Health Care Reform - Exclusions and Compromise

To begin, I don't know all of the details of the current bill. As we're waiting on the House vote, two things seem clear: We're not getting anything close to what, "We the People," need, and the politicization of our identities/bodies, marches on.

The Stupak amendment seems to have passed. This seems to prevent any insurer from covering abortion services.
There is also, (not sure of amendment name,) exclusionary language for services provided to transgendered people.

I feel incredibly naive tonight.

You see, as far as I'm concerned: Abortion is a legitimate medical procedure and a decision that ought be made between doctor and patient. Refusing to cover it amounts to nothing less than reinforcing the notion that women are incapable of being autonomous citizens. Thank you, Congress, for once again reducing my value to that of my uterus.

(Note: The House Bill has just passed. It is completely meaningless.)

The fact that transgendered people are excluded, not just the transition-services, but ultimately, completely excluded as a class, troubles me deeply.

We have, I believe a public option that has a trigger. What's the point? Without a public option providing direct competition to insurers, they have no incentive to change.
We've won nothing except a tick in the win column. We beat the fuckers, now what?

This bill isn't going to help most of us who need it. As a friend just told me, "We only got the door slivered open."
Yes. The trick is to keep our collective foot jammed in that sliver of open door and keep pushing it open.
Fast.
The only real, rational, effective reform possible, is adopting a completely new model. Build on what's been done in France and Germany, perhaps?
We need the safety net of an NHS, but a form of private co-insurance would be fine as well. I don't have a problem with keeping private options available for those who want and can afford them. However, being an ethical human being tells me that access to healthcare is a basic human right.
It's part of what living in a society requires of us.
We are interdependent, we must grant each other at least a minimum opportunity of health and education.
This seems so utterly simple to me. I cannot understand why it is such an anathema to others.
I really can't.
So tonight, while others celebrate the victory, I mourn a missed opportunity. For real reform, for taking our bodies and identities off the table in politics, for meaningful change in Washington. The saddest thing of all, is that it's been four months of political skirmishing, and now there's a win and even the win is meaningless. This bill is not likely to pass the Senate. The health insurance industry is spending 1.4 million dollars a day to ensure it won't.

Happiness, pain, health care, buying local and RAK's

I confess: I'm mercurial and high-strung. Yet...I'm mostly happy. With who I am, with what I do, with the mark I'm making on the world, (however small, it's mine, it's authentic and it's not evil,) I'm basically happy. There are a lot of things I want to do, see, be, experience, share. There are people I've yet to meet, love, argue with, learn from, teach. My mundane life consists of a fair amount of frustration, which I accept because it's the nature of changing the world, and I'm committed. Maybe I should be committed, I don't know. I can't give up on humanity or making things better. I'm a fixer.

Anyway...

A number of my online and real life circle of friends have been experiencing either the onset of or continuation of various illnesses. My mother, who drives me crazy and rocks my world, has chronic illnesses and pain. Epic pain. Pain that makes my chronic pain look like a stubbed toe.

Oh, yeah. I have chronic and intermittent pain.
1. TMJ / Trigeminal Neuralgia: since I was 9. TemproMandibularJoint pain, that intermittently gives me earaches, headaches, face pain, and has been known to lock my jaw both open and shut at about a half-inch width. Mom has it, too. The TMJ is caused or exacerbated by a severe malocclusion. I'm not having someone break my jaw, move it, and wire it shut. Not unless I can get way better insurance and find someone to pay my bills for 2 months.  The neuralgia is... who knows? It makes my entire head and face and neck hurt to the point where I'd go for decapitation if it were an option.
2. Arthritis: Due to injury and hereditary. I've broken the same foot 3 times. It has an S-curve to the left. Shoe buying is a form of torture. My joints from the waist down and my hands are affected. It's mostly like a toothache unless the barometric pressure gets really wacky. I can feel the bones in my foot grinding, then.
3. Sciatic nerve / Scoliosis : I have a slight S-curve in my spine, too. One leg is longer than the other, one hip higher. This is also hereditary. The sciatic nerve...that's the torment from hell. Imagine fire shooting down your leg from your buttock, imagine white-hot ice picks stabbed into your joints, imagine not being able to move a certain way because it will cause you to scream. Magnify it by 5.
5. Migraine: Auras, nausea, blurred vision, light / sound sensitivity and pain that makes me vomit. It's hormonal, mostly. I manage it with ice, darkness, and preemptive excedrine.

I'm not particularly athletic, no. I love dancing, I'm lazy about my yoga and pilates. I'm not disabled. I'm used to it. It's background noise, mostly. The little aches and pains that occasionally become roaring dragons consuming me. Those are the days I take painkillers and a mental health day. Every once in a while I need to use a cane.

I'm 36 years old. Yeah, sometimes it fucking sucks.

But...

I'm still pretty happy. Unlike my mom and other people, my pain isn't jacked up to 11 all day, every day. I can mostly get by with OTC meds. I'm grateful for the rare totally pain-free days, and I'm used to the dull, nagging aches. I wear flip-flops, sneakers and boots. I can track my migraine patterns, I keep my ears covered in the winter to minimize the chances of setting off either the TMJ or Neuralgia, (stimulating nerves and muscles into overdrive is a no-no.)
Every once in a while I talk someone into giving me a massage to work the kinks out. The yoga and pilates help, too.
Since the stupid sciatic nerve kicked up today, I thought I'd share once. I appreciate good thoughts, but I'm so used to it that it it's usually no big deal to me.  I'm not sharing this to gain sympathy, pity or anything else.
It's how my life is.
I'm sharing this, because there are a lot of people dealing with a lot worse and someone needs to speak up. Most people dealing with chronic illness and pain end up being kind of invisible. Doctors can't fix it, so they stop trying to make it better in palliative ways. The government closes down options for palliative care or terrifies doctors to the point where they don't use the options they have for fear the DEA will come knocking.
Not to mention, there are an awful lot of people who can't get care at all. They don't have insurance and with pre-existing conditions, can't get it.
And there are people who don't understand why we need Health Care reform.

 Yeah. It's like that.

Since this is more of a kitchen-sink, stream-of-consciousness-with-a-point post, I'll move on to the next subject.
On the long-ass list of Things That Piss Me Off: Factory farms, agribusiness and the corporate welfare given to such. I went to a Lions-sponsored Farmer's Market at a local high school today with my mom.
Pennsylvania has a program that gives every resident 60+ $20 in vouchers to spend at farmer's markets. I wish they did it for everyone, or maybe expanded it based on income. It would benefit our family farms and help poor people afford more nutritious food. There are a lot of communities without full-service grocery stores, mostly poor ones. There are a lot of people who have to choose between foods they can stretch, and produce. Good nutrition shouldn't be class-oriented. Neither should health-care. (See, I told you I had a point.)
A lot of farmers can't afford health insurance for their families. They end up on SCHIP, or if they're lucky, Medicaid. Eligibility is based on gross, not net income. It kinda fucks a lot of people. You try living on 30k a year in a family of four. It's poverty. Really. If your gross, as a farmer, is $100k a year, but you only net $30k and eligibility is based on the $100k... yeah. I used to have to tell people they weren't eligible.
It sucks big time.

We had such a good time at the market. These are good, hardworking people, trying to earn a living. There were a lot of teenagers. One was a kid, maybe 16. He'd been up working since 6 am, hadn't eaten yet. Looked a little woozy, to be honest. His (I think) sister was working with him and talking about food. My mum, who can't avoid junk food to save her life, went to the baked goods stand and bought some stuff. I'd taken some of our purchases to the car; when I came back, she had this look on her face. After warning me to never leave her alone with baked goods and telling me what she bought, she said, "He looked so hungry."
She looked at me, "Do you think it would be weird if I took him something to eat?" I laughed and told her she was, "Such a mom," and then,  "Go ahead." I walked over with her, and she offered the gob to him, he had a stunned look on his face. As if the idea of someone thinking of a stranger, of doing something kind and thoughtful, without any expectation, was alien. The smile that lit up his face when my mom nodded and stretched her hand further out to give it to him, was beatific.

Those are the moments you can't plan for. When something so simple make so many things clear.

There is hope for humanity. We can care for each other, we can be kind to each other, we can help each other. We can share.
My mom, with her paper sack of pastry and her cane, struggling through the farmer's market to make sure a kid had something in his stomach. Is a snapshot of what humanity can be.

So, yeah: I'm pretty happy.

Health Care Reform and the Politics of Fear, part deux

I repeat: If anyone has questions about Health Care and why a Public Option (weak)/NHS or hybrid Model, (i.e., France,) is better...Let me know. I worked in Health Insurance, specifically a Medicaid/Medicare/SCHIP HMO for 8+ yrs. I know what I'm talking about. I had a license to sell insurance, which is way more complicated than you think and I passed the test on the first try. I'm not stupid. Seriously. 


Medicare is socialized medicine. So is Medicaid. Medicare, for seniors, is administered in an efficient and humane fashion. Medicaid is for bums, (or so the right-wing would have us believe,) sucking at the government teat and wasting our tax dollars. 


Bullshit. 
No, Bullshit. Really. 


If Medicaid were administered efficiently, sick people would get the care they need, there would be no stigma attached to it and hey, people who need temporary help might get back to being productive citizens. 
That's just crazy talk, in this country. 


What nearly all the republican, (and some of the democrats,) in congress don't want you to know :The health insurance, for-profit treatment and pharmaceutical industries rank up there with Big Oil, Coal, Agribusiness and Military Contractors when it comes to who has them on a short leash. Campaign contributions...Money *is* speech, according to capitol hill. Riiiiggghhhtt. 
Pull the other leg, it's got bells on it.


You say that NHS/Universal Health Care/Single-payer will DOOM the free market in this country?


Really? Last I checked, you take what health insurance you're offered if you're lucky enough to have an employer offering it and you can afford to pay for it. How is that a free market from the consumer's perspective? Oh, it's not supposed to be free for the consumer... Never mind. 


You say that NHS/UHC/SP will put an undue burden on employers to offer more direct compensation?
Really? How about this: If I'm not spending 30% of my income keeping my ass covered by crappy insurance just in case something really, really bad happens to me, my kid, my partner... I might actually feel better about my salary and I might be spending money on other stuff. Hey, that could help the economy, couldn't it?


I could, (and at some point, probably will,) go on and on and on...
Hopefully, you're starting to get the picture. 
Ask me questions, I'll answer them in a blog. Really. 

Health Care reform and the politics of fear

I spent more than 8 years working in the Health Insurance industry. Ask me anything, I'll tell you the truth. 1997, the year when privatized Medicaid came into vogue. States were hemmoraghing red ink from their budgets. HMO's seemed like a reasonable alternative. It worked for the general public, after all. When I started working for Company X, I was young, broke, stupid and the head of a household that was barely holding on. We'd just barely managed to keep the house after my grandmother died. $7.50 an hour, plus commission seemed like a good deal. It was, actually. I doubled the value of my annual wages inside of 10 months. I also felt like I was serving a purpose. I was helping people. In the beginning, the benefits were actually far better than what Medicaid offered. A win-win scenario: Save the state money and help people.

Over the course of the next 8 years, it became more about maximizing profits and less about serving either of our clients. Irony of ironies, my health insurance was worse than the plan's members. Eventually, Company X had contracts in 3 states, about 500k members and was making 20 million dollars a quarter as a privately held company.

I was making 36k a year, and I was miserable.

Here's why:

1. If you're on Medicaid, chances are you're either desperately poor or you have a debilitating health condition. (There are a lot of nuns on Medicaid, btw. Seems that priests get taken care of by the diocese and nuns are left to fend for themselves.) We're talking about people who are mostly in vulnerable economic strata and often don't know how to advocate for themselves. Add profound illness on top of that and you've got a member pool already hanging by a thread.

2. Doctors. Yes we've all got to wait too long and finding the right doctor is a pain, but if a doctor provides services, they deserve to be paid in a timely fashion, without dispute. This does not happen with HMO's.

3. Red tape. Covered physicians, referrals, out of network authorizations, authorizations for procedures, drug formularies, brand-name authorizations, non-formulary letters of medical necessity...(I could go on, but it's endless.) Providers spend more time dealing with beauracracy than patients. Tell me that's not compromising patient care. Ha.

4. Routine denial of care. Everything that's not a covered service or routine diagnostic test is denied pro forma. So are non-formulary drugs. Period. In the hopes that either your provider will do something that is covered or that you'll be too sick, too helpless or too stupid to fight.

5. HMO's make money based on the number of members they have. Each member = x number of dollars per month whether you get services or not. The fewer services you have, the more of that money goes towards bulking up the profit margin.

All of the things the right-wing chorus of, "No," is saying will happen with a Govt-run plan are exactly what's happening every day in this country. Only, we're paying for it and we can't even afford to use it. Health care is a basic human right and it contributes to the public good. It's also economically smart. A national health care system would force commercial plans to become more competitive and actually provide what their members pay for. It would relieve the pressure small business owners are bearing the brunt of and we'd have a healthier populace.

Does anyone have any questions?