor Jindal would do well to try that veil on for size. He might just see how truly fortunate he has been.

*If you care, this is Season 4, episode 17, Red Haven's on Fire, and the scene comes almost at the end, where Will and his speech-writing interns finally click.


Mrs. Spit said...

Ahem. The political science grad must take a gentle bit of disagreement over your post.

Rawls only inteded his theory to tell us about how to deal with each other justly, not to set our tax systems and health care systems. In fact, you could easily use the veil of ignornace to argue that you should only have a minimilist tax system and a minimilist health care system.

But Bobby from Louisiana is still a dink.

Gal aka SuperMommy said...

I saw parents in the NICU forced to make decisions about their children's care based on what their insurance would cover and what they could and couldn't afford. It broke my heart into a thousand pieces. By pure blessed chance, we got lucky, and we didn't pay a cent for the two months of Tikva's life, which I know surpassed a million dollars in cost if I asked.

Tash said...

What pissed me about that interlude was that he used "preexisting condition" like it was some kind of joke, but you know what? MY INSURANCE THINKS PREGNANCY IS JUST THAT. Here's the deal with our self-employed insurance: you need to pay a "pregnancy premium" per month in order to cover pregnancy costs. The kicker? You need to start paying two months in advance of being pregnant. Now. Obviously this is discriminatory against women in general, because who the fuck can time things like that? What about infertility or condoms breaking or religiously abstaining from birth control? Their point, obviously, is to get women to pay a premium during their "child bearing years" -- just in case. In VA, we decided to hedge our bets and not, and we saved money. it took two years to get pregnant, insurance doesn't cover IF treatment anyway, and VA was very nice about giving you a cash discount. We actually Saved Money by not opting for insurance during our pregnancy.

And people, there's something really really really fucked up with that.

Anonymous said...

So when are going to start hearing this kind of thing with the introduction, "The speaker now recognized the distinguished Senator Julia from [enter state]?" :)

Anonymous said...

I have lived in the US and Canada. I know there are problems with our "free" healthcare system; but I much prefer to wait for non-life threatening things and know I am covered for everything. Except for fertility coverage.

Magpie said...


CLC said...

I sometimes look at my doctor's bills and hospital bills and wonder if they only reason they ordered such and such a test is because I have good insurance that pays for just about everything. And then I wonder about the poor souls who don't have any or not as good insurance. It's hard to believe they are getting the same level of care.

christina(apronstrings) said...

I can't imagine how people get by without any insurance. I just can't.

loribeth said...

Being Canadian, I give thanks every day for our universal health care. It is not a perfect system, but I just cannot imagine having to deal with bills and paperwork and insurance companies the way you must in the States. I have way too many American relatives who are way past 65 & still working, just so they can keep their health benefits.

(By the way, do we work in the same place??)

Lollipop Goldstein said...

10 cheers!

Bon said...

amen, Julia. i am frequently baffled by the fact that many Americans seem to think our Canadian system is worse than the horrors of yours. i frequently suspect they are not the people who've fallen through the chasms in your system.

Betty M said...

Another one who is relieved to be here in the UK with the NHS. Ok infertility coverage is poor but I had one free cycle plus drugs costs in 4 cycles and I had to wait for treatment but the expensive ante-natal care and the operations for my son plus my own long term chronic illness - no waiting and treatment as good as any anywhere. What gets me is that there are people here who think we should move to the US system.

Miryam (mama o' the matrices) said...

I remember being told that my student insurance only covered three out of network visits. That is to say, visits outside of the student health care facility. Including, of course, ER trips.

The Eldest, by being born, bled, ambulanced, admitted and diagnosed, had used up his quota. And there was the crack in the system: I had insurance for healthy people.

I'm with Mapgie: roar!

Anonymous said...

The sad thing is that even with a "veil of ignorance," I think a lot of conservatives would say that THEY, at least, will always be able to achieve a high level of success, because they believe everything is based on dogged determination and will.

Interestingly, my ex-fiance, who was as conservative as they come in many ways while we were together, has in recent years "mellowed." What caused him to mellow? Well, several job layoffs, financial problems, and a spurious sexual harrassment claim against him by a coworker. I think he finally (FINALLY!) realized that he's not in complete control of his own destiny, and that sometimes shitty things do happen to good people.

Christa said...

"Health care is a human right. It just is."

This bumper-sticker statement is what is wrong with the whole debate. Even if you accept this premise, few people who hold to this premise stick around to deal with the consequences. Such as reduced pay for medical professionals reducing the incentive for truly spectacular people to choose the profession or having complex medical ethics decisions left to a government to make. If you think an insurance company doesn't have your best interests in mind, how much better would the government do?

Picture that child in the NICU. Doesn't it seem likely that at some point the government picking up the tab will want to dictate at what stage of gestation it is financially prudent to offer care? Ask yourself why it is European countries with socialized health care that are the source of a creeping euthanasia movement geared toward the seriously ill and very young.

I don't understand how anyone who has dealt with the government would want them to have any involvement, let along sole responsibility for their health care. There may be a few tasks that governments do well (build roads and fight wars are all that come to mind), but providing health care isn't one of them.

If you really want the government to keep its laws off your body, then don't get your health care from them.

And I am not saying this as someone who has not been touched by the financial hardships presented by our current system. My parents declared bankruptcy after my dad had triple by-pass surgery while not being insured. However much I love my parents, even I can see that they placed too much importance on keeping up appearances money-wise than spending it on things, like health insurance, that would reduce their financial risk. This debate is less about access to health care (my Dad had great doctors, and continues to be treated by them) and is really about money and who pays.

Anonymous said...

I sort of agree with Christa (though I'm a Democrat, and a little more optimistic about government). Yes, some level of health care is a human right, but...what level? Does every human being deserve access to the full capacity of our high-tech medical system? Because even if we could afford to bring that level of care to every American, it we couldn't offer it to the rest of the world. So where do we draw the line? I have no idea what the answer is.

I ask these questions as the mother of a baby who is alive because I had access to outrageously expensive blood thinning drugs. And the final bill for labor and delivery was somewhere around $100k, last time I checked. We were incredibly lucky to have insurance and I'm humbled into stupidity when I think about how many people in the world don't have the kind of access we had.

And sometimes I think, "yeah, well the American for-profit system is the problem. Canada does it better!" But I also have to acknowledge that America is the world leader in medical research *because* it's a for-profit system. So...would the New Jersey-made drugs that saved my son have even been invented without that system?

It's just so very complicated.

Julia said...

Christa and Anon, I do have a response. A great big long one. Cause that's how I roll, I guess. But also because the topic deserves it. What I don't have right now is time to write it all out or the clarity of mind that usually comes with sufficient quantities of sleep (hint: I haven't had those in a looooooong time). So I am begging leave until about middle of next week, when it will be a whole new post.

Wabi said...

When asked if he ever experienced racial tensions growing up as a nonwhite in Louisiana, Jindal said "No, never," and rambled on about how his state is great because it accepts people as they are. Never mind all that KKK/David Duke stuff that happened rather recently in his state's history, right?

If he can't talk about something as obvious as Louisiana's race issues without sounding delusional, then I don't hold out much hope for him sounding reasonable on issues like healthcare!

Emily said...

Okay, this is a little scattered, so sorry...

As a healthcare provider, I am torn on this issue...I agree that every person deserves the same treatment. But, as any man-given right, there will be flaws.

I wonder, who is supposed to pay for it? I assume that you (or your spouse) worked, in order to have health insurance, which means you were taxpaying members of society? That you were contributing members of our governmental system?

And that is where my hesitation in universal healthcare resides. I don't think finances should control, but they are a crucial element that cannot be ignored.

The quality of healthcare WILL decline if the government takes over...have you ever been to a VA hospital? as compared to a private facility? not only is the physical structure starkly different, so is the level of care. Unfortunately, healthcare workers need to pay their bills too.

I work at a non-profit children's hospital, and I love the charity care that we provide. But, we would go out of business if we provided nothing but charity care. And then tens-of-thousands of kids would be without competent care.

Ruffle feathers, please and thank you!