Brenda Siegel: A dog's tale: Health care choices should be based on need, not money

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On Monday, Oct. 28 my son and I had to put our family dog, Maple, down. For the last two years, she has had a myriad of health issues. Throughout this process I had to make many decisions about her care that were predicated on what I could afford, not what the best thing to do was. I signed up for a care program so that I could meet more needs. I paid for hundreds of dollars of medicine for many months. I did everything I could, however, it did not prevent me from having to make gut wrenching decisions about her health that were based on resources, not health care. Our hearts broke at the vet on Monday with thoughts about what we could have done better, how it could have been different. Dr. Rosenberg comforted us that she was old and not well and we had done well with her. Still, our hearts broke in pieces as we laid on either side of her and let a member of our family go.

Every time I made a decision not to get a test, my eyes would fill with tears. Sometimes, I would go to my dad and ask him for help with a test. Some days I would go home filled with guilt. I spent money that was meant to heat my house to care for her. I spent money that I had for other needs on her care. I asked the Humane Society for help and when they could, they did help.

We got Maple just over six years ago at the Humane Society; she was a rescue that had a hard life before we got her and she was a hard dog when we brought her home. Nonetheless, she stole our hearts. There is no evidence that it would have ended any differently had I been able to make different choices, but still, I will always have to ask myself. Each time I was making one of these gut wrenching decisions, my thoughts would become centered on this one theme, that people make these same decisions for the same reasons about their children, their parents, their spouses, their siblings and so on. People are deciding about health care based on what they can afford, not what they need. That is not acceptable.

I now am even more certain that we need Medicare For All. In Vermont we have single payer health care on the books with Act 48, but we have not yet made a plan to pay for it. The All Payer model has been experimented with over the last couple of years. The finding? It is expensive and doesn't have the intended outcomes. Using some Medicaid recipients as guinea pigs of this model in order to test it was never a good plan. Not only does it send the message that experimenting

on health care outcomes with folks already struggling financially is an acceptable model, but there are so many factors and indicators that come with the stress of poverty that are not present in folks who do not experience these same stressors. Nothing short of treating health care as a human right will solve the problems that cause people to make choices between certain basic needs and health care.

I still remember when a young lady I was close to was 15 years old and dying of cancer; I remember the moment the medical bills hit one million dollars. Here her mom was, watching her daughter die of cancer and racking up astronomical health care costs. That is unconscionable. I also remember my stepfather working with a man at Hannaford who chose not to treat his cancer because he was concerned that, if he died, he would not leave his family with enough if he spent that money. So, he opted to work until he couldn't, leave his family money, and die. We are the most wealthy country on earth and yet people are making decisions that often lead to death in order to be a smaller burden on their family, give their children what they need, or simply because they can't make the choice to take care of their health.

Until the day we had to put Maple down and beyond I was questioning the care I gave her and the choices we made. I cannot imagine if I had to question my choices that same way with my child, myself or my loved ones. We have an opportunity in Vermont to work to fund the mandate the Vermont legislature set. We have an opportunity nationally to elect a president that will support and push forward on Medicare For All. Right now our health care is a for profit industry, not a humane enterprise. The pharmaceutical companies that sell us medication rely on us needing it to make their money; this is not health care, it is a business model. Folks worry about the costs to each of us as individuals in such a Medicare for all program. The reality is that the majority of us pay such extreme premiums and deductibles right now. The personal expense of such a program will be so much less. In fact the overall costs go down with a strong program. In other countries, folks are paying one-tenth or less than we do on their health care costs. If the goal is to have better health care with more money in our pockets, Medicare For All is how we do that. It is time to stop the outrageous abuse of an industry that was supposed to ensure that we all have health care.

As far as Maple goes, we did the best we could and we loved that adorable pup until the end for all the gifts that she gave us. Perhaps her story can help teach us that no one should ever have less than the care they need, regardless of the amount of money that they have.

Brenda Siegel is a former Democratic candidate for governor, founder and director of the Southern Vermont Dance Festival, vice chair of the Newfane Democratic Committee and delegate to the Windham County Democratic Committee. She is an anti-poverty activist and single mom from Newfane. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.

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