Susan Campbell (opinion): A for-profit health care system is not a health care system

This artwork by Donna Grethen health care plans.

This artwork by Donna Grethen health care plans.

Donna Grethen

Rickey and his family lived just down Pine Street from us, and in that small-town-America way, our families were intertwined. Our parents had gone to school together. My oldest brother played baseball with Rickey’s stepbrother. My cousin was Rickey’s best friend.

Rickey had a cute giggle and a shy smile, and in that deeply felt love found only in the heart of a 6-year old, I knew we were meant to be. Rickey and I never discussed the arrangement. In fact, looking back, I never received a shred of encouragement from my future husband.

Yet in my heart, I Knew.

Of course, life doesn’t work that way. My family moved when I was in second grade. I didn’t see Rickey again until our classes merged in junior high. I was happy to see him, but we weren’t boyfriend/girlfriend or anything like that. He was, instead, an old friend, if one can be an “old friend” at 13. He was also one of the sweetest boys I ever knew. You couldn’t talk to him without smiling. He was quiet and smart, and he didn’t appear to operate with a great need for his classmates’ approval.

I, who had a raging need for my classmates’ approval, admired that greatly.

After graduation, I kept up with Rickey from afar. I knew he’d gone to college, and that he’d gotten a job in computer programming. He also earned a master’s degree in statistics, got married, had kids, played guitar, and joined a big Baptist church in Joplin, Mo. He worked the same job for a quarter-century. He also stayed friends with my cousin, which how I kept up with him.

You know how some people in your life are in your life, but not an active part of it? That was Rickey. I thought of him and smiled.

And then I saw his obituary. Rickey died on Jan. 6 at age 64. He had taken early retirement and figured, said a mutual friend, that he couldn’t afford COBRA , and so he was rolling the dice and living without insurance – I suppose until Medicare kicked in. From a Kaiser Family Foundation December 2022 report , 64 percent of people who live without insurance say they’re doing so because coverage is simply too high. From that same report, in 2021, 20 percent of uninsured adults opt to go without medical care. As with so many others – and not just in red-state Missouri -- when ill health struck, Rickey put off seeing the doctor.

From a recent U.S. Department of Health and Human Services report, 10.5 percent of adults under age 65 live without insurance in this country. In Missouri – Rickey’s and my home state -- the number is slightly higher , according to the Census Bureau. In Connecticut, the Census Bureau says 6.1 percent of people under age 65 are uninsured. That’s nearly 220,000 people who are rolling the dice in the Nutmeg State and hoping for the best.

This is a tragic and very American story with the only ending you should expect. A for-profit health care system is not a health care system. It’s a profit-making system, and if you are blessed to have insurance and have ever spent time on the phone disputing a charge, you know precisely what that means.

People like Rickey don’t stand a chance against that.

In the early days of Obamacare (the Affordable Care Act ), there was a lot of talk about expanded insurance rolls and less needless deaths such as Rickey’s. Obamacare has cut those horrible statistics significantly – particularly during the pandemic -- but we still don’t have universal health care, and in that, we join a list of countries that include South Africa, Iran, and Afghanistan – nations with significant human rights abuses that include, to be honest, not offering decent health care to their citizens. Conversely, some nations with the worst record for violating human rights (think Saudi Arabia) nevertheless offer health care to their citizens .

But not us. Our health care “system,” despite Obamacare, is still flawed. Even with insurance, the gaps can be deadly, and getting coverage can be complicated to the point of ridiculousness. CNN’s award-winning chief international correspondent (and Yale University graduate) Clarissa Ward took to Twitter last week to bemoan the refusal of her insurance company, Cigna , which counted its third-quarter revenue in the billions , to cover a type of therapy the company had approved earlier for her son. In succinct language, she described a universal event for anyone seeking coverage for which they’ve paid.

“For 7 months @Cigna hasn’t reimbursed routine therapy for my son who has special needs. For 7 months they have stonewalled me about why, even though the therapy is clearly covered in my policy. For 7 months, I have sat on hold, shuttled from operator to operator. At my wit’s end.”

Within two hours of her first tweet, Ward shared that a Cigna representative had called her at home. She thanked people for their support, and acknowledged that not everyone appears frequently on CNN, and has a Twitter following of 519,000, and so not everyone can expect a phone call from an insurance company representative. Struggling to get affordable and accessible health care doesn’t just affect people living on the financial edge, trying to eke their way toward age 65. It’s a great and awful equalizer.

Susan Campbell is the author of “Frog Hollow: Stories from an American Neighborhood,” “Tempest-Tossed: The Spirit of Isabella Beecher Hooker” and “Dating Jesus: A Story of Fundamentalism, Feminism and the American Girl.” She is Distinguished Lecturer at the University of New Haven, where she teaches journalism .