Blinded by Shortsighted Policies
Upon meeting a client a few weeks ago, I noticed that his left eye, barely visible through his permanently narrowed eyelid, was sunk deep into its socket, as if someone had pushed it backwards and left it there. I could just make out the pupil, twitching uncontrollably, unable to register images before it.
Looking at me through his other eye, my client told me that five years ago, while standing on 14th Street in Manhattan, wallet in hand, someone approached him from behind and sucker-punched him in his left eye, knocking him down. The assailant ran off empty-handed, save for the sharp object my client believes he was holding in his fist.
As a result of the punch, my client's eye was forced back into his head. After receiving preliminary care at a hospital emergency room, my client was told that he would need special surgery to repair the damage. Without health insurance, however, he was unable to afford further medical treatment, and was instead forced to leave his eye displaced and functionless. If my client were wealthy, and thus could have paid for his medical expenses out of his own pocket or afforded medical insurance, or if he had a job that offered health insurance, perhaps today he would be able to see out of his left eye, or at least have had reconstructive surgery on it. But no such luck.
He is far from alone. Today there are 45 million Americans who do not have health insurance. The majority are poor, though a significant percentage (17%) live in middle-class households. Many of my clients in the Bronx have grave medical conditions that are not being properly addressed, including those in wheelchairs, without limbs, in need of operations, or suffering from asthma, malnutrition, diabetes, Hepatitis C, and HIV/AIDS. None of them can afford to pay for medical expenses out-of-pocket, and most cannot find jobs, let alone jobs that offer health insurance (37% of small businesses in 2004, for example, did not).
In addition to age-old racial and social barriers they face when trying to find work, their job searches are made much more frustrating by their often incomplete educational backgrounds, criminal records, and/or time in prison. These obstacles to employment --- yet another example of the severe collateral consequences that flow from arrests and convictions --- make it very difficult for them to find jobs, leaving them without affordable health insurance.
Although some of my clients receive medical treatment through Medicaid, its reach is limited. If you make $700 a month (less than $10,000 a year) and have resources that total $4,200, you are ineligible for Medicaid.
It is unfortunate that anyone anywhere in the world should have to spend the rest of their life blind in one eye because they could not afford corrective surgery. But it seems particularly inexcusable that such should be the fate of a young man injured in the middle of prosperous Manhattan, with its many hospitals and doctors, the wealthiest borough in one of the wealthiest cities in one of the wealthiest countries in the world.
Universal health care might sound idealistic, or simply overly ambitious, as might reforming our public school system, changing our aggressive, arrest-happy policing strategies, abandoning our destructive war on drugs, and investing more money into inner-city economies, but as I watched half of my client's pupil quivering in a dark corner of his eye socket, I felt like our society had not been idealistic or ambitious enough.