This past Saturday, I received two telling pieces of mail.
The first was a thick package of postcards for the upcoming Philadelphia Trans-Health Conference at the Mazzoni Center.
The second was a doctor's bill. My wife, Katy, has rheumatoid arthritis. A cutting-edge generation of medicines has allowed her to manage the joint pain and degeneration, but the effectiveness of each new drug diminishes over time. Recently her doctor ordered a treatment that must be administered in-office. The cost of a single biweekly dose: $2800.
Perhaps it's an indication of how inured I am to health care crisis, but my first thought was, "We can address postcards while we wait on hold to haggle with the doctor's office."
Activists who work on marriage equality are frequently encouraged to share their stories. But marriage equality will not fix my family's health care problems, nor will it fix the health care disparities faced by most of my communities. So today, as I look forward to National LGBT Health Awareness Week (March 8-14), I want to talk about why I am beginning to shift the focus of my activism to health care access.
Our family's situation is better than many. In a nation where 47 million people are uninsured, we actually have health insurance. In a nation that organizes health care access around employment, relationship status, and good health, we are extremely lucky to be covered at all.
It almost goes without saying that our home state of Texas, which passed a marriage discrimination amendment in 2005, does not recognize our relationship status. But even if Texas were to miraculously pass some form of civil union or marriage equality, it would not be a silver bullet for our health care woes.
Katy and I are both self-employed. And because she has rheumatoid arthritis and hepatitis C, Katy is virtually uninsurable on the free market. The state allows her to purchase private insurance through what's called a "risk pool." For this dubious privilege, we pay more than $700 a month--about what it costs to rent a one-bedroom apartment in Austin.
Luckily, Katy and I are able to earn enough to cover the costs of Katy's policy, as well as private insurance for our son and me. What's more, we both come from supportive, middle class families. Katy's parents routinely help us pay her medical bills until her high deductible kicks in. But for many of our friends and loved ones, family support and private health insurance are simply out of the question.
Our community in Austin is made up of musicians, artists, and activists. My friends--and especially my queer elders--have inspired me to make my own path, to live my values of justice and creativity and love. But now, as the people around me enter their forties, fifties, and sixties, I am seeing lifetimes of courageous choices come up against the reality of living without the safety net of health insurance. A few have been forced to take physically demanding jobs in order to get benefits. Others have been navigating the frustrating (and diminishing) world of low-cost community health services. Some are simply going without care. And that means that, eventually, my queer community will be smaller and less vibrant because of a lack of access to health care.
I like to think of health care access in terms of a Venn diagram that connects me to increasingly broader communities. There's the LGBT community, but there are also immigrants, young adults, people who are un- or under-employed. Then there are the workers at my son's preschool. Many of them have been working at the same school for 15+ years. They've dedicated their professional lives to creating a child-centered intentional community. They basically taught me how to be a good parent. But they don't have health insurance.
Last fall, one of the teachers--a married mother of five named Jenny--had a freak brain aneurysm. While she was in the hospital, parents at the school organized to bring meals to her family and collected cash to help with the bills.
I was proud to be part of such a caring community. When Katy had a heart attack in 2003, I learned the importance of friends who show up to cook, clean, and care when someone is sick. I could empathize with Jenny's husband, because I know what it is like to sit at your partner's bedside, unsure whether she will live or die, and to find that part of your mind is compulsively totaling up the financial devastation of hospital bills and missed work. Luckily, Jenny survived and even made a miraculous recovery. But the teachers at her school are still uninsured and vulnerable.
We need more than piecemeal solutions. Americans need health care as a basic human right that is not based on employment, relationship status, health history, gender, race, class, or any other social marker. And although LGBT communities face many community-specific health care challenges, our basic need for access and adequate care is something that connects us, perhaps even more than marriage, to other communities and other struggles.