Healthy Children in a Sick Country

To the extent that this country has had a commitment to anything like universal health care, that commitment has focused on children. And the current decision to extend health care for low-income children in California makes it clear that the commitment is, at least in some places, bipartisan.
But something is missing from the calculations that justify public health care only for low-income children. As a housing advocate in western Pennsylvania, I routinely saw human examples of this failed calculus. Working homeless parents who had serious health issues but lacked insurance and were over the (very low) income limit for Medicaid would tell me on intake that they h ad personally not seen a doctor for the past two years, although the last one they saw mentioned that they had hypertension or diabetes.
Some reported health-related problems at work. The boss was threatening to fire one father because he passed out when he picked up heavy bags of concrete. A mother was having trouble keeping her fast food job because her leg went numb if she stood too long.
The good news was that these parents had children who were up to date on shots and had seen a doctor right on schedule. The bad news was that these healthy children had parents who were chronically ill.
Ugly ironies turned up daily. There was the single mom who brought her child in so that I could help with filling out the paperwork needed to get braces for his crooked teeth. The state's low-income insurance program for children would pay for the braces once the right boxes had been checked. The mom had been about to lose the family's trailer when her hours got cut at the gas station where she worked. Then she had a spot of luck- she got hired on part-time at Walmart. With two jobs, she could just manage.
But, as always happens in the low-income world, things went south again. The local Walmart notoriously found reasons to fire cashiers who lost front teeth. Too-visible dental problems gave a poor impression and upset the customers. The mom, who hadn't been to the dentist in more than eight years, bit into an apple one day and left a front tooth in its flesh. Mom was still on probation at Walmart. She had no dental insurance, made too much for Medicaid, and lost her job.
As I filled out the paperwork for her child's braces, the family was heading into the sort of semi-homelessness common in the low-income world. Mom, her son, and his new braces would have to move out of their trailer. They would be joining a former sister-in-law and her three kids in a single-wide, one and a half-bedroom trailer in the worst trailer park in town.
Cancer was worse. Some of the uninsured low-income parents who came for housing help had advanced stage cancer- they hadn't been to the doctor for years, nothing was ever caught early Sometimes you could solve the problem of providing income if they couldn't work, but that did little to solve the real problem. Too many children were faced with the possibility that mom or dad might die in the near future and, while waiting to die, mom or dad was usually too shell-shocked and ill to do much effective parenting. Early detection, of course, would not have prevented all these scenarios, but the thing is this: Our country doesn't even try.
The really amazing thing was that no uninsured parent, no matter how ill, ever made the obvious comparison between his or h er lack of medical and dental care and the services available for his or her children. No-one ever expressed envy, became angry, or questioned the arrangement- there was just acceptance of the situation, and pride that the kids had their immunization paperwork in order and had a regular doctor.
It is not just these parents who are at risk of serious untreated illness, however. The society that permits these untenable choices is on the critical list and on the way to an ethical flat-line.