Relying on the Kindness of Strangers. No Way to Run a Country's Healthcare System


(Interview 2/2010, oil on canvas, 40 ins. x 30 ins.)


Update 2021

I only had a phone number for Ron. When I first interviewed him in 2012, he had not yet set up an email account. I googled his name before trying to call. His obituary came up. It was him. I knew it. "Ronny was a self-employed carpenter and builder," the obituary said. Ron described himself to me as a jack-of-all-trades. All the particulars lined up


My heart broke. One of my Art As Social Inquiry family died in 2015 on my son's birthday.


My subjects share so much even though our encounters are brief, just a 2-4 hour interview. Many share intimate details of their lives beyond healthcare. They trust me to get their stories right. I am the accidental confidante. For too many I am their hope for relief from their healthcare troubles. I wish I had more to offer than wanting to hear every bit of their healthcare journey. Many say that just being able to tell their stories from start to finish is cathartic.


Ron lost his health insurance in 2004. He let a leg ulcer go untreated. Ron happened to be working at a physician's home. The doctor was so alarmed Ron would lose his leg that he sent him to a wound center and said he would pay for it.

Sometimes all we have is the kindness of strangers to save our lives. But relying on the kindness of strangers is no way to run a country's healthcare system.

I somehow was in touch with Ron in 2012. I don't remember if I called him or he called me. I remember him telling me about having cancer. The first thing I asked was did he have health insurance. I wondered if his years of being uninsured and going without check-ups meant that cancer's early signs were missed.


In my 2012 notes I wrote," He applied for Medicaid coverage, medical assistance from the state program for very low income adults. It remains to be seen if he will qualify although the medical professionals believe he will, so they have proceeded with his treatment. I am in the process of trying to meet with him again to get his full story." We never did meet. I don't remember why not.


Eligibility for Medicaid in 2021 is based solely on a reasonable income test thanks to the Affordable Care Act. But not so in 2012 when uninsured Ron needed health insurance (and before that all the way back to 2004). In 2012 before Medicaid expansion, it was near impossible for an able-bodied adult to get Medicaid. The Kaiser Family Foundation reported, "Historically, Medicaid covered low-income children, pregnant women, elderly and disabled individuals, and some parents, but excluded other low-income adults."


Now that Ron had cancer he was still low-income but no longer an able-bodied adult. Reading between the lines, I figured the doctors treating him for cancer were probably confident Ron would pass the low-income, disabled adult acid test and become eligible for Medicaid under the old 2012 rules. The new Medicaid rules in Pennsylvania didn't happen until January 1, 2015.


I don't know how Ron's last years were. Was he in a lot of pain? How sick did he get before he saw a doctor? Did another stranger insist he get medical care like the first one I talk about in the portrait story? Was it too late? Was he scared? How did he feel being uninsured all those years? Did he give up? I wish I could have met with him before he died. I would want to look into his eyes and find that open spirit who was so willing to share his story. I would want to see how his healthcare journey changed him like it changed me. I had to match Ron's openness with my own so that I could take in his being-ness and transfer it onto the canvas. One does not recover from such unchecked compassion. One should not.


Thanks for everything, friend. Rest in peace.



Artist Note (2012 with some 2021 commentary)

I love this painting. I was only two years into my art project about social issues when I painted this portrait. I was so pleased. Ron jumped right onto the canvas. I don't know why some subjects do and others don't.


Ron was one of the guys pumping out my septic system on a not so cold February morning when I approached him. In 2010 I embarrassed my teenage children all the time. I stalked anybody I thought would be interested in telling me their healthcare stories. Some looked at me like I was crazy. But the people who were suffering always wanted to talk. So what would it be with Ron? Was he going to talk or would he try to get away from me ASAP?


I found myself chatting up Ron by the septic mound on my front law where the grass was always greener than the rest of our pockmarked two and half acres as he shimmied the vacuum line into the septic tank. I asked a lot of questions about how a septic system works. I also asked if he got health insurance through the septic job. No, he was not a full time employee. He was just helping out for the day he told me. And, no, he did not have health insurance.

~


This interview happened in February 2010. President Obama did not sign the Affordable Care Act into law until March 2010. For uninsured people like Ron, the Affordable Care Act offered little relief. Full implementation -- when people could actually buy an individual policy and get financial help to do it -- wouldn't happen until 2014.


Ron told me that when he first lost his insurance, he was not a real worrier. But in time he said, "I was afraid to get hurt." He hadn't had an eye exam or new glasses in nine years. He felt a bump in his anus he thought he should have checked out at his age.

 

A study. Oil on canvas, 24 ins. x 20 ins.

(from a 2010 interview)

Carpenter/Jack-of-all-Trades, age 52, Uninsured


Ron lost his health insurance after a 2004 divorce. He was insured under his wife’s employer-sponsored health insurance policy. The company also paid for his health insurance as the spouse of an employee.


The couple separated in 2001. The health insurance remained in place until the 2004 divorce became official. When the signed divorce papers formally ended the marriage, the health insurance benefit as an employee's spouse ended as well.


Ron found himself facing the consequences of being uninsured. Without health health insurance, Ron could not afford his bimonthly counseling sessions. He could not pay the $572 ($808 in 2021 dollars) drug cost to treat his OCD, a diagnosis he received as an adult. He reached out to a local mental health center and they came through for him. They are a private, not-for-profit organization. The mental health center accepts private and public insurances, and offers their services on a sliding scale for the uninsured. Ron was able to get the counseling and medicine he needed.

~


Ron remembers tearing a tendon playing softball. As an adult he developed a chronic leg ulcer. He put off getting treatment until he couldn't walk anymore.


How one gets on the good side of Lady Luck is a mystery to most. That day. The one where Ron happened to be working on a physician's home is the day that may have saved Ron's leg from being amputated. Ron also happened to be wearing shorts, another intervention by Luck. The doctor could see a discoloration moving up Ron's leg.


The doctor insisted Ron get his leg ulcer treated and he would pay for it. He told Ron he could lose the leg if left untreated. The doctor sent Ron to a wound care center and said, "Don't worry about cost."


Sometimes all we have is the kindness of strangers to save our lives. But relying on the kindness of strangers is no way to run a country's healthcare system.


Ron told me that when he first lost his insurance, he was not a real worrier. But in time he said, "I was afraid to get hurt." He hadn't had an eye exam or new glasses in nine years. He felt a bump in his anus he thought he should have checked out at his age.


Ron and I talked in 2012, two years after our interview. Getting treated for the leg ulcer did not go so smoothly. He was billed repeatedly by the hospital for $2,750. He said he can't pay it and he would reach out to the doctor who offered to help.


Ron also told me he has cancer. He applied for medical assistance from the state program for very low income, disabled adults, Medicaid. It remains to be seen if he will qualify although the medical professionals believe he will, so they have proceeded with his treatment. I am in the process of trying to meet with him again to get his full story.


Ron and I never talked again before he died.