Cure This - health insurance

best website ever. unicorns and rainbows.

los anjalis — Mon, 29 Mar 2010 20:03:25 GMT

Say no more: http://didtheypasshealthcarereform.com/

Sure it's perhaps a bit too elated, but the website energy and design (and the fact that it went live almost immediately after the health insurance reform bill was signed by President Obama) get a big YAY.

Plus, here at Cure This, we like unicorns.

calling for civil discussion among progressives

los anjalis — Mon, 28 Dec 2009 16:00:00 GMT

This week has seen intense discussion among progressives over whether to support and fix the health insurance reform bill or whether to kill it. Such debate began after the Senate version of the health insurance reform bill was stripped of its hugely popular "public option" and then further stripped of a possible "Medicare buy-in" by Senators who essentially held the US Senate hostage.

This debate has been important, and it is healthy for progressives to have differing opinions on a piece of legislation, but recently there has been some disappointing yelling across the aisles and name-calling. On both sides.

[Of note, there are some folks who from the start have called everything "less" than single-payer (100% government-funded and privately/publicly delivered healthcare) a compromise and vowed not to support anything but single-payer. Those folks have a right to their opinion but I'm not referring to them, they haven't been fighting together with other progressives for improving this bill all along. I'm talking about progressives who have tried to make this process workable from what was put on the table.]

(more after the jump...)
I'm referring to the progressives who are being called out now for wanting to kill the bill -- the same progressives who have been tirelessly fighting to support this bill and gaining support for key provisions in the bill this whole time. It seems unfair to taunt them and call them crazies because of their frustration and feeling that this bill has been compromised too much.

Emotions are high, no doubt about that. The key message here is this -- at this crucial time, it's important to reflect on what we can build together, and healthy differences are ok. Those who support the bill are not sellouts and Obama-forgivers, as there are very real life-saving benefits to millions of Americans in this bill. And those who are frustrated enough to want to start from scratch have very real and understandable concerns about the bill. We must keep the communication open and consciously work to move the unproductive criticism and hate off the table.

With that said, please check out the video from GRITtv about this issue, featuring Miriam Yeung of Women of Color United for Health Care, the always wonderful Chris Hayes of The Nation, and Lizz Winstead, host and producer of Shoot the Messenger. It's a productive discussion about the bill, the future, and what progressives have done and can do.

Feel free to share your thoughts on this issue too, in the comments section on in a new post of your own.

cooperation with evil

los anjalis — Sat, 26 Dec 2009 05:36:29 GMT

This is very interesting, this concept of cooperation with evil. Now, I don't know much about the Catholic Church, I'll admit. But it seems, in the Catholic faith, there seems to be an OK cooperation with evil and a not-so-OK cooperation.

The New York Times has a piece out today -- Christmas Day -- that sheds some light on cooperation with evil in the context of the abortion debate and the health insurance reform bill that just passed the Senate yesterday.

The Senate bill, approved Thursday morning, allows any state to bar the use of federal subsidies for insurance plans that cover abortion and requires insurers in other states to divide subsidy money into separate accounts so that only dollars from private premiums would be used to pay for abortions.
Just days before the bill passed, the Catholic Health Association, which represents hundreds of Catholic hospitals across the country, said in a statement that it was "encouraged" and "increasingly confident" that such a compromise "can achieve the objective of no federal funding for abortion." An umbrella group for nuns followed its lead.
The same day, the United States Conference of Catholic Bishops called the proposed compromise "morally unacceptable."

(more after the jump...)
So, it seems the Catholic Hospital Association is possibly following an OK cooperation with evil by supporting the health insurance reform bill as it stands in regards to abortion, in order to bring great good for Americans through the greater availability of health insurance for all healthcare. So, it's morally OK to the Catholic Hospital Association to support a bill that has less of a hardline abortion stance, if in the end the bill is going to improve the greater good of Americans.

Professor Cathleen Kaveny of the Notre Dame University Law School said the CHA's decision could (as paraphrased and quoted in the NYTimes):

permit support for "imperfect legislation," as long as one's intent was not to "further abortion," one made every effort to "minimize the harm," and one achieved "an extremely important good that can't be achieved any other way."

Leave it to a set of morally (and financially) obliged corporations to figure that one out.

On the other hand, Roman Catholic bishops have taken a hardline stance, that ANY compromise on federal funding of abortion = Kill the bill completely.

"The Catholic Health Association does not represent the teaching of the Catholic Church on the non-negotiable defense of innocent life," the conservative Catholic activist Deal Hudson said in a statement, calling the association's move "utterly offensive."

So to review the logic here: Roman Catholic bishops, bigtime religious leaders, wildly respected by many in the world, are politically involved in completely opposing a bill that may improve the greater good of Americans. In other words, their "non-negotiable defense of innocent life" starts with conception of a fetus and ends when a baby is born? How does the principle of cooperation with evil apply and the principle of non-negotiable defense of innocent life apply here? I'm confused.

I have nothing against Catholics being strongly against abortion or against a women's right to choose. But I'm just not able to wrap my head around a desire to by all means defend innocent life, while threatening to stop progrss in its tracks because it even FURTHER regresses current standards of abortion coverage in the US (see Hyde Amendment).

Oh yes, 'tis the spirit. Merry Christmas everyone. Don't forget -- on this holy day -- to defend innocent life and not cooperate with evil. Interpret that how the hell you want. And to hell with separation of church and state while we're at it.

PS - is this legislative/moral back and forth really a huge ploy to stop us from dreaming big about improving health and wellness and creating big beautiful radical transformative changes in the world? Win some, lose more, two steps forward two steps back...

'twas the night before christmas and all through the senate...

los anjalis — Fri, 25 Dec 2009 01:50:43 GMT

The US Senate convened today -- the day before Christmas -- and passed the Senate's version of the famed health insurance reform bill, the Patient Protection and Affordable Care Act. This bill will move into conference committee with the House of Representatives' version of the bill in January, before finall passage (Previous discussion of this week's Senate events here). It is not a common occurrence to meet the day before Christmas. The last time the Senate held a roll call on Christmas Eve was in the year 1895, when Senators lifted a ban on government officers who had joined the Confederacy from serving in the post-Civil War military. Below are other interesting facts about the Senate.

Today (Christmas Eve) marked the 25th straight day of debate. This is just short of the record for the longest number of consecutive days that the Senate was in session, in the winter of 1917 (thanks to @wonkroom on Twitter for this fact). The extended debate in 1917 was due to anti-war legislators stalling debate about whether or not to arm US merchant ships during World War I ... (more below)

The Christmas spirit inspired some poetry this week, from Illinois Senator Burris. He took to the mic and started with “It was the night before Christmas and all through the Senate, the right held up our health care bill, no matter what was in it.” ...and he went on from there [link to poem transcript and video. Then, the New York Times, uninspired by the average poetry and meter of Burris's rhymes, challenged its readers to think up more rhymes. Readers' submissions are quite entertaining.

On the etymology of filibusters: "The term filibuster was first used in 1851. It was derived from the Spanish filibustero meaning pirate or freebooter. This term had evolved from the French word flibustier, which itself evolved from the Dutch vrijbuiter (freebooter). This term was applied at the time to American adventurers, mostly from Southern states, who sought to overthrow the governments of Central American states, and was transferred to the users of the filibuster, seen as a tactic for pirating or hijacking debate." (from Wikipedia)

The longest running filibuster in US history was over 75 hours, when southern Senate Democrats tried unsuccessfully to block the passage of the Civil Rights Act of 1964.

The filibuster and its buddy -- the cloture vote (the supermajority vote of 60 Senators needed to overcome a debate-halting filibuster) -- were invoked 112 times after the 2006 mid-term elections and projections continue to rise, rendering our American democracy subject to the whims of a few Senators. Here's are two representations of the increased numbers of filibusters and cloture votes -- in table format and in chart format.

Senator Barbara Boxer (CA) made these remarks on the passage of the Patient Protection and Affordable Care Act today: “Today we demonstrated that we will no longer stand by while 14,000 Americans lose their health insurance every day, nearly two-thirds of bankruptcies result from a personal health care crisis and California families watch their premiums rise four times faster than their incomes. This legislation will make health care more affordable for small businesses and families, end insurance industry abuses, strengthen Medicare, help our seniors afford prescription drugs, and expand coverage to 31 million Americans - all while reducing the deficit."

And an excerpt from President Obama's remarks on today's vote: "As I’ve said before, these are not small reforms; these are big reforms. If passed, this will be the most important piece of social policy since the Social Security Act in the 1930s, and the most important reform of our health care system since Medicare passed in the 1960s. And what makes it so important is not just its cost savings or its deficit reductions. It’s the impact reform will have on Americans who no longer have to go without a checkup or prescriptions that they need because they can’t afford them; on families who no longer have to worry that a single illness will send them into financial ruin; and on businesses that will no longer face exorbitant insurance rates that hamper their competitiveness. It’s the difference reform will make in the lives of the American people..."

January will bring a new year and the start of heated discussions among legislators, lobbyists, and advocacy organizations to reconcile the major differences in the Senate and the House versions of the health insurance reform bill.

a bizarre process & a historic vote: healthcare reform

los anjalis — Mon, 21 Dec 2009 16:00:00 GMT

Although it was highly anticlimactic, awfully frustrating for Americans, and just the beginning, the early hour of this morning marked a historic vote for health care reform.

So what exactly happened? Well, the US Senate voted 60-40 NOT in favor of PASSING the bill -- but in favor of ending debate and stopping further filibustering on a specific set of amendments put forth by Senate Majority Leader Harry Reid. Yes, they voted for "cloture" -- to end debate on the bill. Were the debate to continue, Republicans (or Sen Lieberman or Nelson) would have more and more chances at filibustering the bill (a process by which they are allowed to read every page of the phone book aloud or do other things a 2nd grader wouldn't even do, in order to stall the process of moving a bill forward)...
Republicans have already filibustered the healthcare bill a few times, which not only stalls debate, but which allows for a full 30 hour debate after the filibuster ends. The bill would actually only have needed a majority vote to continue passing through these hoops in the process of moving a bill forward, but in order to STOP DEBATE on a bill (read: stop cranky senators from filibustering it), the Senate needed 60 votes. The Democrats have 58 Senators, there are 2 Independents (Sanders and Lieberman) and there are 40 Republicans. Every single Republican Senator was committed to voting against moving the bill process forward (in other words, every Republican senator was in favor of continuing to filibuster the bill). In order to make 60 votes (again, to stop a filibuster), Democrats pandered to Senator Lieberman (independent) and Senator Ben Nelson (democrat) and others who were threatening to filibuster the bill. The bill was watered down greatly.

The public option -- widely popular by the American public -- was a measure to allow individuals buying health insurance to buy from many sources, one being a government health insurance plan that would increase choice for consumers and increase competitiveness of the private health insurance market which right now has NO incentive for affordability and non-discrimination. The public option was swiftly stripped away in order to please a few Senators so that they would not filibuster the bill from moving on in the process. Then a Medicare buy-in was presented, allowing those aged 55 and over to buy into Medicare, a hugely popular government-run health insurance program for those 65 and over. That was then stripped out for the same reason.

It seems that the process around this hugely popular health care bill is being watched by more Americans than ever before -- and its colors are showing. Americans are fuming at the undemocratic process of our government. There's a growing movement of folks who are passionate about slowly but surely making this whole process more democratic in the future. Some of this will come from voting out obstructionist elected officials. And some will arise from greater awareness and pressure from the public about undemocratic procedural issues (the ones we weren't educated on in our high school politics and American government classes).

What's the next step for this bill? There are four more procedural steps like this (in which it is expected that there will continue to be a 60/40 vote split and the bill will continue to move forward). The next step is a conferencing between the Senate and the House bill to create one solid bill (the Senate and House bills are different right now, as the house bill contains a "public option" and crucial senators are refusing to vote for a bill with a public option. Also the senate bill has an individual mandate -- that every American will HAVE to buy health insurance or pay a penalty, and without insurance regulations or the option of a 'public option' this may be prohibitively expensive for many people). So after conferencing and presenting a compromise bill between the House and Senate, the bill will come to a vote -- Dems hope that will happen the eve Christmas, and Republicans would do oh so very much to stall that process and take the process over into the new year.

But what the heck is in the bill that the Senate finally voted to stop Senators from filibustering? Well, mcjoan at dailykos has a nice summary of what is contained and what is missing from the Senate bill.

Recommended reading is this article from the New York Times, which highlights the events of today, including a Republican who prayed that a key Democrat would not be able to show up for the vote (Senator Coburn), other Republicans who lamented the late-night 1am EST vote (although the resolution to go to war in Iraq, Medicare Part D, and a ton of other votes were even later in the night and pushed forth by Republicans), and Republicans claiming that this bill was not really legitimate unless 75 or 80 Senators voted for it (a super super super majority). A few days ago on Countdown with Keith Olbermann, The Nation magazine's Washington editor Chris Hayes said of Senator Coburn and other Republicans that they have withdrawn completely from the project of legislating, and instead are jokers.

And for a precise look at how absolutely perverse our democratic system can be, definitely read Ezra Klein's "The Death of the Public Option". It's short, easy to understand, and a must-read, no matter how frustrating.

For Americans, the process from here until passage of the bill requires much scrutiny. There's a chance to pressure our elected officials to ensure this bill will improve affordability, possibly by taking out a health insurance mandate (that all Americans must buy health insurance) if there aren't affordability practices put in place, and oh so much more. There's much to fix, and much to reflect on about American democracy, but onwards we move...

public option = citizen owned alternative

los anjalis — Fri, 28 Aug 2009 02:50:32 GMT

This week's Slowpoke cartoon (by Jen Sorenson) is titled "Name that Plan!" and features a few new names for the public plan. The "young, hip, citizen owned alternative" name caught my eye. Nice framing. And it's true. The public option WOULD be a citizen owned option. Why aren't we talking about it that way?

biting satire

los anjalis — Sun, 23 Aug 2009 04:57:40 GMT

From Congress Deadlocked over How Not to Provide Healthcare" at TheOnion.com:

"Both parties understand that the current system is broken," House Speaker Nancy Pelosi told reporters Monday. "But what we can't seem to agree upon is how to best keep it broken, while still ensuring that no elected official takes any political risk whatsoever. It's a very complicated issue."
"Ultimately, though, it's our responsibility as lawmakers to put these differences aside and focus on refusing Americans the health care they deserve," Pelosi added...
"People should know that every day we are working without their best interests in mind," [D-NV Senator] Reid said. "But the goal here is not to push through some watered-down bill that only denies health care to a few Americans here and a few Americans there. The goal is to recognize that all Americans have a God-given right to proper medical attention and then make sure there's no chance in hell that ever happens."
"No matter what we come up with," Reid continued, "rest assured that millions of citizens will remain dangerously uninsured, and the inflated health care industry will continue to bankrupt the country for decades."

How to explain the public option for healthcare reform. Really.

los anjalis — Fri, 21 Aug 2009 16:00:00 GMT

Really. President Obama's healthcare reform proposal ranks highly among least understood policy proposals in current politics. What follows is a concise and easy to understand explanation of the popular but often muddled "public option" that is contained in national legislation and that forms the centerpiece of President Obama's proposal. This one is great for cocktail parties and loud bars, because it's so easy to explain.

The speaker is Chris Hayes, DC editor of The Nation magazine, and the setting is the Netroots Nation blogger/media conference in Pittsburgh, August 2009.

After the conference, a blogger named Nicholas Beaudrot transformed Hayes' flowchart-gesturing and converted it into an easy to read and share flowchart about the public option. Click on the image to enlarge it.

FINALLY, easy to understand, right? Precisely why you should share it with your colleagues, friends, and foes alike.

The healthcare debate: don't let anyone tell you it's beyond your grasp

los anjalis — Tue, 18 Aug 2009 23:48:12 GMT

Health-care reform is not that hard to understand, and those who tell you otherwise most likely have an ulterior motive. Reform proponents exaggerate the complexity of the issue to elevate their own status as people who understand it; opponents exaggerate it to make the whole endeavor out to be a bureaucratic monstrosity.
- from "Your Handy Healthcare Cheat Sheet" by Alec MacGillis, WashingtonPost.com

OK, you've got my attention. Any article, video, blog post, or conversation that attempts to break through the false hierarchies of the current U.S. healthcare "debate" is one I'll listen to. There are way too many motives and egos running around. Racism, classism, and various other -isms are playing loud and clear in this debate. There's also a very clear attempt to derail any productive discussion around ANY kind of healthcare reform, by many on the political right.

Here's an example. Last week, as I waited to board a flight, I was drawn to a mainstream "politics" show at the airline gate. This was a show on CNN, which featured an old white conservative man talking with old white male guests on his show. The topic: health care reform. In 20 minutes of discussion, the only information I could glean from the show was that we are screwed. Numbers and $$ costs and statistics were thrown at the audience in rapidfire fashion, in a very obvious attempt to derail the actual debate and incite fear in the public around the steep costs of reform. Nothing of great substance was discussed, and I came away not more knowledgeable, but more anxious.

So, coming back to this wonderful article. Please check it out. Pass it on to your friends and family. Make sure you all know the framework and facts on both sides of the debate. Thanks greatly to the author for clearly and concisely presenting the information. The article ends with this call to action:

It's your health care. Don't let anyone tell you that it's somehow beyond your grasp.

Right on.

everyone's talking about it. everyone.

los anjalis — Tue, 18 Aug 2009 05:38:59 GMT

Everyone's talking about it. Whether shouting or debating at townhall meetings across the country, or talking about it over the dinner table, health care reform (which is really health insurance reform) is the talk of the town.

Tis very true, there's much debate over how much the various proposals for health insurance actually help the health of people in this country. But it's also true that there are some very true access issues and life and death realities that need to be addressed.

So, shall we discuss? I'll try to post thoughts, creative framing, and interesting ideas and actions around moving forward in the health insurance reform debate. A strength of the CureThis community is that folks share personal narratives and stories, and perhaps this website can function as a space for such discussion. As always, healthy debate is a good thing, and feel free to write posts or add your thoughts in the comments section of posts.

half of latinos & native americans in new mexico without health insurance

los anjalis — Mon, 30 Mar 2009 03:28:43 GMT

I recently made my nth trip (of the past few years) to Albuquerque, New Mexico, where my friends run an amazing, innovative, and quite revolutionary medical clinic (fair-priced; integrative; acupuncturists and naturopaths and midwives in addition to docs and NPs) for the uninsured. I'll write more about that experience, but I may move to ABQ, NM to work in this clinic (and at a rural hospital). So THIS news in ABQ), found on my twitter feeds, piqued my interest...

ALBUQUERQUE, N.M. -- About half of Hispanics and Native Americans in New Mexico were without health insurance for at least a month and up to two years in 2007 and 2008, according to a new study from Families USA.
The study states only 28 percent of whites said they were uninsured during that same period.
Families USA, a health reform advocacy group, says 49.5 percent of Hispanics were without health coverage at some point over the two years.
And 56 percent of people who described themselves as Native American or as members of more than one ethnic group said they went without coverage sometime during the period studied.
New Mexico Human Services Department spokeswoman Betina Gonzales McCracken said the department recognizes that ethnicity does play a role in the uninsured.

These are absolutely shocking statistics. The Families USA document that's referred to can be found here (.pdf file).

RIP Levi + Standing in the Shadows of Care

nightowl724 — Wed, 29 Oct 2008 05:35:37 GMT

I got SSD this year, but I won't get Medicare til 2010. I'm sick, so I can only get costly junk insurance. Continuing the irony, if I don't see my doctors regularly and stay on my meds, I'll be "non-compliant" and lose my disability benefits!

I often pass by hospitals and pharmacies. I pass by because I can't afford to enter. For two months, my best friend was in the hospital receiving complex, long-term treatment paid for by her insurance. Without insurance, I wouldn't get that kind of care - if any.

I've survived thanks to a few kind doctors who gave me free care and drug samples. Recently, one of them moved away. Prescription samples are scarce these days, too. I've applied for pharmaceutical "indigent programs" with no luck. My scripts are $1000/mo, so I often do without. And, forget lab work, let alone a hospital stay.

Saddened by Levi Stubbs' death, I revisited the great music of The Four Tops. Listening to Standing in the Shadows of Love, something clicked. I realized that I, too, am standing in the shadows - in the shadows of some of the best health care in the world. From that came my modest tribute to Levi and to the 47M of us without health insurance.
Just some of the praise for Levi Stubbs:

Arguably the most powerful voice in Motown's storied history has been silenced. (Billboard)
...the Four Tops have charted with scores of upbeat love songs featuring Levi Stubbs' rough-hewn lead vocals. (Rolling Stone)
Levi's baritone-like a velvet scarf pulled over gravel-was the linchpin for the Four Tops' seamless harmonies. (NPR, All Things Considered)
Although Stubbs was a natural baritone, most of the Four Tops' hits were written in a tenor range to give the lead vocals a sense of urgency. (Wikipedia)
Need and longing would be the hallmarks of Stubbs' singing... (William Ruhlmann, Vocal Group Hall of Fame Foundation)
Stubbs' bold, dramatic readings of some of Holland-Dozier-Holland's choicest material set a high standard for contemporary soul in the mid-Sixties. (Rock and Roll Hall of Fame)
...Levi Stubbs became an international star and became an influence on singers from the Sixties to the present time. (History of Rock)

Some insiders speak out:

"We have lost one of the great voices of the 20th century," said Otis Williams of another Motown hit-maker, the Temptations. "A few years ago in Las Vegas, I told Levi, 'You are our black Frank Sinatra.' Levi could phrase a song just as beautifully."
In a statement, Motown record label founder Berry Gordy Jr. called Stubbs "the greatest interpreter of songs I've ever heard" and the Four Tops "the greatest and most loving group."
========
Stubbs "could easily have made it as a solo star," Gordy said, "but his love and loyalty" kept the four men "together longer than any group I know. His integrity and character were impeccable."
Author and music historian David Ritz told The Times that Stubbs had "one of the great soul voices of the last 50 years."
"You could hear the tear in his voice -- there was a kind of plaintive cry and an anguish and a pain," Ritz said. "He's going to live forever in the annals of American pop music. (LA Times)

From the last surviving member of the group:

Four Tops leader Abdul "Duke" Fakir called the late Levi Stubbs "one of the best singers in the world, period, of all time" and "a great man" in the first comments from the group's camp since Stubbs died last Friday.
========
...the loss is "a big hurt"
========
"He had such power," Fakir said. "He had a baritone voice and a tenor range. He could do anything with his voice. He could take you anywhere with it. He could take you to a love scene. He could take you dancing. He could take a great old standard and make you feel like you're right there in that song. Just an amazing voice, an amazing interpreter, an amazing man."
Even more importantly, Fakir noted, Stubbs "was dedicated to us. He had many chances and many offers to be lured away into his own solo world, but he never wanted that. He said, 'Man, all I really want to do is sing and take care of my family, and that's what I'm doing, so all is well. Everything else that doesn't include you guys, it doesn't mean a thing to me.' That kind of character and commitment is really hard to find these days."
========
"There'll never be another Levi. We don't expect to replace a voice like that, or a personality like that. But we can keep singing his songs, 'cause the world should always hear them." (Reuters)

A tip of the hat (and maybe even an apology) to Levi Stubbs.

Standing in the Shadows of Care
(original lyrics)
Standing in the shadows of care,
I'm getting ready for the sickness I'll bear.
Can't you see me standing in the shadows of care?
I'm getting ready for the sickness I'll bear.
I want to run, but there's no where to go.
'Cause sickness will follow me, I know.
Without health care, the care I need,
It's the beginning of the end for me.
'Cause you've taken away all my chances for living,
When you have denied all the care I need given!
Now wait a minute...
Didn't I work real hard, USA, didn't I?
Didn't I do the best I could, now didn't I?
So, don't you leave me standing in the shadows of care!
I'm getting ready for the sickness I'll bear.
Don't you see me standing in the shadows of care?
Just trying my best to get ready for the sickness I'll bear.
All alone, I'm frightened to be,
With no health insurance company.
It may come today, it might come tomorrow.
But, it's for sure, I won't get nothing but sorrow.
Now, don't your conscience kinda bother you?
How can you watch me die after all I've done for you?
Now hold on a minute...
Gave you all the years I could, now didn't I?
When you needed me, I was always there, now wasn't I?
(Standing in the shadows of care,
Getting ready for the sickness I'll bear.)
I'm trying not to cry out loud.
You know, crying, it ain't gonna help me now.
What did I do to cause all this grief?
Now, what'll it take to make you care for me?
Now wait a minute...
I gave my heart and soul to you, now didn't I?
And, didn't I always work real hard, now didn't I?
I'm standing in the shadows of care.
I'm getting ready for the sickness I'll bear.
Don't you see me standing in the shadows of care?
Trying my best to get ready for the sickness I'll bear.
Standing in the shadows of... [Fade]

Remarkable music from a remarkable man. Gone, but still touching my heart.

"Standing in the Shadows of Love" reached #6 on the Billboard Hot 100 in 1967.
========
It is ranked #464 on Rolling Stone's list of the 500 Greatest Songs of All Time.
========
This song is referenced in the John Mellencamp hit "Lonely Ol' Night" from the 1985 Scarecrow album: "Radio playing softly some singer's sad sad song. He's singing about standing in the shadows of love; I guess he feels awfully alone." (Wikipedia)

Levi's death is sad for us, but it's comforting to think of him instead out of the shadows, standing in the sunlight, surrounded by loved ones, singing his soulful songs, peaceful, and smiling forever...

Great hope lies ahead; Kennedy brings people together

los anjalis — Sat, 25 Oct 2008 07:12:01 GMT

Mind you, Senator Kennedy has been doing all this while dealing with an aggressive brain cancer and complications from other problems (kidney stones, etc). This is WONDERFUL:

Sen. Edward Kennedy (D-Mass.) has been organizing and overseeing meetings with members of both parties to draft health care legislation to present to the new president and Congress next year that would extend health insurance to all U.S. residents, the Washington Times reports.
The talks have included 14 roundtable meetings attended by Kennedy aides and staffers for both Democrats and Republicans in the Senate Budget Committee, Senate Finance Committee and Senate Health, Education, Labor and Pensions Committee, chaired by Kennedy. Kennedy has monitored the talks, which started in June, through telephone updates from his staff.
The talks also were attended by representatives from a broad array of groups with an interest in health care, including the:
* AARP;
* AFL-CIO;
* American Medical Association;
* America's Health Insurance Plans;
* Business Roundtable;
* Consumers Union,
* Families USA;
* Federation of American Hospitals;
* National Federation of Independent Business; and
* National Retail Federation.
In addition, Kennedy aides have started meeting regularly with consumers and small groups of people representing each area of the health care industry.

The Times reports that the conversations are "extraordinary" because they are bipartisan and have "managed to put in the same room interests that rarely meet -- let alone agree with one another."

Bold emphasis is mine. It truly is the beginning of a new era. I'm going to try to be less cynical too :>

From California Health Line, October 24, 2008.

Connecting some dots.

los anjalis — Tue, 30 Sep 2008 09:00:38 GMT

Michael Moore cleverly links the economic crisis to individual medical bankruptcy:

NOTHING in this "bailout" package will lower the price of the gas you have to put in your car to get to work. NOTHING in this bill will protect you from losing your home. NOTHING in this bill will give you health insurance. Health insurance? Mike, why are you bringing this up? What's this got to do with the Wall Street collapse?
It has everything to do with it. This so-called "collapse" was triggered by the massive defaulting and foreclosures going on with people's home mortgages. Do you know why so many Americans are losing their homes? To hear the Republicans describe it, it's because too many working class idiots were given mortgages that they really couldn't afford. Here's the truth: The number one cause of people declaring bankruptcy is because of medical bills. Let me state this simply: If we had had universal health coverage, this mortgage "crisis" may never have happened.

Uninsured and Lucky to be Alive Part 2

nightowl724 — Sun, 24 Aug 2008 17:18:02 GMT

I'm lucky to be alive. I'm a 53-yr-old woman who has been without health insurance for most of the last 18 years. During that time, I developed several medical conditions, some potentially fatal. Yet, because of a few sympathetic doctors, loving and generous family members, and publicly-funded or charitable programs, I'm still here to write about my experiences. Many others have not had my good fortune.

If you've read my other diaries, you know I usually don't write about myself and I usually approach my subjects with snark. I laugh to keep from crying. However, this time I was asked specifically to write a serious and personal post. I hope those who have insurance get a sense of what it's like not to and those who don't pick up a valuable tip or two. I invite readers to share their stories and suggestions in the comments section.

In Part 1, I related the background of my story. In Part 2, I am revealing the rest of my story, starting with the onset of my medical problems.
After battling illness for eleven years, my husband's condition had begun to worsen rapidly. We knew he probably wouldn't live much longer. His doctors asked if I could afford to quit working to take care of and be with him. I couldn't.

A few months before he died, one of his doctors insisted that I come in for a free check-up. She said she was worried about me and that I didn't look good. She discovered some problems right away and she provided me with sample pills. As my health has declined, she has continued to see me at little or no cost and to give me drug samples whenever she can. When she can't give me samples, she tries to give me coupons to use at the pharmacy. This arrangement has continued for almost six years.

My husband died in early 2003 at age 52, one day before I turned 48. We had been together nearly 30 years, married almost 28 of them. Happy birthday to me...

Using my paycheck, my Social Security Survivor's Benefits, my husband's small insurance policy, and my small savings, I was able to get by, and I even managed to pay off numerous bills and loans leftover from my husband's illness. But, I wasn't making much headway with those credit card bills. And, every year, I always seemed to be about $20 over the monthly limit for Medicaid.

Late in 2003, I became much sicker and was suddenly diagnosed with high blood pressure, high cholesterol, and diabetes. My faithful doctor loaned me a blood pressure meter and a glucometer. She provided me with a few hundred testing strips, lancets, and samples of the drugs I needed to treat my three new conditions.

My doctor directed me to the Visiting Nurse Association, where I qualify for free flu shots ever year because my diabetes makes me "high risk." She told me about annual free blood testing organized by a fraternal organization in a nearby town with the cooperation of a prominent medical lab. She pointed me to the free breast cancer screening held at the local hospital every Mother's Day weekend and co-sponsored by the Susan G. Komen For the Cure Foundation and the American Cancer Society. This in turn led to a free Pap smear that year, and every year since. It also led to me having a biopsy (thankfully benign) I needed at no charge. The nice OB/GYN who did the biopsy later treated me for several other problems at reduced cost.

My family doctor also referred me to an understanding ENT for treatment of my right ear. I had lived with painful and chronic ear infections for years. I learned that I had an infection that had gone so deep and been so severe that he said I was in real danger of a deadly brain infection. I also had a large cholesteatoma (like a tumor) in that ear, which he removed. And, I had extensive damage to my eardrum and the bones of my middle ear. I was forbidden to fly. My ear hurt like crazy, but I had no idea that I was a ticking time bomb!

The doctor also said I would need to see him weekly for a long time, gradually getting to the point where I would need to go in only every three months - forever. When he said he would treat me for only $10 per visit, I burst into tears! I have been seeing him for more than four years. I am pleased to report that I haven't had an ear infection in months and that I have been given permission to fly again. However, I am virtually deaf in that ear now and plagued 24/7 by tinnitus that varies from bad to worse.

Six months later, I was further diagnosed with arthritis, fibromyalgia, chronic fatigue syndrome, and depression. More doctors, more drugs, more tests. I knew enough to apply for Hill-Burton funds for my out-patient testing. By the end of 2004, I was no longer able to work.

I applied for Social Security Disability and was denied because I "didn't provide enough evidence of my conditions." I saw a lawyer, who said there was no sense in filing an appeal unless I could give Social Security more test results and reports from specialists. Of course, I couldn't. I didn't have the money.

Horrible teeth run in my family. I never had dental insurance and I could never afford the right kind of care, enough care, and timely care. Nevertheless, I paid $1,000s over the years playing "keep up" with just the very worst dental problems I had. I had to have four impacted wisdom teeth pulled, two root canals done, and much more.

All for naught... At the ripe old age of 48, I found the cheapest dentist I could to pull every tooth I had left. This cost $2,600. Then I went to a "Dentures R Us" kind of place to get mine at less than half the going rate charged at a dentist's office. $1,100.

The so-called "cheap" dentures never fit right. They slip when I eat and occasionally fly out when I'm talking. (Yes, I've had them readjusted several times - $65 each time.) I get bleeding ulcers and blisters from them. My jaws ache whether the "falsies" are in or out. I now only wear them when I go out. Either as a consequence of wearing those dentures or of not wearing those dentures, I have TMJ and arthritis in my jaws. (This is possibly related to my fibromyalgia, too.)

Last year, I lost my Survivor's Benefits when my son turned 16. (His continue until he's 18.) I finally had to declare bankruptcy. Luckily, I was able to hang onto my mobile home. At long last, I was eligible for Medicaid and food stamps. I reapplied for Social Security Disability because I would be able to provide the evidence needed.

Boom! Suddenly, I was seeing old and new doctors or having tests done almost every weekday. My regular doctors had a long list of things they wanted done and specialists they wanted me to see. I was evaluated for jaw surgery, under consideration for stomach surgery, and scheduled for ear surgery. I underwent a long-overdue gynecological procedure. I got new glasses. I had a few weeks of physical therapy. I began seeing a psychologist and a psychiatrist for depression. All my prescriptions were covered. I was entitled to free medical transportation. My doctors were being paid somewhat closer to their regular fees - and not by me for a change.

While I had Medicaid, the oral surgeon recommended three things. The first is surgery for my TMJ. My TMJ is "not bad enough" for ANY insurance company to pay for it - that is, if I actually had any insurance. $10,000+. Second, insertion of posts to hold my dentures in place because my ridges were so severely damaged by years of improper/no dental care. "NEVER" covered by dental insurance. $10,000+. Finally, new dentures from a "good dentist" who specializes in posts and "problem fits." "Might" be partially by "some" dental plans. $5,000+.

Six months after that, my Social Security Disability claim was granted!

That's the good news...

The bad news is that I immediately lost my medical insurance. I am not eligible for Medicare until February of 2010. Because of my pre-existing conditions, the only insurance I can get is expensive and doesn't cover those conditions. And, my Social Security benefits are again about $20 a month too high for me to receive Medicaid.

Boom! Just as suddenly, I was back to square one as far as medical care goes. In my case, when Medicaid paid for something, it covered everything. But, it moved very slowly on approving things and denied coverage often. I had several procedures and tests under appeal. Pending tests and surgeries have been canceled. I simply ran out of time. Questions hang in the air about two very serious conditions I may have. There they will stay, too, because the tests involved in finding the answers run around $10,000.

My long-suffering physicians are back to their tiny payments. One of my new doctors has cut his fees in half. Another isn't charging me at all. The others, I just won't see for now. Conditions newly-diagnosed in the brief time I had insurance mean that I need more drugs and routine blood work than ever. My doctors are again helping me to apply for pharmaceutical assistance programs and giving me samples when they can. If I had to pay full price for all of my meds, it would be $1000 per month. That's just not an option. Chances are, I will be doing without them often. There will be no more physical therapy.

The oral surgeon said I will need jaw replacements in the future if I don't follow his recommendations. Ironically, dental insurance plans, Medicare, or Medicaid probably WOULD cover that surgery - if I actually had any of those coverages. The oral surgeon told me to come back when my condition gets much worse AND I have good dental insurance. If you are struggling to pay for dental care, please see nyceve's recent diary at Daily Kos Unaffordable dentistry and an epidemic of dental disease and the comments for priceless tips.

I am angry that all of this happened to my family. I am angry that my husband had to agonize over the cost of his care and the bills he knew he would leave behind. I am angry that his medical care forced me into bankruptcy. I am angry that I had to spend so much time and energy seeking affordable care for my husband and myself. I am angry that we had to feel as if we were begging for charity to get medical care. I am angry about the mistakes and bad decisions I made and the stuff I wish I had known at the time. I am angry that caring medical professionals must waste scarce resources helping patients without insurance. I am angry that health-related organizations must burn up their funding just trying to keep sufferers alive. I am angry that those who advised me to quit working and declare bankruptcy so I could get medical care might have been right. I am angry that the same government that classified me as disabled still won't provide me with health care. I am angry that universal health care might have enabled me to stay healthier and work longer and that it would have made my husband's final years less agonizing and more dignified.

However, I am lucky that I have been able to keep my family together. I am lucky that I didn't lose my home. I am lucky to be treated by some doctors who are willing to accept low - or no - payment. I am lucky that my medical conditions were not more serious, such as cancer. I am lucky that I have received as many free drugs as I have. I am lucky that the drugs I need aren't as expensive as some that are out there. I am lucky that I qualified for Hill-Burton funds. I am lucky that a few people went out of their way to educate me about various diseases and health care programs. I am lucky that there were organizations offering free care. I am lucky that I haven't been reduced to seeking donations to have life-saving surgery or chemotherapy. I am lucky that I have such wonderful and supportive family and friends.

All in all, I am lucky to be alive!

10 Survival Topics for the Uninsured Part 2

nightowl724 — Fri, 22 Aug 2008 19:43:01 GMT

I've lived with illness and without health insurance for about 18 years. This diary focuses on medical savings and frugal living. If you're uninsured and seriously ill, you're probably going to face serious financial issues, too.

The topics are important whether you're a patient or a caregiver. They'll help even if you have insurance; co-pays and uncovered items kill budgets. And, you never know when you might lose your coverage.

It took years to find this information. Unfortunately, I learned much of it too late to help my family. Since it's hard to do when you're stressed, I hope you can learn from my experiences now. I invite you to share your stories and suggestions in the comments.

In Part 1, the subjects included planning for the unthinkable, the Hill-Burton Act, and ways to avoid paying full price for prescriptions, OTC drugs, and medical devices. In Part 2, the topics include finding and asking for help, dealing with long-term illness and debt, as well as some final thoughts and a resource list with links.
Topic #7: Finding help

Contact human resources where you are employed. If your injury or illness is work-related, inform your supervisor and complete all the required forms to apply for worker's compensation. If not work-related, see if you qualify for short-term disability payments. Also, verify the number of sick days or vacation days you have available.

Consider all types of relief. If you or your spouse can no longer work, your income has just dropped significantly. You may be surprised at the benefits to which you are entitled. I was because I had never used any of these services before. Some of the income limits for programs are quite high. It doesn't hurt to inquire.

Apply for Medicaid, food stamps, and TANF ("welfare") immediately. You may find that you apply to ten programs and are only eligible for one - or none. However, if you qualify for any one of these, it might "trigger" a host of other benefits. Even if you don't, many other programs ask for a copy of your denial letters before they will accept your applications. Enroll your kids in the school lunch program. Most people don't realize the CHIP program has been expanded in many states to include adults. This medical coverage is called AdultBasic in PA.

When filling out forms for Social Security or any other programs, go over them thoroughly before submission. Follow directions precisely and attach all the documentation asked for to avoid unnecessary delays or improper denials. Pay strict attention to deadlines. Further, if others (such as doctors) have filled out or signed paperwork for you, inspect it carefully before leaving the office. It saves you time and money if you discover errors or omissions right then and there. It also keeps you in good graces with them and it may even save you extra fees for form completion.

You might not think you "need" food stamps, free back-to-school clothes for your kids, a free weatherization program, or a rent rebate. It's apparently not obvious to everyone, but if you qualify for any aid of any kind at all, the money you save can be applied to your medical bills and other needs.

You may be able to connect quickly with a social worker or resource coordinator when the need arises. Keep in mind that, though they always mean well, some of the ones available to you at no charge are new to the field. They may or may not know any more about programs and services than you do.

Topic #8: Asking for Help

It might be difficult at first to ask for help, but it gets easier. Try to get past feeling embarrassed or ashamed that you are ill, that you don't have insurance, and/or that you are struggling financially. I know this isn't easy in our society. Try to talk to as many people as you can about your situation - but without being a pain, of course. That's how you will find some of your best information. Practice what to say if you must.

It's imperative, whether you are the patient or the caregiver, to guard your health. You need a support system. Look around you. Many of the people you know absolutely mean it when they ask, "What can I do to help?" Some may even be hurt if you don't call upon them! It makes them feel useful and gives them a chance to show their love and concern. You can pay them back or pay it forward later. The sooner you feel comfortable enough to delegate a few things, the better it will be for you and your family. If you are lucky enough to have a lot of friends and family, when each person helps just a little, it helps you a lot!

If you draw a blank as to what anyone could do for you, here are some nice things others have or could have done for me: baby-sitting, pet-sitting, house-cleaning, being with me in waiting rooms, staying with my husband so I could have a break, taking my husband for a brief outing, getting my children off to school, wake-up and reminder calls so I didn't miss appointments, cooking meals, doing dishes, packing lunches, doing laundry, taking kids to activities, phone duty, searching for information, filling out forms, running errands, shopping, rides to the doctor, getting my vehicle inspected, making small repairs, lending me a few dollars, just listening. Chances are, you won't be able to afford to pay for services like these.

This might sound silly or callous to you, but after a while, I consciously "categorized" my friends and family. There are "Doers," the ones I can count on for material support like pet-sitting and rides. There are "Stiff-Upper-Lippers," the people I call if I need to be encouraged or reminded to stop whining. There are "Soft Shoulders," who hold me when I feel like crying and say, "Awww... Poor baby." There are "Zen Friends," who just sit with me and watch a movie or listen to music without asking a single question. There are "Comedians," able to make me laugh no matter what. (Of course, there is overlap.) Oftentimes, I call one or the other and say right up front, "I need a kick in the butt" or, "I need to cry with someone."

I almost lost a dear friend I had worked with but never saw anymore, though we still emailed and called each other. When my husband's condition became grave, I never told her. (She barely knew him.) She was my "Normalcy Friend." She kept treating me the same way she always had. We'd talk about "whatever" instead of doctors, hospitals, and bills. There was no sadness, fear, or pity in the air. But, when I called her to tell her my husband was dead, she asked, "Why didn't you tell me?" It took more than a month for her to understand what an important role she had played in keeping me sane. Eventually, she was pleased at the special nature of our friendship and the special role she had fulfilled.

Next to your family, friends, doctors, and pets, your internet-connected PC is one of your best buddies. Learn as much as you can about the conditions that you or your loved one has. Search and apply for assistance programs online. Save links. Track information. Keep in touch with friends and family through regular updates on your situation. Your phones and answering machine are good pals, too.

Most people you deal with when going after benefits will be kind and at least try to help. Of course, be nice in return. This might not be easy if you are angry, frightened, embarrassed, or in a hurry, especially if this is the "millionth" call this week. Try to be patient, clear, gently assertive - and try not to whine! Ha-Ha! Take notes.

My husband once had to be taken by Life-Flight from my backyard to a city hospital. The bill would have been more than $10,000. I was relieved to learn that our volunteer ambulance company raises funds for people who don't have insurance coverage for ambulance service. I ended up owing nothing. If I hadn't asked, I might not have known. Now, I donate to them when I can.

If you can, get friends and family to help you do online research, make calls, and fill out applications. Have your basic information in front of you when you call or search online - your monthly income, your diagnoses, and your list of prescriptions and other needs. Provide the same list to your helpers. If you or anyone contacts someone who is unable to help, ask if they know someone who can. It's sort of like networking for a job.

Topic #9: Dealing with Debt

As hard as it is, contact your creditors and explain your situation as soon as possible. Utility companies have been particularly cooperative with me. If you can prove true need, my phone company has a service that keeps your line open to dial 911 and to receive calls even if you can't pay your bill. They also have another program for low income customers where, for a very small fee, you can make local and 800-number calls, receive calls, use pre-paid phone cards, and reverse charges for calls. Credit card companies sometimes have "compassion" or financial assistance programs. You might be able to consolidate debts. You should be able to set up a reasonable payment plan with the hospital. They will probably lump all your bills together to create just one payment if you ask.

If creditors start calling constantly, get an answering machine and screen your calls. In PA, there is a law that if a debtor writes a letter to a creditor requesting no phone calls, they must abide by that or face stiff penalties. I found this out online and it worked. My lawyer didn't even know this. No kidding. Also, creditors were only allowed to send me one letter per week.

If you lose a spouse, do not make even one payment on any credit cards or other bills that are in their name only, including medical bills, before speaking with an attorney or some other financial adviser. Once you make even one payment, you have "assumed financial responsibility" and must pay the debt in full. I found out after the fact that in my particular circumstance (and, I don't really understand why), I would not have had to pay off my husband's credit card or the $500 co-pay for his final hospital admission. I had even called the hospital to ask if I really owed it because in every other case I had heard of where a patient died in its care, the hospital ate the co-pay. His hospital said I owed it immediately. I paid it out of the proceeds from his small life insurance policy. Later, an attorney told me, "They lied."

Consult a bankruptcy attorney or other financial adviser if it seems appropriate. You probably know already that 50% of all bankruptcies today are caused by medical problems.

Topic #10: My Final Advice

It's horrible to have to deal with sickness, let alone without adequate health insurance. Finding free or affordable medical care can really test your patience. Take deep breaths. Prioritize. If you are religious or spiritual, draw strength from that. Try to make time for yourself, your spouse, your kids and other family members, and you friends. Try to find non-medical related activities to do with them, even just going for a ride. Sometimes months would pass before my husband and I would do anything else besides going to the doctor or hospital!

Try to find a good balance between "thinking ahead" and "trying to make it through one day (or even one minute) at a time." Try to eat right, sleep right, meditate, play, and exercise. Pay it forward someday by sharing what you have learned with others or helping them in time of need. When you are in a better financial state, consider making donations to the organizations that have helped you.

Draft wills, living wills, and powers of attorney. Today. I believe these documents can be done without an attorney, but I wouldn't recommend it. Fees for them are relatively low, but if you can't afford it, use Legal Aid. My husband and I failed to do this. When he died, this complicated things and unnecessarily cost me lot of money. Soon after, I took care of this crucial paperwork for myself.

Yes, it's exhausting, stressful, and time-consuming. Yes, expect some people not to understand and some frustrating setbacks. Yes, "you do not need this right now." No, it's not your fault that you need medical care. No, it's not your fault that you don't have insurance. No, it isn't fair. Just remember that you are fighting for the physical, emotional, and financial well-being of yourself or a loved one and for your whole family. Just try to hang in there.

My advice would be incomplete if I didn't mention a few things that I don't want to say and you don't want to hear. It came up fairly often that people would tell me to "quit work, declare bankruptcy, go on welfare, and get Medicaid." I will tell you that for several years while I was caring for my husband, this might, in reality, have made sense. I simply couldn't bring myself to do it. However, the more jobs I took and the more money I made, the less and less aid he qualified for. This meant we were mainly just treading water - well, actually, still sinking. It also meant being away from my family when they needed me most and losing out on time with my husband before he died. The stress probably contributed to my own later medical problems and disability. To this day, I'm not sure if that tactic would have succeeded or if I made the right choice to not even try. And, to this day, I am furious that I had to deal with this conflict because the richest country in the world does not have universal health care!

I wish you good health and I hope you found this two-part diary helpful.

NOTE: Previously posted at Daily Kos.

Resources and Links
Here are just a few potential sources and links to get you started. Some are mentioned in my diaries. Some are just examples of resources in my area, but that you might have, too. I'm sure there are countless others. Please add your leads in the comment section. Thank you.
+ nyceve's diary at Daily Kos Unaffordable dentistry and an epidemic of dental disease and the comments
+ Free Medical Clinics and Camps
+ Newsweek article Doctors Within Borders
+ The "blue pages" in the front of the Yellow Pages directory
+ County resource directory (Allegheny County, PA)
+ Social Security - Disability and Medicare questions and applications
+ US Dept. of Health and Human Services Hill-Burton - free hospital care
+ CHIP (Children's Health Insurance Program) - free or reduced price coverage for kids and adults
+ WIC (Women, Infants, and Children program) - free milk, formula, juice, cereal, tuna, carrots, cheese, eggs, beans, peas, peanut butter
+ State Job Service or Office of Vocational Rehabilitation - rehabilitation and job retraining
+ US Dept. of Health and Human Services Find a Health Center
+ US Senate, US House, and state representatives - program information, expediting appeals
+ County Health Department - medical information, medical care (pdf file), safe water testing, more
+ State Department of Aging - information, numerous programs
+ PACE and PACENET - PA only, but your state may have similar programs
+ State Insurance Commission - possible "guaranteed" medical insurance
+ Workers Compensation - for work-related injuries and illnesses
+ County Courthouse - "Homestead" tax reductions, Energy Assistance, Rent/Tax Rebates
+ Legal Aid - wills, living wills, generally NOT bankruptcies
+ County Assistance Office - Medicaid, food stamps, TANF ("welfare"), resource coordinator
+ County Social Services Agency - social worker, more
+ Community Action Group - medical transport, weatherization program, roof repairs, more
+ Chamber of Commerce - local businesses and charities
+ Visiting Nurse Association - countless programs
+ Out of Pocket.com - search for health care prices in your area
+ Area Agency on Aging
+ Local food banks and co-ops
+ Angel Food Ministries - participants of any income buy food at drastically reduced prices
+ Local churches
+ Local dental schools - free or lost-cost care
+ Nearby teaching hospitals - research studies
+ Local universities - research studies
+ Closest hospital - may have community social worker on staff, programs
+ St. Jude and Shriners Hospitals - free care for kids
+ Hospice programs - information, forms, support
+ Free clinics and health fairs
+ Local beauty schools - may have program for free in-home hair care for patient
+ Airlines - some still have free "compassion flights" if an immediate family member dies
+ Vial of Life
+ Discount chains - like Costco, Sam's Club, Aldi's, Gabriel Brothers, Ollie's, Dollar Tree
+ Goodwill, St. Vincent de Paul - and other thrift and secondhand stores
+ Fuel savings cards and coupons
+ Wal-Mart, Sam's Club, Target, Krogers, Giant, Food Lion, and Safeway - $4 prescription list
+ example of non-prescription fish antibiotics (from nyceve's diary - others available - supposed to be the same as for humans even though they carry a disclaimer - USE WITH CAUTION?)
+ CraigsList, FreeCycle, WebMD, MedLinePlus, Wikipedia, and Local internet cafes

+ Pharmaceutical sites - individual manufacturers or PPARX
+ Books, TV, magazines, and newspapers (traditional or online) - health coverage, and "news you can use" features, coupons, estate sales for wheelchairs and hospital beds
+ Groups like Lions, Elks, VFW, Rotary Club, Salvation Army - whether you belong or not
+ Vision programs - such as Sight for Students and VisionUSA
+ Hearing programs - such as found here
+ LensCrafters and other eyeglass providers - for charitable programs
+ Health-related associations - American Heart Association, For the Cure, American Cancer Society, many more
+ Local and online support groups for patients, their families, and their caregivers - I found the National Family Caregivers' Association to be helpful
+ Your doctors
+ Your nurses - at the hospital and in the doctors' offices
+ Your pharmacist
+ Your local ambulance company - free service if uninsured
+ Your library - and the free research department if they have one
+ Your union
+ Your clubs
+ Your place of work - human resources department and co-workers, short-term disability
+ Your church
+ Your child's university financial aid office

+ Your child's school nurse - helping children to adjust, familiarity with local programs, more
+ Your other school staff - school lunch programs
+ Your utility companies - delayed payments, energy assistance
+ Your student loan company - deferments, loan forgiveness for disability
+ Your other creditors - "compassion" and financial hardship programs
+ Your family and friends

Health Care Series: Uninsured and Lucky to be Alive Part 1

nightowl724 — Tue, 19 Aug 2008 17:40:38 GMT

In Part 1, I relate the background of my story. In Part 2, I will reveal the rest of my story, starting with the onset of my medical problems.
My story is so closely linked with that of my late husband that it is impossible to tell one without the other. He died young in 2003 after being terribly ill for eleven years. He had medical insurance for only five of those long years. It was while taking care of him that I met those wonderful doctors who improved the length and quality of his life and probably saved mine. At the same time, I was learning a bit about finding free or affordable health care, a sort of "practice run" for my future health problems.

I also have two sons. They're fine now, but both suffered chronic ear infections. Additionally, one had asthma and the other had persistent stomach problems. Thankfully, both were covered by PACHIP (which was a precursor of and is now part of the SCHIP program) most of their lives. I cannot imagine what I would have done or what might have happened to them if they hadn't. One has been out of college for a few years, is working full time, and has no health insurance. The other will be off to college next year, where he will be dependent upon whatever minimal health services are offered by the university. A second generation of nightowls without medical coverage!

About 20 years ago, my husband and I decided to move to CA In search of a better life for our family. He worked construction, which was booming in CA and busting in PA at the time. I got a transfer and promotion to the LA branch of my company. Unfortunately, we arrived there shortly before the CA economy tanked. I lost my good job (with benefits) in a sudden and nationwide 40% "reduction in forces." I was unable to find any other similar position. Roughly two years later, my husband lost his job (and benefits). We were stunned. I was eight months into a difficult pregnancy and I had a young son. We were jobless, uninsured, and thousands of miles from home. We packed up a U-Haul and drove cross-country back to the place we were born.

Thank goodness we did! I had a tough labor and delivery and I was sick for quite a while afterwards, made worse because I couldn't afford proper follow-up care. I was finally able to go back to work, but my new job didn't have benefits. It took my husband even longer to get back to work again. For a little while, we had medical coverage through his union.

Then, not long after the birth of my second child, my husband was unexpectedly diagnosed with a condition so serious that his doctors told him he must stop work immediately and that he would never work again. We were without jobs and health insurance again, and this time facing some extremely serious medical problems.

But, at least we had friends and family members nearby who were willing to help and we were in familiar territory. We had figured on staying with my dear late mother-in-law for only a few months. As fate had it, we ended up living with her for six years while we struggled and waited for my husband's Social Security Disability to be approved and his Medicare to go into effect.

Soon after my husband's initial diagnosis, we were informed that he needed surgery right away. We were also told that it would cost at least $100,000! We had no idea what we were going to do.

I shared my problem with my friends at work. The next day, one brought me a recent Wall Street Journal article about the Hill-Burton Act, a federal program started in 1946. With Hill-Burton, hospitals receive federal loans and grants in exchange for providing a certain amount of free care to needy individuals. I had never heard of it before, but I immediately called the hospital where my husband was scheduled to have his surgery. We qualified, and Hill-Burton covered every cent of my husband's first surgery to the tune of $156,000! A few years later, my husband needed another major surgery that cost $56,000 and Hill-Burton picked up the tab again. (His third major surgery cost close to $200,000 and was paid for by Medicare.)

In addition, a staff member at the hospital billing department gave me another wonderful tip. She said that, although Hill-Burton has nothing to do with doctor bills, if I called the doctors and told them that we qualified for Hill-Burton, they might reduce their charges. They did, and in a big way! Some forgave their bills completely and others reduced them significantly. Altogether, I estimate I saved at least another $25,000 on the two surgeries because of that.

When my husband first became ill, his medications alone were approximately $1,200 per month. These, along with his doctor bills ate up most of my salary. We still failed to qualify for Medicaid. I was told we would have had a better chance of getting it if we weren't living with my mother-in-law, because her salary was included in our income. We couldn't afford to move out on our own.

After nearly five years, my husband was granted his disability benefits. Medicare came later still. His health stabilized a little and we finally got our own place. At that point, my husband's prescriptions cost as much as $1,800 per month. (This was before Medicare Part D.)

Samples and patient assistance programs cut our monthly medication costs roughly in half. We battled to hold onto our mobile home, pay for drugs, and keep up with co-pays. We also faced rapidly rising costs for my husband's Medicare HMO and prescriptions. Co-pays were skyrocketing. For example, the co-pay for a trip to the ER increased fro $0 to $25 to $50 to $500 in four years! Then there were the uncovered medical needs, like the hospital bed he eventually had to have.

For the first time in my life, I got a credit card - and then another and another.

For the next five years, I juggled as many as one full-time and two-part-time jobs at once along with occasional periods of unemployment. By then, I hadn't seen a doctor in a decade. I didn't have the time or the money for that. I still had no health insurance. I was beginning to feel quite run-down and I was starting to have some medical problems of my own...

10 Survival Topics for the Uninsured Part 1

nightowl724 — Mon, 18 Aug 2008 12:46:51 GMT

It took years to find all this information. Unfortunately, I learned much of it too late to help my family. Since it's hard to do when you're stressed, I hope you can learn from my experiences now. I invite you to share your stories and suggestions in the comments.

In Part 1, the subjects include planning for the unthinkable, the Hill-Burton Act, ways to avoid paying full price for prescriptions, OTC drugs, and medical devices, and dealing with long-term illness. In Part 2, the subjects will include handling debt and getting help, as well as some final thoughts and a resource list with links.
Topic #1: Stuff happens. Think ahead.

Find the time to learn about the medical, social, and monetary resources available in your area in case you have a major medical disaster. I discovered how difficult it can be to find help and information in a hurry. If you can, build up an emergency fund. It's easy to put off, but this sort of planning is as important to your family's welfare as any other crisis preparedness.

Moving has special challenges in this regard. When relocating, consider support systems and resources the same way you consider crime and cost of living. If you don't do this ahead of time, you should do this right after you arrive at your new place. Find and make appointments with new doctors ASAP, even if you have to pay for the visits. You need to establish relationships with them. Line up reliable baby-sitters. Look for ways to build strong ties to your new community. This might include investigating public programs, which vary drastically from state to state. Make new friends quickly by joining a church, club, or PTA. Don't count on friends from work. Unfortunately, those associations can dry up overnight if you lose your job.

This might all sound obvious, but I know from experience that the pressures and pleasures of a new city, new schools, and new jobs leave little time for anything else. If you are unprepared and disaster strikes, you may have to decide - like I did - if it would be best to stay put or to head back to your hometown.

Topic # 2: Meet Hill-Burton

Familiarize yourself with the Hill-Burton Act, a federal program started in 1946. With Hill-Burton, hospitals receive federal loans and grants in exchange for providing a certain amount of free care to needy individuals. I found out that not all hospitals participate in the Hill-Burton Act. Each hospital seems to have its own rules within the federal guidelines for eligibility, benefits, applications, and decision notifications.

For example, my husband's hospital paid 100% of the cost of care for qualified persons, and rendered their decision before admission or treatment. My hospital provides a percentage of the cost for qualified persons on a sliding scale, but does not make a decision until after an admission or procedure has been completed. Both of those facilities will also consider Hill-Burton funds for out-patient care and insurance co-payments, but apparently not all do.

Also, at some hospitals, it's far better to try for assistance earlier in the year before funds run out, while others may dole out free care monthly or quarterly. It pays to ask. If your admission is urgent, you might call other hospitals where your physician is on staff to check on the availability of funds. If it's not an emergency, you might be able to postpone it until the next disbursement period.

Topic #3: Pay Less for Prescriptions

Ask doctors if they have drug samples, especially for new prescriptions. It is awful to buy a month's worth of an expensive drug only to find it doesn't work or you can't tolerate it. Often, my doctors prescribe my meds based on what they know they get samples of regularly.

Look into pharmaceutical manufacturers' patient assistance programs. You can try the widely-advertised Partnership for Prescription Assistance website. However, my experience has been that PPARX underestimates a person's eligibility. Also, not all drug makers participate in PPARX. I have had much greater success going directly to the website of each individual company. You might have to search hard for the link to the patient assistance program or you might need to call. Not every maker has a program and programs vary wildly in requirements and benefits. You'll often find coupons instead of or in addition to assistance programs. Programs all require your doctors to fill out forms regularly. Ask your doctor to forgo some or all of the fees for this service.

(Pennsylvania has two programs called PACE and PACENET. These helpful programs benefit older residents, but your state may have similar ones. Although the age requirements presume you are eligible for Medicare, what's special about them is that they supplement or replace Part D for low income individuals. This might be helpful for future reference.)

As I have never actually used any of these options, I'll just mention them. Consider alternative medicine. It may be better and/or less expensive. However, this is a subject about which I know nothing. Mail order prescriptions are widely available via the Internet and could be worth exploring. I am aware that many people acquire their prescriptions by traveling to or ordering from Canada and Mexico. I wish I could comment on the quality of those drugs and the legality of this option.

Nowadays, Wal-Mart, Sam's Club, Target, and numerous grocery chains such as Krogers, Giant, Food Lion, and Safeway offer $4 prescriptions for generic drugs and other great deals. There may be other stores with similar bargains. Some of these companies have their $4 lists posted online. Ask your doctor to prescribe from these lists if possible. Ask your doctor or pharmacist if they have or know of any coupons for the medications you have been prescribed. Request generics where available.

Beyond that, prescription prices differ significantly from store to store and from week to week. With a monthly cost of $1200 to $1800, I could never afford to get a full month's worth of prescriptions all at once for my husband. Pharmacists are generally willing to fill partial prescriptions, by be aware that you may pay dearly for this.

For example, one of my husband's drugs was $350 for a month's worth, $250 for two week's worth, and $150 for one week's worth. Sometimes, I could only afford one or two pills before payday. Every single week, I called every single local drugstore and got prices for every single drug my husband took. I always had to go to at least three pharmacies to get the best overall price. Some pharmacists were nice about this and others weren't. Eventually, the owner of one small pharmacy said he would match the lowest price being given anywhere else. I still had to make the calls, but I sure did save time and gas money.

Topic #4: Save on OTC Drugs

There isn't much new I can tell you about OTC drugs. Shop sales, use coupons, look for stores that double coupons, buy in bulk and share with others, and try store brands. If you have prescription coverage, ask your doctor to write a script for OTC drugs whenever possible.

Topic #5: More-Affordable Medical Devices

Check with friends and family. Of course, try want ads, CraigsList, and FreeCycle. That's where I have seen $100 hospital-style bedside tables for $5 and free non-motorized wheelchairs. Put up ads at the supermarket. Contact the hospitals, churches, and local organizations. Watch for estate sales. Look for places that sell used durable medical equipment. You can sometimes rent this kind of equipment, but that is often the most expensive route in the long run. Ask at the doctor's office, at work, and at even your child's school. Most makers offer at least one of their glucometers at no cost. Just be sure to check the price of the testing strips before you order one. They vary widely.

Where I live, it is against the law and it carries a stiff fine to put used syringes and lancets in with the regular trash. My trash collection company charges a fortune to take them away. I discovered that the local hospital has a program to collect these items. They must be in safe containers, like coffee cans with lids, and be clearly marked with the person's name and phone number. It must also be noted on the containers that they hold hazardous medical waste.

We bought my mother's stair lift gently used for $2000 (including installation) at a company that sells them. After she died, we sold it there for the same price (including removal) minus a small commission. The one she had would have been about $6000 new. I got my husband's hospital bed for only $25 through a lead from the local veteran's center. A family member found us a free wheelchair through a former co-worker of hers. After my husband died, I called the school nurse. She happened to know of a child who was in desperate need of a hospital bed and wheelchair. I donated those to him. Various organizations like the Lions offer assistance with glasses and hearing aids. LensCrafters has a campaign during which they provide eye exams and new glasses to the needy at no charge.

Topic #6: If you think you're dealing with serious and/or long-term illness

Start a journal immediately and keep it with you. Record emergency phone numbers; names of doctors and hospitals; symptoms and diagnoses; allergies; treatments, doctor visits, and hospitalizations (dates, locations, outcome); prescriptions (names, doses, dates filled, efficacy, side effects, interactions, warnings, prices at different sources); phone calls (contacts, dates, reasons, outcome, follow-up); "significant events" like accidents, strokes, heart attacks, seizures, 911 calls (dates, treatments, where treated, outcome); programs (contacts, application date, outcome, follow-up); notes and anything else pertinent. Keep copies of medical reports and aid applications. You will refer to this journal over and over again.

I condensed the emergency and medical information into a spreadsheet and kept a copy in my purse, my husband's wallet, and on my refrigerator. Doctors, ER staff, and EMTs were thrilled when I was able to present this and I know it expedited my husband's treatment. Now I utilize the Vial of Life. This is a large pill container with a rolled-up paper inside listing all pertinent information. It comes with a bright sticker to affix to your front door that notifies emergency personnel where to find it. It also has Velcro on the outside so you can stick it anywhere. Some people keep it in their refrigerator. I have three, which is not uncommon - one in my purse, one in my glove box, and one on the outside of my fridge. I got mine free at the front desk of my hospital. There are several other similar products available.

Begin saving every medical-related invoice, cancelled check, and receipt in an organized manner, including for OTC drugs and parking/gas or bus/taxi fares for doctor/hospital visits. This may become vital when applying for programs, declaring bankruptcy, doing your taxes, and other circumstances. For example, my son was given better terms on his student loans because of our situation. Some students receive additional grants or tuition reduction. To get this benefit, though, I had to submit copies of everything I listed above to the financial aid department of his university - in a very large box.

Apply for Social Security Disability right away if it seems that the patient will not be able to return to work. Even the Social Security Office recommends this because there is a six-month waiting period for benefits once you have been determined to be disabled. You can always withdraw your application if things improve.

Cut back as much as possible on your expenses. Even with a great deal of help, without insurance, you will probably accumulate massive debt. You are likely to miss work or even lose your job. Use the money you save to pre-pay utilities and your mortgage (be careful - check with your mortgage company about the way to do this that is most advantageous to you), to build up your pantry, and to cover medical needs. Be aware that if you simply bank your savings that it may hurt you when you apply for help.

I wish you good health and I hope you come back next time for the second part of this diary.

Note: Previously published at Daily Kos.

Single Payer Health Care: what your doctor read this week

river — Thu, 07 Aug 2008 06:24:35 GMT

Reposted from Daily Kos at los anjalis' request.

Several months ago I subscribed to Medscape, a weekly web medical journal. Subscriptions are limited to the profession, but I lied and said that I was a nutritionist, so I get this publication in my inbox every week. It's full of interesting articles on various medical issues; my main areas of interest are usually endocrinology and diabetes, and nephrology.

This week's lead editorial is by Dr. Quentin Young, National Coordinator, Physicians for a National Health Program. I have permission from PNHP to reproduce this here in full, as most Kossacks probably do not have access to a Medscape subscription. I have followed this with a few excerpts from the comments from both health care professionals and laypeople. This is what your doctor is reading this week.

(click on "there's more")

Will America Enact National Health Insurance in 2009?
Posted 07/28/2008
Quentin Young, MD
The 43rd anniversary of the passage of Medicare is an appropriate time to examine just why this single payer government-run national health insurance has not been expanded to everybody. Despite its deficiencies, Medicare serves the elderly remarkably better than the confusion of for-profit private insurance schemes that have steadily disserved the American patient.
Of course, the failure to have fundamental healthcare reform has been the result of the awesome power of the industry, which profits from the present arrangements -- big pharma, for-profit hospitals, and health insurance giants. In addition to the increasingly frustrated "beneficiaries," America's physicians have suffered under the health system organized to assure returns to investors.
Doctors have, at long last, realized that there is something worse than government: corporate-run healthcare.
Heretofore the prevailing political and health policy wisdom has been that expansion of Medicare to everybody was simply politically unfeasible. Billions of dollars are ready to be spent resisting health reform; recall "Harry and Louise" in 1993.
Recent months have seen a huge shift in public positions on single payer healthcare. In a recent AP poll, 65% of the public agreed that the United States should "adopt a universal health insurance program...like Medicare that is run by the government and financed by taxpayers." In January, the American College of Physicians endorsed single payer for the first time as a pathway to universal coverage. In April, the Annals of Internal Medicine published a national survey of physicians indicating that 59% of doctors support the adoption of legislation to create national health insurance.[1]
Significantly, on June 23, the US Conference of Mayors, representing cities of over 30,000 people, unanimously endorsed legislation for Medicare for All, HR 676.
Could 2009 turn out to be the year this nation takes the leap to enact a national health system?
That's my opinion. I'm Dr. Quentin Young, National Coordinator, Physicians for a National Health Program.
Readers are encouraged to respond to the author at info@pnhp.org or to George Lundberg, MD, Editor in Chief of The Medscape Journal of Medicine, for the editor's eyes only or for possible publication as an actual Letter in the Medscape Journal via email: glundberg@medscape.net

However, many (though not all) of the doctors who have commented on this editorial disagree with Dr. Young. We have a long way to go.

A family practitioner:

Government-run and financed health care will be a huge shell game that places huge power in the hands of an ever-growing and inefficient government. Can someone please demonstrate where our Constitution provides for such a role for government? I was the administrator of a Medicare Home HEalth agency. Nearly 75% of my costs had to do with government-required processes that provided no enhancement of care for the patient. In fact, I was once cited for providing an extra visit to a patient (in the capitated payment system this cost my agency money, not the government).
Most of the money to fund a national health plan will go into more wasteful administrative rules and another huge agency of staff that add nothing to the benefit of the recipient - but which WILL provide more government jobs and therefore more government power.
If you think healthcare is expensive now, just wait until it's free.

A surgeon:

The speaker/author has not viewed the terrible Veterans Administration Health Care. Government medicine has been has been here a long time, and shows how bad such a system can be.

An oral surgeon:

Our practice reluctantly opted out of participation in Medicare. We're oral and maxillofacial surgeons so this was a realistic option. We accept Medicaid as well as most insurance. Why opt out of Medicare? They are the most obnoxious of the bunch to deal with. They represented a small enough part of our practice to make this practical. Submit justification as to why this particular radiograph was needed. Provide justification as to why this particular handicapped patient needed general anesthesia. If these people represented a large enough part of the practice that we couldn't opt out, I'd consider selling used cars.

This same commenter adds:

Most of the poorest Americans are poorest for a reason. Let's reduce those who have lifted themselves up by hard work and responsible behaviour to the level of the lowest. In the short term, young physicians who have invested everything into getting that MD will provide a lot of talent to the system. In the long term, talented young people will not look towards a career in medicine. If you can depend on talented physicians from India forever, more power to you, otherwise, you're sending a capable medical force to the trash heap.

An emergency physician:

With all due respect, who would recommend that our entire healthcare system go to Medicare? I can understand those that perhaps do not deal with Medicare directly, but I assume Dr. Q. Young has dealt with it directly. Medicare is a huge government program that is rapidly going broke; new "quality measures" are little more than roadblocks to allow the government to not pay providers-there is little to do with quality and much to do with denial of reimbursement in these measures.
Further, I would think that Dr. Young would be smart enough to realize that once government controls healthcare, there is no going back. The program will be with us forever once it is started. Can anyone truly imagine the possibility of ridding ourselves of Medicare or Medicaid programs, even if this were to be desired? No, these programs will never go away, even if we as citizens decided that we no longer want them. Too many people become dependent on them. Further, ever try to negotiate with the government? What are people told if there is a questions about taxes? Pay and figure out the problem later. Once government takes control, there are no negotiations. The government tells what providers will be paid. Period. If you don't believe me, try negotiating for better reimbursement from your Medicare provider, or even better from medicaid. Reimbursement for Illinois Medicaid is a joke; there is no negotiations-doctors in Illinois do not cover their costs caring for Medicaid patients. This has lead to patients not being able to find doctors, overcrowded EDs, patients not getting care until their condition is serious. Expect more of the same in Medicare in the future.
Does that mean that there are not problems with the current system? Certainly not. However, one must look with a critical eye at the alternative. Change for change sake without concern for the result is irresponsible. Some change is for good, some change will not be good. It is imperative that we investigate the consequences of any changes fully.
I do worry about access to care. Especially for seniors. However, government run healthcare, like everything else government controls, would be a disaster. To close one's eyes to this reality and take on the Pollyanna view of Universal Healthcare is at best naive, and at worst ignorant.

An opthamologist:

Using Medicare as a model for universal health care is unwise. A) When the entire population has to be covered, there aren't enough tax dollars in the system to finance reimbursement rates at current levels; how many docs will use that as a good reason to quit or decline to see "government patients"? B)Using Great Britain or other countries with socialized medical care as shining examples of proper health care delivery is really pathetic: what none of these systems want publicized is that the primary cost containment mechanism is to triage their most elderly or sickest patients to the morgue, which is the de facto result of limited availability of the most expensive services. C)Resolving the issue of the uninsured or so called non-insurable is clearly a high priority item for moral and ethical reasons, if not the pragmatic problem of reducing the need for patients to dump themselves on the ER so they have to be taken care of under Title 22. Universal health care insurance as a solution to this problem is like using dynamite to dig a hole in the yard to plant a tree. Taking on 40 or 50 million under-insured is bound to create a bigger boondoggle than anything ever witnessed since the fall of Rome. A better method is to simply allow people to be in large risk pools, set premiums based on income or some other reasonable measure, and require insurance carriers to accept participants from any geographic region and with any pre-existing condition. Insurers could be required to set aside a portion of premiums to set up a nationwide fund for extraordinary expenses, so no one person or family is hit with huge bills. Why give government a mandate to tax more and have more power? The same government that can give you everything you want can also take away everything you have. D)Under the best of circumstances, there may always be some degre of compromise between the health care needs of the population and the availability of resources. Universal health care biases the algorithm in favor of the lowest common denominator: the least amount of care for the largest number of people. Why is that acceptable? The goal should be the best care possible for the people who need it most, with all people given access according to their need. There is no universal health care system on earth that does that well as evidenced by the many docs and patients who opt out of it any way they can. E) Free markets work best when there are incentives to provide a product or service, not disincentives. Therefore, "incentivize" patients, doctors, hospitals, and the health care industry. The government can no better be the operator of a universal health care system than it can efficiently run a factory or create wealth. It can be a regulator, even though it may not do that very well. Just look at the trashed housing market and ask, "Where was the regulator of Fannie and Freddie?'; Where was the SEC and the FED?" The current system has it's flaws, but at least the government doesn't have the power to dictate who lives and who doesn't. If politicians get caught up in that power, be prepared to find out what mean nasty fascists they can be, especially if they decide health care "just costs too much." Those who would say our current free market approach is also flawed and failing are only partially correct. We do not have a free market system in health care. Truly doing so would improve things far more imaginatively than even the most remarkable exertions of the government.

But there is hope! Here's a women's health provider:

It may surprise you to hear that some Americans, middle class and adequately covered through insurance provided by employers, still favor a system that covers all Americans and would willingly accept a decrease in efficiancy of service to know that millions do not go uninsured as is now the case. I suspect that the elimination of the paperwork and bureaucracy of the current system would make way for improvements in direct care, and even if it didn't, some of us still have a "one for all" attitude, perhaps unlike the physicians you know who may prefer a system that allows for them to profit hugely from the health care industry, no matter who dies for lack of care.

She adds:

Probably the reason that doctors opt out of accepting Medicare patients is that they don't make enough money. Maybe if they can learn to go for the Honda instead of the Porsche, they can be part of the solution.

And then there are the laypeople. This one broke my heart and made me angry:

I have pre-existing conditions of cancer, epilepsy and depression. I am not considered disabled enough to collect disability and have had trouble all my life with private insurance programs. Currently I am on [state plan], [state]'s Medicaid system. I will lose [it] if I make more than $851 per month.
[state plan], in its infinite wisdom, decided to forgo chemotherapy in my case because the type of cancer I have is rare (Pseudomyxoma Peritonei) and there are only two IPHC treatment centers in the United States. If I had had the chemo, I would have about a 60 % chance of living to 5 years. Without chemo, my chances of survival to five years are 5%.
If we had National Health Insurance, I would be covered if I had to travel to another state for chemo.
Amazingly, I have been cancer free for three years. However, [state policy] policy has forced my doctor to see me every three months and run frequent tests such as CT scans and Colonoscopy to make sure I am indeed cancer free. Also, because of the income limitations imposed on me, I live in a shelter. The City of [my city] pays $130 per night for me to stay on a cot in a shelter. I have been there for a year. For those interested in math, that's $47,500 per year just for a cot.
National Health Care would actually drop the cost of treatment! It would also provide healthcare to those who are currently ignored or criminalized for their diseases. That includes persons with epilepsy, in wheelchairs, with psychiatric conditions and drug addicted.
I could return to my full potential. I have a B.S. in Biology and a dual Masters in Business Administration and Health Administration. I would be paying enough in taxes to offset the cost of my care.

In short, we have a lot of education to do yet. The meme of "socialized medicine" is still held forth as a scare tactic. If this is what physicians are saying to each other, we need to show them, somehow, how universal single-payer health care will benefit them; these responders almost universally seem to think that it will harm them and bring no benefit at all.

Update: I received this email from the publisher of Medscape and wanted to include it here to correct misinformation I inadvertently presented.

Hello,

Medscape is not a "weekly"; it is a platform for a huge amount of information, from a wide variety of sources, changing daily in multiple ways. The 40 or so MedPulses are mostly distributed weekly.

Although intended for physicians, pharmacists, nurses, medical students, and other health care professionals, membership is open to anyone, free of charge.

Register as you like......it will not change what you get...go anywhere on Medscape. Enjoy.

George lundberg MD, EIC.

how they roll in other countries: germany and healthcare

los anjalis — Thu, 03 Jul 2008 04:25:07 GMT

Let's roll with this knowledge, and dream of what can be.

Those of us who live in America know next to nothing about how other countries' health care systems operate. Not because we're stupid or ignorant, I'd like to think, but because we are not allowed opportunities through our mainstream media to learn about other countries, so myths created easily perpetuate. Many of us turn to alternative sources of media or the internet (or both), but still, there's generally so much policy jargon to sift through. THIS is partly why Michael Moore's documentary Sicko left so many in the American public stunned regarding the various types of health access and services that citizens of other nations receive.

NPR did a piece today on Germany's health care system, a system which by the way has existed for over 125 years. For some jaw-dropping action, read the whole article, it's not that long. What really struck out for me was a fundamental difference in the set of values we hold above all else, in both countries. What we tolerate or praise here would not be tolerated there. What we struggle with here in regards to access to healthcare, bankruptcy from medical bills, huge deductibles, time to see docs, are a non-issue there. Obviously there are problems in every system. Here's a glimpse, though, of some of the virtues of the German system we're not exposed to in most of our media sources. Some quotable quotes:

Germany on access to doctors at times of need:

On one particular night, Juergen was the doctor on call for the region. Any German who needs after-hours care can call a central number and get connected to a doctor.

On access to humane and intuitive support services after an operation, as told by a woman who had thyroid surgery:

"Then I came home to my little daughter, who I couldn't really lift up because of my neck having been cut open," Sabina says. "So I asked my doctor, 'What can I do?' And she said, 'Well, your health insurance will pay for someone to come help you in the house.'"

They also pay for support services and money to families who want to keep their elderly parents at home and out of nursing homes. Again, a fundamentally different set of values.

On coverage for everyone:

The health care system... is not funded by government taxes. But it is compulsory. All German workers pay about 8 percent of their gross income to a nonprofit insurance company called a sickness fund.

On SOLIDARITY:

Basing premiums on a percentage-of-salary means that the less people make, the less they have to pay. The more money they make, the more they pay. This principle is at the heart of the system. Germans call it "solidarity." The idea is that everybody's in it together, and nobody should be without health insurance.

This one really got me. I dream of the day (it is possible!) when Americans routinely use the word solidarity.

On the cost to employers:

The big difference is that U.S. employers pay far more, on average, than German employers do - 18 percent of each employee's gross income versus around 8 percent in Germany.

On humanity (FUCK DEDUCTIBLES!)

Moreover, German health insurance has more generous benefits than U.S. policies cover. There are never any deductibles, for instance, before coverage kicks in. And all Germans get the same coverage.

After mentioning they would NEVER move to America STRICTLY because of health care costs for their chronic problems, a couple also notes the embarassing statistic about bankruptcy due to medical costs in America. On DIGNITY:

"It's also the No. 1 reason in the United States that people personally go bankrupt," Sabina translates, "which would never happen here ... never!"

On family coverage:

Nicole pays a premium of $270 a month for insurance that covers her children, too. Nicole pays a single $15 copayment once every three months to see her primary-care doctor - and another $15 a quarter to see each specialist, as often as she wants. She pays no copayments for her children's care --and her insurance even covers her daughter's orthodontia bill.

If you're self-employed you have to buy insurance from a private for-profit company (not the non-profit sickness funds). This is also an option if you make more than a certain amount a year. Interestingly...

But most people don't opt out. Chris says that's because there's a fundamental difference in the way Germans view health care and the government's role - which, in Germany, means refereeing the system and making sure it's fair and affordable.

The German govt regulates the insurance companies, or in better terms, holds them accountable to a basic set of guidelines:

So Chris' insurer can't raise his rates if he gets sick or jack up his premiums too much as he gets older. The government also requires insurers to keep costs down so things don't get too expensive.

And again, on SOLIDARITY:

Germans really hate any hint of unfairness in health care. The fundamental idea is that everybody must be covered and, preferably, everybody should get equal treatment. So the fact that 10 percent or so can buy some perks is an irritant - something Germans complain about but manage to put up with.

I noted that the article didn't mention anything about the uninsured in Germany (those who are not employed or are not self-employed, or who are self-employed but cannot afford the monthly premium). And then I realized that NPR had done a piece on the uninsured in Germany. 0.2 of the population there is uninsured, there are only 8 free clinics in the country, and that's changing for the better as a new law was passed that would allow for the uninsured to be covered. Picking up my jaw again from the floor.

ALSO check out the interactive international health care comparison chart at the NPR site -- you can do head to head comparisons of US vs Germany, Britain vs Germany, Switzerland vs Japan, and other such permutations. It's pretty interesting.

Thoughts on all of this? Let's roll with this knowledge, this new perspective, and dream of what can be. Cmon, pick your jaw up already!