Lady Caroline was a gift from the New Zealand government, given to me following the birth of my twins—at least that’s how I saw her. She was an earthy, warm, loving woman who came by her title when she filled out magazine subscription card. In the list where she was asked to pick Mr., Mrs., Ms., Miss, Dr. or Other, she chose “Other” and filled in “Lady.” “I figured, why not?” she told me. “They did present the opportunity, after all.”
When I was preparing to leave the hospital, someone from the staff came in and asked if I had everything I needed, and if I was aware of all that was available to me in the form of help—all that I was entitled to. That’s when I learned about the possibility of someone like Lady Caroline helping me manage twin infants, a two-year-old, and keeping my household in running order as much as was humanly possible. (Any mother of new-born twins or a higher order of multiples that also had a preschooler at home was entitled to this benefit.) Amazing. Never in America.
Caroline was a home-helper whose wages were covered by taxes paid by the citizens and residents of NZ, including me. She came to my house once a week to help with cooking, cleaning, and entertaining my two-year-old. Even after her stipend was used up, she continued to come around to offer me friendship and play aunty to my children.
This quirky little home-help subsidy was part of a list of culture-shocking things that came my way after I moved New Zealand, starting with a Goods and Services Tax (GST) that was around 12 percent and much higher prices on gas and food.
Another on the list was the cultural difference in the attitude toward universal health care. When I became pregnant with my first child, the local health nurse explained that my baby and I were covered throughout the pregnancy to six weeks following birth, and that they baby would be covered until age six. She never asked about my income level or made me feel like I was possibly scamming the system. She was incredibly helpful in directing me to the path toward a healthy, supported pregnancy and birth. I asked what it would cost me if I opted for a midwife and homebirth. That, she told me, was also covered. It was my choice—a decision no one else could make for me. I was ready for government mandates on how I would use tax dollars to birth my baby, but there were none (people pushing to change that, though).
And then there was that hospital staff person I mentioned who actually sought me out to make sure I had everything I needed before I headed home with my twins. Finding financial help with my kids’ medical and dental here in the U.S. was an exhausting journey with lots of obstacles, including doctors who wouldn’t take our government subsidized coverage.
Not long after I moved back to the states, I needed medical attention, but didn’t have insurance and couldn’t afford what was out there. We spent months paying off an emergency room visit. The bill was a hardship because we were flat-out broke and getting by on odd jobs, but we found a way to manage. I think we could have managed to find a way to pay for a low-cost insurance plan. Our income has improved, so I now pay a flat $40/month to cover my kids’ subsidized medical, dental and vision care. It wouldn’t take much of bump in our income to have that taken away, and I have no idea what it would cost cover the kids ourselves. I worry.
We pay around $250/month for my self-employed husband’s insurance, but that kicks in after we pay a $1,000 deductible. It probably has caps and limitations that I should educate myself to. I would gladly instead of grudgingly pay that premium if we could make better use of it instead of having it just in case something awful that could ruin us financially happens. I would be even gladder to pay if that premium cost less.
Reality check because I do get nostalgic about our years in the Land of the Long White Cloud and the births of my babies: Yes, there are those in New Zealand (and in my husband’s home country of the Netherlands and in other countries with universal health care) who gripe about higher taxes and paying the way for anyone they perceive as doing nothing to help themselves. But generally, people in New Zealand didn’t look twice at us for using government assistance because everyone uses some--it’s a right, an entitlement. I was on food stamps here in the U.S. once for a few months way back in time, and clerks at groceries stores could be awful. Kiwis have similar attitudes toward dole-mongers, but not about taking your kids to the doctor for free or getting a rent subsidy when you need it. I won’t pretend to know everything about the NZ system or the NZ attitudes, but that’s the impression I came away with.
And no system of taxation or health care is perfect, but in our memories, which tend toward short-term, it's the way it always been. You’re born into the system of your country and you sort of get used to it. It’s easier to go with the status quo than deal with radical change, so we become complacent even if we’re not happy, and we’re threatened by change. We all want to believe that the perfect solution will come along and that it will please everyone. Until then, we’re reluctant to budge. The reality of what it takes to bring about change can be overwhelming.
A few friends and family members I have talked to are all for universal health care, but don’t see the Affordable Care Act this way. I’ve told them that if legislation for purely socialized medicine were proposed, a whole lot of people would be seriously, seriously unhappy—even more than they are now. I can't see the U.S. public going for a big tax hike to help take care of EVERYBODY (too many think no one else is their problem anyway) or taking insurance out of the hands of the free market even if it means fewer medical costs in the long run or lower insurance premiums. I see similar arguments around the impacts on low-income people taking place.
One person just told me (via a relative’s Facebook where a little debate is going on), that this ACA thing is really, really bad (not very informative, but he's obviously frustrated and possibly misinformed). I said the system we have now is really, really bad and lower income folks are suffering anyway because preventative and other health care is out of reach. There’s a problem with believing that perfect solution will come along and that it will please everyone. We need to establish a foundation of affordable health care and start working to improve on it.
Lady Caroline was not a wealthy person—far from it—but when she was diagnosed with cancer, she was looked after until the day she died. In a letter she wrote to me to be sent once she was gone, she said she was “sitting overlooking the sea and warmed by the sun on a New Zealand spring day.” I think under the current system in the U.S., she would have died sooner, possibly alone and possibly in less savory conditions. I believe had I started my family in the U.S., the gift of the opportunity to meet her might not have been presented.
No reality check here for my nostalgia for Caroline and those spring days or feeling a little gloomy about the current argument here at home. We also need to establish that foundation to allow us to work toward a cultural shift of understanding that as a nation we are a community that looks after its own. In my heart of hearts, I want health care available for everyone. One way another, we all have to help with the cost.