Fiction: Enforcing Obamacare at the Memorial Healthcare Network in 2020 - part 3/9

It's 2020 and Obamacare's mandates have Sam, an insurance agent with Memorial Healthcare Network, out patrolling Massachusetts looking for new ways to cut costs.

I remember when I first started selling health insurance. I got my license and my regional supervisor sat down with me one Monday afternoon. "Everybody knows a hundred people," he said. "We're not leaving this table until we make a list of one hundred people you can ask." They were mostly family and friends. I was twenty-six and was tired of working nights and weekends at a rather terrible seafood restaurant here in Worcester.

Things fell apart pretty quick. The dotcom bubble burst. Then there was 9-11. Still, I did okay. I never matched the first few years, but in our business there are a thousand guys who fail for every guy like me. Or were. Nationalized healthcare changed the game. Insurance companies became arms of the State. Enforcers of the law.  Insurance salesmen were given new and different responsibilities, and job security.

I admit, I wasn't holding my own compared to the other younger agents. The whole company worked like clockwork, except for me. What can I say? I'm a salesman. The government has removed the salesmanship. It's just not the job I originally signed up for. A lot of guys left in the years after nationalized healthcare became law. I didn't feel the need. I could handle anything.

Today was going to be easy. I needed to convince an old man to kill himself. It would get me out of the office most of the day.

And that was a good thing.

Sitting in my car, I took a sip from my flask. Nothing fancy, just some cheap whiskey. People say I drink too much. Nonsense. It was the puritans who passed along our cultural neuroticism regarding alcohol. In most cultures, throughout most of history, a mid-morning drink was the norm. Alcohol was the best medicine in the fight against cholera. I paced myself, enjoying six or seven drinks over the course of a day. Less than one an hour.

You'd drink more too, if you were allowed.

Worcester was my home. I loved it, despite itself. Life was just a little slower here. I found Ben Labre's house and walked to the door and knocked. A response came quickly.

"If you're here to convince me to sign a Dignity Declaration, you can save yourself some time and just go home." Straight to the point. The Old Man didn't waste any time.

"Look, can't we just talk?" I said. "We've been providing all your healthcare for a long time, after all. That's got to mean something."

The Old Man shrugged, opened the door and walked me to the kitchen table. It was a simple kitchen, an old fridge, a gas-stove, wood cabinets. Two wood chairs flanked a small dinner table, also made of wood. A few wood crosses were scattered across the counter; deceased friends and family.

I knew his wife died about twenty years ago of breast cancer. Repackaging that fact subtly to him would help him do what I needed him to do, to get what I wanted.

"I normally enjoy a glass of port around this time of day, you want some too?" Labre asked me.

"Certainly."

And so we sat for a few minutes enjoying our drinks. Catholics are not afraid of these quiet moments. It's something I like about them. I let some time pass before I got to business.

"You believe in charity, right?" I started.

"Of course."

"Then you have to see that there's a limited amount of healthcare available and by agreeing to euthanasia you leave more of those limited resources for the poor and the young. It's charity."

"I've told you guys this a hundred times, I'll pay for my own treatments."

"That's not the issue. This isn't about money. They can print money. This is about resources."

"If people purchased their own healthcare, supply and demand would meet at a settled price and there'd be no reason to ration. Limited resources would go to where they're needed. Competition would increase the quality of care and control prices. It's not rocket science."

"In an ideal world, maybe, but that's not where we live, we live here. What about the poor?" I asked.

"That's what charities are for."

I've heard arguments like this before. It can go back and forth and no one can come to a conclusion. You have to get ahead of them.

"Look, whether the free market rations healthcare with prices or the government does so with committees, healthcare still needs to be rationed. There's not an infinite supply."

"Firstly, the free market favors people who need healthcare the most, the elderly, like myself. We've had our entire lives to work and save money. And thus, we can most afford to pay our way. I have more than enough to do so, and I still have plenty left over to give to charity."

"That's not true for everyone."

"And thus the charity. But secondly, and more importantly, is life worth living?"

"Excuse me?" He just got ahead of me.

"Is life worth living?"

I realized where this was going. I dodged. "Not when you're in pain."

"We're always in some pain. It comes and goes. But knowing you'll be in pain someday in the future, does that mean you end your life now?"

"I'm not the one with a terminal illness."

"Life is a terminal illness, isn't that what the Health Services Secretary always says?"

"Some of us are more ill than others," I replied.

"And does illness equate with worth? Does my right to life depend on my health? Is life only worth living as long as you're comfortable?"

"There might be some gray areas, but you're well outside of them."

"Am I? Are you telling me that my life is not worth living."

"Yes, what you're about to go through will be awful."

"Should I only accept creation when it gives me pleasure? Am I to accept the gift of life only when the sun shines?"

"This cancer is going to eat you alive."

"As a person of faith, I must accept God's creation for what it is. Just as I receive blessings, so I must endure suffering. I have to believe it's part of God's plan, that we live, suffer, die, for a greater good we can't necessarily see or understand. Maybe it's about character. Maybe it's a test. Maybe suffering and pain help us come closer to God. Or closer to each other. I don't know. And just because I don't know doesn't mean I reject God. We were meant to live, God put this world in motion for that purpose alone. And to refuse to live the whole thing, to endure every breath of life, is to reject the Divine."

"Do you know how crazy that sounds?"

"I don't expect you to share my faith, if you've never experienced God at work in the world, you are beyond my ability to help you see. But I would like you to respect my choices regarding my life."

Mike was right. This guy was hardcore.

"But what about the fact that you're stealing time away from other, younger, people."

"What's the waiting period for an MRI in Massachusetts right now?"

"Depends on your age."

"For a middle-aged adult needing a knee-replacement."

I wasn't exactly sure. But I knew he was fishing for something, so I gave him the overall average instead, "Seven weeks."

"My neighbor's dog got one in under 24 hours. Now why is that?"

"It's not fair to compare veterinary medicine and people medicine."

"And why not? Why do dogs get the care they need and humans have to wait? It's because government controls one, and not the other. There'd be plenty of healthcare to go around if it weren't for the constant meddling of the nannystaters."

"Half the time, they kill the dog. Come on, if there had been plenty of healthcare to go around, there wouldn't have been any meddling in the first place."

"There's a hole in the bucket, dear Liza, dear Liza," he sang.

We laughed together. There wasn't anything else to do, I knew it, he knew it. I had lost. He poured me another drink, and I was able to delay returning to the office to report my failure for another hour.

***

"You told me you could get this done." Mike looked angry. "You're always bragging about how you can speak the language, speak across generations."

"Some people are just different."

Mike nodded. His face relaxed. "We'll work him down...I got something else for you." He threw a file on the desk in front of me. "Cerebral Palsy case. Less than a year old. Lots of complications. No chance for anything approaching an acceptable quality of life. The parents are younger, so it should be an easy sell. Get the company a resolution. No failure this time."

***

Read part four, here