A slow drive down the Boulevard and Broad corridor will give you some interesting insights into Richmond’s uninsured population.

Start at the Greyhound station and head south past Discount Medical Supply, a emporium boasting bizarre storefront specials, including cut-rate wheel chairs, CPAP machines and grosses of adult diapers. Continue down to Broad and the GRTC bus stop flanking the fire escape to my old West Grace Street flophouse. This is where my roomie and I met the self-proclaimed “Hop-a-long Cassidy,” an engaging, always-smiling amputee who crutched around the back alleys. The closest he would get to affording a prosthetic was some Duct tape and one of the empty 40 oz. bottles littering the lot.

What’s my point? Sometimes it’s less overwhelming to look in our own backyard when weighing in on issues as huge as health care reform. And in the River City, you’ll find intersections, people and stories that can convince you at one moment that change is needed, and the next moment that the status quo is just fine.

For example, take that same intersecting stretch of blacktop, and what about the full-time Hardees manager who has health benefits, but is getting her paycheck taxed so hard, that she has to go across the street to the check cashing store on the 11th and 26th of each month in order to put groceries on the table? This is who I want at the next health care town hall, not an upper middle-class mob yelling at each other across party lines, but Hop-a-long Cassidy and the Hardees manager, two tough stories that make it even tougher to forge a cut-and-dry solution to health care.

Now I would watch that.

I work in health care as my full-time gig, and part of my job entails researching and learning about the nitty gritty of health care reform: Public option implications, the impact on primary care physician availability and the fallout with insurance providers. And the more and more I soak in from doctors, articles and even long, acronym-ridden medical association blogs, the more I find myself saddled up firmly on the fence. With a public health care option in the bill heading for a Senate vote, here are a few interesting wrinkles to consider as you wrangle over health care reform ...

A shot in the arm: Between the H1N1 flu and proposed system-wide reform, health care is currently a two-headed syringe sticking it to seemingly every headline. Sure, I have little idea of what’s specifically entailed in creating a new vaccine for something like swine flu, especially when you’re under the gun. And yes, pharmaceutical pundits and doctors gave us warning that it might take a little while to prep and distribute the shot. But when you contrast the communication and distribution efforts between the seasonal flu vaccine and the new H1N1 vaccine – the latter of which is entirely controlled by the government - it sheds some potential insight on how bureaucracy could affect the productivity of Uncle Sam donning O.R. scrubs and checking our blood pressure. 

West Coast bias: Did you know that San Francisco has a healthcare program that’s attracted three-quarters of the city’s uninsured to sign up? The program, called Healthy San Francisco, is a one-of-a-kind citywide “universal” healthcare option I read about it in the L.A. Times, and it’s odd that the program hasn’t drawn more ink considering it’s so unique. And because San Francisco is the home district of public option advocate Nancy Pelosi. You can earn up to $54K as an uninsured individual, or $110K as a family of four, and still get coverage, but it’s only good within city limits.

This is just a quick and dirty description of the plan, and it’s no coincidence that the city known for free love is now known for free (or discounted) routine surgery. The plan itself is quite controversial, even with the widely liberal populace. It’s not likely Richmond would be maverick No. 2 in pursuing citywide health care. After all, all we know about health care is that the knee bone reaction is connected to the hambone. Plus, if any sort of plan passes that would give states the option of granting the option, gubernatorial candidates Bob McDonnell is a firm “no” on the public option while Deeds has waffled a bit on the issue.

It's tough to be both self-determined and truly sympathetic when it comes to facing up to big issues like health care reform. Heck, it's near impossible to be empathetic to Hop-a-long, who once claimed to my roommate that he crutched his was down Broad Street to Charlottesville. True empathy requires being able to walk 70 miles in his shoe.

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