Am I really sick? At what point do I need to use my limited child care and go without work so I can rest and get well?

The emotional and mental stress woven throughout physical health is complicated for everyone. For those of us living with limited resources, the challenges of physical illness grow exponentially.

In the last four years, I have been sick a lot. For the illnesses I’ve had — shingles, psoriasis, eczema, gastrointestinal troubles, frequent low-grade fevers accompanied by various symptoms, and mental health issues — stress has contributed to the likelihood they will occur. Stress leads to illness, which leads to more stress, which leads to more illness.

Any time I’m sick, the diagnosis, treatment and recovery costs me time. That means it costs money. The child care I have is limited. When I use child care, I need to be working for money. Illness — and the time required for diagnosis and treatment — means I need more child care, which means less income

In many cases, the treatment and recovery time required for being sick means I’m not able to work as much as I need to. As a small business owner, even the shortest setback has significant consequences. My clients need me to get the work done. I have been lucky that my relationships with my clients are so personal I have been able to stay afloat — but barely.

Most people are not as lucky as I am. Most people work at jobs where sick days are limited, and absences mean lost jobs. Which leads to more stress. Which leads to more illness.

The one thing that has made a significant difference in the terrible snowball effect of illness/stress/illness/stress is that I am enrolled in MaineCare. While I have been treated poorly by office staff on occasion — even the tone of voice changes sometimes when they learn I’m a MaineCare patient — overall, MaineCare has been a lifesaver.

I am reassured knowing my health concerns won’t cost me money. If it weren’t for MaineCare, my financial life would be decimated — which would lead to more stress, more illness, more stress, more illness.

When I saw that South Portland’s Dr. Michael Ciampi had stopped accepting health insurance and was instead posting fees on his website, it struck me as a bold and excellent move. As someone living with limited means, the idea of paying the monthly premiums, deductibles and expensive co-pays that come with private insurance feels like an expense I can’t afford. Since I can’t be sure I will need medical care, why would I spend money on it? It’s an appealing idea to just pay when I actually need the care.

However, MaineCare removes the stress of deciding whether it’s better to pay as the need arises or pour money into the coffers of a private company on the off-chance I might need coverage, only to find out the copays and deductibles are so high it would be impossible to cover the costs of care even with insurance.

For all of the years I was paying income taxes, and simply as a responsible member of our country, it seems right to me that my health care costs should be covered by the government — we, the people. After all, it is the government’s job to “promote the general welfare,” and how better to do that than to keep our citizens healthy?

It seems a wise investment to give everyone access to health care. While preventive care doesn’t always provide direct cost savings, my experience tells me that access to high-quality health care in all its forms without a fee means I am more likely to get the medical care I need. If I had to pay — either insurance premiums or directly for services — I would put off going to the doctor even more than I do now.

Living in the United States of America brings with it responsibilities that include supporting the common good. Our money will go and does go — in the form of our contribution to the common wealth (taxes) — to support our fellow citizens. Making a longer-term investment by providing healthcare to everyone will pay off for all of us as people not only are able to work but find themselves living with less stress, which can lead to less illness, less stress, less illness, etc.

Whether you call it “single payer,” “Medicare for All,” or “ Maine AllCare,” the government should be responsible for paying medical care providers. Based on my experience as a member of the “newly poor,” I am sure we would all be better off if we, the people, provided health care for everyone.

Heather Denkmire is a writer and artist who lives in Portland with her two young daughters. After a few challenging years, she is growing her small business, where her team helps nonprofit organizations win grants. She can be reached at