* EDITOR'S NOTE - Edwin Tanji died Sept 12 after a losing a battle with cancer. He wrote several columns in his final weeks. His last column will run on Sept. 28.
There are zombies in real life, something both alive and dead at once. They're called cancer cells - living cells with no purpose other than to displace healthy cells in a body, eventually to kill the body.
That has been my experience for the past two years. The problem is the year when a cancer formed in my throat that I ignored, an odd little lump in my neck that was a symptom. If I had taken care of it then, instead of waiting until the little lump turned into a mass that could not be ignored, possibly those zombies would not have multiplied to infest other body parts to displace healthy living cells with tumors - living-dead tissue taking nutrition from healthy living cells and growing more rapidly.
Multiple treatments with chemical cocktails, surgery and gamma rays have been unable to kill them all. Another lesson learned, too late. Cancer cells mutate constantly and can develop resistance until there is no effective treatment protocol for the mutants.
There is no one to fault in this losing scenario other than myself. But it is a reminder of what is necessary in health care. Patients are responsible for their health, not the doctors who can only treat when they are asked to do so.
It is also a reminder of the difference between health care and health insurance. I have health insurance. I didn't use it as it should have been. The result is that I have cost my health insurance company hundreds of thousands of dollars for my care, adding to the burden on all plan members who are healthy and are not adding to the cost of their health care.
What President Obama advocates for the nation in the Affordable Care Act is access to health insurance, which in turn provides access to health care by covering costs of seeing the doctor. Elements in the law are designed to encourage people to utilize plans for regular medical checkups, which could help avoid the massive costs of a catastrophic illness.
As with any insurance, health insurance might be characterized as gambling. As an insurance buyer, I'm betting that I will need health care, sometimes for catastrophic events - a serious accident or a serious illness. The insurance company bets that I won't, setting the odds based on actuarial analysis. With health insurance, there is an anomaly in the bet. The insurers pay for ongoing checkups to avoid that catastrophic payoff. Most health insurance plans will do that. It remains up to the gambler to take advantage of the anomaly.
For the United States as a whole, there is another issue: the millions who need access to health care. As a country of caring people, we are not yet willing to prevent access to health care, even for those fellow citizens who have not prepared for it. When they fall ill or are injured in an accident, we do not allow them to lie bleeding on the street just because they can't afford the health care they need.
It's called the Emergency Medical Treatment and Active Labor Act. Hospitals and emergency rooms cannot turn away patients for the inability to pay. When the uninsured are treated, hospitals and doctors providing the care can attempt to seek payments. But they cannot refuse treatment, even if the bill isn't covered.
It's a given that the bill for someone who falls ill of a preventable disease will be larger just because that patient - like the cancer patient who neglects to seek early care - will wait until the illness is catastrophic. They add to the high cost of medical care.
Those who remain healthy subsidize that cost because medical service providers make up for those uncovered patients with higher fees to those who can pay, or governments use tax dollars as subsidies to the health care provider incurring losses.
Based on the campaigns being run today, health insurance and care will be debated again in 2013 over how much the government should be doing. No one can legislate that individuals take full responsibility for themselves.
* Edwin Tanji was a former city editor of The Maui News. "Haku Mo'olelo," "writing stories," is about stories that are being written or have been written.
