I AM the health-care debate

The health-care arguments and counter-arguments may aim at and ultimately impact everyone, but perhaps no one more than me. How can I make such a preposterous claim? Simple.

First, I have a pre-existing condition. I was born with spinal muscular atrophy, a severe, degenerative neuromuscular weakness. I've never walked or stood, and have limited use of my upper body.

Having a pre-existing condition is not so big a problem insurance-wise as it used to be. In the Clinton administration, new regulations were passed that basically require insurance companies to accept a subscriber with pre-existing conditions if he or she was covered by another insurance carrier in the past year. This made a big difference in my life. Still, for that coverage, I have to pay an arm and a leg. Yes, even if they're an atrophied arm and leg.

That's largely due to the second reason I'll be deeply affected by health-care reform. Because of my lifelong disability, I've never been able to land a real job. Despite graduating with honors from Harvard College 25 years ago, I've only received temporary, short-term assignments, never full-time employment. Thus I have to go shopping for my own health insurance.

When Obama opponents worry that he wants the government to take over health care, I don't listen. (A) It's not true. And (B), if it were true, I'm not sure that would be so bad. The government couldn't do a worse job than the for-profit insurance and pharmaceutical companies.

When they call Obama's plan Socialist, it's meaningless to me. Considering what rampant capitalism has done to our economy and our health-care-delivery system as I've experienced it, Socialism begins to sound pretty good.

But when the right wing cautions that a government insurance option will lead to rationing of medical services, that's when I take note. I know that when it comes to rationing I'll get the short end. Those of us with significant, continuous disabilities are a bigger draw on the nation's scarce health-care resources. I know that's true. If you're counting dollars and cents, keeping people like me alive and healthy just doesn't add up.

I know this, because I already feel the squeeze of rationing from the managed-care system we have today.

Don't get me wrong. I've been lucky. But the question of whether it's worth providing equal quality medical care for someone like me, a 46-year-old quadriplegic (who also happens to be a husband and father of two daughters), became dangerously clear last year, when I was hospitalized for gastrointestinal infection and septicemia. I was unconscious, inches away from death, I'm told. Before the doctors would perform their magic, they asked my wife, "Are you sure you want us to do this?"

In other words, should should they provide me with the same degree of life-saving intervention as they would anyone else?

So for me, the risks of bureaucratically controlled medicine and rationing already exist. I only hope the Obama plan--or whatever reform ultimately passes, and I do hope something does--will include a provision to guarantee equal access for all, including or perhaps especially the one in five Americans who has a disability.