Early this morning, while it was still dark outside, my small family made the trip to our friendly local emergency room. As emergencies go, this one was sort of small-scale: no one was dying, there wasn't any blood, and the patient (my husband) is resting at home now after a painful throw-down with a kidney stone.

Given our current fortunate status as Blue Cross employer-health-plan-covered patients, it was easy getting into a treatment room and equally simple checking out. Beyond verifying our address and phone number, the hospital didn't besiege us with a large amount of Q&A regarding exactly how their substantial bill was to be paid. What a difference that little piece of plastic – our insurance card – makes.

On the day I became a committed advocate of Medicare-for-all style health insurance, a little over eight years ago, our emergency room experience was startlingly different.

It was a cool January evening, and my friends and I had just gone to a girls' night out movie, "Sweet Home Alabama", with Reese Witherspoon. When we all trooped into our house, my husband had a late-night dinner waiting for us. The girls didn't stay long: since I was six months pregnant for the first time at age thirty-six, I got tired early, and they respected my need for sleep. 

Though we didn't have health insurance, my small-businessman husband and I had made sure that I had regular prenatal care, choosing to see a respected local mid-wife rather than a medical doctor. Part of our health care choice was based on the more natural and holistic approach that we perceived a mid-wife would bring to our birth experience; undeniably, however, part of our choice was based on the fact that the total cost of care and delivery would be about a third the cost of a traditional OB. As a cash-pay patient, this was a significant factor.

Up until that January movie night, it seemed that we had made a good choice. Our mid-wife clearly knew what she was doing, had a wonderful bedside manner and would arrange to transport me to hospital during delivery if any problems she couldn't handle arose. But that night, everything changed.

I started feeling odd about an hour after my friends departed; assuming it was a run-of-the-mill upset tummy, I tried to go to bed and not worry about it. But when I saw the blood, I realized we had a bigger problem on our hands. We immediately called our mid-wife and she directed us to meet her at the nearest hospital, about a two minute drive from our home.

When we first walked into the emergency room, the admissions clerk was solicitous, offering me a wheelchair and murmuring soothing platitudes. Then we began the check-in process.

About two minutes into that process, when she realized that we had no insurance, the admissions dragon's tune completely changed. I was twenty-four weeks pregnant; she explained that the hospital did not admit patients who were not at least twenty-six weeks pregnant. Our mid-wife showed up and pleaded with the admissions department to call her friend, the OB who ultimately ended up delivering our only child a year later. No dice. No insurance, not twenty-six weeks, do not pass "Go", do not get admitted. I was allowed to use a restroom, where I deposited yet more blood, and then I was helped up out of the wheelchair and we were sent on our way.

Our mid-wife did what she could, but without the drugs to stop labor or without a neonatal team to do a preterm delivery, there was no hope. After several hours of hard labor, our little boy, who was to have been named Joshua, was still-born.

We know firsthand now how different the outcome of such a situation can be. Our son, who is seven, was born at twenty-nine weeks a year later, after I had been on hospital bed rest for almost a month. That time, we were prepared; we had arranged (and prepaid) prenatal and delivery care with an OB who had admitting privileges at the hospital. To avoid any issues, when our doctor realized that I needed to be admitted, she wheeled me straight across the parking lot from her office to the hospital and into a room – avoiding admissions all together. Once the billing office figured out that it was just us rather than some big insurer writing the checks, it was too late for the hospital to kick me out.

Up until the night that we were refused care at the ER, I had totally taken it for granted that the United States had the best health care system in the world. Like most, I assumed that anyone needing care wouldn't be turned away from an ER, regardless of ability to pay.

When we were turned away from that emergency room that January night, we were not indigent. We were proud small-business owners, contributors to the community, college-educated, hard-working, well dressed and well-spoken. We presented ourselves at the admissions counter checkbook in hand.

This type of tragedy was not supposed to happen in our world, the world of the friendly General Practitioners who had cared for us from birth to college, the world of the medical system that had provided us miraculous cutting-edge Lasik surgery a scant few years before, while we were still covered by employer-provided health care.

Because the United States has a profit-driven health system, our first-born son was sacrificed on the altar of a balance sheet. It costs a fortune to deliver and care for a premature infant, especially one as early as twenty-four weeks. From a business perspective, I can understand the hospital's policy: the costs compared to the chances that such an early baby might not have made it anyway, multiplied by the possibility that we might sue them for something. I get it.

I get it, but I refuse to accept it. I feel certain that our society is better than that, that we've come further than use a dollars and cents cost-benefit analysis to grant or refuse access to life or death medical resources. It is my belief that no one should have to face losing a loved one or undergoing tremendous pain because they don't have health insurance. And it is my belief that changing our system from a profit-driven medical model to a universal care model would have practical benefits that match, or maybe even outweigh, the moral benefits. After all, how can a small entrepreneur - the engine of our economy - possibly function and raise a family with looming medical disaster always hanging over his or her head?

When the "personal responsibility" folks virulently hiss "let them die" in answer to the question of what to do with members of our society in need of care, but without insurance, I don't know that they are thinking of people like my husband and me. Maybe they have a rum-soaked bum in mind, rolling into the ER with liver disease. Maybe they are picturing a life-long smoker, suffering from lung cancer through no one's fault but his own. I have no idea.

The reality is that they should be picturing hard-working small business people, poorly (and expensively) insured or self-insured. They should be picturing college students. They should be picturing employees working part-time schedules, without insurance, because that's the work that they can get. They should be picturing people just like them, in all likelihood.

And they should ask themselves: how would they have felt had it been their wife, their sister, their niece turned away from the ER that January night eight years ago?