Living and Working Uncovered

— an interview with Sonya Huber

SONYA HUBER (www.sonyahuber.com) is the author of Cover Me: A Health Insurance Memoir (Class in America, University of Nebraska Press, 2010), The Backwards Research Guide for Writers: Using Your Life for Reflection, Connection, and Inspiration (Equinox Publications, forthcoming 2011), and previously Opa Nobody (American Lives Series, University of Nebraska Press, 2008). She teaches in the Department of Writing and Linguistics at Georgia Southern University. Dianne Feeley interviewed her about the background of her latest work on the health insurance crisis.

Against the Current: What brought you to write this book?

Sonya Huber: I wrote Cover Me because I’m interested in the complex question of what happens to our real lives under this patchwork for-profit system.

I’m positive that most people know it’s bad, and we know through empirical studies and news articles both the patterns and gaps in coverage, the patterns of discrimination, and the worst-case scenarios covered in news articles.

But I think real life stories point to the depth of the problem as well as to possible solutions and possible ideas for organizing. I had a lurking sense — and still have the sense — that there’s a level of reckoning we have not yet started to do in public, the “personal is political” connection made by the women’s and also Civil Rights movements, that what happens to each of us is not just data for a spreadsheet or a case study.

We haven’t gotten anywhere close to where we need to be, and in frustration as a result of my labor and health activism, I decided to go back to “the lab” of my life, combing my own experiences to really understand how this situation of minimal and no insurance had shaped my life. I don’t completely understand it, but I think there’s a level of honesty about personal experience — and willingness to talk about that experience in an analytical way — that has not happened yet in a wider movement for healthcare and economic justice.

Part of what I found was that many more of my decisions had been based on healthcare access than I ever thought possible, and that many of my moments of desperation and difficulty coincided directly with lack of access to healthcare. I also found very interesting patterns about who would talk about this issue with me across social classes.

Finally, now that the book is written, I’m still learning: people want the book to have a “solution.” That always takes me by surprise: there are so many good policy solutions out there. We have a plethora of models. That’s not what we’re lacking. We’re lacking the understanding that everyone is in some senses affected, that everyone is a worst case scenario, that every person’s life could be different.

That awareness of universal impact was a goal of the book. It’s very different than the goal of collecting statistics or policy recommendations or worst case scenarios. It’s the goal of asking every reader to consider how their own life may have been different, to define themselves as a veteran of the healthcare war, as a way to build personal investment in this movement and personal understanding of the movement’s goals.

ATC: What was it like being on Ohio’s welfare health care for you and your child?

SH: I discuss this toward the end of the book. I will say that it was both surprisingly gratifying and also gave me the tools to get what I needed from that system.

By the time I got on the state healthcare system, my level of rage and knowledge at for-profit healthcare was pretty well honed, so I was a pretty good advocate for myself, which you need to be. And I wondered, as I wonder under the for-profit system, what happens to the people who don’t have hours to pour into these battles, playbooks about what to do, or a sense that it will help in the end.

Overall, I’m exceedingly glad I was on the state system. The system was bureaucratic and completely underfunded, but the level of support and actual healthcare was quite good. It was the only healthcare experience I have had where I did not feel like I was a bad person or annoying customer for needing medical care.

ATC: Would this be a good model for people without insurance?

SH: I think a national system is ideal. At the state level (in Ohio) there was a choice between a system of clinics and a state-run HMO... I’m not sure if the HMO was partially contracted out or if it was non-profit. But it worked for me — at least until they turned around and revoked all the funding for all the care my son received in his first year. That was difficult, and I eventually got that solved.

I think the scary thing is that the state-funded systems are always in danger of block grants being revoked, and their funding bases change so rapidly over time. Or they’re given a mandate to streamline and cut costs and they’re thrown into chaos. So I think the tenuous nature of these programs indicates that a block-grant funded patchwork of solutions is not viable.

Funding for childrens’ healthcare, for example, took forever to get passed by all the states. And that could disappear at any time, and it was always threatened in Ohio, and it’s always time-limited and ready to run out. That’s just not sustainable.

ATC: Many of us make job decisions based on the health care package. Is that true for you? Is that true for your friends?

SH: I think it’s true for everyone in this country, if I may be so bold. And I have friends who have even made decisions about marriages, children, and relationships based on their coverage. I have relatives who have made a decision about which continent to live on solely based on health coverage.

The scariest part of not being covered by health insurance, for me, is that it makes the future into a completely different animal. Your body becomes the source of potential bankruptcy. I would get a cold, and when I was a single mom I would think, okay, if this is something bad, I can see how this would domino into losing my job and not being able to support my son. When we didn’t have insurance, there were times that I knew we were one major accident away from bankruptcy.

I think that it creates conditions that make people draw into themselves; they become self-protective and isolationist because they are on higher alert as physical bodies. I think the level of threat about health connects to people’s willingness to get involved in civic affairs, to connect to other people, to advocate for change.

Especially in situations where losing a job also means losing health coverage — and this is true for most of us — people don’t speak up nearly as much at work because job loss could lead to loss of healthcare, which is potentially catastrophic. So people become much more cautious about everything in this current situation.

We live in an environment of fear that starts at the level of our bodies, and many people aren’t even aware that it could be different. I think that’s where an amazing amount of stress in our lives comes from.

ATC: What advice do you have for the single-payer movement?

SH: I am incredibly grateful for all the work that the single-payer movement has done for this country, and I don’t think I’m in a position to offer any advice. But I have one suggestion: I think it is time to change the term from “single payer” to something that expresses the heart and soul of why we need national healthcare.

“Single payer” is a recycled term from the Truman Era, and it explains a funding model. It’s dry, and it can also be misconstrued as a sort of Single=“No Option” plus Payer=”Who’s Gonna Pay for This?” connotation, just based on the meaning of the two words. It can be made to sound very scary to someone who has no background with the term.

I’m not saying people can’t learn what single payer means, I’m just pointing out that people need inspiration as well as information. Terms like “Social Security” and “The Living Wage” are brilliant because they express both policy and the promise of a better life.

I want a term like “Healthcare Freedom” or “Hometown Healthcare” or something cheesy like that, which captures an image designed to galvanize people. Respectfully, and with gratitude for all the work of the single-payer folks, I think “Single-Payer” doesn’t do that, and neither does “National Healthcare.”

ATC 150, January-February 2011

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