YOU’RE ORIGINALLY from Illinois and you recently moved back. What have you noticed about the health-care system here?
I CAME back to my home county, Cook County. I found out that 900,000 of my fellow citizens have no insurance—900,000 people! We aren’t talking about people who are the “slackers,” poor people. (I don’t consider poor people slackers but if you put on that mentality, that middle-class, semi-elitist mentality that says that somebody who doesn’t have a job is somehow a slacker, that’s wrong.) People who are the poorest of the poor in our country can get on Medicaid. If you are permanently disabled or elderly you can get Medicare. But those people who work that don’t make enough to pay for health benefits are the ones who make up this huge pool of the uninsured.
Sometimes it’s parents working two or three jobs to keep the rent paid, mortgages paid, food on the table, clothes for the kids. They just don’t have the money for insurance. The other thing that I found out about Cook County that bothered the daylights out of me, because I am a uterine cancer survivor, is that there are 1,800 women in Cook County on a waiting list to see an OB/GYN. These are women who have already been identified by family practice doctors who need specialized care. They have bleeding or other symptoms that are suspicious enough to warrant further investigation. It could be cancer or some other serious condition. Fifteen hundred women have been waiting for at least six months. There is a serious public health problem of women not being able to get care.
We just passed a Cook County budget that will allow, thank god, for the county not to close down health services. Think about what a public health disaster that could have been. Those women would have never made it to care. The issue of not having a single-payer, universal health-care system, it ripples into our lives exponentially.
Another problem with our health-care system is that the care is so fragmented. The for-profit system, in my view, has created this fragmentation of access, fragmentation of care that makes it nearly impossible for most Americans who don’t have the top-of-the-line insurance to be able to access care without difficulty. I think that the only equitable way to fix that is through a single-payer system.
WHAT DO you think about health-care mandates?
I THINK about the mandates that are in place in Massachusetts right now and that are being proposed by the two Democratic candidates for president. And what concerns me about that is it’s one of the few times that I’ve ever seen people take a system that is so broken—we all acknowledge it is broken—and they try to make it bigger. What kind of logic do we have if we take a system that is not working with this many people and expand it to everyone? I read an article in the Los Angeles Times that said they’re not sure if mandates are constitutional. Can you force people to buy a private product? It’s really different when you say car insurance is mandated.
People are trying to equate buying health insurance with having to buy car insurance. The problem with that is you can choose or not chose to have an automobile. You can’t choose to not have a body. We all have a body. And those of us who were born or live in the United States of America, this is our country, we can’t easily choose not be here. So to force us to buy a private product could be unconstitutional. But the other part of this, to expand the system and make all of us buy into it and it’s not working without significant, very significant regulation of the insurance industry, which I doubt any politician has the fortitude to do, is foolhardy. Massachusetts is failing. They said they would have subsidies for people who are low-income to buy insurance, but the funds are not there.
TELL ME about your health care before Sicko and your experience with medical bankruptcy.
I FELT scared most of the time. I consider myself a pretty intelligent health-care consumer. My father was a pharmaceutical salesman, which was always kind of a conundrum for me. A pharmaceutical salesman dad who would be horrified if he were still alive. What I saw was this very gradual drift in what we were able to do as a family with health care. We always carried insurance, but the premiums kept getting higher and the coverage kept getting lesser. So every month more money was paid out for a premium that was covering less and less. In the 1970s we had Blue Cross and I think we paid a premium of $20 a month. But in the 1990s we were paying $200 a month. By the time we declared bankruptcy we were paying almost $500 a month for the two of us. And with paying out of pocket for drugs and co-pays we were paying an additional $500, so almost $1,000 a month was being spent on health care. There was no way we could maintain that. People get this false sense when they hear that half of the bankruptcies in this country are caused by medical bills. I have no doubt about that. But what happens is you don’t see doctor, pharmacy, or premium bills on the bankruptcy forms. What you see is everything else. You pay your health-care stuff because you have to keep your family member alive. The premiums come out of your check every week; you pay for your medication at the drug store. They’re not going to hand you the medication and you pay later. You pay what you have to pay at the doctor’s office when they demand their co-pays. Then there are the other bills; car payments, mortgage, utilities—you start getting shut-off notices. The stress in life goes up exponentially. I always ask people in my presentations: think about what you think when you hear someone has declared bankruptcy? Be honest. They didn’t manage their money well, they took on too much credit card debt, they have a big screen TV, and they have everything they shouldn’t have had. It’s terrible, and I used to think that way, too.
The thing that drove us to bankruptcy was one doctor who turned our account over to a collection agency because he didn’t want to accept $20 a month; he didn’t think it was enough. The bill was $600 and he’d already received $6,000 from the insurance company and our portion was $600. We could only pay $20 a month. I ended up getting garnishment papers served on me at my office. I was horrified. I was humiliated. If they had garnished my wages they would have taken out so much I wouldn’t have been able to afford my health insurance premiums. So your choice is bankruptcy to stop that garnishment and keep your health insurance, or go without health insurance and risk your loved one dying. We were in bankruptcy court and Larry was having heart surgery. That is the position people are being put in.
It wasn’t until I saw the movie, our story comingled with the others, that even in my own heart I said we are part of a larger picture, a larger problem—it’s not us. I think the thing I felt most often was loneliness and anger along with the feeling that I had to keep the mood upbeat because my husband was sick a lot of the time. So there was this disconnect, all this rage and being scared but saying, honey everything is going to be alright to the person who is sick. That is one hell of an emotional and mental burden that a lot of people are carrying in this country.
ONE OF the most powerful moments in Sicko is when you and Larry are moving out of the house and you break down and start crying. For me, that moment spoke volumes about the state of health care in this country.
IT WAS very healing. I always tell people you get very quiet. Generally I’m not a quiet person, but it quiets you after years of being beaten down by that financial trauma and health-care trauma. You feel like you don’t deserve a voice anymore. You feel as though you have failed. In this country to fail financially is probably the worst way we view each other.
WHAT WILL it take to get single-payer in this country?
I HOPE something short of revolution. But if revolution is what it takes, that’s what it takes. I’m hoping America’s leaders have enough foresight to enact single payer. I personally believe Barack Obama does. I’m not sure Hillary Clinton does. I’d like to think she does. I’m a little nervous about her at the moment because I don’t like thinking and saying that because she is our first viable woman candidate for president. But her mandates worry me and how closely tied to insurance companies she is.
It’s going to take leaders at the national level who are motivated by citizens telling them we will stand for nothing less than every single American having access to health care, period! Not access to insurance, access to care. I don’t want to buy more insurance. I would be very happy to do what HR 676 proposes. I’d pay 3.3 percent more in payroll taxes and I will never again pay a premium. I will never again pay a deductible. I will never pay out of pocket for my medicine. Ever. I will pay 3.3 percent in taxes and I will have care. I think that if most Americans understood that HR 676 already proposes this and that 20 percent of Congress is already cosponsoring that bill—88 members of Congress, we are 20 percent of the way there—then more Americans would support 676.
Fifty-nine percent of our doctors now support universal health insurance. It’s time for the country to move forward. It’s going to take us. We have to stay motivated to push our leadership. They have a lot of powerful people buying their time and attention. We have to remind them that we pay their salaries. We pay their benefits. We pay for what we want them to give us. We want access to what they have, which is care. I don’t want to have to wonder if that care is going to go away. I want health care without worry.
WHAT KIND of organizing have you been involved in to promote single payer?
I’VE DONE a lot of public speaking and I testified in front of the House Judiciary Committee. I organized a group called American Patients for Universal Health Care and we started advocating a little bit. We connected with the nurses from the California Nurses Association because they were out promoting single payer. I went on a national bus tour with them, an activist bus tour in this 1980s school bus that went to a lot of states. That was an experience in itself.
Your family members sometimes don’t understand your devotion to an issue, especially those who have always had insurance and have never been sick. It hasn’t hit ‘em. We Americans are very bad about that. Sometimes until something smacks us we are very smug. “I’m good, it’s all good.” What are you talking about? So everyone was wondering when are you going to get on with your life? And I kept saying this is my life. Until every American, until every American has access to health care and the dignity that I had in Cuba—which sounds totally bizarre to have to go to Cuba of all places to feel that dignity—I’m not going to stop.
