With Health Care at These Costs, It’s Cheaper to Die
Photo illustration. Image source: apomares/Getty Images.

With Health Care at These Costs, It’s Cheaper to Die

I used to be on top of my health. Now, it’s…

I was not raised to be one of those Black men who avoid the doctor at all costs. My mama, a nurse, made certain that whatever the health care equivalent of “nails done, hair done, everything did” was, we had it.

The names of all of the specialists escape me, but I saw plenty of them and well before high school ended. Of the various problems, the one constant involved my ears — I have been told repeatedly that I have an incredibly thin ear canal. As a result of that, every few years, I get an excruciatingly painful ear infection that always, always, always forces me to take a trip to an ear, nose, and throat doctor. Around 16 or so, I was required to have some operation that sought to remove ear wax stuck to some kind of bone in my ear.

I swear I am not a dirty, dusty peasant. I also know that Q-tips only worsen such a situation. It’s not that I am forgetting to wash every part of my body. I’m not — never mind. I have a condition! I can’t help the ear canals I was born with the same way I can’t alter the fact that my ears are slightly too big for my peanut head.

But even when I was disgusting myself while seeking medical care, I always had a relatively good experience with doctors. I had no reason to fear them. I never had anxiety about a doctor’s trip, given that it had been my experience that if something went wrong, it would get taken care of. It might hurt like hell along the way, but eventually, I’d be all right. I just needed to make sure to go when a situation called for it.

We may have wanted for some things, but not our health.

My mom had good insurance, but in recalling all of the doctor’s visits through the years, I imagine that if her health insurance had not been so good, I would have been an even more expensive little problem. My mom changed her insurance by the time I graduated from college in order for me to stay on her plan until I was 25. She knew her sick-ass child might need it.

When the plan told my Black ass I had to go and get my own, it took less than a month of me not on my mom’s insurance plan to get another ear infection — one that didn’t bother with pretense, and so jumped ahead of mild and rushed instantly to wildly painful and frustrating. There is no pain like ear canal pain, beloveds. I wouldn’t wish that on anyone. The free clinic made the problem worse — I couldn’t hear out of the right side of my head anymore, but outside of the near two days it took to be treated in the emergency room and almost having to run over some badass kids who circled my car while I applied for health insurance, it could have been much worse. (Don’t feel bad for those kids, either; rob people your own age.)

For the first few years of having insurance on my own, while I had to work through my learning curve to avoid racist and/or homophobic doctors, I was good about taking care of myself. The weird things happening with my skin; the unbearable headaches; my ears, again; what I came to learn was a panic attack. The low cost of generic antidepressants, in particular, saved my life. I was one of the apparent few millennials who purchased health care plans pre-Obamacare.

It wasn’t only an earache that pushed me back to insurance. It was knowing its value to begin with from the values my mom the nurse instilled in me. I also never got over Big Mama losing her leg in Soul Food, and those niggas going back to eating the exact foods that took her ass out of the game.

Obamacare has become the bane of my existence. I stopped going regularly to the doctor around 30. It’s literally just the urgent care if need be and back to Houston if God forbid.

I had more direct examples to turn to as well. In his late twenties, my friend, Joshua, experienced some sudden health problems — something about the liver, I think — and was rapidly declining in health. He didn’t have insurance. Then people were trying to raise money on Facebook. This was long before crowdfunding’s peak. He died at a county hospital, a few months after he had earned a graduate degree. He wasn’t the first childhood friend of mine to die too soon, but he was the first I knew who might not have had to die if only he had access to health care sooner.

I thought of him when the Affordable Care Act gained congressional approval. I was sad about him but happy about the bill itself. The only people who weren’t happy about the legislation were monsters, the types of people who enjoyed watching Scar murder Mufasa. More people deserved health insurance — especially those who had been robbed of it for preexisting conditions.

Still, I have a secret: Obamacare has since become the bane of my existence. I stopped going regularly to the doctor around 30. It’s literally just the urgent care if need be and back to Houston if God forbid.

I never wanted to be that Black man. There are so many ways to die early as hell as a Black man, and being the Black man who doesn’t get a regular checkup ranks right up there with “just being a Black man in America.” The conservative media industrial complex has already taken that declaration and plastered it on television. I can see the chyron on Tucker Carlson Tonight now: NEGRO AND HOMO WRITER HATES SOCIALIST HEALTH CARE PLAN CRAFTED BY FELLOW DARKIE!

I take no pleasure in sharing this. I would never want to intentionally upset my beloved Michelle Obama, the greatest First Lady this racist-ass country has ever had. Nor do I want to disappoint Sasha or Malia Obama, as I am sure one of them will at least have a dope podcast that I would die to appear on. Barry, too. I don’t want to shit on what was not only the biggest legislative achievement of the first Black president of the United States but also for Democrats in decades.

I’ve got to two-step in my truth, though. Obamacare has made it harder for me to not end up having a future bout with gout. I am not a selfish person. I understand that Obamacare needed to happen because for far too long, millions of people who needed health insurance were denied that right, long treated as a privilege. I recognize that the problems with the ACA are not totally former President Obama’s fault.

As an independent contractor, I am responsible for my health insurance bill. Some boast about the rise of the gig economy; some berate those working 9-to-5 to make a living rather than being an entrepreneur. Let me tell you: I envy you W-2 bitches. You don’t have my tax headaches, and more importantly, you generally have health care provided by your employer. I would be less envious if my options were better.

Initially, Obamacare had no real impact on me in terms of what I paid for my insurance. The good old days, as I’ve now come to see them. My plan stayed roughly in the $170 to $200 per month range, and I was free to make the most of my PPO.

Three years in, though, my reasonably priced plan rapidly surged in price (as some had warned it would, without a public option to compete with the private sector). Even after I paid the new higher premium, I was informed that the plan I had would no longer be available in the next enrollment year: My insurance company was leaving the market. So I had to join another. And then that company left, so I had to find some new folks.

I miss Aetna so much. That was my bitch until she decided she couldn’t be bothered with the Obamacare market anymore. Once, I called a different health insurance provider for information about their plan, and she said that for well over $400 per month, I could basically get one physical a year and one trip to the emergency room. It was the third year I lived in New York, and I was trying to find a plan comparable to the ones I’d enjoyed in California and Texas. Everything is more expensive in New York, but when she told me that price, I literally laughed out loud and hung up.

By now, even more of the insurance companies have left, and my current provider is basically that bae that let themselves go and only wants to punish me for every wrong that I’ve ever done in life.

What I have is insurance by name alone. The $350-per-month, shitty HMO doesn’t give me much in the way of options of doctors, the visits cost far more than they should, the deductible is too high, and the drugs that used to be cheap for me are no longer covered. God forbid I get cancer, but if that were to happen — it’s surely happened to enough people in my age group at this point — I would take that garbage insurance to access doctors in the Texas Medical Center and turn to GoFundMe to cover the rest. I’m not being facetious. That’s the best I can do right now until I meet the requirements to join a union that provides insurance. Or marry someone, preferably in the military. I’d say a rapper, but a lot of them don’t have health insurance at all.

When I’ve tried to explain my situation in the past, many have barked back something about the subsidies associated with Obamacare. Yeah, about that: If you make even 3 cents over the median U.S. income, ya ain’t getting naan subsidy. Guess who makes way more than the subsidies but doesn’t make nearly enough to afford these ridiculous private health insurance plans plus my private student loans, credit card debt, rent, cable, internet, and free condoms they hand out every Pride?

But perhaps the best part is that, like any aging person, my body has turned on me.

My stomach truly antagonizes the everlasting hell out of me. Do I have IBS? Or is it the copious amounts of caffeine I drink all day, every day in order to work obsessively to cover my ass (barely) and not turn into a blob of a man?

Not often, but sometimes there is a pain. When it gets too unbearable, I go to urgent care. The last time that happened, the doctor tried to diagnosis me with syphilis. I don’t know if there was a language barrier — perhaps my country twang was too much for this Black woman who spoke like Gabrielle Union doing an impersonation of Lindsay Lohan’s weird British accent — but I told her that no, a dick had not been inside me recently. I didn’t want to get into sexual politics just for her to tell me what the lick reads on this pain.

And oh bitch, do I have arthritis already? These long-ass arms have been folded up like a Tyrannosaurus rex’s for a decade pumping out grist for the content factory, and they are finding new and interesting ways of pushing me toward voice notes and dictation.

In the midst of all of this, I try to lead what I consider to be a holistic approach.

I try to eat healthy, or healthy enough, most of the time. I repeat the following prayer as I season my food: “Please don’t get hypertension! Please don’t get hypertension!” I can’t be getting strokes and heart attacks. I can’t be getting the sugar either, so I try to drink my alcohol straight.

Meanwhile, I don’t get as low when I dance as I used to. As much as I aspire to be able to dance like Jennifer Lopez in the second half of life, one false pop and drop and I could end up with a walker. It’s not worth the risk right now.

During his second State of the Union Address, President Donald Trump announced his plan to end the HIV epidemic by 2030 — making PrEP part of that strategy. But the drug remains far too expensive to be accessible. The average cost of PrEP is $1,989.57 per month. It’s cheaper to die, no?

So the same way I pray over my food as I season it, I say a silent prayer before I . . . enjoy an edible arrangement.

I use protection, too. But prayer on top of protection.

Copyright © 2020 by Michael Arceneaux. From the forthcoming book I DON’T WANT TO DIE POOR: Essays by Michael Arceneaux, to be published by Atria Books, a Division of Simon & Schuster, Inc. Printed by permission.