If the Republican administration and Congress repeal the Affordable Care Act without a replacement, the former status quo revisits us, meaning twenty million people will be without insurance, possibly incapable of affording a market-based replacement policy. I am not sure the administration or Congress cares. The Department of Health and Human Services (HHS) makes clear the Act represents a fundamental sea-change in health care in this country, particularly as related to the treatment of mental health and substance use disorder:
The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage in a generation, by requiring that most individual and small employer health insurance plans, including all plans offered through the Health Insurance Marketplace cover mental health and substance use disorder services. Also required are rehabilitative and habilitative services that can help support people with behavioral health challenges. These new protections build on the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) provisions to expand mental health and substance use disorder benefits and federal parity protections to an estimated 62 million Americans.
Years ago, during a Saturday meeting with students enrolled in a trial advocacy class at the University of Houston Law School, the pre-meeting discussion moved from gossip, classes, to regional differences. Listening, not listening; unfamiliar with any of the names, never part of the conversation, waiting on the clock to strike the anointed hour before beginning. One of the students was an African American female from Detroit. She started down the ill-advised road, meaning she turned the conversation toward regional differences. I attempted to stay out the conversation, listening, not listening; diverting my attention to the traffic below, casting periodic glances at the time, the oleanders swaying in the medium, counting the number of boards interwoven/interlaced in the alcove. The sun remained affixed on the other side of the room, staring, not yet making its journey over, across the room.
She didn’t stop at any of the visible stop signs. Continuing, never taking a breath, openly questioning, “I don’t know why I’m here”, “I was accepted to at least two other law schools located in the northeast”.
Interspersing choice words, “backward”, “different”, “in the North we” … words designed to invoke a difference, assertions of superiority; driving a chasm. Directing words at the six other students, five females, one male, all white Southerners; erecting walls, using truths, half-truths to evoke myths, northern myths, as much a part of America’s historical lore and the War of the States.
Dividing to strengthen her sense of self-worth, ignoring commonalities, not recognizing everyone has a crazy Uncle Donald, irascible, stupid; forever a tad bit narcissistic. Tortured accents, fly-away, fly-over hair (blue-grey, black-grey-dirty white, brown/grey/black/blue), commonalities not seen solely in the South. Generations’ past styles, mouthing the inappropriate, crazy, stupid-crazy souls, a universal commonality, as common as the universe of males suffering from male-pattern baldness, our crazy Uncle Donald, everyone got one. Digging and picking inappropriately, wrong place, wrong time, from crotch to ear, to nose, to mouth. Shocking everyone by the choice of movie, “Has anyone seen Finding Dory”, with the rest of us remaining perplexed, not able to tell if he is serious or not, or if it’s just more craziness.
Telling stories thirty years old, always beginning with, “I use to”, followed by and the word, “boy” and too many exclamation points. Forever non-hip, even when trying to be hip; two steps forward, five back, stumbling over the table, breaking the table on step three, every time, every time, step three.
Touching every female relative the wrong way, a generational repulsion, none willingly to ride with him, stay in the same room, hastening a retreat when he smiles and moves one inch in their direction. “Uncle Donald” … always followed by that exclamation point, slanted eyes, and a look of disbelief, directed at anyone who would dare suggest any other conclusion than crazy; crazy yesterday, today, tomorrow. My, my, my … I’ve digressed.
The African American female never crossed the line of attempting to compare her relatives to theirs. No she didn’t go that far. She might as well have done so; hers were the words of myth-making. Somewhat akin to “Mexicans will cut you”, “Black people will shoot you”, “Southerners are backward.” Seeing their eyes and body movement, the appearance of pride (in their southern heritage), causing her to abruptly change course, seeking support and affirmation, searching the room, turning to the only other African American in the room, me. I couldn’t. I wouldn’t. I didn’t, lend support, suggesting instead she should look at transferring to Wayne State. “If we’ve that stupid, move back.”
Years ago the New York gifted the rest of us another billionaire scion. Traversing the country in disguise, living a vagabond’s existence, dressing out-of-type, hiding, secreting his wealth, killing, discarding the body, possessing enough money to structure more than an adequate legal defense – yes, he did. He sure did. Killing a white man, oddly named Black, cutting him up in discrete parts, discarding the parts against the wind, into the surf … Lord knows where …. His acts, actions, conduct were never identified as “not as sophisticated.” No one categorized the behavior as the fundamental character trait of rich white men from New York. Never distinguishing them from others, refusing to apply the adverse label to the region, the small sub-group (rich white men existing in the unique world of the nano-percent). Everyone agreeing, even those who have a tendency to trend toward urban myths, the conduct was that of a demented soul, and nothing more.
Myth-making represents the blending of facts, half-truths and flat-out lies. Sometimes working to type, other times against type; always working toward a desired end, casting aside “the others” in order to bind a targeted group. Done both orally, in writing, consciously and subconsciously, part tradition, evolving and perfecting over time; dividing, driving wedges, sustaining itself against logic to make the myth-maker more confident in himself/herself/themselves. Oftentimes packaged differently, combed-over, dyed – the packaging matters not – the message is essentially the same, to convince the listener of the difference. “We will be great again.” “They’re different from us.” “We are superior.”
Sometimes we have to just say no, and work against type. Other times we have to ignore the persuasive messaging, no matter how wonderfully packaged. No matter how well delivered, even when our conclusion seems illogical at the time. A crazy Uncle Donald with money doesn’t mean he is any different than other crazy fools showing up at family affairs. No one, in none of our families, dare assume our Uncle Donald is anything but crazy. Crazy, always has been, always will be, crazy, money or no money.
“You are kidding me, right? Please – that’s Uncle Donald – enroll him in the Affordable Care Act, get him help while we still can, and pass the peas.”
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Today the oleanders remain in place, swaying gently against the southern breeze. Last time I checked, the sun still tracts east to west. Today, tomorrow, the day after, we must cast aside half-truths and lies, no matter how discomforting; a necessary elixir to protect “the others”, to protect ourselves. If not, we should be free to believe that all billionaire white men from New York are crazy.