Kathleen Shine Cain, Windham, NH

My brother suffers from severe rheumatoid arthritis, the treatment of which involves a variety of prescription medications, frequent physician visits, and occasional invasive procedures—all of which are exceedingly expensive.  Jim works in a restaurant that requires service personnel to average a minimum number of hours per week in order to qualify for health care benefits.  If an employee fails to maintain the required number of hours in a given quarter, benefits are suspended until the next open enrollment period, which could be as much as a year away.  Even those who maintain benefits pay high premiums and co-pays.  Since the cost of health care is skyrocketing, it is in the best interest of the restaurant chain to attempt to keep the number of eligible employees at a minimum.  At the same time, illness that prevents an employee from maintaining the minimum number of hours already jeopardizes coverage.  Thus, employees who rely on coverage from the chain are constantly struggling to keep their medical coverage, while the employer is constantly attempting to eliminate employees from eligibility.

Jim’s condition is such that he could possibly qualify for disability, making him eligible for a minimal Social Security benefit and Medicaid, which would cover some of his medical expenses.  But the benefit would not be sufficient for him to live on, especially given the out-of-pocket costs of his treatment.

I worked as a visiting professor in Northern Ireland for a year, and recently discovered that the father of one of my students also suffers from rheumatoid arthritis.  Given the design of the Northern Irish health care system, Paul not only enjoys full coverage for all prescriptions, but also for physician visits and procedures.  And since he has a qualifying disability, Paul receives a pension, his rent is paid, and his wife receives a small stipend as his primary caregiver.

Based on our conversations, it appears Paul’s medical treatment is equivalent to Jim’s, the only difference being that Paul is assured treatment and Jim is always on the brink of losing his coverage.  Like most Americans, Jim is dependent on his employer for medical coverage.  Paul, on the other hand, enjoys medical coverage in the same way that he enjoys education, police and fire protection, and regularly maintained public roadways.  When considered in this light, it is incomprehensible that Americans continue to embrace a health-care system that features insufficient coverage, limited access, and spiraling costs. We need to ensure that every American has access to quality, affordable health care.