A few who are reading this won’t know what plush carpeting is, so the title of this piece may not make sense. I am not writing about Donald Trump’s hair as the plush carpeting. One definition I found read like this, “Plush carpets offer a dense, luxuriously soft flooring option.” When my husband, Larry, told me that his father offered up the statement about the carpets as sage advice about seeking services from health care providers or other professionals, I got it instantly. Larry’s dad was simply stating the reality that providers who spend their resources on expensive interior design are signaling what matters most to them and to those they hope to serve – money, wealth, and those who will bring them more.
Over the course of my 60 years on the planet, there have been many times when a situation was uncomfortable because my status as a working class person was inconsistent with the place, the event or the group of people where and with whom I found myself. Most of the time, wealthy people are polite enough not to point out the obvious differences in our backgrounds and social status. But on a few painfully memorable occasions, comments are made that are instructive to those of us who want to believe we can change the world – or at least those parts of the world in which we all ought to be equal.
And what are those areas in which I believe we are all deserving of equal treatment? Access to appropriate levels of health care is right at the top of my list. Perhaps that’s why when I hear terrible, class-related, harsh and judgmental comments made in a health care setting, it pounds home the awful reality of our profit-driven system that certainly values the health, bodies and lives of some over any needs of working class people to get needed care. It’s a business, after all. It’s a very big business.
Most working class patients – those with insurance and those without – have had cruel comments made and crueler decisions made about their care than we would care to admit. We have all heard so much over the course of our lives that we become accepting of the unacceptable. I ran into yet another situation this week during which comments were made that were so hurtful and off-putting that I screamed and cried with rage, and I felt like the road to real change will be littered with so many “Donald Trump think-alikes” that I will explode before I’ll tolerate more.
This week, a provider evaluated me for some dental health concerns and offered a few options for going forward. The best option – the appropriate level of needed care – is so costly that the out-of-pocket expenses would exceed $15,000 after my insurance coverage is applied. Anyone who has priced dental care lately knows how expensive it can be. But ask any reliable health professional, and they will tell you that dental health is important to overall health. Ask any working class person, and they will likely tell you that unless a tooth or teeth are really painful or unless we have the insurance or cash to pay, we have to wait to access most dental services. It isn’t that we’re stupid. It really isn’t.
So, as this health professional explained my options, he felt the need to repeat a few times that if this were his wife, there would be no question. The $15,000 option would be the choice. He also made it clear that if a person is going to wait to get care until that much care is needed, well, that means they were irresponsible. Really? Here’s where a little working class education might help. If you make too much to qualify for dental services through any public programs and you purchase dental insurance that doesn’t cover the enormous costs of even a “small” dental problem (just one tooth can top $3,000 if it needs root canal therapy, filling and a crown), you may have little choice but to wait until the pain and/or infection is so bad that you cannot ignore it any longer.
Imagine how it makes my husband feel to have one of the plush carpet guys say so smugly that his wife would get the $15,000 in dental care. Imagine how it makes him feel to know that option number two – pulling the three or four of my teeth that are in need of treatment and then making a bridge would still be at least $2,000 out-of-pocket. Then there is the third option: just pull the teeth. Not a great choice given what most people think about the status of people with missing teeth.
What did we decide? We did what working class people do. I asked politely if I could buy time with antibiotics to help the infected teeth and pain pills to keep me going. Then we left the office. I sobbed and yelled before we got to the outer door. It wasn’t bad enough to know I’d be losing some of my teeth (I have actually invested as much as I could over the years in keeping my teeth), I also was so angry about being reminded that with the kind of care the wealthy take for granted, I never would have been in this position. I screamed at Larry, “I am not worth it,” and I meant it. For those several minutes it took me to come back to my senses, I was once again – and this has happened way too many times in our health care system – measuring the value of my life against the amount of money needed to care for myself.
How many times during a lifetime do working class people have to justify their life choices or prove that they are hard workers or demonstrate that they are just as thoughtful, diligent and intelligent as anyone else? It’s the hurdle that must be cleared in order to be accepted into the circles in which health care and other human needs are given without needing to be forgiven for not being rich.
During the coming week, I will join people all over the nation in celebrating Medicare’s 50th anniversary. Join a celebration event for Medicare’s 50th anniversary somewhere close to you. (Click Here for more info.) We’re reminding everyone that Medicare is as American as apple pie, and as such that it needs to be protected, improved and expanded to cover every one of us. One of the things I support most about a Medicare for all for life system is that it will force even the “plush carpet guys” to see a few of us who fall into the carpet remnants category. If the providers driven by the bottom line (and that’s an awful lot of providers) see money to be made from treating me and my kind in addition to those who are wealthy, they may stop thinking it’s acceptable to treat working class people as inferior.
Under an improved and expanded Medicare for all for life system, dental care is treated like any other health care need. That’s equality I think is appropriate. If the plush carpet set wants veneers and implants and whitening treatments and any other cosmetic dentistry, that’s fine. But we working class people want and need equal basic dental services as part of a humane health system.