Dear Building Residents,
I grew up underneath you. Some of you made a show of knowing my name, would call to me and wave if you passed me in the lobby. Some of you didn’t even know your building superintendent had a daughter. My father, when he was still your super, used the computer in our basement apartment to write you letters a little bit like this one—notices telling you to please be advised about upcoming hot-water outages and elevator-maintenance work, which always ended with an apology for any inconvenience and a note of thanks for your patience and cooperation. He would often tell me there were lots of worse jobs out there. But last year, when he announced at sixty-six that he was leaving the job, one of you, surprised, asked him why. You thought he’d stuck around the building for over thirty years because he loved being a residential super, or working for you, or the Upper West Side location.
Please be advised: he was mostly there because he wanted health insurance.
Spelled out like that, it all sounds a bit underwhelming. In fiction-writing textbooks, there’s often a passage urging fledgling writers to ask, What does this character want? “Access to affordable health care to protect his family” lacks narrative oomph—despite the fact that affordable health care is what so many people want, need, and increasingly don’t have. That access, or lack thereof, has bent the course of my parents’ own stories in ways that may not have been cinematic but have always been high stakes. You don’t know about these contours, which is partly why I want to tell you now. It seems strange to me, in a late-capitalist-end-times way, that I can know your life from your garbage—the garbage room was right next to our apartment—yet you don’t know the way the health insurance industry shaped my family’s life.
When I was a kid, every year on my birthday (celebrated beneath your very feet!) my mother would tell the story of how my parents were between paychecks on the day she went into labor with me, six weeks before the due date. “We had to borrow twenty dollars from a neighbor for a cab to the hospital,” she’d say. My parents were broke when I was born, but not for any of the reasons that we see often in movies and books (drugs, alcohol, fallen-from-grace genteel poverty, et cetera). Rather, my mother had developed an autoimmune disease in her late twenties that forced her to leave her job. She paid for health care as needed out of pocket. With my mother only able to work sporadically, the savings my parents had vanished. And the money from my dad’s job meant no Medicaid, either.
Are these technical details about health care access boring? Thank you for your patience while the building staff works to tell you this necessary story as efficiently as possible.
When my parents decided to have a child, my father found a new job doing building maintenance, which was supposed to offer insurance after my dad had worked there for six months. After the six months passed, my mother became pregnant with me. The health care company deemed my mother’s pregnancy a pre-existing condition and said my father would have to work there a year before my family would become eligible for pregnancy benefits. Outraged by this, my father’s boss at the time, Jerry (a man my mother described, whenever she told me this story, as “a complete gangster”), paid for my mother’s health care out of pocket. The system failed us, but we were briefly protected by this individual’s simultaneous anger and compassion. “For a little while, I worried we’d have to name you Jerry,” my mother told me over birthday cake, “though we decided against it.”
Is this information, my inclusion of the birthday cake detail and my mother’s voice, too personal for comfort? A reminder: Please do not store personal property in the hallway, including but not limited to scooters, bikes, and strollers. These are fire hazards.
I’m thankful that Jerry had the financial power to back up his outrage. I’m thankful that my father’s job as a residential super gave all three of us health insurance when I was growing up (even though we had to go through a three-month trial period at the beginning of my father’s employment, during which time my parents had to pay for our private health insurance out of pocket; even though our insurance from the building never included pharmaceutical benefits). And I’m enormously thankful my parents were able to get on Medicare last year and that my father doesn’t have to be a sixty-something-year-old essential worker in the city right now. I’m thankful that after years of hard work and paying into this system, my parents won’t have to rely on the luck of meeting people like Jerry. Is this a thank you letter after all? To whom? So often, when writing to someone with more resources, more power, my expression of gratitude seems to creep in on just the other side of lack.
When I’ve told others that I grew up in a rent-free basement apartment of an increasingly upscale building in Manhattan, they often assume that I wished I was one of you, the residents to whom my father wrote neutrally worded letters. Dear building residents: I do not require access to your residential units or your lives. While I certainly envied how your apartments got natural light, I liked my life and I didn’t want to be you. I heard your arguments in the hallways, your calls of complaints, and knew you were just people. Sometimes it seems to me that we’re unconsciously subscribing to one very limited story about inequality—the nonrich aspiring to be like the rich—over and over. But I’ve experienced a second story: that of the nonrich aspiring simply to live. Working a lifetime, just so as not to get screwed over by a health care industry that can easily eat away any savings and bankrupt them without any real social safety net in place.
The first story, the hyperaspirational I-wanna-be-one-of-the-elite stories, is the one we see most often on screens. It’s sexier, with its big ole arc, and is also more appealing to various gatekeepers. Baked into it is the inherently flattering idea that the rich must be doing something right because the rest of us want to be like them. And there’s the false idea that if we try hard enough, we can be. The second story—the one of shaping a life’s work around access to affordable health care—can be more difficult to handle because not only does it take away the glowing feeling of being envied, it suggests that we need to work together to end the extreme disparities in our country, designing a health care system that is fair and humane. It is not only a matter of moral urgency—though caring about each other’s well-being, especially now, is one of the crucial ways to feel connected in a time of so much insolation—but also stems from the way our health care system so often keeps people from getting care until they’re in expensive emergency situations, which wind up costing more for everyone and destabilizing medical access for all. When people are left with hospital bills they can’t pay, the hospital charges those who can pay more to make up the difference. (Dear building residents: “those who can pay” is a euphemism for you.)
This second story, while perhaps less cinematic, is deeply important, especially now, as millions lose their health insurance during a global health crisis; as our president tries to overturn the Affordable Care Act; as already cash-strapped hospitals struggle to provide care for the thousands who need it; and as so many essential workers risk their lives and the lives of their families. It’s a story that needs to be told more frequently. As more people lose their jobs in this pandemic, and as more people need care that costs astronomical amounts they can’t pay (and which you yourself will wind up paying for through higher medical costs), the fragile health care system in place may itself be what struggles to survive in its current shape.
Maybe this is the kind of letter my father used to write you. A notice. Something is wrong in the building and there’s a good chance, if you’re paying attention, that you are about to be more than inconvenienced.
Lee Conell is the author of the story collection Subcortical and the recently published debut novel The Party Upstairs. Her short fiction has received the Chicago Tribune’s Nelson Algren Award and appears in the Oxford American, Kenyon Review, Glimmer Train, American Short Fiction, and elsewhere.
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