I Wrote a Long Letter and Got Back a Post Card

I wrote the following letter, by hand, to Senator Robert Portman in which I attempted to articulate my concerns about healthcare policy and the importance of affordability.

I wrote to Senator Portman because I was fairly certain that our other senator, Mr. Brown is much closer to my position and because I believe it is important to engage in respectful debate.

It was not my intent to share this letter, but I was disturbed by the way the Senate bill emerged not as the product of the traditional legislative process of hearings and amendments, but by escaping from closed-door negotiations among a handful of members of the majority party.

That the finished product largely apes the House bill while delaying some of its more painful features until after the mid-terms are over speaks more to a commitment to job security than to the welfare of the governed.

I will say that I did receive a response to this letter which I will include at the end.  It was a particularly creepy response in that I hand-wrote the letter and got back an e-mail to an account I rarely use and the address of which was not included in the letter.

(Updated to reflect Mom's editorial comments.  Letter mailed 5/27/17.)

Dear Senator Portman:

I'm a new American, circa 2014, and a new voter.  I've lived in this country for more than 30 years, but it was only after a lot of hard work and saving that I was able to afford the attorney and other fees that would let me apply for citizenship.

I came here from Canada both because of the opportunities and because I had grown up watching Americans challenge themselves, rally to meet those challenges and then exceed their expectations all while my country seemed mired in questions of language and sovereignty and process.  We never seemed to be able to get anything done whereas Americans always seemed to be doing everything.

I came here ready and able to work hard and challenge myself.  I wanted to be a contributor, part of the team.

Unfortunately, my timing was not good.

I came in the mid-Eighties while the country was changing from a making country to a taking country.  I came at a time when people stopped wanting to be engineers and scientists and wanted to be lawyers and MBAs instead.  I came at a time when the future was changing from being limitless to being either a one or a zero.

One or zero; on or off; yes or no.

It was not long after I got here to attend graduate school that I saw a news item about an elected official proposing a Constitutional amendment to make English the country's official language.  It was like I had never left Canada.

But I stayed.

I stayed because I really wanted to teach, because I loved the work I was doing and because it felt like a grand adventure.  

Hard work, determination and a bit of luck and the possibilities are limitless:  isn't that the ideal?  Isn't that the headline in the national press kit?

Whoever developed that message deserves a raise because it's short, pithy and, to use a modern expression, "sticky."  It gets under the skin and becomes malignant.  If you weren't successful today, then you didn't do enough, weren't fast enough, weren't good enough and tomorrow you have do more, do it faster and do it better.

What is less apparent is that while one is busy focusing on one's adverbs, the goal line keeps moving.

I am not your core constituent.  I identify as a liberal democrat, but having said that, we do share some common ground:  I believe in hard work, I would rather pay my own way than get a handout and I am suspicious of regulation from whatever the institution.

Where we differ, I suspect, is on the concept of a common good.  

I do not believe this is a liberal concept, but rather one that is central to the concept of democracy.

If there is one thing that binds the country together, then there is more than one thing.  If we believe that a common defense is a shared value then we have to accept that there be some mechanism to pay for it.

That's an easy one.

As you go on down the list of things that are, or could be, shared, or common, values it gets trickier.

I understand that.

But I think that's why you have constitutions:  to remind you what we all think is important and what is worth fighting for.

I am sharing all of this because I want you to know that while much is expected from each of us, there are some things that are too big for an individual to handle on their own.  In just the same way that I cannot, alone, defend the country against all of its enemies, so too I cannot be counted upon to solve healthcare and provide for the protection of myself and my family--much as I would like to.

There is too much money in healthcare for any individual to change the system.  Why would it change for me, or for anyone else?  But, if there is research to suggest that our health outcomes per dollar spent are not comparable to other industrialized powers then should that alone not be reason for a stronger solutions-focus?  And by "solutions" I do not just mean reductions/elimination of public spending.  

The President has acknowledged that healthcare is a complex issue but addressing it has to be more nuanced than the binary public versus private insurance meme that permeates our conversation.

You no doubt know the numbers better than I, but there are a lot of people--my family included--who depend on the exchanges to make healthcare accessible.  I'm in my mid-fifties now but I still am not afraid to work and I still want to pay my own way.

I just can't.

Time and genetics have had their way with me and so I have had some health issues that puts unregulated private insurance out of reach.  Without healthcare and the access to more reasonably priced medications I would not be a contributing member of society and no longer be able to pursue the American Dream.

That's a choice that should not be forced upon any of our citizens, especially if it is within the nation's power to fix it.

I understand that there are powerful incentives to leave things as they are, or to make it the next guy's problem.  I understand that it is really expensive to get and keep an elected office.  I understand also  that America is about more than who has the deepest pockets and the loudest voices; it's about doing the right thing instead of the easy thing.  It's about staying when it's easier to leave, passing even though the net is open and "taking one for the team."

I'm about to lose my customer service job in part because I subscribed to the company's stated guarantee more than their monthly sales quotas.  It was my job to resolve the customer's concern about a product of service and I could not reconcile protecting their good will for the company with leading them to make a new purchase.  That's on me and so I cannot challenge them when they come to tell me it's time to go.  I did what was right for the customer.

Having come of age in Canada and socialized medicine and then been exposed to America's private insurance model, I have an obvious preference, but I know an "American" answer lies in some sort of a compromise.  My hope is that you are allowed the room to look for a honest compromise that celebrates life and the quality thereof over money and the quantity thereof.

Thank you for your kind attention.

The response:

Dear Graham,

Thank you for taking the time to write me with your concerns regarding reforms to our nation’s health care system. It is good to hear from you.

As you know, members of the House of Representatives recently passed a bill to repeal and replace the Affordable Care Act, otherwise known as Obamacare. This bill, the American Health Care Act (AHCA), replaces Obamacare with a market-driven health insurance system and makes significant changes to the Medicaid program. Since the AHCA has passed in the House, it now comes to the Senate for debate. 

I have already made clear that I do not support the House bill as it is currently constructed. My concerns that the AHCA does not do enough to protect Ohio's Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse, remain unchanged. We have an opioid epidemic in this country, and I will continue to work with my colleagues on solutions that will ensure those who are caught in the grips of this epidemic can continue to get the treatment they need.

This said, we must not lose sight of the fact that, for many Ohioans, the status quo is unacceptable. Individuals and families continue to face higher health care costs and fewer choices for health care providers. Insurance companies, saddled with costly and cumbersome regulations, continue to pull their health plans from the individual market across the State. Small businesses continue to pay more money for insurance premiums that could have otherwise been used to hire more employees or provide better pay for those they already employ. Congress must provide solutions to these problems, and I look forward to working with my colleagues to do so. 

After seven years of increasing costs and decreasing choices under the Affordable Care Act, it is clear that the current course of our health care system is unsustainable. Ohio families who are struggling to pay for health care need relief soon. Our nation’s health care system is broken, and while changing such a large and complicated system is no easy task, I believe that such change is necessary to ensure affordable access to high quality care for Ohioans and Americans across the country for years to come. 

  Sincerely,
Rob Portman
U.S. Senator

 I understand that nobody wants to go back to the summer of discontent that preceded the passage of the ACA, but there has to be a better way than one side imposing their political philosophy on the other:  that's not governance, that's bullying.

I wrote a letter because I wanted to live my belief in engagement and compromise solution.  I got back a letter full of boiler plate language.

I heard a lot about American exceptionalism and the remarkable healthcare system that is the envy of the world.  Why then do we appear hell-bent on making active choices to put it out reach to so many of our citizens?

For me, there is no more important context to this issue than the inevitable march of time and the decay and failure of our health and prospects.  We will all need healthcare; some sooner than later, some more than others.  We have a common interest in getting this right for everyone and yet will "fix it" so only a tiny subset of us can pay the cost of their own care.

To borrow from another transplant to these shores, "America:  what a country!" 

Those Who Were Seen Dancing

My step-father died this week.

That's not exactly right; he didn't so much die as disappear over the horizon, like a ship heading out to sea, or the sun clocking out at the end of a long day.

It wasn't very dramatic and it wasn't sudden; there were no heroic measures taken by doctors and nurses with "complicated" personal histories and no emotional musical underscore.

The end came with Eric and my mom holding hands.

They were, as they had been for most of the last three decades, together.

I say "most" because, for the better part of the last ten years, my mom has had to share Eric with dementia which resulted from a stroke.

For those whose families have not been touched by dementia, or Alzheimer's, no words can adequately explain the slow, inexorable dis-connecting that happens as lovers become partners, partners become acquaintances, and acquaintances become people who keep showing up, but whose names you can't quite recall.

For those who have been through it, no description is necessary.

I won't pretend to speak for my brother and sister, but it took me a while to get it.  I mean, I understood that Eric was the man that my mother had fallen in love with and it was clear that he was nuts about her:  that was clear from the beginning, but getting to know Eric as a person took time.

It took patience.

My dad was loud and one of those people who made an immediate impression:  you knew right away if he was happy or sad, furious or frustrated.  Eric was a much harder read.

One of my father's favorite jokes was "Get into the roundhouse, Mother; the brakeman won't corner you there."  

I don't know if Eric had a favorite joke.

Away from work, my dad liked transformational pursuits such as taking down trees, or fixing broken equipment:  he liked to solve problems.

Eric liked to watch.

Both my dad and Eric liked to be outdoors, but Eric was more interested in being a witness to the wonders of nature and, in particular, its birds.

Birdwatching?!?

When this word first entered my mother's vocabulary I couldn't understand its charm.  What could possibly be interesting about standing outside staring at small objects through binoculars?

Of course, this was more than thirty years ago when the world and I were both in a different place:  everything was go-go-go and birdwatching was stop-stop-shhhh!

Or, at least, that's what it seemed like, before I went out in the woods with Eric and my mom.

As they built their lives together and I had the privilege of spending more and more time with them, I came to appreciate that going out "birding" was an active pursuit, a conscious choice to seek stillness and quiet in  both the environment and one's self.  It was a meditation practice to quiet the noises in your life so that you could hear the song and see the movement that would help you train your "bi-nocs" on another entry for your life list.

Eric's stillness and his patience yielded an extensive list of birds and made him an ideal partner for my mother who came into the marriage looking for strength and stability.

Watching Eric out in the woods, you would see him almost disappear among the trees he was scanning; and not just because he was tall.  Eric would get to a spot and then he would stop moving.  For long periods of time, it was like he was rooted to the spot listening to the forest, picking one bird's song from another until he focused on the one that he wanted.  In a flash, the glasses would come off, one ear-piece would go into his mouth as he raised the binoculars and scanned for his target.  Like a sniper, he zeroed in, captured the image in his mind's eye and then he moved on to another spot, another set of sounds, another bird.

Try as she might, I don't think my mom ever reached the same zen-like state of birding.  Perhaps it might have been because I was there--she was always worried about her guests--but she would always move from a spot before Eric did.

It was a revelation to me to watch the two of them together.  

After growing up in a house where it always seemed as though my parents each had very different interests, seeing Eric and Lois together, in the woods, scanning the canopy for birds was compelling.  I never got the bug for watching birds, but I always interested to watch them, together.

For those to whom birdwatching is a thing, I know it can be pretty exciting to see the heretofore unseen, but, for me, the most exciting part was the annual swan count.  This happens in the winter and involves teams of counters racing around the back roads of the British Columbia interior looking for patches of open water to estimate the number of birds at each location.  It was still birdwatching, but interrupted by occasional fits of road racing.

Eric was a company man; he spent his professional life working for The Hudson's Bay Company, first in retail management, then as a sporting goods buyer and finally back in retail management.  He weathered the often rough seas of retail and corporate life with the same relentless patience that he took into the woods whenever he could. 

In his role of buyer, Eric traveled extensively in Asia and Europe which fed his interest in people and his curiosity.

After retirement, he was able to travel to Africa, see its animals and meet its people.  I know this was an important experience because of the care he took in documenting the trip and cataloging his photographs.  And I know because of the passion he brought to sharing those images and stories with me.

At first "passion" might seem to be an out-sized word to use in describing Eric, but I know it to be an accurate one.  

While he could seem like one of those inscrutable stone heads on Easter Island, it didn't take long to recognize that, like those immense figures, Eric was a witness.  He would watch, he would listen and, quite often in my experience, ask the right questions, or call you on your bullshit.

Eric's passion was evident in his love of jazz, of nature and of my mother. 

It was rare to see him angry, but when it did happen it was most often because he felt that one or the other of her kids were not treating my mother the way he felt she should be treated.  

Eric Burton McAlary was a good man, a kind man and, most importantly, the right man for my mother and it is just cruel that it took so long for them to find one another and, once together, that he should be taken from her in such a manner.

My last visit with Eric was about a year ago.  

At that time he was living in a long-term care facility.  Whether he knew who my mother was, or that she was just a nice lady who came to see him regularly, is hard to say.  He wasn't speaking much.

But he was watching.

At one point, he was in the day room standing next to the window and staring out at the trees that were just across the narrow courtyard.  Now, whether he was looking for birds is anybody's guess, but that is how I would like to remember him:  as a witness to nature; a totem recording history and pointing toward the future.

At one point, my wife worked for the local chapter of the Alzheimer's Association and she told me about one of the people who came to their adult daycare facility.  Her name was Sarah.  She was a petite apple doll of a woman who had bright eyes and a quick energy about her.  She was very verbal, but the language she was using at that time was Pennsylvania Dutch, her first language. 

Sarah was anxious to communicate, but could only do so in a language that nobody at that facility understood.

Kristen explained to me that one way to understand dementia is that it impacts the ability to make and keep short-term memory as it erodes long term memory.  Like peeling back layers of an onion until, at the end, all that is left are your earliest memories.  In essence, you become your true self, before experience, culture and society have taught you what to hide and what to show.

This is where the dancing comes in.

Later that same day we visited Eric, we came back for their Friday dance party.

When we got there, Eric was dancing with staffers, other residents and, eventually, with my mother.

I believe he was fully present in that moment, because I would like to believe that was who he was:  someone who loved life, experienced true passion and was possessed of a poet's soul.

Which, inevitably, brings me to Nietzsche who said:

And those who were seen dancing were thought to be insane by those who could not hear the music.

 Farewell Mr. MaCallery and thank you for letting me add you to my life list.