In 1995, I was accepted to Harvard from the former "Eastern block". As an eighteen year old, who lived through the perestroika and the subsequent velvet and not-so-velvet revolutions, I had roughly divided the world into two: the free, capitalist society where everyone gets what they can afford, and no more, and the repressive, socialist world where everyone got approximately the same amount of everything.I thought of all the fabulous clothes, chocolates and toys I had been receiving as presents from abroad whenever my grandpa would go on government business, and how much more of these that talented family of ours could have had, if only we had been allowed to live in a "western" country.Those were all things we could have afforded. Also maybe one of these fabulous cars, so quiet, that you can listen to classical music inside, while curving on smooth roads overlooking magnificent lakes. Perfume.Saran wrap. Earl gray.My country had none of that. But I had never in my wildest dreams thought to ask myself - could we afford healthcare? (read below)
Even as a physician's daughter, it had never occurred to me that what my father does at work is provide "services" to a consumer. To me, doctors were special people - smart, strong, serious and compassionate, who had a special mission in life - to help other people. The reason why someone practiced medicine was not in order to buy a house. It was because he would not do anything else. He wanted to alleviate suffering and he knew how. And that was that.
Whenever I would get sick I would go to our local clinic. I would wait in line and be seen, the same day. I went there for every sore throat, and every scratch I got while playing in the yard. You know, just in case. I never once had to think to myself "this scratch is not so deep, should I risk getting tetanus rather than pay $100 bucks?" or "so what if it is angina, maybe I can get by without antibiotics, or else there will be no money for chicken soup?".
In my admission materials from Harvard, there was a question on whether I am insured through my parents. My mother, a translator for 30 years, did not understand this question, and neither did I. Perhaps they meant life insurance? Why would Harvard want to know that? Reading further down, we realized this had something to do with health - perhaps they were worried I would have to miss school and the financial aid will be in vain. After a few back and forths with the admission's office, we had it figured out: "health insurance" was something you could buy only through your employer in the US, and Harvard was for all intents and purposes my employer, so I was supposed to pay them back some of my financial aid in order to be insured. Otherwise I wouldn't be able to see a doctor.
Weird, I thought. We were really pressed for cash, so I inquired back "can I refuse health insurance?" If I get very sick, I will fly back home to get treatment (free). "No," the admissions office said, "Harvard requires you to have insurance." And there my neatly divided socialist-capitalist world fell apart. So I was supposed to buy my own insurance, but I was not allowed not to buy it. Then you should call it a tax, or give it to me for free, shouldn't you? No answer.
Later, I arrived in Boston and I learned an ever more bewildering series of facts - as a Harvard student I was required to have insurance, but not all people were. Furthermore, no one checked ID at hospitals so I could have gone and claimed to be someone else (insured) and gotten their insurance to pay for it. My husband and I keep joking that whenever an elderly relative visits, we can submit a urine sample under our names to figure out if they are healthy, while baffling our doctors. Finally, and most perplexingly, even if I had no insurance, no one would refuse me treatment in emergency care. So what's capitalist about that, I ask? where is the principle which claims you only get what you can afford. If you really honestly believe in this, you should just let me die out there on the floor of the ER. If not, you are a socialist.Or a hypocrite. Which one would you rather be?