Not Down Or Out

It could be worse. I might not be laughing.

Tag: Obama Care

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.

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.

Thank You, Cook County!

On Monday I was standing in line to apply for CareLink, Cook County’s program for helping people with their medical bills when they are uninsured. It was six thirty and the line wrapped outside of the waiting area into the hospital lobby. My bladder was on a forty-five minute time clock. We waited with our birth certificates, pay stubs and miscellaneous other documents. There was a number on a screen that said the office left off serving applicant 863. The line was so long that I was uncertain how many people were ahead of me. I leaned against the chapel’s outer wall as the clock moved slowly and more people joined the line. I was perspiring. My knees were sore. I wanted to lock them for stability but then felt a little faint. So I leaned. The wall was my friend.

At 7:00 a.m., a manager came out and announced how she wanted to manage us. She would send people who had appointments in to an interior waiting room with yellow slips bearing numbers like those you get when you wait at the grocery store’s deli counter. They had to show their documents to her to reassure her that they were prepared. All of us took out papers to hold in our hands.

People without appointments, like me, would also show her our documents. If we were not ready, she would offer us an appointment for a future date. The next appointment was in May! It was March. As I waited I learned I needed utility bills to verify my address. I had none on me. I decided to wait and make an appointment if necessary. If by some miracle my papers passed muster, then I might get a white slip bearing a number from 864-910. That was how many walk-ins could be taken that day.

I finally made it to the start of the line. I pointed out the omitted utility bills. The woman with the master sergeant voice stared at me. I was one of few people there who looked like me–bald with baby fine hair growing in the wake of chemotherapy. She ushered me to the window where someone was handing out white slips. I was number 903.

I took a seat in the waiting room. Others were not so lucky. I saw many turned away that morning. The atmosphere was tense.  When people were turned away because there were no more white slips the line had wrapped its way down the hall toward the emergency room. Many left rather than wait to arrange an appointment. There were many who needed translation assistance. Those with English language skills tried to explain what was happening in Spanish and other languages. The manager’s impatience was not directed entirely at the people in line. She was LOUD and irritated with her co-workers, too. People spoke quietly so as not to let the many speak over the one with power.

It must be tough to turn away so many, but her authority was unquestioned. I never considered arguing with her if she dismissed me.

There were several young men sleeping on their backpacks in the waiting room. They appeared to have been discharged by the ER during the night. All had fair hair, ruddy coloring, and scraggly facial hair. One had bare legs that were lobster red and swollen. Another young man wore the hospital band. He looked fine to me and the man with the red legs looked in need of care. You never know, do you? The rest of us took seats around them. People were soft-spoken, respectful, patient. Several had bad coughs and others offered them lozenges, as if all of us might fare badly if they were disruptive, and not because we wanted to help. Those who were alone were silent. Those who were in the company of others spoke in hushed tones even after the manager went inside to begin evaluating claims. We were there for a long time. At 8:00 a.m. the number on the board was 868. There was still a good chance that I might be rejected for not having enough proof of my address. I resolved to wait.

Outside it was raining. The day before it had been 80 degrees. Flowering trees were in bloom.

It has been “raining” in the restroom, too. When my bladder could wait no longer I slung my purse and briefcase straps around my neck, clutched my pants to keep the hems from touching puddles of liquid and nests of long black hairs, and crouched over a filthy toilet. There were only two soap dispensers. One was empty. I knew I would feel compelled to strip down and shower as soon as I got home. It was depressing. I expected nothing else.

The mess has been made by people who seemed earnest and sincere. Apparently, none could aim.

As I returned to the waiting area I encountered a man with a beaver hat with its flaps strapped up. He paired this hat with a t-shirt. What was his plan for the day?

At 8:30 a.m. the board said we were up to 871. A man in a purple on purple plaid suit with brown shoes, navy Nike socks, an African tribal scarf, and a Gourmet To Go shopping bag filled with stuff took a seat across from me. He had a black leather baseball cap and a winter jacket, too. He took candy from his well worn shopping bag and tried to give it to children, but the children wouldn’t take it. He told me he hoped that my shoulder would feel better soon. It was painful. I wondered how he knew.

At 10:00 a.m. the number was 883. A baby was screaming. Late arrivals had to be directed to the window at one side of the room. The people who waited for service took turns answering the late arrivals’ unspoken questions. Otherwise they stood there staring at a number dispenser that had no more numbers to dispense and signs that told only part of the story about how to get served.

The man in the purple suit was hitting on a voluptuous teen who sat with her mother. At times he hung over her shoulder staring down the front of her t-shirt. He offered her candy, too. There were other women he hovered near. He kept scurrying back to his shopping bag and drawing out treats to offer them.

I dropped my glasses and he ran to get them for me. I thanked him, but my eye contact was not grateful. His bag was the source of many treats for children and young girls. He offered no candy to me.

The rain stopped. The sun came out. In the waiting room we were frozen in time. The person being served was 892 for a very long time.

I hazarded the restroom again and found it worse. I prayed I would return to the waiting room and find the “line” moving. I returned to find everyone waiting while 892 continued to be served. It was 1:35 p.m.

When the number reached 895 we were allowed to wait in the interior waiting room. A woman sat beside me in a group of three connected chairs. She jiggled her leg until I thought my bladder might fracture and scatter like pearls from a broken necklace.

It was getting close to 3:00 p.m. when Ms. F called 903. I took a seat and offered my I.D., birth certificate, and pay stubs. Even now I blush as I recall my nervousness. I wanted charity. I have never wanted that before.

She entered my medical records number on her computer and invoices started rolling up onto the screen. At one point, Ms. F said, “Twenty-three so far.” She looked at me long and hard. “You have had a bad year, haven’t you, honey?”

Tears filled my eyes at her compassion. I had been watching her for some time. She was a tough woman. She spoke Spanish fluently although it was plainly not her first language. She gave folks a piece of her mind with the lash of a quick tongue when they were slow to respond. She sent people packing if they were unprepared.

I did not look away. I have medical bills well into the six figures from two hospitals. I had imagined I might be paying off these bills the rest of my life, which I hoped would be long. “Just how many jobs do you have?” she asked me.

“Two universities,” I answered.

“And you’re still working?” she asked.

“I have been working all along,” I answered.

She stared at me again.

I felt queasy. Whatever she decided, I would find a way to bear the cost. I was so grateful to be alive. The price would have to be paid.

“Let’s see what we can do about qualifying you for some help, honey.”

She typed. She scanned my documents. She studied her screen. She handed me papers to sign. The last one barely registered with me.

“Where do I sign?” I asked.

“You don’t.” Ms. F smiled a little. “You qualified.”

“God bless you,” I said.

“He always does,” she answered.

According to the form, I qualified for a 100% discount on whatever is covered. I have no idea what that is or means. But I walked back to my car as if someone had removed a six figure tumor from my shoulders.

I know the United States Supreme Court this week considers oral arguments for and against Obama Care. I understand that the Commerce Clause has been used to stop discrimination by intrastate businesses and to stop the growing of wheat by a single farmer. If the burden placed on interstate commerce by discrimination and farming for private use is enough to warrant federal intervention, then it seems a minor difference that the same government order one to buy something to ease a burden on interstate commerce. Nevertheless, people stand outside the courthouse screaming “Obama No” and “Obama Yes.” Have you ever imagined yourself in need of charity? If so, then maybe you can understand why I wish we had a way to make health insurance affordable for everyone.

The day was humbling for me. I have never asked for charity before. I have received scholarships, which are a form of charity. They were awarded for work performed. But I could not figure out a way to handle my medical bills without the county’s help so I asked for charity. I did not demand it. I did not utilize my talents to argue or debate. I was a supplicant. I asked for help.

I am grateful for charity. I will admit that I would be even more grateful to be able to leave that charity on the table for someone else. I spent yet another day in the company of people who seemed just as much (or much more) in need as I was, just as grateful for any help received, and just as deserving of help. But I learned something by asking for help. I learned that I need to ask for help to receive it. I learned that I want to live more than I want to be proud that I can handle anything myself. I need others just like everyone else does. I appreciate the fact that the people who extended charity to me treated me with dignity because it was painful to ask for that charity. I hope that I will be the sort of person who treats others that way when it is I who can extend help to them when they need it.

In the greatest nation in their world shouldn’t everyone be able to get quality healthcare? Thank you, Cook County and all of its citizens for helping me get that care. Thank you for creating a safety net for people in their time of greatest need. Thank you for using that safety net to help me. I will do my best to make the kindness a good investment for you.

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