America's Health Care Crisis

Cross Posted to Clintonistas for Obama

Instead of being ignored, one of my pet issues has become a proverbial Third Rail of this election cycle. It has become one of a small core of issues that candidates will live or die by. However, to many of the candidates, this issue will only be important in the abstract. For myself, and millions of uninsured and under-insured Americans, this issue is not abstract ... it's an unfortunate part of life. For many of us, affordable health care is just out of reach.

Let me preface by saying I work as a Contractor for one of the largest Technical Staffing firms in the continental US. As an employee, I am offered medical coverage, which would be best characterized as ineffective. In short, the plan covers office visits at a decent co-pay . . . but that’s about it.

I’m not used to this low level of coverage. Having been in the IT field for the past decade, I’ve been accustomed to having a compensation package that includes a decent medical plan. I’m not used to having to pay retail for prescriptions. It’s a rather humbling experience when you work 40 hours per week at what most would consider a good wage, and still cannot afford your medicines. And while I’ve got a good job, having a long-term chronic condition has really opened my eyes to how the uninsured live.

It makes me wonder how we, as Americans, can allow so many of our fellow citizens to live in these deplorable conditions. We, as a society, allow our elderly to go without care due to the cost. We, as one of the richest economies, watch our children grow up without the preventive care that they so desperately need. And yet our elected representatives choose to debate rather than act. This is an issue that transcends partisanship, ethnic background, economic status, truly all the concepts we use to call each other different. This issue hits at the core of what makes us all the same … we are ALL part of this rock we call Earth, and blessed enough to be part of the idea that is America.

I’ve always mulled about this issue, but have not been very outspoken. That changed the other night when I went to karaoke at a venue here in Sacramento. I spent a few minutes talking to Alice, one of the best bartenders in the city, about this issue. She spoke of the cost of her health care, and how it’s almost too expensive for her to afford. She also lamented that her out-of-pocket costs would increase later this year as she turns 50.

She floated an idea to me that I found amazingly simple, and yet a way we can begin to effect change. I’d like to float that idea here, and hear feedback from everyone as to their impressions.

Alice’s idea was simple – to mandate that Doctors of all stripes be required to give 2-3 days per year to treating the masses. Her concept is to have health fairs in communities large and small where these doctors give away their services. As long as a financial need is demonstrated, no-one would be turned away due to the inability to pay. This would take some of the strain off the public health clinics and the Emergency Rooms, which are grossly overtaxed. This would help insure that everyone has access to quality health care at a potentially lower cost to the taxpayer. And this would ensure that we are keeping our promise to our children to give them better than we got.

Her idea is an idea of first impression, as she saw a documentary about Doctors Without Borders and thought it would be an idea that would help Americans with the health care crisis. I agree with her that it would at least help improve the situation, even if in a small way.

If nothing else, however, we need to raise the level of public debate on this issue. We need to find creative solutions coming from government, NGO’s, CBO’s and FBO’s alike to better serve the needs of our entire population. And we need to impress on our legislatures, both state and federal, that this is an issue that needs to get pulled out of the muck. We need to shed our partisan blinders and take up a truly inclusive stance. We need to come together to solve one of the toughest social issues of our day.

Just my 2 Cents – comments and suggestions welcome!

Dizzy

Honey

(cross-posted at Clintonistas for Obama and MyDD)

That's what I call my paternal grandmother. Before I was born, my grandparents each chose what they wanted me to call them. My dad's mom picked "Honey" because she said she'd never been called anything sweet before. That wasn't strictly true, but she did have a difficult upbringing and an overbearing husband. She grew up as "poor white trash," and why my grandfather married her, I'll never know. Honey taught me a lot of things, as a kid and as an adult, but I don't know that any of the lessons were good.

Sheltered though I was, I learned about sexism when I was a child, and my first experience with it was probably the most hurtful - though not the most damaging in terms of academic or professional advancement - because it was the most personal. When I was a young girl, I slowly began noticing that my paternal grandparents treated me rather differently than they treated my brother. He was cooed over and treasured in a way I hadn't been, he was given attention and praise in a way I wasn't. The differences seemed stark. At first, I couldn't figure out why it should be so - why would I be treated differently when I was so pretty, so intelligent, far kinder, and more polite? What had I done wrong? Hurt and uncomprehending, I finally thought to ask my mother, who I could always trust to answer my naïve, innocent questions in the same way: Truthfully. Gently but bluntly, she explained that my father's parents were children of the Depression and had been raised with an old Southern mentality that men were more valuable. My brother was more cherished, more loved, and more important in the eyes of my grandparents because he was the male heir, and because he would carry on the family name, whereas I, as a woman, would lose it when I married (in the old South, marriage was a question of when, not if). This was a difficult truth for a young overachiever to understand because it was something which had to be accepted rather than overcome; no amount of success on my part would ever make me equal.

My paternal grandfather died in 2002, and my recently divorced aunt moved back in with her mother. In August of last year, she remarried, and my grandmother became extremely ill around the same time. We had two options: send her to a nursing home, or find someone who would be willing to care for her. The choice was clear to everyone except me; they were willing to send her to a home, whereas I couldn't bear the thought of locking her away - she was family, after all, even if I didn't know her very well. I decided to put my education on hold for a year so that I could move in with her and care for her. For nearly nine exhausting, miserable months, I essentially ran a nursing home.

I discovered that Honey was a petty person, and very possibly the most selfish woman I've ever known. Her daughter - my aunt - suffers from a serious mental illness, and she didn't marry for the first time until she had entered her mid-30s. In the meantime, she filled her loneliness with cats. When I was a young girl, she had three: Emerson, Tiger, and Marie, and they were like her children. For years, when that lonely, troubled woman went home at night, they were all she had, and I recall how deeply she loved them.

My grandmother doesn't like cats, though. My aunt had very little money, so she had to use a cheap litter which didn't clump, meaning that the litter quickly became soaked in urine and stank of ammonia. My grandmother was fastidiously clean, and she hated smelling the litterbox when she visited her daughter's house. So Honey enlisted a couple of family friends to go over to her daughter's house one day while she was at work, break a window, and steal the cats. Then they put the cats in the car, drove out deep into the country, and dropped them. The cats were domesticated and de-clawed; there's little doubt in my mind that they either starved to death within days, or were eaten by larger animals.

My aunt went to the animal shelter every day for weeks upon weeks, and then every weekend for over six months, hoping and praying that her children would be there. She still doesn't know that her mother killed them.

Within two weeks of moving in with my grandmother, she had her first heart attack, and I had to rush her to the hospital. Shocked and trembling, I stood outside the cath lab and realized how woefully unprepared I was to take care of a dying woman. Determined to do it right, I learned quickly and thoroughly. I fed her, I cleaned her, I kept up with dozens of medications, more than a dozen doctors, scores of doctor's appointments, and 14 hospitalizations. I learned the ins and outs of each of her conditions and medications. I scrubbed every bodily fluid and every form of waste out of carpets, sheets, and clothing. I was half secretary, half nurse - making notes, taking messages, scheduling, canceling, and rescheduling appointments, typing up and revising lists for myself, lists for my family, lists for the doctors. I was at the pharmacy nearly every day. I spent many nights in the ER with her, sometimes until after 4 AM; I spent even more nights sleeping in a chair beside her hospital bed. I spent days and days - and on one occasion a full week - sleeping in the chair by her bed at her house, either because she'd been experiencing strange symptoms that might have meant an impending heart attack, or because she'd recently had surgery and couldn't walk to the bathroom without me.

Honey was noncompliant, petulant, and occasionally cruel. If I glanced away for even a second, she would try to hide or throw her medicine. She cursed at me and fought me whenever we had an appointment (usually several times a week), and even hit me a couple of times. She expressed her displeasure at anything anyone cooked for her. I hooked up baby monitors so that she could yell and wake me if she fell, and she used them to call me constantly, day and night. By the end, she was hollering at me two or three times a night, disrupting my sleep cycle simply because she wanted me to tuck her back in (after she'd crept to the bathroom) or needed a cup of coffee or a glass of juice. She made everything as difficult as humanly possible.

If caring for her wasn't bad enough, dealing with her bigotry - and that of her sister - made everything seem so much worse. She was a hateful racist and a bitter sexist - "self-loathing" doesn't even begin to describe it. I can't count the number of times I had to hear her call Hillary "that hideous bitch" and Obama "that goddamn nigger". I endured months of listening dispiritedly to my grandmother and her sister (who was even more caustic, in part because she was brain damaged from a stroke she had in '03) talk about how Jews lie and steal, and how Obama is a Muslim and a "high yeller", and how Hillary is a lesbian who only had Chelsea because Bill raped her. Nearly nine months of cringing and gritting my teeth and squeezing my eyes tightly shut to prevent myself from screaming and cursing at a dying woman and her crazy old sister. Morning after morning, sitting in the corner of my shower with my head in my hands, trying to wash away the anger, depression, frustration, and disgust. Part of me hated her, part of me pitied her.

Part of me loved her, too, but probably only because I felt like I had to. It's funny the way some Southerners think - especially old ones. A lot of them are very sexist, even the women. In the first month of caring for Honey, I noticed that she never expressed any genuine gratitude. I hadn't taken on this assignment because I wanted to be thanked, but it stuck me as strange that she didn't seem to appreciate anything I did for her. For awhile, I thought she just didn't like me. She certainly didn't seem to love me the way she loved my brother, but I already knew that; what surprised me was that she didn't seem to love my aunt as much as she loved my father. I finally said to her, "I'm sorry, but you're going to have to do a better job of working with me. I know you'd rather have your son or your grandson taking care of you, but there's nothing I can do about that." All she said in response was:

"No, no, they shouldn't have to. Boys have more important things to do."

Something about that response was incredibly... crushing. My grandmother's opinion is of little significance to me, but the realization that such a mentality is still alive (though perhaps not well) was very upsetting. That was why she didn't appreciate me, and that also explained why she was always so resentful of my aunt. You see, my aunt had remarried when her mother was ill, and that isn't what she "should" have done. A proper daughter would have quit her job and put off her marriage - she would have taken care of her mother. My aunt neglected her responsibility. I didn't do anything special; all I did was step up where my aunt failed. My dreams were unimportant, and my sacrifices were not only unappreciated, but also unacknowledged. I had given up spending time with my friends and family, and I'd dropped out of school for a year. I had put my entire life on hold, and Honey saw nothing unusual about it. It was what I was supposed to do as a woman because all the men were too busy. They had more important things to do.

Around May 15th, one of my doctors finally told me that I had to stop caring for my grandmother. I had largely quit eating, and my sleep was so disturbed that it was doing me little good; I was walking around in a perpetual state of exhaustion, and I was undeniably depressed. The rest of my family had been begging me to send Honey to a home for months because they'd seen what it was doing to me, but I had been too stubborn. My sense of duty outweighed my common sense. But I trust this particular doctor. If he said it had to end, then it had to end.

I know this diary isn't political, but I've been thinking about my grandmother even more than usual today. I was out of town for awhile yesterday, and when I returned home, I received news from my aunt that hospice was being called to the nursing home, and that the doctor had given Honey "a short while" to live. We aren't sure whether that means a couple of weeks or a couple of months, but the doctor said it wouldn't be long. They're going to keep her comfortable. I'm still not sure how I feel about it. In a lot of ways, I know my grandmother is a terrible person; on the other hand, I can't imagine what it must be like to believe for all your life that you're inherently less valuable than others. Just as I know in my heart that I can be any man's equal, she knew in hers that she was inferior to her husband, her brothers, and her male coworkers. She was raised in an environment of intolerance and lived her life in the shadow of sexism, which she ultimately embraced rather than railed against. Her own sense of inferiority fueled her bigotry. She wanted someone to be beneath her because she felt so low - so African Americans, Jews, and other women became the targets of her frustration and bitterness.

I have to wonder, what sort of life was that, and who would choose to live it?

Bob Dylan - Masters of War

Bob Dylan, Blowin' in the Wind (Live Newport Folk Festival)

How can I resist this one? This is another song for my funeral.

Bob Dylan - The Times They Are A-Changing

My family has strict instructions to play this at my funeral 40 years from now. Sometimes I play this on a continuous loop, as if the song itself will makes the times change.

I Ain't Marching Anymore by Phil Ochs

"Love Me Love Me I'm A Liberal"

This is what great offensive, tasteless. satirical political protest sounds like. Reincarnate Phil Ochs. I wish it included pictures of Obama as well as Clinton.

Uproar and Trolls

Cross-posted at MyDD

Apparently the term "troll" originated in the 16th century to describe political debate and insult in London coffee houses. The term is thrown about too loosely. When I was active in bipolar listservs in the mid-1990s, a troll was a despicable person who joined the group pretending to be bipolar. He often set people against each other, preyed on the vulnerabilities of achingly vulnerable people, pretended to be in crisis, etc. We all knew what the word meant. Who knows what it means in political debate? In my first weeks on mybarackobama, I was accused of being a troll daily. Anyone capable of rational debate is not a troll. We all get intellectually lazy about explaining our principles and policies. It does us good to be challenged.

Parents learn to ignore obnoxious toddler or preschool behavior rather than to make a big fuss about it. Why don't you ignore the people that you consider trolls, don't bother rating their diaries and comments, don't comment on their diaries nor respond to their comments, don't impose timeouts. Concentrate on writing your own diaries and blog posts.

When my oldest daughter was 1 and 2, she pulled hair and dumped sand on people's heads. I finally realized that she wasn't inherently vicious; she just adored uproar. Her criminal behavior only occurred in the presence of parents absolutely guaranteed to go round the twist. She stopped eating sand when her pediatrician looked her in the eyes and told her how important it was to eat enough sand daily to stay healthy.

Real trolls love uproar. If you enjoy the insult game, you can't complain about your comrades in insult being trolls because you obviously relish uproar as well.

Here is what the devil child is doing now. She no longer eats sand, although she has spent a suspiciously long time in African deserts unobserved by me.

There might be hope for trolls and the troll accusers. When I was in high school and college debate, we addressed our most cutting remarks to "the honorable gentleman or lady of the affirmative (or negative) team." Listen to how Senators do it. Mixing courtesy with invective is more effective.