Under the cloak of night, when dirty deeds are often done, the Senate started the small cancer that if left unchecked will grow and metastasize and kill Obamacare.
One by one these brave lawmakers, oblivious to what might happen to others without the sterling health insurance that their jobs provide, gutted Obamacare. They even voted against an amendment from Sen. Bob Casey to preserve the protection for preexisting conditions.
I have never been so glad to have the job that I do.
Twelve years ago it became clear we needed to move. I was working at the University of Colorado in academic medicine and my job was just fine. My son Oliver’s lungs were not. Born at 26 weeks he developed bronchoplumonary dysplasia. He also had the bad luck of having a serious congenital heart defect. The combination was very bad and so he started getting pneumonia after pneumonia after pneumonia eventually scarring one his his lung lobes very badly. His bad lung condition became worse. His scarred lung lobe became a garbage trap for bacteria and viruses. We all inhale bad stuff and our healthy lungs and airways cough that stuff out. When you have unhealthy airways and a pokey heart it is entirely another matter. When you are living one mile up and the air is thinner it is harder still. Each pneumonia required oxygen and prolonged hospitalizations and then home oxygen.
There was a lot of bad medical stuff going on with his brother Victor who has cerebral palsy and congenital thyroid dysfunction and retinopathy of prematurity and was also on home oxygen, but we were in the ABC mode of triaging home life: airway, breathing, circulation. Oliver’s ABCs were not doing well. We were giving him the best medical care, but what about more oxygen in his daily life? Could that help?
And so I became obsessed with living at sea level. I am (I think) the only person board certified in both OB/GYN and in pain medicine by the American Board of Pain Medicine and the American Board of Physical Medicine and Rehabilitation. I did a fellowship in infectious diseases. I’m an expert in pain, vulvar skin conditions, and vaginitis and there are not very many of us. I put out feelers and was fortunate enough to have a lot of interest and many offers.
The first thing I looked at wasn’t the salary or the people it was the health insurance. I had a shitty HMO at the University of Colorado. It was so legendarily poor that our own department of Psychiatry didn’t accept the faculty’s (i.e. their own) insurance! I maxed out my children’s annual home oxygen benefits in May. Imagine running out of your oxygen allotment, kind of makes everything else you run out of moot.
I turned down all private practice offers, despite protestations that they had great plans, because I knew what would happen. Oliver needed more surgery and had many hospitalizations ahead of him and who knew what Victor would need? A year or so into the job my children would have driven up the premiums and they would have found a way to let me go before becoming partner. A small company cannot bear the burden of the health care costs of one child like mine, never mind two. If I were let go before finding a suitable job there would be no way I could purchase health insurance for my children on the open market.
I had a few job offers with good health insurance. I know that makes me incredibly privileged. In the end I was able to choose the one that I felt would allow me to provide the best care to my patients, but I wouldn’t have even looked at it if it had not offered great insurance.
When I took my job my children were guaranteed health insurance until they were 18. When Obamacare passed I heaved a sign of relief for my kids, myself and for other parents because now we had a breather to the age of 26. Enough time to help them cultivate careers that will provide them with health insurance.
Let than sink in. I’m not career planning for my kids so they can be rich or explore their artistic talents or be inventors or to help build this great country, I’m trying to guide them in ways so they will always have health care. Last night the Senate took the first crucial step to making that harder and I am doing my best trying to not cry out of worry.