I’d like to tell you a story about why I support Obamacare. It isn’t a tragic story, or even particularly uncommon. But it is mine, so if you read it and think about it I’d be obliged. This is really long, but I can’t figure out how to make a cut, so you’ll have to scroll. Indulge me.
In my early 20s, I was diagnosed with an Obsessive-Compulsive personality disorder. It’s not something I talk about with people. Most people in my family don’t even know about it. I don’t talk about it because there’s a lot of stigma against people with problems like mine, and I don’t like to make my life more difficult than it needs to be. I don’t much like to talk about it, but it’s not like it’s an incredibly well-kept secret either. Anyone who knows me is at least dimly aware of how I struggle with depression and massive anxiety and other things that are similarly hard to talk about, but impossible to hide. If you weren’t aware- surprise! I have OCD! Sorry my apartment is still gross most of the time.
The problem isn’t that I have this disorder. OK, that part sucks, but the real issue lies in how I was diagnosed. Most people don’t realize that they have OCD until their compulsions begin to disrupt their daily lives, and I was no exception to that. I have probably had it for years, but the reason I sought treatment is because I started to be late for work. I was constantly late because I had to keep going back to check my door and make sure it was locked. Every morning I would fight myself on it- tell myself the deadbolt was thrown, I’d checked it twice, etc. -and every day I would lose. Sometimes I would just have to run back up the stairs to my apartment, but sometimes I would make it into the car and drive half-way to work before I broke down and turned around. I spent every minute between leaving and performing the ritual honestly feeling like I was going to die if I didn’t do it, and die if I did. Eventually my boss noticed. I couldn’t cover it up anymore, so I called my insurance company and asked how I could go about seeing someone who could help me figure out how to make it stop.
Unfortunately, I was serving as a national service member at the time I was diagnosed. National service members are people who agree to spend a year living on the poverty line in order to work with non-profits to improve their communities. The health insurance is notoriously terrible for national service members, and the coverage for an issue like mine was basically squat. I used one of my two (!) yearly visits to a mental health professional doing an intake and a battery of tests. I spent my second visit being told about my diagnosis, and getting an offer of referral to a psychologist who could teach me how to cope with having an actual personality disorder. This psychologist would not be covered by my insurance, since OCD is not lethal and I can function without medication. My insurance providers considered the psychologist visits “elective care”, like learning how to not be afraid of your phone ringing is of the same importance as a shot of botox. If I chose to go, it was going to be out of pocket, or through a lengthy process of calling the insurance company and begging them for reimbursement that would not be guaranteed.
At that time, I had a choice to make. There were three options:
- Quit my national service job. Give up doing one of the first things I ever felt passionate about in order to find a job with better benefits. This just wasn’t an option. I was deeply invested in my job, and I had also committed to a year of service and I had no intention of abandoning the work I was doing.
- Suck it up and pay thousands of dollars out of pocket to see a psychologist once a month, and hope my insurance company would pay it back. This also wasn’t an option. I was on foodstamps. I fixed my broken glasses with fishing line and superglue. If I had thousands of dollars a month I would have spent it on food, a new pair of glasses and a car that didn’t have a giant hole in the floor. Knowing what I know now, I would have fought like hell for coverage. As it was, I was young and poor and too scared of the gamble.
- Use the internet to research how people handle having a problem like mine, try to find a good therapist through public services and muddle through the best I could. Start seeing a real shrink after my term ended and I could find a job with better benefits.
So, in case it isn’t obvious, I went with number three. One year of service became two, and then a real job. I can honestly say the experiences and skills I gained as a national service member have made me who I am today. I have zero regrets about choosing to stay in the program, and I am proud of what I accomplished there.
And yet, sometimes I can’t help but wonder what my life would have been like if I could have simply moved forward with treatment. There’s only so far books and self-help websites can take you. I did find a therapist who would see me on a sliding scale for a little while, but she was fresh out of school and frankly unprepared to provide me with the help that I needed. And then the program funding her time was cut, so it was a moot point. From there I was on my own. Once I had the resources to seek treatment I chose not to, thinking I was handling things fine on my own. I was not, and I hit bottom hard. I’ve spent the last year slowly regaining the ground I lost from disaster after disaster. I think I am doing better now, but to be honest, I still struggle every day with social anxiety and compulsive behaviors. I also struggle to overcome the problematic coping mechanisms that I developed in lieu of real treatment, such as my tendency to drink my social anxieties away. (That usually goes about as well as you would guess.) If I could have had consistent treatment with cognitive behavioral therapy and even medication when I needed it, how much better off would I be today? If I’d had the chance to learn how my disorder worked, and was encouraged to realize that I really needed help and it was OK to ask for it, how much progress could I have made?
I can hear what some people would say to this story. “Stop complaining! You made the choice to stay in a job where you had lousy health insurance. This is all a result of choices you made, and nobody is responsible for that but you.”
And yes! I agree with you that it is a choice. I made the choice to continue serving my community, and to make that choice I had to roll the dice on my mental health. The reason I support Obamacare is because I don’t think anyone else should ever have to choose between their health and making their lives exactly what they want them to be. I support Obamacare because I believe in all people having access to the care they need, especially when it comes to mental health parity. I want to live in a country where people aren’t made to feel like freaks or burdens because they have problems like mine- problems that are as real and visible as sprained ankles, but for some reason we’re told we don’t deserve access to crutches. Maybe if we live in a country where health insurance and access to care is a right, and it’s expected, we can learn to ask for it. We can move away from shame and stigma and move towards a world where everyone can be exactly who they want to be.
Or maybe not. But it’s worth a shot. Obama 2012!