Dear Seema: The Politics of Prevention


Note: Seema Verma is President Trump’s nominee to lead the Centers for Medicare and Medicaid Services in the United States.

Dear Seema,

I’m a Registered Nurse who works in Boston, Massachusetts. I have witnessed first-hand what it is like for people to go without insurance, to delay preventive health screening only to find out that cancer is a far more expensive problem.

There are not a lot of things that make my proverbial blood boil, but reducing access to preventive healthcare, including maternity benefits, does. It makes me so angry I can’t see straight.

Look, I get it. Health care is expensive. Someone has to pay for it. But everyone bears the burden of an unhealthy society and while the Affordable Care Act (aka Obama Care) was not perfect, it began to put some policies in place that have been needed for a long time.

I come to this not from any political party line. I am a proudly independent voter – in fact, prouder by the day that I don’t buy into that assanine system called “two party.” I also live in Massachusetts where a Republican governor put health care reform as a top priority over 8 years ago and we are slowly reaping the benefits.


When, at your confirmation hearing, you mentioned that coverage for maternity benefits should be optional, I shook my head in disbelief.

Optional? Optional? I had to repeat it to myself to believe that you actually said it. The argument goes that if you’re a man or too old to get pregnant, then why should you have to pay for someone to have a baby? The lack of logic and understanding in that idea astounds me! The logical conclusion is that I shouldn’t have to pay for any of the choices that others make. So, by your logic, I shouldn’t have to pay for the business man who has a heart attack and needs bypass surgery. After all, I wasn’t the one who ate and drank too much. It was him.

Maternity benefits are an essential part of a healthy society. Maternity benefits speak to the value of family and children, they provide essential care for a future generation.

As Linda Blumberg, a senior fellow at the Health Policy Center at the Urban Institute. Women says: “We buy insurance for uncertainty and to spread the costs of care across a broad population so that when something comes up, that person has adequate coverage to meet their needs,”  But insurance is not designed to be an  “a la carte approach”. “Women don’t need prostate cancer screening, but they pay for the coverage anyway.”

When as a nation did we allow politics to co-opt our health, to feed us misinformation about insurance and that terror-producing term ‘socialized medicine’? Truth is the term ‘socialized medicine’ is a made up phrase. It was first heard in the early 1900’s but came into wide use when the American Medical Association fought against a national health insurance plan proposed by President Truman. It conjured images of a hammer and sickle approach to health care that would lead us down the slippery slope to communism. That was in 1947 – and it was a public relations coup, for in the six and a half decades since that time we have allowed the term to rule us, to be thrown around willy nilly to produce fear and anger, obnoxious and ignorant voices leading the way.

Here’s what happens when you let politics coopt prevention: 

A breast cancer lump ulcerates and eats away the flesh of a breast; a cervical lesion, easily removed, grows and turns into a completely preventable cancer; a gnawing indigestion and bloated feeling turns into cancer eating away at your colon – fully preventable had screening taken place early in the disease process. You know what else happens when politics coopts prevention? Abortion rates, already far too high, go up. You can’t have it both ways – you can’t want abortion rates to go down and yet reject the notion of maternity care and birth control coverage.

Preventive health is not about being Republican or Democrat or Independent or Green Party or Libertarian. Preventive health is about the health of a society as a whole; it is about being human, living in a broken world where illness and death and “pre-existing” conditions are a reality. Preventive health and being sick is not about politics. When will we in the United States get that?

What you should want to do in your tenure is make the Affordable Care Act better! You should want to expand on it and leave a legacy that puts Obama Care into the water. You should want to make a name for yourself as a person who makes health care great, not just tolerable.

Instead, I’m shaking my head and saying: “What in the name of Sam Hill is she thinking?” 

C’mon Seema! Be a Woman. Stand up for what is right. 


6 thoughts on “Dear Seema: The Politics of Prevention

  1. Maybe I don’t understand insurance. I thought it worked like this: xyz insurance sets up shop, usually with X, y, and z putting in their own money to start up. They tell the public to ‘subscribe with us and we will be there to help you when you get sick’, and people take out policies. Say I do. I pay a sum every month, and the xyz company takes the gamble that I will not get a catastrophic illness that will eat right through all the money I have paid in to them. Most people will not, so the xyz company can make some money, which is reasonable since they took the risk. But then I get cancer, and need ongoing and expensive care. I have several rounds of chemo and then surgery and then more chemo. Even worse, I develop an allergy to the chemo and have to change to one of the very most expensive drugs ever made to stay alive. One single treatment of that drug costs what I am paying in for a whole year, and I am getting this drug every 3 weeks.
    Is the insurance company evil for not wanting to keep me on as a policy holder? No, of course not, because insurance is a business, the same as a grocery store. X, y, and z all have their own kids to put through college, braces on teeth, etc. They deserve to make a living from their efforts. They put a maximum amount on what they would spend on me to protect their business, not because they have any animus against me.
    Now costs start going way up for health care, for a number of reasons, and the government steps in and says hey xyz, you are not allowed to set a limit on how much you will spend on Nancy, and you can’t stop covering her, either. So now xyz has to keep paying out to cover my wildly expensive chemo and so my costs eat into the money they used to earn to pay for their own family expenses. Is xyz evil for not being happy about this? No, they are trying to run a business and it is only government that gets to spend huge amounts of money it doesn’t really have, businesses eventually have to close or declare bankruptcy.
    And now the government says that insurance is no longer a regular business, that having it is a requirement to stay alive in this country, and therefore insurance companies are required to exist, and to somehow stay solvent while having a lot of policyholders like me, who cost more than we pay in. This is not a sustainable system, and I contend that it really isn’t fixable, it needs to be totally replaced with some thing that is not trying to be a business at heart, because it cannot work on a business footing. I used myself and my literal situation so that you would see I really do have skin in the game, my staying alive depends on my continuing treatment with Avastin, which costs $21,000 every 3 weeks, until a new treatment is available. My doctor is hopeful, but not currently aware of something that would cover my fairly rare form of ovarian cancer.
    So I don’t truly understand the gripe in your post, because I don’t understand what your view of insurance is. It began as a business, to cover my possible health needs in the future. So why should I pay for prostate cancer, or why should the 55-year-old man pay for maternity care? It should be up to the insurance company how to spread the money available to cover their policy holders’ costs, as it is the insurance company bearing the risk. My policy covers my possible needs, I pay my money in, the insurance company pays out what my policy covers as I need it. Now please tell me where you differ, because I truly do not understand where you are coming from!

    Liked by 2 people

  2. Reblogged this on The Sick and the Dating and commented:
    We are the only privileged nation who allows insurance companies to make a profit off of our sick bodies and demonize those of us – ALL OF US – who need healthcare. Because after all, all of us will need healthcare, whether it’s at the beginning, middle or end of our lives.


  3. Thank you for bringing a human element to this usually cold, detached topic. Your points about preventive care are eloquent. Unfortunately I don’t think we go far enough when we try to place preventive care in the insurance realm. Since prevention is not unpredictable, it really isn’t insurable in the true sense. We should instead have a population prevention fund where preventive services are payed through a pooled mechanism that is shared by everyone. This distributes the financial burden across the population, without siloing distinct populations based on the insurance plan their employer (or state) provides. Anagously, we all know that children must go to school. We don’t buy school insurance nor have high school savings accounts; we pay taxes so that every child has the ability to go to school. Preventive services should be covered in the same manner. Everyone should have access to at least those recommended by USPSTF.


Add to the discussion...

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s