If a traveler from a distant land--Sawtooth Valley, for instance--were to visit Greater Boise these days, he could be forgiven for thinking that there's a frenzied religious revival going on. Huge cathedrals are being built. Pious statements about serving humanity are being made by priests, some of them in white robes. Saints are involved. Thousands of worshippers submit to vows of poverty and dedicate their lives to an all-powerful God, without whom eternity would be an impossible dream.
But Boise's frenzy has nothing to do with the spirit. While the cathedrals might be named after St. Luke and St. Alphonsus, the spiritual salvation they provide and $5 will get you a cup of coffee at Starbuck's. What they do offer, for a price, is a temporary salvation of the flesh, after which the flesh can get back to work to pay off the hospital bills.
The traveler from Sawtooth Valley might wish for a little truth in advertising. If a hospital billboard were to read "Charging What the Traffic Will Bear and More," or "Home of the Four-Dollar Tylenol," or "Capitalism Red in Tooth and Claw," the traveler might conclude that at least some people in the Treasure Valley health care industry understand what health care looks like from below.
Instead, the traveler reads that two great hospital corporations are doing battle in the courts over who cares more about the public interest. Phalanxes of opposing lawyers are trumpeting a noble dedication to a healthy, happy and well-cared-for public. That sort of hypocrisy is reminiscent of the Fourth Crusade, whose soldiers sacked Constantinople in the name of Christ.
The traveler from Sawtooth Valley is insured, of course, and much of his life has been organized around getting and keeping health insurance. It's been far more important than any salary he has ever been paid, simply because an illness or an accident would have beggared his family, whose members would have tried to pay his hospital bills if he wasn't able to, and they would have lost everything they had ever worked for.
But if you asked this insured traveler if he would willingly enter a hospital these days, you would get a resounding, shuddering, "No. Thank. You."
He has a horror of the places, not just because he's read too much about hospital-borne infections and emerging super-bugs, but because even if insurance is paying for it, he's appalled by the prices charged for simple procedures and overnight stays. He's disgusted by laws that send poor families to emergency rooms when it would be far less expensive to provide them with good insurance and health education.
He lives in terror that age or accident will leave him witless and incapacitated but alive for as long as his insurance represents a profit to the hospital he ends up in. He's upset that a system that denies preventive care to the poor will keep demented and immobile old people hanging on long after their souls have left for somewhere else.
He's nauseated by people forced into bankruptcy by collection agencies when their only fault was to get sick, and he can see that an unpaid and unpayable hospital bill can destroy people's will to work or even maintain a home, effectively imprisoning them in poverty, and worse, in a no-hope mindset that makes them a permanent drag on the whole economy.
He's horrified by the sinners in this new religion: people who have insurance but refuse to maintain their own health. They smoke, don't exercise, eat too much, drink too much and refuse to do the hour's research on the Internet that would teach them to avoid lifestyles indistinguishable, over time, from suicide.
He wonders if his medical insurance makes him complicit. He wonders about the medical systems of countries like Great Britain and Canada, who spend half as much per capita on health care but whose citizens live longer and healthier lives. He wonders if Obama, who had majorities in the House and Senate for his first two years in office, missed his single fleeting chance for greatness by not pushing through a single-payer system.
He thinks that the Affordable Care Act is by the insurance companies, of the insurance companies and for the insurance companies, so that they would not pass away from the earth. He understands that the very existence of insurance companies proves that money--lots of it--can be squeezed from human ills. He understands that the Affordable Care Act is an extension of an inhumane system, not a cure for it.
He thinks, sadly, that the current state of health care reflects a shallow financial solution to a deep moral problem. Further, given money's proverbial connection with evil, he wonders if the whole system isn't a Satanic device, and that naming hospitals after saints isn't a kind of diabolic joke, and that the small chapels on hospital critical-care floors shouldn't have walls of stained glass backlit by fire. (It's a train of thought that suggests another of Boise's new cathedrals, Zions Bank, should replace the temple-inspired spire on its rooftop with a giant mechanical figure of Lucifer pitchforking an unseen foreclosure victim.)
In short, the visitor from Sawtooth Valley reacts like any other innocent from the sticks who encounters the worldly, amoral, richer-than-rich, poorer-than-poor Big City: He wants to go back home, where the air isn't subject to inversion, the water isn't tainted with cleaning fluid, where money doesn't curse or even talk much, and not everybody sees material gain as the highest form of grace. But he cannot go home again, at least not in a spiritual sense, at least not as long as he has his Blue Cross card, and before he'd give that up, he'd give up life itself.