Not Down Or Out

It could be worse. I might not be laughing.

Month: July, 2012

Have You Seen Peggy?

I am very concerned about Peggy, the patient in the Cancer Centers of America commercial. Have you seen the latest commercial? I have only seen it. It was on in a public place and I could not hear what she said, but she looked drawn and tired and was seated in a chair that could have been a wheelchair or a hospital waiting room chair.

In contrast, I am doing well, as well as I could hope to be doing eight months after my treatment ended. I have hair, eyebrows, eyelashes, and am no longer down to what my niece Maureen called “the hard wood floors.” All my external burns from radiation are red marks. I can’t even see the scar from my hysterectomy. I ate some nuts this week without feeling I would pass glass fragments. My bladder still hurts to a 7-8 on a scale from 1-10 in which 10 is very bad when I eliminate; and my knees and hips don’t feel the same as they used to after all that radiation. But that’s minor compared with what preceded it.

I only teared up twice this week as I felt frustrated by my inability to do something I would have liked to do if I were completely recovered. I am not projecting fear for my situation onto Peggy’s. Is it just me or does it seem that there have been a significant number of deaths from cancer in the past month or so? I can remember when I used to think deaths came in threes and that seemed horribly sad. Now I’d find three deaths in a relatively short time period an improvement.

I’m going to call my new cancer buddy Joyce on Wednesday to see how her second chemotherapy treatment turns out. I have been praying and practicing my affirmation for her every day. I pray and think positive thoughts about Peggy at the same time. But today I read Yvonne’s post about her recent scan, and I could not help but think that we’re all in this together and I don’t really feel all that good while people who I care about feel scared or sick.

I am no scientist and have much to learn about my own brush with cancer, much less how it presents in others, but it seems to me that it is always described as a fast growing cell. And that makes me wonder why it doesn’t seem to get old. Or is its quick aging the reason why it is so dangerous? It seems like every day on the news I get advice on how to stay young. Why haven’t we figured out a way to age this scourge so that it dies before we do?

I gather that my skin ages more quickly if I expose it to sunlight without wearing sun block. I can age by not exercising or by not sleeping. Don’t these darn cells have a life cycle? Why do they keep growing when other cells fail? Do they fail but do they simply get replaced? Do they divide faster so they outnumber the healthy cells in us? Isn’t that a Baby Boom problem? Don’t we have ways of dealing with that phenomenon, too? If we could give (fictionally) the alien  war ship in Independence Day a cold by uploading a virus, why not give cancer one? Is cancer invincible? What is its Kryptonite? Why do so many other diseases “run their course”? I realize cancer is not the only disease that kills. All life ends at some point in time, but it is difficult to think that the best approach remains to poison with chemotherapy drugs or scorch with radiation. The “host,” who dearly wants to show this disease to the door, must hope to survive the same treatment as will kill the unwanted guest. Sort of a Russian Roulette with an unfeeling opponent. All the fear is on our side. We never get to see the cancer sweat what makes us most afraid.

We need to support each other and the search for cures. We need to stop wasting money for “health care” when “health care” means duplication of tests because we still don’t have a way to make a person’s medical records available to doctors at another facility without delay. Honestly, if the credit industry can tell the local gas station I’m good to go when I need gas, why can’t my doctor see more than a single pathology report sent by fax when I have to switch hospitals? We need to eliminate the completion of forms that repeat information already in everyone’s possession. How many times have I watched my local hospital print an entire page of bar code labels when I check in for an appointment even though it will need at most three labels for every report and order generated? The rest of the page ends up in the trash. Can we get that money back for medical research? How about the money spent on magazines in waiting rooms? I’ll bring my own reading material if it means more funds for prevention.  How many people do you know who take aspirin like breath mints or antibiotics like aspirin? What if we used the money to give the HIV cocktail to people when they are HIV positive rather than waiting until they are sick? If stem cell research could help us find or effect a cure for Michael J. Fox and others with Parkinson’s disease and there are stem cells in umbilical cords, then why aren’t we using stem cells from umbilical cords to save lives whenever possible? Can’t we save the cords of babies born every day so that we can help more people? I don’t mean to make light of suffering or take away from anyone the care he or she is willing to purchase. I am saying that we have national policies on all kinds of things and manage to make breakthroughs. Why not a groundswell movement for this country to do what it is best suited to doing? We have the resources to send another vehicle to explore Mars. We have the resources to track the temperature of the polar ice caps on a day-to-day basis. We can do this, too. We can make health care, and not its decentralized and wasteful administration, our priority. What if we actually stopped fighting over whether to have health care for everyone in this country and put the spotlight on our common enemies–disease, contagion, deterioration, and ignorance?

Have you seen Peggy? I’m worried about her. I think all of us should be. She seems like a really nice person. I want her to live a long life and be happy doing it. And I’m willing to do my part. Let’s not pay any more money to kill people in some place far away while we let people die here at home. Let’s save Peggy and everyone else like her.

Saying My Prayers

I saw Dr. H Monday. Dr. Z apparently completed his studies. He was not present. Last year’s junior doctor whose name I never discovered greeted me (I’m going to call her Dr. Y until I can get a good look at her ID card) and took me back to the exam room. She reviewed my CT scan results with me, checked my lungs, and examined my healed incision. She verified that I had enough prescription refills to keep me going until October. My appointments will now be spaced out over three months. She asked me how I was feeling and made notes. I had her undivided attention.

Dr. H came by at the end of the appointment, followed closely by a young man in a white coat. I educate young lawyers so did not think he looked too young to practice medicine. I said, “Hello doctors.” The young man looked at me and smiled tentatively. His black and neon green backpack hung on the back of the examining room door. I know it was his because I first wondered if a patient had left it. Dr. Y looked at it and smiled. “It belongs to my new colleague.” I wondered if all professions had “trappings” that were being reconsidered in modern times. If doctors have exchanged little black bags for backpacks, what have lawyers adopted in place of leather briefcases? I no longer have a conventional leather briefcase. I have rolling carts in various sizes and a Tumi leather backpack that cost me several hundred dollars in wealthier times. Maybe we’re all becoming pack animals!

I recall once carrying a lovely calf skin briefcase engraved with gold letters that read Arnold & Porter. I received it my first day as an associate at the firm. I used it to carry my research materials and case files when my office was in one downtown office building and the partners for whom I worked were in another. I recall joking that carrying the briefcase all day long spared me the experience of being asked to go get a partner coffee. In those days there were plenty of female associates but few female partners. I did go fetch a few cups of coffee in my time. I did it with an ironic smile.

Dr. H commands respect without any trappings. She came in, asked me how I was feeling, and listened intently to my report. Her husband has cancer. That must be the worst experience an oncologist can manage. You spend your life treating cancer and your spouse succumbs to it. Her husband, like me, has experienced severe burns to the bladder during radiation. She left the room to call him to ask for the name of an over-the-counter medication that has given him some relief from bladder pain. When she returned she handed me a prescription for Cystex. It is ordinarily used by persons suffering from urinary tract infections. The pills contain a high dose of cranberry with something to ease pain. It is intended to soothe until a person can see a physician and obtain an antibiotic. She told me to take it to a Walgreens as the hospital does not carry it.

I like this doctor. I have several times seen her and been told to suck it up–pain, bleeding, burns, weakness. Nevertheless, I am comforted by the fact that she let me decide whether to go nuclear or cross my fingers when faced with the unknown condition of my untested lymph nodes, she gave me her cell phone number when things started to get grim during my treatments for cancer, and she has offered me the latest in care offered to no less than her husband.

I hope that she can continue to treat me. When it came time to arrange my next appointment I learned that she only has clinic hours on Monday mornings. I will be teaching Monday mornings this fall. I had no idea that she met patients on no other days of the week. I would have moved my class schedule had I known this. But it is too late to do that now. Students already have signed up for the class. If my appointments will now be spaced at least three months apart, then it will only be the one Monday when there will be a conflict. I discussed the matter with the receptionist. I will be teaching my Monday class at the law school. I have been told that I cannot miss any classes. That was a condition to my being offered the opportunity to teach Transactional Drafting. I was not offered the class all last year. Before I had cancer I would have considered asking my students to reschedule class for later that week. I would have felt bad about it, but I would have asked them to accommodate this one event as it is critical to my care. No longer. As I stood there I was afraid that seeing my doctor might cost me my job. I thought, maybe that’s me doing my best to stay professional. What did I read recently about professionalism? “Being a professional is doing the things you love to do on the days you don’t feel like doing them (David Halberstam, quoting Julius Erving).” David Halberstam, Everything They Had: Sports Writing from David Halberstam. Even as I worried that it would be a mistake to miss an appointment, I worried more about how my supervisors would react.

I told the receptionist that I would have to miss an October appointment. She asked me why. I told her briefly and she closed her eyes and sighed. She asked, “Is it a catholic institution?” I nodded. She told me that she was the victim of racial discrimination when she worked for such an organization a number of years ago. It was strange because I really was not looking for this connection. I anticipated that the system would let me slip through the cracks. I was headed next to the pharmacy that refills prescriptions for county patients. You can’t drop off or pick up a prescription on a weekend at the hospital. It is only open Mondays-Fridays 8 a.m.-6:30 p.m. I’ve wondered before how people manage to hold down jobs and still receive care and have figured out that they adapt or go without care. So I was resigned to missing care so as not to lose my job. But the receptionist was not prepared to let me do that. She studied her computer screen and scheduled me for an 8:15 a.m. appointment. She told me to arrive at 7 a.m. and check in as soon as the clinic opened. She told me to ask for the receptionist who had originally greeted me that morning. “Tell her about your employer,” she told me. “She’ll make sure you get in first. Tell the nurse your story when she takes your vitals. She’ll help you, too. That way maybe you can make it on time to your 10 a.m. class.” I thanked her for her advice. I wondered, not for the first time, whether or not someone “upstairs” was looking out for me, guiding me through the difficult path that I have been walking.

I headed next toward the Fantus Clinic, located in another building, where I drew a number and waited my turn to pick up my medicines for the next sixty days. As I leaned against a pillar waiting for someone to call B214 I tried to remember the last time I felt safe. It has not been for a long time. I have felt loved. I have felt cared for. I have felt pretty good. But I have not felt safe. I have worried that I might die. I have worried that I might not recover from cancer treatment. I have worried about my job. I have worried about medical bills. I have worried about my reputation. I have worried about cancer returning. I am not prone to worry about things. I have always had a strong belief in the potential for things to work out even when they don’t. As I stood there thinking about the receptionist I decided to stop being afraid. I think things will work out even if I do work at a place that might terminate me for seeing my doctor to ensure that cancer has not returned. If I keep on thinking that way maybe things will work out. And, if they don’t, well, maybe there are things that have to be accepted no matter how difficult they will be to bear. Haven’t I already met many wonderful people who have had to accept grim medical situations? Haven’t I been a witness to at least one failed effort to fight cancer?

Professionalism isn’t education. It isn’t a degree. It isn’t title. It isn’t experience. It isn’t income. It isn’t a calf skin briefcase or a black bag. It isn’t something you acquire. As Julius Erving said, it is how you do your job. Dr. H is a professional. Her two doctors in training are professional. The oncology clinic’s receptionists are professional. It may be the county hospital and many of the patients may be without insurance or financial resources, but the hospital is a teaching institution and it is teaching people to be professionals. I am grateful for the care I have received there. Over at the law school, I will handle my situation as professionally as I can and hope for the best. Maybe the only way to maintain professionalism is to continue to demonstrate it. Joyce Meyer has been quoted as saying, “Courage is fear that has said its prayers and decided to go forward anyway.”  Joyce Meyer, I Dare You: Embrace Life with Passion. I’m saying my prayers that the next time I need my employer’s support to secure my continued good health that the school will not let me down.

All That and the Brooklyn Bridge

Last week was the first time in ten months that my life did not run at full throttle. I taught an online class. I attempted to attend a faculty meeting until I was turned away by four downtown parking garages and returned home. Those were my only serious commitments for the week. My average week has included teaching as many as five classes. In addition to those ongoing commitments, I hemorrhaged until I had depleted two-thirds of the hemoglobin required for healthy life. I was diagnosed with uterine cancer. I underwent major surgery, chemotherapy, and radiation. I spent two weeks in the hospital. I went through menopause.

Cancer–something buried in the middle of everything else I did–was just something on my weekly “to do” list:

1. Prepare five sets of lecture notes.

2. Grade 60-100 papers.

3. Grade about 20 exams.

4. Get treated for cancer.

5. Spend Saturday with Mom.

After all of these months, I finally sat down and thought about all that I experienced.

I read my blog entries from beginning to end. I went through my in and out boxes in my email account and moved all the cancer-related messages to a cancer folder. Then I took out the several journals that I kept over the last ten months. I skimmed them. Then I flipped through my calendar to read the entries for doctor’s appointments and treatments. I opened up my linen closet and tossed out every nightgown, towel, and sheet that bore stains from my uncontrolled bleeding prior to surgery, the orange medicine I took in December to alleviate bladder pain, several months of painful gastric and intestinal distress, and the bloody radiation burns I had around my hips from December to March. I put my wigs back in their boxes. I threw out all of the hair products that I used to use and have not touched since October. I started trying on my pre-October wardrobe and figured out how many items were too large to be worn again. I put them in bags that I plan to contribute to charity.

I emptied my camera and took a roll of film to Walgreens to get it developed. I transferred the few digital photos that I took during the last year into a folder. I stared for almost thirty minutes at a photo of blood clots that I had passed from my bladder in early December. They were so large that I found myself thinking that the photo appeared to have been “photo-shopped.” It was not.

I sat in front of my lighted 10-X magnification mirror and studied my new hair, brown, sprinkled with silver, short, wavy, and standing up all over the place. I evaluated the longer length of my eyelashes and my eyebrows. I studied the sparse white hairs on my arms. I determined that the calluses that formed on the tops of my feet and the backs of my hand during anemia and chemotherapy were all gone. I examined the ridges on my fingernails that mark the period when I was receiving chemotherapy.

I went to the full length mirror and studied my completely healed and nearly invisible hysterectomy scar. I have not looked at it in so many months that I cannot recall when it changed from red to white. If I did not know it was there, I would not be able to find it. I cannot even feel it with my finger tip. I studied the hernia that I did not know I had before October, which has become prominent after surgery and weight loss. I realized that I am still sort of numb at the top of my left thigh because some of the nerves around my incision site have not yet repaired themselves.

I opened up my freezer and resolved to eat in one week all of the vegetables I bought and could no longer eat once I hit that rough third week of radiation when my digestive tract felt burned. I uncovered a baggie filled with health bars that my friend Tracey made for me in early November. I ate one without feeling like its Chia, pumpkin, and other seeds would tear my intestines to shreds. By this time next week they will be gone. I finally used up the last of the paper towels and toilet paper that I bought from Peapod in December when I could no longer carry supplies up my back steps because I was physically exhausted. I moved the last two twelve-packs of ginger ale from the front closet to the refrigerator. That’s what I used to drink when I was a little nauseated after chemotherapy. It has no caffeine that might irritate my bladder.

After taking stock of the events as they relate to my home and my body, I felt tension like a twisted rubber band running from my ears to the back of my neck. The tension was not alleviated by letting go of so many items. It ratcheted up appreciably. I felt nauseated, as if I had consumed Thanksgiving and Christmas dinners at one seating and then swallowed a bottle of seltzer. Everything that I had been absorbing without digesting from the time I was told I had cancer until now seemed swollen and expanding.

I cleaned my desktop off. I last did that in September 2011. I filed away all the receipts, notes, and address changes that I had accumulated. I moved to the floor more than one hundred magazines and books that I had marked for articles, assignments, lectures, and books I plan to write. They are now in piles so that I may systematically go through them before consigning them to bookshelves, storage, or trash. I made a list of people to contact because I never got around to answering Christmas cards, birthday cards, or other updates all year if they came from people who did not know about my “health crisis.” I read every last get well card that I received one more time before discarding them.

After I did that, I sat hunched over my desk because my body had become so taut with tension that I could no longer hold my head up. I felt as if my joints were made of glass and the effort it would take to get up and move might shatter them. I was “Tin Man” stiff with unreleased anxiety.

My eyebrows hurt. My cheekbones hurt. The sides of my nose hurt. Every prior effort to force my lips into a smile when I was asked how I was doing felt like it had been performed in reverse. My jaws hurt as though I had been chewing gum all day. I felt the weight of my own prior cheerfulness descend upon me like an avalanche or a crashing wave.

It’s only been about a week since I stopped racing around, but my primary reaction to the entire experience is that I am not the same person any longer. I could not figure out how to put these changes into words that would make sense of my experience.

My cousin Susie called yesterday. She doesn’t call herself Susie since she became an adult, but she will always be Susie for me. She has a way of getting me to open up about how I’m feeling that is better than therapy. All she has to say in her loving and measured way is, “How are you?” I start singing like a canary.

I still am not sure how I feel except that I sense that I am on the verge of a new wave of change and I want to measure how far I have come before I move on to the next place. In the last few weeks I have encountered two psychics that have told me that come October 2012 my professional life will be changing. I have heard recently from ten people who have ideas for new projects that we can work on together. I start new classes in another month. Two people have told me that I must do more to help others who have cancer or do not have health insurance. No one tells me what to do. I make that decision, but people are trying.

As I heard from Barb and Kathy during the day, the process of assessing the last year’s events continued. Nevertheless, by the end of the day on Sunday I was so stiff with tension that my toes were clenched like I wore a new pair of flip-flops for a run up the stairs at the U.S. Capitol building.

When I climbed into bed I felt older and more uncomfortable than I had since my hospitalization in December. It was like I had worked out with Jillian Michaels from Biggest Loser. I was physically and emotionally whipped. I stayed in bed for four hours and got up when the clock said 4:00 a.m. and I could not recall whether I had managed to sleep at all.

I now sit at my desk before my laptop and I am no closer to figuring out what has happened to me than I was yesterday. This past week I read Mary Pipher’s Writing to Change the World at 83 (Riverhead Books 2006), in which she wrote:

The writer Craig Vetter once remarked, “The Brooklyn Bridge was built by a guy who had a term paper to write.”

Maybe the last week’s efforts were nothing more than, and just as exhausting as, the construction of the Brooklyn Bridge, effort undertaken to delay moving forward. This is what I do know. I do not now have cancer. I want to live. I have important things to do. There are people I want to know better. I am grateful for all of the blessings in my life. Maybe that’s all there is to know.

Make New Friends

When I was a Brownie we used to sing a Scout song that began: “Make new friends, but keep the old. One is silver, the other is gold.” Yesterday I received a phone call from Joyce, the woman I met while waiting for my June CAT scan. She has learned that breast cancer has invaded lymph nodes. It is has spread to the point that it is difficult to remove. For twelve weeks she will undergo chemotherapy in the hopes that the cancer can be contained, reduced to a size more manageably removed. She has already had her first treatment. It went pretty well. She was nauseated, but not overcome by her treatment.

We spoke for about an hour. Toward the end of the call she said that she has not claimed the cancer as her own. It is just the cancer, not her cancer. She won’t claim it because doing so gives it more power over her.

She has read quite a bit about the Laws of Attraction. The theory is that you manifest what you contemplate. More power to her. I hope that she keeps getting well by focusing only on good health. I have put an index card over my desk that says, “Joyce is 100% cancer free.” I say it aloud each time that my eyes pass over it. I want to help Joyce deal with the cancer in her own way.

I have claimed my cancer. I have gone warrior, which is pretty funny if you know me. I much prefer to fight for others than for myself. When I was a kid, my little sister Kathy fought my battles. As I walked home from kindergarten, I turned the corner on Victoria Lane and the Kirky Boys (named for their leader Kirk) would run after me. If they caught me, they pounded me with their puny fists. It was scary. But Kathy, who struggled with asthma and allergies, would see me coming and run into the fray. She was a fearsome ally. She is a fearsome ally still. Her prayers on my behalf have mighty mojo.

I have had my cancer “excised” by doctors. I have “scorched” the “earth” that was its last known site with radiation and chemotherapy. I have prayed and others have prayed for me to be strong enough to handle what I must so that my cancer is “vanquished.” So far that is working pretty well. There have been some casualties (my bladder reminds me every day that the war has been costly), but I am on a march.

My Aunt Arlene has metastasized breast cancer. She has been fighting it for years, unwilling to give up the battle because she loves her life. She recently lost the ability to stand and walk. After a bad fall, she learned that her one leg and hip had become appreciably less strong than the other. She began physical therapy and learned to walk again. Her therapists told her she was amazing. No one expected her to be able to do that.

I know of at least one person who has decided to do nothing. Ann is in her nineties, a widow, living with her slightly younger sister. She has breast cancer and has decided not to treat it. I understand that the cancer is visible at this time. It turns her skin an ominous black as it spreads. She still goes on living, each day waking in the easy chair that she sleeps in and struggling to her feet to walk with her sister’s help to the bathroom. You cannot say she isn’t a fighter. She has simply chosen a different battle. And, like others I know, she looks to her faith for the strength to carry on.

Through this blog and by reading others’ blogs, I have made new friends in the community of people who deal with cancer. All have sought the help of husbands, wives, lovers, mothers, fathers, sisters, brothers, sons, daughters, friends, doctors, or God. But they fight with the tools available to them, whether or not they claim cancer as “theirs.”

Today I watched a video from a breast cancer survivor who urged women to fight the implementation of the Obama care program because it would stop mammograms for women under fifty. It would, she said, limit Medicare coverage for women with cancer. No more mammograms for young women. That bothered me because I did not think it was right and it seemed inconsistent as Medicare doesn’t cover many women under fifty. Moreover, I had just read a discussion of the program in an article of the new issue of The Nation, which stated that more women would have access to mammograms under the program.  If you have not read the list of health care benefits for women, including women who now have health insurance, you might want to do so.  As an example, do you live in one of the thirty-seven states that permits health insurers to charge women more for health insurance than they charge men? That is gender rating and, according to the article,  it won’t be permitted under the Affordable Care Act.

Why should you believe The Nation or me? You don’t have to. I found a copy of the Act online– I am reading all 960 pages of it. You can read it, too. I’m going to figure out for myself why people fear it, whether I will be helped by it, and how to use it in my battle. The thing about fear is that it starts with ignorance. People who hate others fear them. They do not know them. People who are angry fear people and things, too. I am not going to be afraid of a law that is intended to help me and people like me without good reason. I am not going to listen to every person who tells me to be afraid and be very afraid. As long as I rely on others to inform me I will be vulnerable to their efforts to manipulate my fear by playing upon my ignorance. Isn’t this the game that makes me change channels when Peggy from Cancer Centers of America talks about expiration dates on people? Well-intentioned people use fear to cultivate new patients for their business. If I’m determined not to be manipulated by people who use my fear of cancer, then I will be just as determined not to be manipulated by that same fear into rejecting a plan that could help me vanquish cancer. Maybe cancer isn’t the Boogeyman. Maybe it is just like the Boogeyman. Either way, I will find it easier to face with the lights on and the shadows dispelled. Maybe I should battle cancer by not claiming it as mine, as Joyce does. Maybe by eliminating as many of my fears about what cancer is and who my allies might be, I will find myself stronger in my war against it. I can claim the war even if I don’t claim the cancer.

God is an old friend whose value is proven in my war. He is the friend of gold, as are all the others who have supported me these last ten months. But Obama care could be a silver lining and a source of new strength. I’m out to make new friends, too. The Laws of Attraction say that I can manifest what I contemplate.

So this is what the index card over my desk says right now:

Peggy has no expiration date. Ann will know peace at the end of her days. Arlene will live a long life. Joyce is 100% cancer free. My family and friends are my “secret” power. Prayer is the best medicine. Cheryl is winning her war against cancer. All of us find strength in knowledge and faith.

Universe, make it so.

My Car/My Cancer

I have been feeling very uncomfortable this week because of the overwhelming anger of some Americans over the Supreme Court’s decision to uphold the insurance mandate of the Obama care Program. I do not have health insurance. I currently am the recipient of charity to cover my extensive medical treatment for cancer. I am unable to afford insurance based on my health and other risk factors.

I insure my car because I must have car insurance. I also have a car loan and it is required that I have insurance to protect my lender’s collateral interest in the car. It’s sad that I can afford to insure my vehicle in case I injure myself or others while operating it, but I cannot insure myself. I am, after all, the most important asset that I possess.

I work for several educational institution employers, none of whom feel it necessary to offer me assistance in acquiring health insurance, even though I usually teach as many courses for them per semester as a full-time professor does. They get to choose my designation as full- or part-time and have chosen to categorize me as a part-time employee, often based on the amount of time required for administrative duties. They also pay a very low salary to their part-time faculty, much lower than they pay to full-time professors.  Some have estimated that close to 50% of higher education courses are taught by part-time faculty.

Much has been made of the fact that employers should not be required to insure their laborers, or even aid in the payment of their insurance premiums. It is a burden on small businesses to pay these costs. It makes it difficult for them to compete with other businesses if they must contribute to the employees’ insurance costs. That makes sense. Labor is an expense that employers seek to minimize, just like materials, utility expenses, administration and overhead costs.

I have read about how angry people are that they will be forced to buy insurance or pay a tax (some call it a penalty). None of the angry people who have written or spoken have announced that they do not want health insurance. Many of them are members of Congress–all of whom have health insurance made available to them and their families.  They can choose from approximately 300 plans, all of which offer immediate coverage with no limitations for pre-existing conditions. The government pays 72-75% of the expense. When I say that the government pays, I mean that my tax monies and yours pay those premiums.  So, it’s okay for tax money to be used to pay for insurance for some, but not others, to be insured.

It must be nice to work at a place that can afford such excellent coverage and so many choices. Of course, the government does not compete with the private sector so the cost of this coverage is not a burden to the government. It is a burden to the taxpayer. I may not be able to afford health insurance, but I pay taxes so that others may have health insurance.

I have no idea whether I will be able to afford health insurance in 2014. If the Obama care Program is still in effect, there will be no single-payer system like so many other countries offer. There will continue to be competition among insurance companies. The inclusion of people with few health risks in the group of insureds should lower the cost of insurance for some because the pool of insured people will include many who will have few claims due to their good health.

I suppose that the young and those in excellent health may resent the fact that they must have insurance in the future. I suppose that some of them are resentful already at the prospect. There are poll results that suggest women and youth oppose the program, even though they are expected by the program’s supporters to benefit from it. Yet I have not read a single news story or commentary written by a young person who would prefer that people like me die of cancer or be saved by charity to having me pay for health insurance. Indeed, the only opinion I read objected to the plan on grounds that it might encourage abortion. I can remember being young and not having health insurance. I often had insurance through my parents’ employer, my employer, or my ex-husband’s employer. But there were years when I did not. On more than one occasion I was sick and did not seek treatment. I often went without regular dental or eye care. I don’t recall thinking that it was my right as a free American to not buy insurance. I wished I could afford it then, too.

If I did resent the fact that my tax money paid for health insurance for children or pregnant women or senior citizens, I cannot recall it. I grew up in a conservative Republican home. I can remember thinking government was too big. But I never thought that people should die because I should be free of the burden of paying for their health care.

There are some signs that the public is willing to begin the process of implementing the Obama program:

According to a poll released this week by the non-partisan Kaiser Family Foundation, 56 percent of Americans believe opponents of the law should “stop trying to block its implementation.[“] Just 38 percent of Americans said opposition should continue. But that 38 percent is very well funded and speaks loudly. It seems to me that many Americans fear that the plan will prove expensive to the nation and many Americans fear that in this economy they are precariously close to becoming uninsured themselves. Loss of employment triggers rights to COBRA continuation coverage, but that coverage is expensive. It is not right that employers bear all of the costs of insuring their workers when they, too, face an insurance/medical system that cannot control costs no matter how many efforts are made to lower the cost of healthcare. As a nation, we need to work on modifying the delivery of medical services to all citizens to reduce the cost of keeping people healthy.

I paid taxes that paid for emergency care for starving people in foreign countries. I paid taxes for military intervention in matters involving disputes between other countries, sometimes for disputes between other countries and their own people. I paid taxes for education even though I never had any children of my own. I paid taxes to finance public transportation for people who could not afford to use it without government subsidies. I paid taxes for many programs that did not directly support me.  I thought that was my civic duty and that such sacrifices were part of the price of freedom.

I have paid taxes as an employee and as an employer, too. I have paid sales taxes on my consumption. I have paid capital gains taxes. I have paid penalties for accessing my pension funds early. I have paid penalties when I have let my meter run out.

Why is healthcare different from all of these other programs undertaken by government for the general welfare of the American people? It’s not. It may be for some the straw that breaks Uncle Sam’s back. Philosophically, many favor a smaller government. They have the political right to object to the plan. But the Congress has voted and they have lost. It is time that we explore what can be done to ensure that those who cannot afford to buy health insurance can afford it.

If some can pay to insure their cars despite the fact that they have never caused a car accident so that those who do cause them can afford to buy insurance if they own cars, then someone else now in excellent health can pay health insurance premiums so that others who need healthcare and could not otherwise afford it can afford to buy health insurance. It does not make sense to say that driving a car is a privilege but living is not and so warrants less protection and less responsibility. I could argue that insurance for cars makes more sense than insurance for cancer because driving a car is risky and being diagnosed with cancer is not, but I am not unintelligent, simply uninsured.

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