8 posts tagged “health care”
No, seriously, please, someone call 911 and get the cops down here to save these kids.
Oh, wait, I guess the police are already there. I suppose that means this falls under the heading of freedom to raise your children to be pinheaded assholes. 99% of the time, I believe pretty strongly in that kind of freedom, because I'm sure there were a lot of people who felt the way my family raised me was a terrible mistake. People who thought I should have had the Devil beat out of me. So, when I think about that, I'm grateful that generally speaking, parents are free to raise their children however they see fit. Every once in a while, though, something tweaks me, makes me wonder how it can be legal for children to be the absolute property of their parents. How it can be okay for children to be held captive by their parents, denied exposure to the rest of the world? Isn't that one of the reasons we developed public school--to expose all kids to a basic level of culture and civilization. Because you know these poor little bastards are home schooled and otherwise protected from the rest of life.
I try to take solace in the fact that there are some lines drawn in that parental freedom. We do seem to hesitate when parents deny basic medical to their children and instead treat lethal ailments with prayer. The family in Wisconsin who tried to pray the diabetes out of their daughter has temporarily lost custody of their other children, at least.
The worst part seems to be how often stupidity masquerades as religious freedom. If your basic negligent parent doesn't take his/her very sick kid to the doctor, we call it negligence, if your basic religiously fruity parent doesn't take his/her very sick kid to the doctor, we call it a tragedy and a matter religious freedom. So, word to the wise, if you ever screw up and your kid dies from negligence, tell the cops you were busy praying.
As for saving some children, if you'd like to, consider sending a message to your senators in support of a bill that would deny US military aid to any country that uses child soldiers. Currently, our country continues to support the military infrastructure of countries where children as young as 7 are used as soldiers.
It is a beautiful day. Sunny, high clear skies, about 65 degrees. I even have the day off, but only because today has been set aside for a series of medical torments.
First to the lab for some blood work in an effort to sort out exactly what kind of reindeer games my thyroid is playing. Five attempts and three technicians in, they'd only managed to wrest a dozen drops of blood into a little vial. This is sick, but I finally had to say, "Just get me a butterfly needle and let me do it. I know where the one vein that works is." So my insurance is paying the doctor's phlebotomist I-don't-know-how-much* to watch me stick myself.
Then on to the optometrist to have my eyes poked, prodded, dilated, and blinded with a little flash light. No changes there. I'm still mostly blind, but my strained left retina is no worse than last year.
I've got a brief respite at the moment and plan to spend it on the screen porch with the cats, but then it's on to The World's Smallest Dentist, where I'll have two more of my old dilapidated amalgam fillings replaced. Joy.
*As for not knowing how much any of this will cost me, I have to say, it's really nice to have good insurance. I won't pay much for any of these little torments, and I didn't pay anything today. At some future point I'll get a polite bill in the mail telling me what amount my insurance didn't cover. If you have insurance and have forgotten what it's like to go without, let me assure you, it's about a million times better to have this experience.
I don't think there's anything wrong with people making decisions about health care based on their religious beliefs. You have to live (or die) with the decisions you make and you ought to be allowed to consult your conscience for those decisions. Like the 14-year old Jehovah's Witness who refused a blood transfusion. He died yesterday, from a combination of leukemia and the chemotherapy being used to treat it. The blood transfusion would have saved his life in the short term and perhaps even the long term, but he stuck with his convictions to the end. Good for him. He was old enough to make that decision.
Not good for me. I'd want that blood transfusion to save my life. That's how the world ought to work. Unfortunately, the world works like this: people want you to make decisions about your health care based on their religious beliefs. Conservative Christians wanting to deny women abortions, because they happen to believe it's a sin. Catholics wanting to deny people access to birth control, because they happen to believe it's a sin. We've heard the stories by now of rape victims delivered to hospitals, where they were refused emergency birth control, because the attending physician or a nurse or a pharmacist was opposed to it on moral grounds.
Imagine your daughter has been in a terrible car accident and the ambulance has taken her to a hospital run by Jehovah's Witnesses. In the waiting room, the doctor says, "Well, yes, a blood transfusion would save her life, but we oppose blood transfusions on moral grounds. We're going to be treating her blood loss with prayer."
Imagine your son has a serious health problem and you check him into a Jewish hospital. "Yes," says the emergency room doctor. "We're going to be able to help him, but we'll have to circumcise him first."
Sounds crazy, doesn't it?
Kzinti forwarded me a piece from The New York Times about a volunteer medical organization that has brought basic third world medical care to the first world. They set up tents at fairgrounds in rural areas in America, offering free medical, dental, and vision care to people who otherwise wouldn't get care. I'm not sure if the article and the basic concept is supposed to give me a warm feeling, but it doesn't. That old saw, "charity begins at home," seems to apply here, and that's hardly heart-warming to someone like me who feels like health care shouldn't be charity. It just should be.
When I went to read the article, though, the one next to it caught my eye: Denial Makes the World Go Round. Don't it? It's an interesting read and references some books on the topic that might be worth checking out. As I read, I couldn't help but recast the health care debate in terms of denial.
According to the article, "recent studies from fields as diverse as psychology and anthropology suggest that the ability to look the other way, while potentially destructive, is also critically important to forming and nourishing close relationships. The psychological tricks that people use to ignore a festering problem in their own households are the same ones that they need to live with everyday human dishonesty and betrayal, their own and others’. And it is these highly evolved abilities, research suggests, that provide the foundation for that most disarming of all human invitations, forgiveness."
So it's a mixed bag. Denial makes it possible to get through our daily lives, but it also has the capacity to blind us to harmful problems. When it comes to politics and people in America it's a double-sided issue. Many politicians are in denial about just how bad things are for people without access to health care. They talk about fixes to the system, denying that the system is the problem. They talk about subsidies for employers and covering catastrophic illness above $50,000, all the while denying that for most of the people on the lower rungs of society--like me--a subsidy to my employer doesn't help if I lose my job and a catastrophic illness that costs me only $49,000 would break me. Glorious, glorious denial. It lets the politicians get up on their rally stages and gladhand and god-bless-America and pay a seemingly heart-felt homage to all those salt of the earth farmers and blue collar workers, who don't have health care.
On the other side, that same shimmering coating of denial lets the farmers and the blue collar workers vote for the politicians who are going to stab them in the back, repeatedly. Denial lets them ignore all the myriad ways in which politicians are sticking it to the little people, while living the high life and creating a cushy retirement for themselves in lobbying and consulting.
The article also observes that "Nowhere do people use denial skills to greater effect than with a spouse or partner....people often idealize their partners, overestimating their strengths and playing down their flaws."
Politicians are giving spouses a run for their money. Consider the fact that over 25% of polled Americans still think George Bush is doing a heckuva job. Denial makes that work. Denial makes it possible for people to gush glowingly about people like Bush and Delay and Gingrich. (Sorry, Dick, there's not enough denial to spruce you up.) A lot of poor Republicans I know tell themselves that Republican politicians are "good Christian men," and "honest," and "family-oriented," and "working to keep America safe." Do I have to go on?
Thinking in those terms, I found this bit particularly interesting: "Faced with the high odor of real perfidy, people unwilling to risk a break skew their perception of reality much more purposefully. One common way to do this is to recast clear moral breaches as foul-ups, stumbles or lapses in competence — because those are more tolerable" according to Dr. Peter H. Kim. "[People] reframe the ethical violation as a competence violation.” That's the new denial for former Bush supporters--he's not evil, he's just stupid. Or he's getting bad advice. Or he made some mistakes. (Bartcop opines that if "mistakes" put money in the pockets of your friends and family, most people will go on cheerfully making the same mistakes. That certainly seems to describe Bush's situation.)
As with an extramarital affair or a failing marriage, the denial also squeezes the topic from open conversation. To talk about it is to weaken the denial, so we don't talk about it. As someone who regularly talks about the health care situation in the US, I often have the feeling that I'm the one making uncomfortable remarks at a dinner party where other people wish I would just shut up and stop embarrassing the guest of honor.
It's too late for that. As the article observes, "It takes an outside crisis to break the denial, and no one needs a psychological study to know how that ends." That crisis is coming and it's coming on so many fronts--not just health care. People are angry about the economy, about the environment, about the war, about greed and corruption. Their denial is wearing thin.
About 75% of my actual job is pushing paperwork. It's usually a bloodless affair: travel reimbursement, honoraria for visiting lecturers, bills, payroll. Today, though, I feel like crying. I'm processing payroll termination paperwork for one of our GTA's, let's call him Bill. He's a good kid from what I've seen. Smart, according to his professors, and the first generation in his family to go to college. On Friday, he resigned, dropped out of graduate school, and went back home.
Everyone whispers in the halls, why is Bill going home? Why is he dropping out? Health reasons? Financial reasons? Academic reasons? The truth is so ugly I wish I could tell everyone, but I can't. I'll settle for telling you.
His father is very sick, perhaps not long for this world, and without health insurance. Bill's mother plugs along at her low-wage job, without benefits, and every month they fall further into debt. In the spring, Bill's father got much worse and Bill did the kind of thing you do when someone you love is in trouble. He paid for a large chunk of his father's medical bills with a credit card. Six months later, Bill has no hope of paying back that money. He knew he couldn't when he charged it, but the alternative was to do nothing to help his parents. His GTA stipend pays enough to live on and not much more. Creditors are hounding him night and day, and now his paycheck from the university is going to be garnished.
The only solution is the one I'm filing paperwork for. He's dropping out, subleasing his apartment, and going home to live with his parents and get a full-time job, in hopes of keeping his parents from losing their house to foreclosure.
Health care crisis? Who said anything about that?
My doctor said something to me on Tuesday that bothered me, but it's only this morning that I figured out why. Discussing a possible blood test that isn't considered "standard," she said, "Will your insurance cover that?" To which I replied, "I dunno."
I'm generally a well-informed consumer. I read the stuff my health insurance company sends me and try to have an understanding of what my obligations might be in the event I need to visit a doctor/emergency room/specialist. I'm well-informed, but I don't have an encyclopedic knowledge of my benefits and coverage. At first, I was a little annoyed at the doctor, but I acknowledged to myself that with all the patients she sees, there's no way for her to have a clue whether any given treatment or diagnostic test is covered by any given patient's insurance.
That's when I figured out what had bothered me about the question. What bothered me was Hillary Clinton's proposal to "solve the health insurance crisis in America." Don't mistake me--I'm not a Hillary-hater. She hasn't done anything more sleazy or overly ambitious than any male politician in America. She isn't any colder or more manipulative than the vast majority of male politicians. She is what she is--the Democratic front-runner, and at this stage of the game I'm prepared to vote for whoever wins the Democratic presidential nomination. I voted my conscience once and look where that got us. (Unless the Dalai Lama runs on the Republican ticket with Jesus as his running mate, I won't be voting Republican.)
All this moment of realization has done is made me feel even less hopeful about the future of America's middle and lower classes. Hillary's "solution" is to help more people get health insurance, but the problem isn't that people don't have health insurance. The problem is that so many people don't have reliable access to health care. It's apples and oranges, no comparison. Hillary's "solution" will only increase access to employer-funded and -controlled health insurance, and let me just say--that's no solution to the health care problem.
Why are we expected to hopscotch from insurance provider to insurance provider, switch doctors on a regular basis, read fine print to sort out what prescriptions are covered and spend half an hour on hold to find out if our insurance company will in fact cover a blood test, hospitalization, surgical procedure, or mental health treatment?
I've been lucky enough to have employer-funded and -controlled health insurance for 80% of my adult life. That's pretty good, but I have often accepted lower-paying non-profit jobs in order to achieve that. Additionally, I have played the switcheroo game at least a dozen times, with the end result that since I turned 16 and moved away from my home town, I have never seen the same physician more than a handful of times. At every turn, no matter where I lived, I've had to switch doctors with every change in my employer's insurance and every change in my employment. The 20% of my adult life that I wasn't insured is almost entirely made up of 30- and 60-day waiting periods after I changed a job. (And let's not even joke about COBRA. Please. When I moved back to Kansas, I could have gotten COBRA for 65% of my monthly income at the job I left. That joke never was funny and it certainly isn't now.)
In short, the health insurance industry has created the health care crisis in this country. The more convoluted, confusing, and costly health care has become in this country, the more money the health insurance industry has raked in--why wouldn't they want to promote a system that puts money in their share holders' pockets?
To all those folks who fear the bureaucracy of a national health care system, I have to assume you have never actually had to joust with the bureaucracy of a health insurance company.
Mariser and I were on the same wave length, thinking about this story about a twelve-year old who died for want of dental care. The story brought up two sore points for me:
1.) How can paperwork become a matter of life or death?
In my life I've spent 3 years working at Planned Parenthood (where 80%
of our clients received some kind of cut rate or public assistance), 2
years working at a domestic violence shelter (where 100% of the clients
are thereby indigent and in need of public assistance), and 2 years
working at a church with a homeless assistance program (again 100% of
the clients were receiving or needed public assistance.)
In
those 7 years, the thing I saw over and over was a massive failure of
the system caused by something as simple as paperwork. For some odd
reason the bureaucracy behind public assistance throughout this great
nation cannot grasp that homeless people, and low-income people without
a permanent residence, have difficulty receiving mail. That something
so obvious has stymied the government is frustrating, especially when
you read that the dead boy's mother suspects he lost his Medicaid
coverage, because the proper paperwork didn't reach her in time to
prevent the cancellation.
On so many occasions, I've seen people in similar and occasionally in similarly dire situations, because they lacked a permanent address. In one case, a brother and sister (both somewhat mentally delayed, both eligible for Medicaid and Social Security) had been living with a relative in Tennesee, but that relative started dating a guy who was a drug dealer. The brother and sister moved out to a homeless shelter. Then a cousin invited them to come live with him in Florida. Then he got tired of having them there and kicked them out. In the midst of all that chaos, they both fell out of the Medicaid system, and the brother was no longer receiving treatment for his diabetes. By the time they reached the church where I worked, their Medicaid paperwork was in a snarl of interstate confusion that took weeks to sort out. In the meantime, the brother had developed a foot infection that ultimately ended in amputation. All because of some paperwork.
My question is, hasn't
technology advanced enough to help solve this floating paperwork game?
Couldn't we make it possible for people to access and maintain their
Medicaid paperwork online? Rather than waiting weeks and weeks for the
right documents to spool through mail forwarding, couldn't we make it
possible for people to access and print out the paperwork they need to
get treatment? Is the technology gap in America too wide? Or are we
unwilling to acknowledge that homelessness means not having a fixed
address, and thereby unwilling to create a system that works regardless
of one's residence?
2.) Why isn't dental care considered part of health care?
Why do I have to have two kinds of insurance--dental and health? The
case of Deamonte Driver is a perfect example of how dental health and
whole body health are intertwined and interdependent. Having a tooth
infection isn't just a dental problem. It can kill you. After all
these years, why haven't we integrated the two professions to provide
comprehensive health coverage? I've seen 25-year old men and women
with no teeth, because after a lifetime without dental care, the only
solution was complete extraction. These were not meth users or junk
addicts. They were just low-income day laborers with no access to
dental coverage. In some cases, they were young women who'd had too
many children and lost bone mass in their jawbones. Public assistance
was willing to provide pre-natal care for them, but no dental care.
**Flaming Liberal Alert** It may be easy to dismiss a lot of this as people needing to pull themselves up by their bootstraps, or get better jobs with insurance, or whatever. I've said it before and I'll say it again: Everyone deserves healthcare, not everyone is capable of doing the kind of work that comes with health insurance, and we all do better, when we all do better.
Mariser and I were on the same wave length, thinking about this story about a twelve-year old who died for want of dental care. The story brought up two sore points for me:
1.) How can paperwork become a matter of life or death? In my life I've spent 3 years working at Planned Parenthood (where 80% of our clients received some kind of cut rate or public assistance), 2 years working at a domestic violence shelter (where 100% of the clients are thereby indigent and in need of public assistance), and 2 years working at a church with a homeless assistance program (again 100% of the clients were receiving or needed public assistance.)
In those 7 years, the thing I saw over and over was a massive failure of the system caused by something as simple as paperwork. For some odd reason the bureaucracy behind public assistance throughout this great nation cannot grasp that homeless people, and low-income people without a permanent residence, have difficulty receiving mail. That something so obvious has stymied the government is frustrating, especially when you read that the dead boy's mother suspects he lost his Medicaid coverage, because the proper paperwork didn't reach her in time to prevent the cancellation.
On so many occasions, I've seen people in similar and occasionally in similarly dire situations, because they lacked a permanent address. In one case, a brother and sister (both somewhat mentally delayed, both eligible for Medicaid and Social Security) had been living with a relative in Tennesee, but that relative started dating a guy who was a drug dealer. The brother and sister moved out to a homeless shelter. Then a cousin invited them to come live with him in Florida. Then he got tired of having them there and kicked them out. In the midst of all that chaos, they both fell out of the Medicaid system, and the brother was no longer receiving treatment for his diabetes. By the time they reached the church where I worked, their Medicaid paperwork was in a snarl of interstate confusion that took weeks to sort out. In the meantime, the brother had developed a foot infection that ultimately ended in amputation. All because of some paperwork.
My question is, hasn't technology advanced enough to help solve this floating paperwork game? Couldn't we make it possible for people to access and maintain their Medicaid paperwork online? Rather than waiting weeks and weeks for the right documents to spool through mail forwarding, couldn't we make it possible for people to access and print out the paperwork they need to get treatment? Is the technology gap in America too wide? Or are we unwilling to acknowledge that homelessness means not having a fixed address, and thereby unwilling to create a system that works regardless of one's residence?
2.) Why isn't dental care considered part of health care? Why do I have to have two kinds of insurance--dental and health? The case of Deamonte Driver is a perfect example of how dental health and whole body health are intertwined and interdependent. Having a tooth infection isn't just a dental problem. It can kill you. After all these years, why haven't we integrated the two professions to provide comprehensive health coverage? I've seen 25-year old men and women with no teeth, because after a lifetime without dental care, the only solution was complete extraction. These were not meth users or junk addicts. They were just low-income day laborers with no access to dental coverage. In some cases, they were young women who'd had too many children and lost bone mass in their jawbones. Public assistance was willing to provide pre-natal care for them, but no dental care.
**Flaming Liberal Alert** It may be easy to dismiss a lot of this as people needing to pull themselves up by their bootstraps, or get better jobs with insurance, or whatever. I've said it before and I'll say it again: Everyone deserves healthcare, not everyone is capable of doing the kind of work that comes with health insurance, and we all do better, when we all do better.
