Paul Kusuda’s column
No insurance coverage for health care
One of my nephews (he’s more than 50 years old) is uninsured for health care since he’s a
part-time seasonal employee of a municipality.  For all his life, he has been healthy and
active.  He’s the picture of health and has always been athletic.  In fact, his seasonal work is
as a lifeguard.  He’s an excellent swimmer, naturally, and keeps in good physical shape.

Last Spring, he had a heart attack that came on suddenly, and of course, without warning.  
He was hospitalized and received a couple of stents in arteries to his heart.  Everything went
well, and he returned home.  Then, the bills came.  WOW!  Hospital costs ran into thousands
of dollars as did his physicians’ fees.  Although he has had years of seasonal work, he had
no vested health insurance coverage and his pay was such that he had but minimal
savings.  Now, all his savings are gone, and he has tremendous bills that will take years to
pay.  But he plans to pay as much as he can because he believes personal debts must be
honored.  Some might advise him to declare bankruptcy, but he declines that advice.

In the 1930s and 1940s, my parents didn’t have medical insurance.  In fact, the only
insurance my father had was a $1,000 life insurance policy that in 1942 he turned in for its cash surrender value that was
for a lesser amount.  (The reason was he and others in the family had to be incarcerated according to government edict
applied to all persons of Japanese descent in West Coast States as of February 1942.)  Fortunately, our family had few
medical costs.  The three children had their routine disease-prevention shots but no medical costs other than for my older
brother’s emergency appendectomy.  I had juvenile asthma that required occasional physician visits, but the costs were
not even close to current levels.  They were such as to be handled without excessive difficulty since they were payable on
an informal installment plan.  

There was no dental insurance, so all three of us children had dental problems—decays as well as teeth misalignments.  
My father, who then owned and operated a small grocery store, had a few teeth needing crowns and probably a bridge or
two.  The costs were such that extraction of all teeth and installation of full uppers and lowers was a less expensive
alternative.  Since he could not have much down time, he had a dentist extract all of his teeth and place temporary upper
and lower plates the same day.  I still remember that he came home spitting blood and saying he’d stay home for a day.  
He went to bed and didn’t get up until the next morning when he went back to work, opening up the grocery store, putting
out the fruit and vegetables, and tending to customers.  My mother and grandmother took care of the store for the day he
was absent and helped out for a day, but he went back to his daily work routine.  I would not have the fortitude to do what he
did.  But, he gritted his non-teeth and did what he had to do.

That was then.  Health and dental insurances were not even contemplated by my parents and their friends.  Physicians,
hospitals, and dentists did not need to have patients shoulder huge costs for services.  Most patients paid their way
whether the costs were deemed affordable or not.  They went into debt and paid on some kind of informal installment
plan.  It seems that few people wanted free services.  More often than not, they avoided going to seek medical attention
until they felt they really need it.  Of course, that led to emergencies and often early deaths.  Broken bones, bad cuts, and
the like usually meant getting medical help, but lesser problems were usually ignored.  

Then was then,  now is now.  Costs have soared.  Also, patient expectations have risen.  Now, a condition that used to be
largely ignored is cause for seeking medical, dental, or other professional help.  Over-all health is better; infant deaths
have declined; incipient physical anomalies are diagnosed and corrected or treated; needed surgical procedures are
performed; preventive steps are counseled; and people live longer.

Personal and societal attitudes relating to health, financial responsibility, etc. have changed so much in the past 50-60
years.  We seem to take for granted as a personal right without concomitant responsibility; we seem to be quick to litigate
when we perceive or misperceive some wrongdoing on the part of those who provide services to us; we seem to have a
feeling that the world owes us a living; we seem to radiate a sense of “Hurrah for me! The heck with everyone else!”

Is there as misperception of what is societal responsibility and what is personal responsibility?  Why are hospital and
various other professional costs so high?  Why must physicians and hospitals require so many tests and prescriptions
even though necessity for patient condition may not be at issue?  Might there be concern about possible litigation?  Might it
be concern about possible post-practice review to meet public demand for transparency and unfair or unwarranted level of
accountability?
It may be time for self evaluation to figure out what
part we have played toward excessive litigation; false
allegation of professional malpractice; not taking
personal responsibility when appropriate; unrealistic
expectations as to how others treat us: decreased
respect for others; hostility toward strangers; etc.

It’s time for a truly comprehensive universal health
care plan for all residents of the United States.  Does
the recently-formulated plan meet the needs?  Does
it involve sufficient safeguards for both health care
consumers and providers?  The questions are easy
to formulate, but answers require more knowledge
and expertise than we ordinary folks have.