Right to Work State: An American Healthcare Story
THE ROUGH OUTLINE
“To have cancer in a pandemic and be thrown off of health insurance cannot be summarized with any measure of accuracy by a single word.”
In late January, 2020, I was given the results of my first PET scan. I did, in fact, have Stage IV metastatic breast cancer, but the good news was that it was only the tumor on my chest wall and “a lesion on the spine.” I learned, during the first week of February 2020, that I would be a cancer patient for the rest of my life. This would include yearly PET scans and more when my disease progressed. Naturally, I wondered had my gp had taken the “bump” seriously when I first came to him in November, if the cancer would have been given time to spread to my spine, but there’s no way to know this for certain.
In early February, 2020, I had surgery to remove the breast cancer tumor growing on my chest wall, followed by weeks of successful radiation to my spinal lesion. During this time my beloved dog, Bernie, died suddenly in my lap of a stroke, and all schools in the state of Arizona (and around the country) began to close indefinitely due to the pandemic.
I am a (happily) happenstance high school English teacher. I’ve been in education for nearly fifteen years (the first years in higher education, recent years in a public high school: stumbling into my current job allowed me to realize that — for whatever strange reason — I really, truly enjoy the company of teenagers). The classroom was my Valhalla. My escape from the drudgery of day to day adult life, much less day-to-day adult life as a forty-four year old, newly re-diagnosed, cancer patient in Trump’s America.
The pandemic, and subsequent mismanagement of the disaster by the Trump administration, took my classroom from me, took friends from me, left my older parents thousands of miles away, unable to travel to their eldest daughter who was sick, and at times possibly dying, it seemed, from Crohn’s complications brought on by cancer medication.
During the months from November (2019) to present, I have had surgery, radiation, an emergency room stay, and many arguments with insurance company go-betweens for life saving treatments.
I am but one American with such a story.
To have cancer is terrifying. Life upending.
To have cancer in a pandemic is excruciating. Traumatizing.
To have cancer in a pandemic and be thrown off of health insurance cannot be summarized with any measure of accuracy by a single word.
A SPOONFUL OF SUGAR
“Ain’t nowhere else to go, baby. You’re already here. We’re all in hell now.””
As a person with many prescriptions, I spend a lot of time at the Walgreens Pharmacy. Recently on one such visit, three deep in line behind a blind army veteran and a mother trying to get medication for her daughter with Down Syndrome who was having her tonsils out, I watched as well-dressed, blonde, white woman whose perfume I could smell through my mask attempted to by-pass the line and announced to the cashier she wanted her “own line” because she did not “want to be in line with these people.”
These people: the blind vet. The woman with her kid. Me.
I did not whip out my phone to make her go viral, which she would have carrying such a jarring load of repellant white entitlement. I simply wished to observe, to document, to remember. Her life is already ruined by her personality. Why should I ruin it more?
Actually, I laughed at her.
I laughed at her when she said, “Isn’t there somewhere else?”
I had to resist the urge to wink and say, “Ain’t nowhere else to go, baby. You’re already here. We’re all in hell now.”
There are two ways people might lose their humanity: one, they are mistreated or lost and never again found; two, they are unable to fathom beyond the realm of the self because they have never been asked or required to do so (or possibly they suffer from a terminal personality disorder).
The veteran at the head of the line was rude. Loud. Yelling at the pharmacist about being overcharged for his medication (which he surely was). He was mean because America made him mean. Why was a blind Vietnam Vet, on a motorized scooter, spending his precious days inside of a Walgreens and not on a recliner somewhere with a good blanket, a bowl of snacks, and a glass of choice. He served. He paid his dues; more than most.
The blonde at the end fo the line was rude. Loud. Yelling at workers about how she couldn’t have her own line. Saying, openly and without remorse, in reference to humans (I among them) who were, you know, standing right there that she didn’t want to wait with “us.” As though we were Lepers and she was the Emperor of Rome who could not possibly deign . . .
Behind “COVID-proof plexiglass,” was the pharmacist who was doing his level best to be calm and kind despite the belligerence erupting all around him. The pharmacist is a small-time street pusher. He belongs to the big cartel that is the American pharmaceutical industry. He’s a kid, doesn’t even know the name of the guy who runs the cartel nor does the one running the cartel know him. Just like all low level drug pushers, some hope, someday, they will get to run the cartel, but this is not so. The system is not designed with good old fashioned hard work for reward.
The system has nothing to do with “good” and nothing to do with “rewards” — unless you are the kingpin or kin to the kingpin.
Somewhere that none of us, in that Walgreens line, can see is the Kingpin.
In another life, born into a different set of circumstances and luck, he probably would have been a clown-suited serial killer. Instead, he had that silver-spoon circumstance. So he decided to make some cash in the big racket called healthcare.
At least street dealers — I mean the ones you might find here in Tucson or in my hometown of Chicago — are honest. They’re not trying to help you. And oh, how we love to condemn and punish low-level street pushers. Throw those mostly brown and black kids into prisons, ruin their lives before they even got a start because we cannot “tolerate” this kind of “behavior” in a “civil society.”
And yet, we do tolerate it. We codify “this” behavior into law all the time.
Dealers and pushers.
Money, money, money no matter the human toll.
This is how the American healthcare system functions in its entirety.
Only in this system, the Kingpins are mostly white anglo-European dudes with a few of their faithful handmaidens and buddies of color thrown in lest they appear “uncharitable to women and minorities.”
THIS AIN’T MY FIRST TIME AT THE RODEO
Another PET scan was ordered, earlier than expected, to see if the nodules were cancer.
In 2011, while living in Milwaukee for a job, I was diagnosed with Stage II breast cancer.
I was only thirty-four. No family history. No BRCA gene.
Simply put: on too much estrogen, my body manufactures cancer.
In 2011, I had two surgeries, three months of chemotherapy, radiation, and a 5–10 year course of Tamoxifen (depending on how long I lived).
I was able, through my employer’s insurance, to access some of the best cancer care Milwaukee had to offer.
My doctors, nurses, and nurse navigators orchestrated my care. I seldom had to schedule an appointment myself. My nurse navigator repeatedly told me to focus on “getting and staying well” while she did the tedious, complicated work of organizing my healthcare appointments.
My insurance paid for the treatments my oncologist suggested. I wrote checks to cover co-pays and went into some debt despite having insurance. (Cancer is a haute coutre disease; best only to get it if you have lots of money to spare.) I never spoke to my insurance company because I never had to.
I focused on getting well, and for ten years, I was well (with the exception of regular “getting older” pains and diagnosis of Crohn’s/colitis).
In 2020, after my second/current cancer diagnosis, then living in Flagstaff, Arizona, I spent more time on hold with providers, correcting schedulers, groveling with our insurance company (we had the “good” plan through my wife’s work at Northern Arizona Healthcare), than I ever did “getting and staying well.”
What with the job of managing my own healthcare (my doctors and nurses were more overloaded and disorganized than the ones I dealt with ten years ago — this is not their fault, this is the fault of a shift in the healthcare system: from non-profit to almost exclusively for-profit) and doing my own job as a public school teacher during a pandemic (and also trying to finish my forthcoming collection of essays), there was no time to take care of myself.
Sometime around October of 2020, I had a Crohn’s flare which was exacerbated by my cancer medications and ended up in the one place I swore I wouldn’t end up during the pandemic: our local emergency room.
The staff and nurses and doctors at Flagstaff Medical Center saved my life that night.
My potassium levels were so low from dehydration that I was literally on the precipice of a heart attack (until then I did not know this was even possible).
They saved my life and did so with the utmost kindness and compassion.
During my stay in the Emergency Department (thankfully, we had health insurance then), a chest x-ray found nodules on my left lung. This, of course, was deeply alarming to both my oncologist and me suggesting, as it did, that perhaps my treatment wasn’t working and the cancer was now spreading to my soft organs.
Another PET scan was ordered, earlier than expected, to see if the nodules were cancer.
I was able to reserve an appointment for a PET scan inside of just another terrible week in 2020. In the days leading up to my PET scan, I wrote a piece called “Maybe/Or” in which I contemplated the two ways the results would go.
Writing is one of the only ways I’ve ever known to make sense of my own fears, and I was deeply afraid.
I am in my early forties. I am not a young woman, but I am not an old woman either — at least not by modern medical standards.
One of the privileges, I’ve always joked, about being born when I was born is that I didn’t have to have breast cancer in the 1800s. (I really couldn’t have endured a lumpectomy with a twig between the teeth and a shot of Gin.)
The morning of my dreaded PET scan, I called to double check that my appointment was, in fact, at 10:30 a.m.. I wanted not to miss the appointment due to the anxiety-induced brain fog my gray matter was steeping in.
“Yes,” the scheduler confirmed that morning. “We have you down for 10:30. Your PET scan will begin at 11 a.m..”
So I taught my classes and began to get ready to go to Northern Arizona Radiology for the PET scan (which is nothing like an X-Ray or MRI or even CT scan). I had my keys in my hand when I noticed there was a voicemail from Northern Arizona Radiology on my phone. They had cancelled my appointment because I “failed to arrive for my 9:30 a.m. appointment.”
I did fail to arrive for my 9:30 appointment because when I called that morning to confirm the scheduler assured me my appointment was at 10:30.
I failed to arrive, dumb enough to believe the system would actually furnish me with the correct time for a procedure that basically functions as a crystal ball my oncologists use to scientifically speculate about how long I might live.
That day, I said to my wife Sarah, “We have to leave Flagstaff or else Northern Arizona Healthcare is going to kill me.”
The PET scan was rescheduled. The lung nodules were benign. In fact, the scan showed evidence that the treatment was working.
Sarah and I moved to Tucson, where she’d grown up, where her parents still lived. We had the privilege of stealing a silver lining from the pandemic: we could get out of Flagstaff and keep our jobs for the next little while since we were all working remotely now.
We had stayed in Flagstaff all those years, largely, because I loved Flagstaff. More specifically, I loved the school where I taught, this peculiar and progressive arts high school under the San Francisco Peaks, among the pines, and sunflowers. I found community there, unlike any I had ever known: professionally and personally. The choice to leave Flagstaff was agonizing for me. The American healthcare system had made me, like many Americans before and since, choose between my actual life and what I actually lived for.
I chose my life; my plain, continued existence.
When we pulled up to our rental house near Tucson’s El Centro, I was roughly fifteen pounds underweight. My wife’s naturally olive skin, handed down from the Greeks, had gone pale. However, with family supports, a new GP, and some warm winter weather, we began to heal.
THE HOME FOR MISFIT TEENS & ACTUAL ADULTS
“I have bad news,” she said.
Because I am a public school teacher, I was among the first in Coconino County, where I currently work, to receive a dose of the Moderna COVID-19 Vaccine. The week after we moved to Tucson, I made the four hour journey back up north to Flagstaff which was experiencing a snow storm, to be vaccinated on an army base in the county where I am employed.
In late February, a little over a month after my first dose (per CDC guidelines: I play by the rules), I traveled back up to Flagstaff again for my second and final dose of the vaccine. This trip felt more celebratory. I was in better health. I was going to — socially distanced — see some friends. Most importantly, I was getting vaccinated. There seemed to be a light, however dim, emerging as a faint beacon in the fog.
The plan: arrive in Flagstaff on Saturday afternoon, see a couple friends while the sun was still up and the weather was warm, get my second vaccine Monday, and Tuesday I would head back to Tucson with a detour in Sedona to see my oncologist. (Good oncologists, like good men, are hard to find, and I’m willing to travel for mine. He’s that good.)
Like many other people, the second dose of Moderna made me a little sick. Nausea, body aches, swollen lymph nodes, fatigue.
I called Sarah and she advised me not to come home on Tuesday, but drive back to Flagstaff after I saw the oncologist and “rest” for a day before making the long trip.
Tuesday morning, shortly ahead of my appointment in Sedona, I called to check in on Sarah.
“I have bad news,” she said.
Her tone was such that I thought perhaps a loved one had died suddenly.
I felt my guts clench. “Go ahead,” I said, braced for something that was going to surely take my breath away. (Sarah is not one for histrionics or catastrophizing— so when she takes this tone, I take notice.)
“They fired me,” she said.
In the past three years, Sarah and I both watched as her manager — a young hipster — bent and warped her job duties until her job itself was unrecognizable to the one she’d signed on for eight years earlier.
This is a “style” of management of which I am familiar, because I have been on the receiving end. This is a technique where a manager makes someone’s job so uncomfortable or impossible that the employee quits and the company saves by not having to pay unemployment because “Well, that person quit!”
When the truth is they were forced out.
Sarah and I both knew hipster-boss was trying to push her out, but we relied on Sarah’s income and health benefits, particularly this year when my actual life was at stake, so we were trying to hold out and in the meantime find something better for Sarah so she could leave Northern Arizona Healthcare.
“Fired you?”
I was aghast.
“What about severance?”
“No,” Sarah said.
“Notice?”
“No,” Sarah said.
“So you’re just fired and our insurance . . .?”
“Ends in a week,” she replied.
The cause of her firing? A typo, I think. A typo or a broken hyperlink or a missing verb. I’m not sure. The cause was minor.
My GP and Northern Arizona Radiology were vague, forgetful, and hard to reach when it came to test results — from the ultrasound to the biopsy.
I made this known to the “powers,” and there was no accountability to be found.
I was told (in so many words) that my problems with my healthcare were figments of my imagination.
No accountability. I was just another crazy woman with a bone to pick.
My wife sent an email with a typo or a broken hyperlink.
She was held accountable.
Roughly twenty-eight states in this country have Right-to-Work laws, and that’s if you don’t count West Virginia where Right-to-Work laws have been suspended pending litigation.
Arizona is a Right-to-Work state. Such laws were put in place largely to discourage unionizing and therefore ensure greater profit for those in positions of power within businesses and organizations: they could now fire their employees at any time, without any notice, with impunity and there wouldn’t be a damn thing the employee (unless they had enough money to lawyer up) could do about it.
A few years ago, Arizona educators got inspired by our fellow educators in West Virginia and despite not having a union (Right-to-Work) went on strike for two weeks.
Two weeks of protest, red shirts, me, and my community holding big signs at the capitol in Phoenix and locally outside the courthouse in Flagstaff on famous Rte. 66.
What we got from the strike, as educators, was mostly symbolic.
Meanwhile, in the healthcare systems, no such shakeup was on the horizon.
Nurses, who have never been paid or treated with the respect commensurate to the profession, were but two little years away from one of the most unspeakable traumas any American worker has faced since the industrial revolution.
We were all marching, unknowingly, toward an inevitable catastrophe that would, once again, put the greatest burden on our working poor, our Black and brown neighbors, and here in Arizona it would devastate the Navajo living on reservations in a way not seen since my European ancestors first brought smallpox to the continent.
The public teachers in Arizona never got their unions.
The nurses kept doing their sacred, difficult work.
CEOs of hospitals and healthcare systems bought boats and extra houses and gobbled up the best pieces of property the nation has left while driving longterm residents of those properties away to struggle, suffer, or die.
Living in Right-to-Work states means you know that, in theory, an employer could totally screw you over: fire you over some trivial, meaningless thing, drop your healthcare inside of a week.
I knew my employer in Arizona could do this, but I was naive back then.
I truly believed no reasonable employer ever would flex this law in a reckless manner.
I had forgotten my own knowledge of history. I had forgotten what I teach my students about the Civil Rights Movement or the Women’s Movement: No one gives up their power willingly.
The oppressor doesn’t simply “grow a feeling” and realize the error of their ways. The oppressor’s hand has to be forced, somehow.
King suggested forcing the hands through peaceful provocation.
My formative years were spent in the 1990s. Politically, everything seemed possible. This was, for me, an exciting time to be a woman, a feminist, a lesbian.
By the time the 90s had ended, I had my bachelors, a ton of debt, and a good old fashioned “grown up” job — i.e. full-time employment with health benefits.
Finding work was not simple for a recent college graduate in 1998 — nothing but an English degree and twenty-one years worth of life on the planet to show for herself.
The first employer to take mercy on me, to see my potential, was a Presbyterian minister and the head of a grassroots non-profit in the far northwest suburbs of Chicago where the rural-ness made the poverty deeper and more stark than it was in the more northeastern suburbs where the vast majority of Illinois’ financial wealth was hoarded.
I was a gay girl with a short haircut, a BA in English and Feminist Philosophy, a worthless work history, and Rev. Mueller reached down and pulled me up and into the rest of my American work-life.
I sometimes think Rev. Mueller single handedly saved me from a life in retail or my parents’ basement.
In this respect, I suppose, my first introduction to American employment was one guided by compassion.
I went on to remain for nearly a decade in the non-profit development sector, which has its own brutalities, but which was largely agreeable and full of people who truly, passionately cared about the populations they were making money for.
Then again, there’s an absolute accountability with grants and major donations that, in America, doesn’t exist between student and education; between patient and healthcare.
Back when I was in non-profit development, an organization (or individual) could find themselves in real, legal hot water if they made mistakes or misused funding. I always took this very seriously because I felt the law was just. If someone is giving my organization money to principally benefit the population I serve then I do feel I have an obligation to use the money they have given of their own volition with care and respect.
The non-profit organization Rev. Mueller started served homeless women and children, specifically, though we offered help to anyone. Many of our donors were wealthy white feminists. Others were wealthy people who felt they had an obligation to help the poor for religious purposes.
When these “big donors” made their big donations, they (correctly) wanted the vast majority of that money to directly benefit the women our organization was trying to bring out of poverty. We had to account for every penny in form after form to the donor, to the state and sometimes federal governments. We, in development, had to get really cozy with the most banal details of American philanthropy.
So let’s say I founded The Home for Misfit Teens.
The Home did well because there had never before been such a “home” in my community and it filled a desperate need.
Let’s say I had 100 employees serving 10,000 Misfit Teens because there were more Misfit Teens (an actual thing) than Actual Adults (an actual thing different from just a grownup human) in the community to serve them.
And let’s say the CEO of Acme Corp wants to give The Home for Misfit Teens six million dollars.
The CEO of Acme Corp cares very much about Misfit Teens and their well being.
Then let’s say the CEO of Acme Corp and I have an understanding, as rich people, that of her donation, five million will go to me (since I started the place) and the remaining million will go to my one-hundred Actual Adult employees in the direct service of Misfit Teens.
They will somehow split it among themselves, or fight over it. Who cares?
Let’s say at this point my heart has grown so black, I don’t even give a shit about Misfit Teens anymore because guess what? I own a boat now, and I’m about to buy my niece one, too.
The Misfit Teens were something I once low-key cared about.
Now?
They’re a curtain for my World of Oz.
Would you think I was a bad person? Would you think I was once a good person who had become bad? Would you see me as a great champion of Misfit Teens? Maybe once upon a time, but no more.
What if when the Misfit Teens and my Actual Adults complained about their care and salaries and the Acme CEO and I just shook our heads and chuckled, on my boat, thinking, They should have worked harder to get where we are.
That is the American healthcare system in 2021.
COMMUNITY
“We loved each other. As a community, I mean.”
We are not a nation of states.
We are a nation of communities if we are even a nation at all anymore.
Flagstaff was and will always be a special community for me.
As a public school teacher in a relatively small place, I got to know families all throughout the city. Sarah and I couldn’t go grocery shopping without running into a friend, a parent of a student, a student, a co-worker.
Having come of age in places like Chicago and Milwaukee, I never really knew community like this. This felt different and deep. We loved each other. Once upon a time, that would have felt weird for me to write about my neighbors.
I grew up in Arlington Heights, Illinois and I would never write “We loved each other” in reference to the Arlington Heights “community.”
There just wasn’t one.
But when I say “we loved each other” about Flagstaff, I mean that it felt this way. Most of the time.
(Even Actual Adults can be Misfit Teens sometimes.)
When my grandmother died peacefully at ninety-three, my employer told me “not to worry” about leaving to attend the funeral services in Iowa. In fact, my employer bought me flowers. For losing my grandmother in my early forties.
That sort of sums up my Flagstaff experience.
When I was diagnosed in January with metastatic cancer, the whole community descended, up until the pandemic hit, upon our family with food, money, hugs, long talks, dog walks, offers of housekeeping.
That was my Flagstaff experience.
Many of the students and parents I’ve known over my years in Flagstaff I still keep in close touch with and not just because of proximity — because I want to keep in close touch.
We loved each other.
As a community, I mean.
That’s what I thought.
Despite living in a Right-to-Work “state,” I was part of a close knit community. My wife’s coworkers knew about my cancer diagnosis. Some of my wife’s co-workers had children who were my students. And it was not at all unusual for me to have a care provider for some scan or lab work or procedure be the parent of a student.
My job alone had linked us to the Flagstaff community.
We felt like we belonged.
We felt that we were loved and cared for.
We loved and cared for the Flagstaff community kind.
So we were shocked when Northern Arizona Healthcare made the decision to exercise Right-to-Work to terminate my wife in the middle of a pandemic knowing full well that her spouse had Stage IV cancer and, after eight years, flick us into the abyss as though we were little more than a bit of dust. (Which, at the end of the day, as per Socrates-come-Kansas, we all are nothing but.)
For Sarah’s manager at Northern Arizona Healthcare to terminate her without notice was perfectly legal.
This man did not break any law.
No one in Northern Arizona Healthcare broke any law as it pertains to labor law (at least not as far as I know).
Most corporations, of which Northern Arizona Healthcare is one, are run by money-crazed narcissistic lunatics. Labor laws, for this reason, are mean as hell. They’re made by the lunatics for the benefit of the lunatic, but under the auspices of “helping people.”
Every year, I teach King’s “Letter from Birmingham Jail.” The piece is a brilliant work of rhetoric, philosophy, and civil disobedience. One moment in the text that often stands out to students immediately is the tension King asserts between “just” and “unjust” laws. Specifically, this:
[. . . ]there are two types of laws: just and unjust. I would be the first to advocate obeying just laws. One has not only a legal but a moral responsibility to obey just laws. Conversely, one has a moral responsibility to disobey unjust laws. [. . .] Now, what is the difference between the two? How does one determine whether a law is just or unjust? A just law is a man made code that squares with the moral law or the law of God. An unjust law is a code that is out of harmony with the moral law. To put it in the terms of St. Thomas Aquinas: An unjust law is a human law that is not rooted in eternal law and natural law. Any law that uplifts human personality is just. Any law that degrades human personality is unjust. (King, “Letter from Birmingham Jail”)
My students, like me, often end up agreeing wholeheartedly with King’s definition of an unjust law: “Any law that degrades human personality is unjust.”
Really, it’s hard to disagree with this statement unless you’re a true, proud psychopath.
* This is not an invite to linguists, equivocators, pontificators, contrarians, shit starters, and legalists to trouble me with the meaning and use of the word “degrade.” *
So tell me. How do Right to Work laws square with Dr. King’s thoughts?
White liberals, especially, like to hold up Dr. King and his works and words as evidence of their dedication to anti-racism, to justice, so how do Right to Work laws square with Dr. King’s thoughts on the matter?
The only mercy Sarah’s manager showed her was when he said this wasn’t “personal.”
Sarah’s manager was right. This wasn’t personal; it was a sin.
We all know there are secular, human “rights” and “wrongs.”
My youngest sixth grader could articulate what basic human decency is better than many adults I know.
We don’t need to be taught this, most of us are, in fact, born with a moral compass — even if we choose to ignore it as is well within our rights, but not where it concerns people’s actual existence.
When Sarah’s manager flexed his Right-to-Work muscles, he pushed us away from our right to exist: literally and figuratively.
And learning that Flagstaff wasn’t the community we thought it was — that hurt.
That broke my big sloppy heart for the millionth time this year.
Sarah’s, too.
But if I’m being honest, it wasn’t Flagstaff or the people in Flagstaff who broke our heart, it was a company and Arizona’s Right-to-Work law.
THE MEAT — PUBLIC INFORMATION
Who is profiting in the “non-profit” healthcare system?
Below are the salaries of the folks who, ostensibly, “run” Northern Arizona Healthcare. They are not only the highest paid in Flagstaff, but the highest paid executives — period — in the area:
Looks pretty damn profitable for a non-profit!
But only for some.
Interesting that I have been a very active patient with Northern Arizona Healthcare and yet I could not pick one of the aforementioned people out of a lineup.
Who are these people?
I don’t see my wonderful doctors or nurses or their assistants on this list.
I don’t see the people who are doing the real hard work of cleaning up shit and feeding grieving families in the cafeteria on this list.
I don’t see on this list the surgeon who held and rocked me as if I was her child while I cried after receiving my Stage IV diagnosis. Why is she not on this list? She’s one of the best doctors I’ve ever met in my life (and trust me, I’ve met some doctors).
I don’t see a single COVID nurse on this list. (Granted, the list may be old and surely next year NAH, along with all other American healthcare systems, will appropriately financially compensate their nurses for the horror they’ve had to contend with this year!)
I don’t see a nurse on this list unless you count the stint in nursing the company website says Ms. Spyrow did many years ago.
We need to start asking why.
Why are COVID nurses not making half a million dollars a year, but paper pushers are?
Why are we calling non-profits “companies”?
What are they producing?
They’re not producing health (physical, mental, or otherwise) in their patients or employees for that matter.
What are they producing?
What are any of the people on the above list doing?
What I see is that nearly 100% of the people on this list are white.
82% of the people on this list are white men.
(Flagstaff, contrary to what this list might have you believe, is not “all white.” Flagstaff, however, suffers, too from the same racist “lockouts” in employment and education that plague every city in the nation.)
If you are a person with the kind of mind or patience for numbers and statistics, I would welcome you to dig deeper and see if you can puzzle out just how much places like Northern Arizona Healthcare actually spend on the people who deal directly with patients (and therefore the patients themselves).
Back in the day, I used to understand employment in a “non-profit” to mean: you might someday earn a comfortable living, but this isn’t an industry for getting filthy rich.
THE JOURNEY
“No one person or thing was at fault, but there were systems that made the hardship harder when what they were supposed to do was make it easier.”
My “journey,” and do I loathe that term unless we’re talking about Joseph Campbell, with Northern Arizona Healthcare began around January 7th, when after roughly three months of polite groveling for results, crying at scheduling assistants, and playing phone tag with my doctor’s office, I was sent the following email (name redacted) to inform me of my diagnosis:
I have a book coming out in the fall that will better illustrate my experience after this point, but suffice it to say, this is the kind of treatment people like me get in the American healthcare system — and I’m white.
If you think I’m merely writing about Northern Arizona Healthcare, you miss my point.
Northern Arizona Healthcare is but one small system in a series of systems governed by the same ugly bloat, devoid of compassion.
I am conflict adverse. Those who know me well would tell you that I am a soft spoken, gentle person most of the time. I was raised by good parents to have good manners. I am Midwestern polite and proud of it. I believe in being respectful to all human beings. I believe all Americans have a right to make as much money as they like, but not on the backs of the struggling and the suffering. I believe that businesses have the right to hire and fire how and when they like, but sometimes humanity has to come into play.
I believe when you work for a system that is in the service of humans: like healthcare, like education, you must be guided by passion over profit.
In the scary times since my re-diagnosis with cancer, I have had some beautiful, transcendent, meaningful experiences at Northern Arizona Healthcare — with my doctors, with nurses, with staff. I have interacted with people at Northern Arizona Healthcare that seem to care about their patients with the same sincerity that I bring to the care of my students.
I will be the first to admit that I am an idealist.
When I was discussing this article with friends and family, some said, “Well, what do you want from this?”
Justice.
I want justice.
I want Arizona to reconsider its Right-to-Work Laws. Do these laws serve the common good? Or just the good of a select few?
Has justice been executed when a woman is suddenly fired over a typo/a broken hyperlink/wonky formatting, after nearly a decade of service when her wife has Stage IV cancer and there’s a pandemic going on?
Nothing illegal happened here, but did the right thing happen here?
I don’t want Sarah to have her job back. She was miserable in her last years there. She kept the job in an effort to keep me safe. I will forever owe her for that. She kept the job so that I could have a little more time in the job I loved. Now it’s her turn to find something that makes her as happy as my job has made me.
I want American healthcare to become more empathic, more considerate, more just.
I want to know that the guy who is always sitting outside the Circle K nodding his head to music only he can hear will be treated the same way I am treated when I walk into the emergency room.
I want American healthcare systems to spend more money on care providers — doctors, nurses, their staff — those in the direct service of patients, than they do on lawyers and “human resources” and paper pushers and spin doctors because you know what? If you do the right thing by people, you don’t need all the lawyers and “human resources” personnel (no offense HR friends) and spin doctors.
If you do right by people, you don’t have so many problems as an organization.
I want every corner of the American healthcare industry to ask itself this question: “Do we save more people than we sentence?”
Because sometimes as a patient in the American healthcare system, I feel like a prisoner.
Metastatic breast cancer means I’m a “lifer.” I don’t want to feel like a prisoner for the rest of my life.
I don’t want to feel hopeless, and powerless, and I don’t want any other fellow patient or worker in America to feel hopeless in the system — no matter your career or what ails you.
I don’t want workplaces to be able to break the spirits of their workers with laws like Right-to-Work that only serve to keep people down or, as in my and Sarah’s case kick them while they’re down.
I cannot lie. The past thirteen months have been atrocious for us.
I know they’ve been atrocious for so many, but I can only speak to our story.
Our story is a story of two women who were handed more than our fair share of hardship this year. No one person or thing was at fault, but there were systems that made the hardship harder when what they were supposed to do was make it easier.
Ours is just one American story about our broken healthcare system, about unjust labor laws.
I have been emboldened by age and an acute awareness of my own mortality to speak my truth.
This is my story.
This is also, I am certain, the story of countless Americans.
Most Americans don’t have time or a good platform — I have both, as it turns out.
Actually, I don’t. I don’t have time to write this, but I found the time. I needed to write this.
Now is the time to start reflecting on what is broken and can be fixed. Healthcare is broken. Let’s fix it.
If Trump showed rational Americans anything at all, maybe he showed that a nation cannot be run like a company that’s schilling golf courses and frozen steaks.
A hospital, a healthcare system, a school? They don’t work under corporate rule, either.
At the end of this long week (it is Sunday, after nine p.m.), I will say if there is a moral in all of this, it is this:
There is right.
There is wrong.
Let’s start acting like we know the difference.
