The best thing about writing for the Indy is the chance, on a pretty regular basis, to talk to people who are generous of spirit and engaged in the hard work of trying to make the world a better place for the rest of us, not just for themselves. Even so, Dr. Carol Kirschenbaum stands out in my recollection. I met her five years ago, when she first went to the General Assembly with a simple idea--that "appropriate health care on a regular basis" should be everyone's right in North Carolina. Carol was a fighter with a gentle soul. She was ahead of her time--we trust that's the case, anyway--in seeing medicine as a gift to share, not something to be put up for bid. She knew her own time might be limited, and the goal beyond her own reach. But she kept on, with determination and a smile.
When I learned that Carol died last week at age 55, ending her eight-year battle with ovarian cancer, I re-read my story about her, called "Dr. K's Cure." We could run it again today, if we just changed a few numbers. North Carolina had almost 1 million people with no health insurance five years ago. Now we have 1.4 million. For those with insurance, premiums were increasing by almost 10 percent a year then. Now it's double-digit increases, or else big co-pays and deductibles.
Carol's legislation, which sought a referendum to amend the state constitution, was House Bill 1396 then. Now it's HB 1358. The amendment, modeled after a similar provision about public education, would read: Health care is an essential safeguard of human life and dignity, and there is an obligation for the State to ensure that every resident is able to realize this fundamental right. Not later than July 1, 2007, the General Assembly shall provide by law a plan to ensure that by July 1, 2011, every resident of North Carolina has access to appropriate health care on a regular basis.
The politics of health care being how they are, Carol's amendment is going nowhere in the legislature of 2005, just as it went nowhere in 2000. This country, alone among the so-called advanced nations of the world, still sells health care in the marketplace while treating the poor--belatedly, inadequately--out the back door. It was immoral then, as she said. It's immoral now.
Carol Kirschenbaum wasn't your typical doctor. For one thing, she worked as a special education teacher and then a physician's assistant at UNC Hospitals before going to medical school at UNC-CH in her 30s. As her husband and partner, Dennis Lazof, wrote in an eloquent obituary (you can read it at www.ncdefendhealthcare.org/obit.htm ), she stood out to her mentors from the start for her dedication to patient comfort and well-being. She never lost that. Though her cancer eventually limited her ability to practice, she continued for as long as she could to care for a number of "unprofitable" and time-consuming patients who suffered from a disease called lymphedema that other doctors steer clear of.
As the founder of the N.C. Committee to Defend Health Care, Carol stepped into the debate over reforming medicine in the wake of the Clinton reform-lite disaster of 1993-94, when Democrats tried to get this country's insurance companies to act a little more like healers and less like heels. She was convinced that only a single-payer system--a public system, that is, paid for by you and me--could rationalize the piecemeal services, and lack of services, that the health-care industry has created for us. But that would be step two, she thought. And maybe somebody else could think of a better idea. Step one was embracing health care as something we're all equally entitled to have, regardless of income or place of employment. That's what the amendment's about.
Dennis was sitting shiva with family and friends Monday night at their home in Durham. He, too, is a gentle soul, and the talk was about good times and how they fell in love. When shiva ended, I asked him if Carol had been discouraged by the lack of progress toward reform. Not at all, he said. She was optimistic. Dennis, too, who was Carol's partner in everything including NC-CDHC and a broader, national initiative of his own devising that you can read about on the Web site, thinks a breakthrough is coming.
Why? First, more and more people see that the current system doesn't work. Huge sums of money are wasted as "providers" try to avoid the sickest, poorest patients. So support for change is growing "at a grassroots level." Second, businesses recognize that skyrocketing insurance costs, and the uncertainty of coverage for their employees, is making them unstable. If you doubt that, ask any small business owner. For that matter, ask General Motors.
It won't be long, Dennis believes, before business starts to call for universal public health care in the same way that, a century ago, it called for universal public education. "That started with a call in one state too, and then it spread to other states," he said. "That's how reform happens."
Carol was very sick the last year, and he was her primary caregiver, so their work for the NC-CDHC lately was "weak," he said. But the good news is, others have stepped forward to provide leadership and raise money. The committee has much more support now than ever, and is on the verge of being staffed full-time, he said, from an office that is not in their house.
It's Dennis's hope that Carol's life, and death, will inspire a renewed push for reform. Donations to NC-CDHC will be split between work at the state level and the national project. Checks should be marked "Honoring Dr. K" and mailed to NC-CDHC, 1815 MLK Parkway #2, PMB #142, Durham, NC 27707.
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