Not Down Or Out

It could be worse. I might not be laughing.

Tag: Affordable Care Act

I Can Hear You Now

One of the several lingering effects of chemotherapy appears to be tinnitus. Tinnitus is that ringing or buzzing in the ears that some suffer for various reasons. My tinnitus began back when I was in treatment for uterine cancer at the end of 2011 or beginning of 2012.

I did not have the benefit of a huge medical team as I went through treatment. I did not have medical insurance and relied on the county’s medical services. I remain so very grateful for the county’s care that I will state up front that tinnitus has seemed a small matter by comparison with cancer.

No one has ever explained to me what causes my tinnitus or how I might treat it. Ever since the enactment of what people call Obamacare, I have had insurance I pay for without receipt of subsidies. I pay for a gold plan because I know how expensive life-saving care is. But I seldom have used my bought-and-paid-for insurance because, after I pay the high premiums and the deductibles and co-pays, medical care remains very expensive. I have had a more expensive safety net, not an affordable source of ongoing healthcare.

So I have worked on acquiring my substitute for qualified healthcare. I read online sites and try to reason my way through conflicting, incomplete, sometimes advertiser-generated, and often anecdotal information. It has suggested that chemotherapy may have damaged the hairs in my ears that assist with hearing. That damage may have caused or contributed to causing my tinnitus. Do not take my word for it. It is a theory.

I take a Biotin supplement that includes Silica and Collagen. I know. Some will say supplements are unnecessary if your diet is nutritionally adequate. Overweight people often have nutritional excesses. There is no way to judge the purity and efficacy of supplements across the marketplace. What I know is that the hair on my head, my eyebrows, my eyelashes, even the unwelcome hairs on my chin, are all thriving. Just this week someone who has not seen me in years was asking what was with the hair. It is brown, shows very little silver for one who is 58, is thicker than ever, and it is wavy. Once again, I am relying on “sign reasoning” instead of double blind tests conducted by scientists.

Still my ears ring. Sometimes it is a din. Sometimes it is a buzz. I never work or relax in a silent place. Because the “sound” is distracting, I often play a radio, turn on the TV, or run a fan to mask it in part. Nevertheless, it is never absent.

A couple of weeks ago my mom and I traveled east by car from Chicago to visit family. We picked a day in which each of the states through which we passed experienced rain. I’m not talking about wet road conditions. I was thinking Ghostbusters (1984) rain. From its script:

Dr. Peter Venkman: Human sacrifice, dogs and cats living together… mass hysteria!

For most of the four to five hours it took to cross Ohio we had trouble seeing the taillights of the cars and trucks ahead of us. It goes without saying that there was road work. The big rigs traveling on the other side of the road were in what turned into a channel formed by cement walls on either side. The water collected. As they drove past our car they sent up waves of water that slapped the windshield. Mom and I flinched each time that happened.

Road conditions improved in Pennsylvania, but the weather did not. I kept going. We did not stop for lunch because neither one of us could handle the mad dash from the car to the service stop buildings.

I turned on the car’s radio from time to time, but we never did find a station with weather reports. I would let the radio roam through the few available stations and then shut the radio off. My mom was silent except for the occasional breath caught in fear and released with a sigh when the rain eased a bit in its ferocity or a truck moved a safe distance or the windshield wipers cleared our view for a moment. I was very conscious of my tinnitus during that long drive.

While we pressed on through Pennsylvania, I located a station that was broadcasting the daily rosary. Sponsored by the Knights of Columbus Bellevue Council #1400, someone led us through a rosary addressing the Sorrowful Mysteries. I left it on and we prayed along with the priest and the others present at the recording of the event.

Shortly after the rosary ended I shut the radio off. The rain slowed down. And the tinnitus stopped.

I started to cry because it was so quiet. I cannot explain how peaceful it felt to have the noise stop. I seldom complain about it. It’s not cancer, is it? I have handled many more scary situations. It is not painful. It is not employment discrimination. It is not isolating. It is part of the soundtrack of a busy life. There are a million other things that occupy my mind on most days. I cope with it. It bothers me most at the end of the day. I lie in bed and try to clear my mind. That is when it seems most loud. Sometimes I turn on a “sound machine” that plays crashing waves or a babbling brook or rain. But that is not silence. Most nights I turn on a fan and an air cleaner. But that is not silence.

I say my prayers of gratefulness for family and friends, health and hope, talents and opportunities. I fall asleep focusing on what I have and not what I need. I am blessed, not burdened in my earthly life. I still have the little scraps of paper on which I listed my blessings and my angels on October 6, 2011, when I could not sleep on the night before my hysterectomy. I know what they say.

I pray for the people I know and some I don’t. I pray every night for the souls of the departed. I spend a lot of nights focused on the special intentions of my mom, sister, brother, and their families. I pray for friends and students who face challenges, whether large or small. I pray every night for Mike Terrill and his family and so many other brave and kind people I have met here on WordPress during my cancer treatment and recovery. Somehow those prayers make my mind quiet even if I can still hear that ringing in my ears. But let’s be honest about my prayers–I’ve been doing most of the talking.

That’s why the trip through Pennsylvania was different. This was silence. I kept wiping my eyes because it was so wonder-full.

I did some more reading online and found some reports of tinnitus reduced or abated following fast descents. Maybe the mountainous roads of Pennsylvania helped. But, in the same way I put stock in my supplements, I am putting some stock in the possibility that prayer has found for me another way to silence the din.

The tinnitus has come back. In the week after it stopped, it faded in and out. It did not stop completely during the trip home, even though we passed through Pennsylvania’s mountains on a cloudy and dry day. It continues without change today.

My mom gave me a rosary recently. This past week the old friend who commented on my changed hairdo gave me a rosary she bought for me long ago in Medjugorje, the site of many unconfirmed miracles.

I pray, but I am not one who often says the rosary. I think that might be changing.

I am sending a check today to the Knights of Columbus of Bellevue, Pa. so that they can continue broadcasting the daily rosary. And, Lord, I am listening. Whether or not prayer will stop tinnitus, I cannot say. I can still hear the tinnitus, but I think I can hear something that will help me cope with it now, too. Lord, I think I can hear You now.

Humbling Experiences

Another Waiting Room

Another Waiting Room

My relationship with my gynecological P.A. is a work in progress. She very much wanted me to see a general practitioner in a clinic setting. So she put me into some waiting list for an appointment at a clinic in Logan Circle. The first time I came up for an appointment the notice came about a day before the appointment. I was unable to make it because I had to work. When I was last at the hospital to see my oncologist the resident checked and informed me I was scheduled for today. So I had a month’s notice.

I will confess that I was reluctant to go. I’m feeling pressure from the P.A. to take blood pressure medicine. My blood pressure has gone up and down. It was at its highest within minutes of learning I had cancer. I shed no tears–not even one for several months–but the stress was affecting my blood pressure for a couple of days. Within three days my blood pressure was back to normal and stayed that way until sometime in the last year. Back in about February it was 180/96. That was the day I had my second post-hysterectomy internal exam. I was over-the-top nervous about the exam. About a week before that appointment it was only 161/111. In May I started getting a swollen ankle and leg and felt the blood pressure climb. My oncologist doubled the dose of the water pill I take. That seems to help the edema and the blood pressure. I have my own cuff at home and take it periodically and my blood pressure was back in the 140/86 range. In August, my blood pressure was 151/92. Dr. H felt it was not a problem, particularly because I have lost weight since February and continue to do so. I am resolved not to start another drug unless I first research it. Once you start some of these drugs it is hard to get off of them and they all seem to cause more side-effects. I am tired of dealing with side-effects!

The other reason I was not keen to go is the hernia. Dr. H wants it fixed. I really cannot contemplate checking into the hospital for surgery after my December 2011 admission to hell there. I am well aware of the risks of exposure to infection in hospitals, and that place did not maintain cleanliness. I thought I might die in that place. I’m not going back there as an inpatient until it is the last option on the table.

October 1 is when the health insurance exchanges open in the U.S. I have not even been able to get a quote for health insurance since my diagnosis with cancer. This will be a new opportunity for me to obtain health insurance on my own. I have no idea what I can afford, but I pray I can afford some new options.

I went for the clinic appointment despite my misgivings. I arrived early. It took forever to find street parking. I entered and went through the same type of processing as at the hospital. Get up. Answer questions. Be seated. Get up. Answer questions. Be seated. It is like the childhood game Simon Says.

I brought work. Lots of work. And I waited. At one point my vitals were taken. My weight was down. The clinic is part of the same county hospital system as my hospital, but the nurse had to ask me about my allergies to medicines because my records were not available or she did not access them. It was so disappointing to know that once I saw a doctor we would need to go through so much medical history.

My blood pressure was 190/110! I had been waiting for some time amidst other patients. I have to admit it was uncomfortable. Small children crying. Wendy Williams (big news today–absolutely nothing), Bethenny Frankel (big news today–some people have friends who make them fat by cooking for them), Fox News (big news today–Sen. Ted Cruz read a Dr. Seuss bedtime story in his 21+ hour diatribe against the Affordable Care Act), and some other talk show that drove me up the wall as angry people yelled at each other.

All voices today at the clinic were heavily accented. I did not recognize my own name when it was called, and I speak some Spanish. My ex-husband could speak Spanish. I’ve heard my name spoken with that accent. At one point, I heard my name and got up and went over to the reception area only to find no one looking for me. All three receptionists were taking on phones. So I said to myself, “Now I’m hearing voices.”

As soon as I sat down, the receptionist called me again. She said, “Sorry, I forgot I called you.” I was not the only person having trouble focusing.

I should be used to this. But I am no longer sick. Just pained after surgery, chemotherapy, and radiation.

The nurse asked if I felt okay, and I did. No headache. No stress other than the situation. I had plenty of work to do, deadlines approaching, and twenty things I’d rather be doing. Even unpacking sounded great.

Two hours after my scheduled appointment I was out of work to do. I was sitting next to a man with a bad cold in the waiting room. I was tired. I was unbelievably sad that there were so many people for whom this was the best option for care. I told the receptionist I needed to leave. I had work to do.

The receptionist called a nurse who put me in a room. Then I heard my future doctor (Dr. S) ask someone to prep the woman in the next room for a procedure, and he went in there. I waited another fifteen minutes before I left without seeing the doctor. It did not matter if he would be free in five more minutes or in fifty. I was as twitchy as I ever get and needed to get out of there.

This is nothing new. This is medicine for people without health insurance. I think by now I should be philosophical and copacetic. But I am tired and stressed and I wonder how anyone with a job ever gets medical help in the system. From the time I left home in the morning until I got out of the clinic I had spent more than four hours without meeting the doctor, and I fell behind in my work.

I am grateful to have this as an option, but I am praying that the Affordable Care Act means I can afford insurance and schedule an appointment instead of being ordered to appear on a day when I need to be at work. I am praying that one day soon I will be able to speak to a doctor about my concerns for more than five minutes.

I have felt bad all afternoon for leaving, but I am now one-half day behind in my work and have non-negotiable deadlines to meet on Friday. This semester I have 25% more students in one class and am paid 40% less than I would have been if law schools could help their graduates find jobs in the current job market or if full-time pay was a little lower than it now is.

At the rate I’m going, tomorrow for me will be like a blister on the back of your heel when you’re wearing new shoes and it is still morning.

Some days I have to remind myself that I am just underpaid and not down and out. I may be feeling humbled by my circumstances, but I still have my sense of humor. That’s the real reason why I’m Not Down or Out.

Checking In

Back at the hospital

This morning I went for my six-month exam. Other than fatigue from having survived a swift move, I have been feeling well. In late February/early March. the daily, serious pains associated with radiation cystitis abruptly stopped. In June I determined that the other side-effects of cystitis–distress and incontinence–were well behind me. I stopped taking the Oxybutynin that had been prescribed for me. My bladder and bowel seem to have healed from the effects of chemotherapy and radiation.

I have had several “clean” pelvic exams and tests for cancer cells. My last scan was June of 2012. It showed no signs of cancer. In October it will be twenty-four months since my hysterectomy. In December it will be twenty-four months since treatment ended. I was thinking there would be a scan and blood tests, but there were no tests today.

My oncology team wants me to undergo surgery to correct a pre-hysterectomy hernia. The surgeon who originally diagnosed my cancer was going to repair it as part of my hysterectomy, but he ended up having someone else perform the surgery. That doctor did not touch the hernia. But it was in the way of his reaching my lymph nodes. As a result, no lymph nodes were tested–which explains why my chemotherapy and radiation treatments were “adjuvant.” They addressed risks unknown. I learned that the scans also can be confounded by the hernia, and that my radiation was more extensive because of the state of my “habilis.”

Everything looks good right now, but, if cancer were to return, everyone would feel better if things got “tidied up.” There’s no question but that I would like to get this addressed as well–EXCEPT–I do not have health insurance, I do not have the money to pay for this surgery, I am about to start school and cannot imagine undergoing surgery during “school time,” and the very thought of checking in to the hospital after my December 2011 experience there is out of the question unless it would save my life.

I am returning this week to teaching at the law school that terminated me the day of my hysterectomy. The law school is facing declining enrollments and has decided to cut the compensation paid to adjuncts, like myself, by 40%. At the same time, it has increased class size by 25%. The school has conducted its own internal investigation of my case and has cleared everyone involved of any breaches of university policies.

I suppose that means that the school would support my termination a second time if I underwent surgery–even if my surgeon said, “You can return to work next week.” That’s what the surgeon said last time.

The EEOC is examining my case now. I would like to wait for the results of that investigation before chancing fate on the subject of job security. As if an adjunct has any job security.

The Affordable Care Act will go into effect this fall. I would like to wait to see whether I can afford insurance when the new exchanges open in my state. I might have new options for treatment at a hospital that does not scare me.

The doctors think the charity that covered so much of my post-surgical care would agree to pay for this surgery if I appealed to it. That will take some time.

The doctors want me to go now for a mammogram. My cancer was estrogen-related. Some breast cancers are estrogen-related. So, I’ll do that. My maternal aunt died after more than a decade of dealing with breast cancer, so I will have the test.

My weight had dropped somewhat. My blood pressure was much better. I’m only taking a water pill for that. The doctors put off until my next check-up an ultrasound of my legs that might rule out varicose veins as the reason for my sometimes swollen right leg. No one else reacted when I mentioned the possibility of lymphoedema–which means nothing. I know that it could be the reason for my swelling from reading the excellent blog http://lymphnodetransplant.wordpress.com/. Check it out if you have unexplained swelling after surgery or other treatment that might have affected your lymph nodes’ ability to function.

I am seeing a GP in late September. I see the P.A. for another gynecological check-up in October. I can investigate my insurance/charity/surgical options between now and my next oncology appointment in February 2014.

I am feeling relieved to have gotten through this check-up, but my definition of “relief” has changed from “phew” to a sort of uneasy reduction of the alarm level from orange to yellow.

Photocredit: ripsaw-defence.co.uk

Photocredit: ripsaw-defence.co.uk

A lot can happen in six months. And I have some checking to do before checking in again with my oncology team.

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.” http://www.scoutsongs.com/lyrics/makenewfriends.html. 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. http://www.thenation.com/article/168833/obamacares-women.  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–http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf. 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. http://www.usatoday.com/news/education/2008-12-03-part-time-professors_N.htm.

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. http://www.factcheck.org/2009/08/health-care-for-members-of-congress/. 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. http://www.commentarymagazine.com/2012/03/26/opposition-to-obamacare-high-among-women-youth/. 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. http://studentsforlife.org/2012/07/02/channeling-frustration-into-energy/. 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.

http://www.seacoastonline.com/articles/20120708-OPINION-207080315. 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. http://www.dol.gov/ebsa/faqs/faq-consumer-cobra.html. 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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