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Originally published in Modern Healthcare, January 19, 2009

Letters to the President

Dear Mr. President Obama,

I want to tell you about my situation. I worked for a company that sold parts to Chrysler for 38 years before I was laid off. I was offered COBRA health insurance benefits, but they cost $1,300 per month, and my unemployment payments are ending, so I am going to have to give that up. That means my wife will not be covered, either. I am 55 and have little chance in this job market, but I will not qualify for Medicare for years yet. I am scared, Mr. President, because I have high blood pressure and a family history of cancer. I don’t know what to do.

Dear Mr. Obama,

I know you have important things to do, but I hope you will read this. I am a single mom in California. I have two boys and we are on Medicaid (it’s called Medi-Cal here). The state is in bad financial shape and the governor says he wants to end Medi-Cal dentist care for adults. I know my boys will be able to see a dentist (dentists here don’t take Medi-Cal, so we go to the county hospital children’s clinic), but I may not. One of my teeth has been hurting a lot, and a friend looked at it and said it may be something called an abscess. I heard about that little boy in Maryland who was poor and couldn’t find a dentist and died of the same thing. Who will take care of my boys if I die because of this tooth? Please, Mr. Obama, you said you care about poor people.

Dear Mr. President,

I am writing to you because you said during your campaign that you support health insurance for everyone. I used to work for a big accounting firm, but I lost my job because of the Enron scandal. I started my own practice and got coverage through my husband’s job. But my husband died suddenly last year, and I have to buy my own coverage. The insurance company said they would not sell me a policy because I had a Cesarean section 20 years ago. Mr. President, I am 48 years old! I told them I won’t have any more kids, but they still won’t sell me a policy, and they are the only company that sells affordable insurance to individuals. What should I do?

Mr. President,

I am 74 years old. I worked all my life and am now on Medicare. I keep getting mailings from companies that want to sell me private Medicare insurance. Some of them say I have to sign up with them if I want to continue to get healthcare. Some want me to join an HMO. Some want to sell me insurance for my prescriptions. Some of them offer me a free meal if I come listen to them. I called the Medicare hot line to find out what I should do, but I was on hold for 45 minutes one time and an hour the next time, and I have arthritis and it’s hard to hold the phone that long. I finally talked to someone at Medicare, and they said I should choose the right plan based on my medical needs. I think they were reading from a script; it sounded like it. But I don’t know what my medical needs will be! And why can’t I just stay with regular Medicare? I didn’t vote for you, Mr. President; I voted for Hillary. But I hope you will help me, anyway.

To the new President:

Sir, I am a Republican. I believe in capitalism. I run an auto repair shop and have five employees. I have always offered health coverage to my workers. Recently, I have had to ask them to pay more of the freight and take larger deductibles. But now, Mr. President, three of my guys say they can’t afford it anymore. If they all drop out, then we won’t be a group for insurance purposes, and I won’t be able to offer them coverage. I am trying to do the right thing, Mr. President, but in this economy, I can’t pay these prices, and my employees can’t, either. I believe in private insurance, but us small employers need a break.

Dear Mr. Barack Obama,

I am a home-health aide. I take care of old people so they don’t have to live in nursing homes. I work for an agency, but I am not even paid minimum wage because the Supreme Court says I am not entitled to that. I am 52 years old and came from Jamaica, but I am now a U.S. citizen and proud of that. But I don’t have health insurance, Mr. Barack. When I was younger, that wasn’t a big deal because I was healthy. But now I have bad headaches, and I found a lump in my breast when I was in the shower last week. I would go to the county hospital, but it closed two years ago, and I am ashamed to go to the private hospital and beg for charity. I work, Mr. Barack, and I work hard. All I ask is that I get healthcare without losing my dignity.

Dear Mr. President,

In the end, health policy is not about theory or wonks or lobbyists or political convenience. It is about how to alleviate the suffering of fellow human beings. Although the problems in these letters are serious, they are not unresolvable, and to address them would not cost a trillion dollars. It is not so much money that threatens those who are at risk, but rather weak political will, ideological bigotry and a lack of compassion. Is it possible that we could lay down our arms and remember what we are supposed to be about, as a caring society?

Emily Friedman is an independent health policy and ethics analyst based in Chicago.