Class Discrimination and the Republican Health Care Bill

In my last two blog posts, I have talked about my fears of, and experiences with, medical discrimination. I haven’t talked about medical bills, though they are rapidly stacking up. I was raised in the middle class, and my current income from my numbers-heavy job keeps me there (so far. ADHD isn’t a great thing for my career, exactly, as I may have mentioned.) I am fortunate that right now that I can pay those bills. Too many Americans already can’t, and what we are about to further do to Americans with preexisting health conditions is an abomination.

I am sick of soul about the prospect of Republicans taking away healthcare from 24 million Americans who desperately need it. Paul Ryan and his cadre of fundamentalist pricks wrote off 47% of Americans as eugenically and spiritually unworthy, then had a beer. Apparently, Senate Republicans are now ready to do the same. If any American Spoonie is without a job for three months, they could easily be priced out of the insurance pool and go bankrupt trying to manage their chronic illnesses under this bill. They’d even be among the (comparatively) lucky ones. Behind closed doors, Senate Republicans have rushed through healthcare decisions that will result in 43,000 Americans dying needlessly each year (as was the norm before the ACA.) These men are willing to let Americans die for the “sin” of having too few dollars, and they even have the gall to claim they deserve it.

Congressional Republicans have fully embraced their personal greed, and they use a warped Calvinist smugness to justify it. They have made a mockery of the Christian faith they noisily profess. These men are evil, there is no other term for them. I hope someday that they meet their Maker and, rather than being lauded in Heaven as they expect, are sent somewhere nice and toasty. Jesus did say, after all, that whatever they do to the least of their brothers, they do unto him.

How do you properly respond to men who, with their votes, will sign the death warrants of 600 times more Americans each year than all foreign and domestic terrorists? I can’t process the cruelty of that. I’m not surprised by it, unfortunately. I have a trauma history, after all, but am certainly not inured to it. How is anyone, with PTSD or without it, supposed to believe they are safe when their fellow Americans celebrate their murders?

I don’t know how to talk about the magnitude of that cruelty, so I’m instead going to talk about a minuscule thing by comparison. I’m going to talk about the assumptions middle and upper-class Americans – even liberal ones like me – often make about lower-income individuals with mental health challenges. I am a Progressive, and, given the evil infecting the current Republican Party, that means I end up voting Democrat, even though I often disagree with the Democratic leaders. I view my vote as a life or death matter in our current political climate. Yet, I acknowledge that subtle classism sneaks its way into even the most liberal of policies. It may seem hardly worth mentioning compared to the betrayal of so many Americans by Congressional Republicans, but it is still there.

For example, I met someone recently who works for a home-visiting program. Home visiting programs provide social services and parenting education for low-income mothers. Later, I read more about how home visiting programs are effective anti-poverty programs. They are very successful – for those low-income parents who complete them! Their retention rates, unfortunately, aren’t great. This is apparently ascribed to a “lack of motivation” on the part of the parents, but I am skeptical of any evaluation that blames the recipient for not being worthy of the program. I wonder if anyone else with PTSD instead suspects what I suspect about why retention is so low?

I absolutely believe that if people facing severe poverty were offered the same healthcare, education and mental health services as their lower-income peers, they would be able to excel just as much. I absolutely support offering mothers who may not have experienced loving care during their own childhood the tools to be the kind of parent they wish they had had. Home visiting is also just what it says: a program that happens in the home. As I first heard about it, I pictured my own home, which (thanks to ADHD) probably hasn’t been uncluttered since before I moved in. I am lucky to have a partner who does more than his fair share, especially when I have no spoons. Our place is always clean – if not neat – thanks to him. However, I was also taught that I should feel shame if visitors view anything less than a spotless house. (As you can imagine, we don’t have much company as a result!) I couldn’t imagine the burden of being a single mom with depression – and a young infant – trying to keep her house presentable enough for biweekly company.

I support helping low-income families (and I’m not an asshole!), but I just don’t get why everyone assumes that support should be only offered in-home. Did I mention I’m solidly middle class, educated, and I lie every time on mental health screeners? I don’t even trust doctors until I’ve built multi-year treatment relationship. It’s a trauma trigger for me to lose autonomy. These families in poverty we’re trying to help? Many of them have trauma histories and a lack of trust as well. Does sending a stranger to them to view the messiness of their depression – right there in their homes – every two weeks really alleviate more stress than it creates? I believe in the spirit of home visiting – just like I believe in the spirit of universal mental health screening – but assuming moms drop out because they aren’t “motivated” enough bothers me. Someone entering my private space, at a time of their choosing, at their insistence instead of mine, would at best be another stressor for me. At worst, it would be a full-on PTSD trigger. Yet, the same program offered at a neighborhood center would be a lifeline. Did anyone ever ask low-income moms if having home visiting is really what they want? Or did they just assume?

Many of these women probably also feel the shame of undiagnosed learning disabilities, which make it even harder for them, and many may feel additional (unwarranted) shame that they have no home at all. Some of these women may feel they must join the program, even if they are stressed by it, lest their refusal disqualify them from other benefits or raise red flags. I say this simply because I know that’s what my PTSD would make me feel in their place.

Many probably fear that their neighbors will think the strange social worker coming into their home is from Child Protective Services, and that probably adds to any shame they already feel. (It would for me.) Many probably read the same news articles I do, and probably further know how quick the rest of America is to assume they are on drugs or trying to be the (fictitious) “welfare queen.” Worst yet, they are probably justified in those fears, because even liberal Coastal folks like me don’t seem to realize that they would struggle just as much in poverty. They, too, seem to assume lower-income families are the “less fortunate” intellectually, as well as financially, though they try to help.

I know it might seem like nitpicking to worry about trauma or shame when much of America is a third-world country in health care, education and living-wage jobs for individuals from backgrounds of poverty, especially individuals of color. Yet, trauma and PTSD rates are correspondingly higher for low-income children and adults as a result. I feel fear watching the Republican healthcare bill advance as a middle-class Spoonie. How much worse would it be to watch as a low-income Spoonie? I think the same mistaken views about poverty underlie both my home-visiting example and the healthcare bill, even though misguided liberals are only trying to help (while Republicans actively try to harm.)

It isn’t the privilege of the middle and upper classes to have PTSD. It’s their privilege, though, to have the healthcare and insurance to diagnose and treat it. It’s their privilege to be able to afford yoga, $150 dollar/hour therapy, and Prismacolor gel pens for their adult coloring books. It’s their privilege to be able to eat a diet high in omega threes, or take vitamin D supplements, or even just eat plenty of healthy fruits and vegetables to support their treatment plan. It’s their privilege to diagnose their allergies, and to not buy the wheat-based products that will make them sicker. (Gluten-free isn’t typically available at the local food pantry, even if it is vital for individuals with celiac disease or food allergies to work and be productive.) It’s their privilege to be able to afford the 5-6 doctors it typically takes to get the correct chronic illness diagnosis. It sure as hell is a privilege to have all of those things, to see someone else facing the same challenges without those benefits, and to still declare them unworthy of care because they weren’t “motivated enough” to take care of themselves. I have many privileges, and I still struggle. I cannot imagine the strength it takes to face the same challenges with no support.

America isn’t the Land of Opportunity anymore. It isn’t, apparently, even a land of kindness or compassion. My own experiences have shown me firsthand that my fellow Americans will look for any excuse to ignore the pain of others, even if that means blaming them for their own misfortune. I know what “blame the victim” feels like, and I know that it’s founded on casual lies told by the wealthy, the powerful, and the in-group members that their victims “deserve it.” That mentality is abusive, whether it’s found in the “little” things, like trauma-insensitive care being blamed on patients, or in Apocalyptic things, like stripping the poor of their rights to basic health and safety.

I don’t know what to do about the Apocalyptic incarnations, so I guess I’ll have to keep talking about the little ones. I’ll talk about what it’s like to feel fear for my own health, my own career, and my own future. I’ll talk about what it’s like to feel shame, and I’ll remind my readers why no one deserves to feel that. I’ll talk about dignity, and why something so “little” matters so much. Maybe reminding others that everyone deserves dignity, everyone deserves autonomy, and everyone deserves a little empathy, will start to chip away at the abusive lie that the poor “deserve it.” (Also call your Senators if you live in the U.S. and say you oppose the healthcare bill!)

Maybe it will even help dull the sense of helplessness that I know I will feel watching Congressional Republicans vote – on the day before the celebration of the birth of our country no less – to destroy the self-evident rights to life, liberty and the pursuit of happiness upon which our country was founded.

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Need a recap of anything I’m talking about in any post? Check out the Glossary of Terms.

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