Dirty Deeds Done Dirt Cheap ("Health Care Bill")

Yeah, that's right, I said it. I am a woman who suffers from several chronic and, well, expensive disorders. In effect, my life is a preexisting condition. I am a registered Libertatrian, for whatever that may be worth to you, dear reader. I am a woman who has lived with a working socialized medicine program. Sorry Canada, but it really can be done. And I was, for a good long while, on the side of the folks attempting to pass some form of health insurance reform in this country.

Why? Because I am privileged in being a graduate student and being forced to pay high premiums for "coverage" that takes my drug bill from nearly $3000/month to just over $150/month. Of course, the fact that my monthly earnings put me a few hundred dollars over the poverty line is pertinent to that math as well. And yet I am very aware of my privilege. I have an education (and almost a PhD), I have life experience many may not ever have the chance to get, and best, I have doctos who care, listen to me, and even when I don't fully agree with their opinions, work with me to make my life livable.

And yet...

I am very aware of the people in this country who don't have these things. I am very aware of the people who die from minor illnesses we have the technology to cure or care for. And I'm aware, on the more fiscally conservative side of my brain of the actual monetary cost of caring for these people as we currently do--via emergency rooms and urgent care centers. Worse, we not only end up paying more for their care than necessary because we force them to wait for acute situations or go to Urgent Care with minor illnesses, we create the situation in which we find many people easily and even cheaply becoming addicted to prescription drugs by depending on UC centers and finding the many available ones so overloaded that they do not have time to worry about much less deal effectively with drug-seeking behavior.

Meanwhile, people with "health insurance" go to the ER with an acute case and then get a statement for "their share" of the bill. Let me tell you about how this played out in one case I am intimately familiar with: a friend went to the ER. When he received his bill, he went over it carefully; something most people don't bother doing. What he found was an inexplicable difference between his costs, the total bill, and the amount the hospital had received. He called to find out why.

As it turns out, he was told that the hospital has a contract with the insurance company through which they can write off the majority of the bill as a loss and the insurance company pays only a minor fraction. In fact, the "insurance company" paid $41. No, there are no missing zeros there. He paid well over $500. The hospital got to write off (read tax break) about $10,000.

Imagine that. I teach writing and work as a freelance editor. This is the equivalent of my charging a client $1,000 per page, but having a contract with said client that allows her to pay me only $5 per page, after which I write off the difference as a loss on my tax statement.

If I did that, I'd be in jail. The IRS would slam me down for tax fraud faster than I could write the receipt. But, then, I'm not an insurance company. If I were, apparently I could commit insurance AND tax fraud and no one would even blink twice at the act.

So, yeah. I thought health care reform was necessary. I don't, however, think the bill that was passed can, in any manner, be considered productive reform. All the new bill does is bring more people into the fraud fold--it opens the market for hospitals to make money off tax losses and insurance companies to make money off insurance fraud at a greater level.

Worse, in the name of "political progress" the party of "change" actively considered passing the bill in a "deem and pass" move which would create deniability. Why? Because they are very well aware that they are not fixing anything. Why? Because none of the Republican ideas would have fixed anything either. In fact, the process has been on the wrong path for decades and will continue to be so until we are prepared to face the real effects and real outcomes of the system we currently have.

Here's what they did instead: They gave themselves 15 minutes to vote. According to CNN, this was so that if they hit the magic number of 216, those democrats who needed deniability for their homebase, could simply not vote. We now openly admit that our system is so messed up that we have to wheedle our way into the legislation that messes it up further. I don't know if that's progress or congress.

Health insurance in this country is neither health nor insurance. Insurance is a system in which one pays into a massive fund against major losses in case of catasrophe, not a system in which people pay into a massive fund so that they can then pay a copay and have their insurance give their doctors a write off opportunity.

With the current system, not insurance, we also have "not health." Why? Because doctors get awarded (monetarily) for performing unnecessary exams (and often in that rush fail to perform necessary ones). Why? Because in order to make money, doctors must see 40-60 patients daily, meaning that they neither spend enough time to give good care, nor have enough mental capacity to pay individual attention to each patient's needs. It's simple: even a doctor's brain is not capable of that kind of multi-tasking.

"Health reform" as it has been enacted is a dirty deed. Deem and Pass (I heard Demon Pass for a while and find it far more appropriate a term), is how one does this dirt cheap. To avoid that label, take as much time to pass as is necessary for Dems facing tough races is, well, just as dirt cheap; it just looks prettier.

Make no mistake: I think the Republican party would have made a greater mess of things had they bothered to fully participate instead of just adding an amendment here and an amendment there.

So what now?

I am quite used to the fact that I will not get what I want and the system will not be fully fixed, but I am also always happy to share what I think are good suggestions. Maybe, if we start talking about this, really talking about this, we can begin.

Here's a way to start looking at things differently: How American Medicine Killed My Father may sound like a whiny "why me" kind of article, but it isn't. It's a real, economically sound, and workable plan.

Discuss.

writers

Writers are a scab-picking, zit-popping, scalp-scratching bunch who care not so much for the blood let as for the sound, the feel, the sucking away as flesh leaves itself to open a space that can only be seemingly seamless in its ease, and yet reveals the easy seams of a clean tear.

Writers dig in to the truths that are the ugliest. We write about ourselves and ourselves within others. We point the light--and even distort it for our own purposes. We bend the mind by speaking directly into the ear in ways others cannot. We change the world with little more than the electricity and force of our own selves.

And at all times, writers turn the knife inward, perform self-surgery, defend by amputation. Writers plunge their hands, elbow-deep, in the blood and let it flow over their clothes just for the pleasure of inspecting the sinew that holds the body in motion.

I failed as a writer this year because I realized fairly early on that my dream of writing a book about the year of being a mom would come at odds with my year of being a mom--in that I would have to turn the knife on me and on "my child" and on my husband, and while I could see my own blood without flinching, theirs made me cringe deeply. I must now complete the major task at hand, which requires my dissection of others' writing and lives. But then I will have to pull up my big girl panties and delve into the not-quite-a-year of not-quite-parenting. I will be honing my knife and saving up my pain meds for those around me.

Writers are a scab-picking, zit-popping, scalp-scratching bunch.

One should always pay attention to what Annie says:

In my lat post I thanked Annie for reminding me of why I do this--any of "this". In her post on her blog (link here), she had mentioned reading The Year of Magical Thinking By Joan Didion. I had been reading Fixed Ideas, Didion's brilliant explication on the matters surrounding the anti-intellectualism movement's use of 9-11-01 to keep people "not thinking" and was enjoying Didion's ability to keep the personal political and the political in personal view. I am in awe of Didion.

So, one night, at the bookstore, before my lovely honey gave me my lovely Kindle, I had nothing to read and some down-time, and went looking through the shelves. I came across Didion's "Year" and decided to pick it up. To use my teenaged daughter's terms, O-M-G! (I text such things, but actually pronounce the words when speaking.)

The Year of Magical Thinking should be required reading for everyone. The only caveat I can have in saying that is that not everyone will be ready to read it a any given age, but before one gets to the age of loss, one MUST read this book. The age of loss, I am certain, is different for all. I had a best friend in grade school who lost her mother when we were 13. Her understanding of loss began at too tender an age. I have friends who have never lost a loved one, who wander forth in a magical bubble of good health and a general sense of immortality. I envy them in some ways, but not completely.

I know those I have lost have changed my life. I also know the ways in which they died affected my life for better or worse, and I think in some cases, loss is healthy--not happy, mind you, but healthy. My grandmother had basically had enough. I am fairly certain her death was simply a matter of her feeling she was done. My uncle died after a long, drawn out illness. And yet, my loss of him was the "best" loss I've been able to experience. He gave me the gift of telling me he no longer wanted to fight the cancer. He gave me the gift of time. We had no idea of how long he would live after stopping treatment.

Elie told me on the phone that he had decided not to try the next round of experimental treatments, that he was tired, that he was through with fighting, and that he had lived a good life. I wrote him a rather long letter telling him just how much he meant to me. Reminding him of moments when he had touched my life and brought a positive light into it. Telling him in so many words how much I loved him and how much his life had impacted mine for the better. Because regardless of what, if anything, happens "after" life, I wanted him to know his impact in life had been great. I thought I was telling him how much I loved him for his sake. Boy was I wrong.

I was in London when Elie died. I received the phone call in London. I landed in Florida three hours before his funeral in New York (we Jews don't wait around to bury). I was unable to be there to talk to my aunt Judy, to share her grief and try to be of help.

But Joan Didion, and aunt Judy, made clear to me some things I would not have otherwise understood. My letter to my uncle Elie was a letter to my aunt Judy as well. My getting the chance to say goodbye was a gift to me and to Judy. I got closure, but, Judy told me, she and Elie also got a gift in knowing how their lives made mine better. "You were there before the funeral," Judy told me. That was the better thing to do.

And Joan Didion confirmed this for me. Her deep, honest, difficult grappling with grief delayed, grief doubled, helped me see that Judy and Elie benefited more from my presence before the funeral than either would have from my presence at. I do not pretend to know what a spouse goes through in cases like Joan's or Judy's. I can only know what the two have taught me. And they have taught me a great deal and taught me well.

I return, often, to the decision to send Elie a letter. It may well be one of the best decisions I have ever made. Uncle Elie told me, after I left the US Naval Academy that I was not a failure, that I would find my way, that I would become who I was meant to be, and that my purpose in life would be a great one. He believed in me more than I did. He made clear to me that there was hope. I cherish his memory and try to keep him in mind when I think I can't--because he said I can, and he meant it.

Joan Didion and Judy Cassorla are two of my heroes. I am in awe of their strength.