Well, since I can't figure out how to embed the fucking video, here's the link.
He's awesome.
Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts
Friday, May 09, 2008
Tuesday, November 13, 2007
Feeding the War Machine
A recent blog post by a friend about what is coming to be commonly known as the "healthcare crisis" inspired me to add another chapter to the saga.
Roughly 15 years ago, my older brother (who was 18 at the time) was in a terribly debilitating car accident, was in a coma for 9 weeks, and upon awaking, spent months and months in physical therapy. He had to learn how to do everything again: eat, walk, talk, even sit up straight. After 3 months in rehab at Baylor in Dallas, his total hospital bill topped out at well over $100,000. And that didn't count the weekly rehab he still had to get once he moved back home to Arkansas. Luckily, he was covered on my mother's state insurance (she's a public school teacher) and very little of that actually came out of my parents' pocket. But imagine if one or both of my parents hadn't had good insurance, or my brother hadn't been covered? That would have been the end of my parents. There's no way they could pay that bill without losing everything.
Eventually he's able to work again, but only part-time, and he collects Social Security. Due to only working part-time and being disabled, his only real insurance is Medicare. He could, especially now, work far more than he is, but due to receiving Social Security, he can't make more than a certain amount of money each month, which is basically poverty level. Otherwise he loses his Social Security. And if he loses his Social Security, he loses his Medicare, his only form of insurance.
Somewhere along the way, he contracts HIV. (We won't even go into how his brain injury impairs judgment and inhibits control of impulsive behavior; that's another post, or a book). For years he's fine, but at the beginning of 2005 (or 2006, I'm not sure), he sees a spike in viral loads, and his T-Cells drop. Which means it's time for the dreaded "cocktail." Luckily, the cocktail works, with little to no side effects, which is rare, but all the drugs combined cost over $3,000 a month, which, with a small co-pay, is covered by Medicare.
Well, about 6 months after he starts on the cocktail, he receives a letter from Social Security informing him that he's been being overpaid because he makes too much money, and he now owes them $30,000 in back payments. End of payments to the brother; now he owes them.
2 weeks later he receives another letter informing him that he will still get his payments, but they're going to subtract $50 every month to begin reimbursing their $30,000. (Uh, how long you think that'll take? Anybody care to do the math?) Then 2 weeks after that he receives another letter saying he's still going to receive payments but they're going to take $100 out every month to begin reimbursing their $30,000.
Also, because of this, he gets kicked off Medicare. Bye-bye cocktail medicine insurance. Now, in order to pay for those drugs that cost $3,000 a month, it has to come out of somebody's pocket.
Needless to say, my parents are scrambling furiously to try to figure out how this happened, what to do, and how to get him reinstated on Social Security. Clearly, no one seems to be in charge, and their policies for dealing with my brother are changing month to month. Finally my parents start working with a counselor, who tells them to save all of my brother's pay stubs, public transportation receipts (he can't drive due to his injury) and all paperwork pertaining to the HIV meds. She says to send them to her every 6 weeks. So they do. And this works for awhile. She gets him all reinstated, and everything's back to semi-normal.
One day, my father gets a huge package in the mail from Social Security and opens it. It's a package of all the stuff he's been sending this counselor for the past 12 weeks or so, with a note attached from someone else saying, "So and so doesn't work here anymore. What is all this stuff and what am I supposed to do with it?"
And everything started all over again. (For the record, my brother gets his drugs covered again, with co-pays, and after a $4,000 annual premium due up front at the beginning of each year.) But my family has been fighting this for years, and it's still not resolved, and now lawyers are involved (I think it ended up that he's back on SS, but still owes the $30,000, even though all the previous rules were followed). Who knows how long this could continue to drag on, with no small amount of financial and emotional drain.
The biggest problem in all of this to me seems to be a serious lack of oversight. If Social Security and Medicare are both federal agencies, and no one is there to manage them or hold anyone accountable for anything, then how is universal coverage going to work? I have my doubts about universal coverage, despite how badly I want it, and think the citizens of this country deserve it. I also have my suspicions that under a different administration, and were we not in the middle of a ridiculous war that's draining every federal resource there is, this kind of stuff might be handled in a more pragmatic and efficient way.
But also, if the United States had a more formalized version of universal care (and maybe an addendum to this could be a caveat for parents to cover their adult children if the adult children are disabled), then the Social Security wouldn't be so important to my brother, and he could A) work more, and B) probably ultimately be less of a drain on federal dollars (depending on how his federally subsidized insurance coverage would work, and how prescriptions fall into that).
Roughly 15 years ago, my older brother (who was 18 at the time) was in a terribly debilitating car accident, was in a coma for 9 weeks, and upon awaking, spent months and months in physical therapy. He had to learn how to do everything again: eat, walk, talk, even sit up straight. After 3 months in rehab at Baylor in Dallas, his total hospital bill topped out at well over $100,000. And that didn't count the weekly rehab he still had to get once he moved back home to Arkansas. Luckily, he was covered on my mother's state insurance (she's a public school teacher) and very little of that actually came out of my parents' pocket. But imagine if one or both of my parents hadn't had good insurance, or my brother hadn't been covered? That would have been the end of my parents. There's no way they could pay that bill without losing everything.
Eventually he's able to work again, but only part-time, and he collects Social Security. Due to only working part-time and being disabled, his only real insurance is Medicare. He could, especially now, work far more than he is, but due to receiving Social Security, he can't make more than a certain amount of money each month, which is basically poverty level. Otherwise he loses his Social Security. And if he loses his Social Security, he loses his Medicare, his only form of insurance.
Somewhere along the way, he contracts HIV. (We won't even go into how his brain injury impairs judgment and inhibits control of impulsive behavior; that's another post, or a book). For years he's fine, but at the beginning of 2005 (or 2006, I'm not sure), he sees a spike in viral loads, and his T-Cells drop. Which means it's time for the dreaded "cocktail." Luckily, the cocktail works, with little to no side effects, which is rare, but all the drugs combined cost over $3,000 a month, which, with a small co-pay, is covered by Medicare.
Well, about 6 months after he starts on the cocktail, he receives a letter from Social Security informing him that he's been being overpaid because he makes too much money, and he now owes them $30,000 in back payments. End of payments to the brother; now he owes them.
2 weeks later he receives another letter informing him that he will still get his payments, but they're going to subtract $50 every month to begin reimbursing their $30,000. (Uh, how long you think that'll take? Anybody care to do the math?) Then 2 weeks after that he receives another letter saying he's still going to receive payments but they're going to take $100 out every month to begin reimbursing their $30,000.
Also, because of this, he gets kicked off Medicare. Bye-bye cocktail medicine insurance. Now, in order to pay for those drugs that cost $3,000 a month, it has to come out of somebody's pocket.
Needless to say, my parents are scrambling furiously to try to figure out how this happened, what to do, and how to get him reinstated on Social Security. Clearly, no one seems to be in charge, and their policies for dealing with my brother are changing month to month. Finally my parents start working with a counselor, who tells them to save all of my brother's pay stubs, public transportation receipts (he can't drive due to his injury) and all paperwork pertaining to the HIV meds. She says to send them to her every 6 weeks. So they do. And this works for awhile. She gets him all reinstated, and everything's back to semi-normal.
One day, my father gets a huge package in the mail from Social Security and opens it. It's a package of all the stuff he's been sending this counselor for the past 12 weeks or so, with a note attached from someone else saying, "So and so doesn't work here anymore. What is all this stuff and what am I supposed to do with it?"
And everything started all over again. (For the record, my brother gets his drugs covered again, with co-pays, and after a $4,000 annual premium due up front at the beginning of each year.) But my family has been fighting this for years, and it's still not resolved, and now lawyers are involved (I think it ended up that he's back on SS, but still owes the $30,000, even though all the previous rules were followed). Who knows how long this could continue to drag on, with no small amount of financial and emotional drain.
The biggest problem in all of this to me seems to be a serious lack of oversight. If Social Security and Medicare are both federal agencies, and no one is there to manage them or hold anyone accountable for anything, then how is universal coverage going to work? I have my doubts about universal coverage, despite how badly I want it, and think the citizens of this country deserve it. I also have my suspicions that under a different administration, and were we not in the middle of a ridiculous war that's draining every federal resource there is, this kind of stuff might be handled in a more pragmatic and efficient way.
But also, if the United States had a more formalized version of universal care (and maybe an addendum to this could be a caveat for parents to cover their adult children if the adult children are disabled), then the Social Security wouldn't be so important to my brother, and he could A) work more, and B) probably ultimately be less of a drain on federal dollars (depending on how his federally subsidized insurance coverage would work, and how prescriptions fall into that).
Tuesday, August 21, 2007
It's official: the only thing worse than being gay in Republikan Amerika is being poor.
This week, after George Bush told 4 million poor children and their parents to go fuck themselves and stop being so poor, at least 3 Republicans have shown that they still have a heart and a pulse after overturning a particularly insidious piece of legislation from Oklahoma from 2004.
...that's what Oklahoma lawmakers were striving for in 2004 with their chillingly titled "Adoption Invalidation Law," which targeted adopted children with gay parents.
That wrongheaded statute declared that Oklahoma would refuse to recognize "an adoption by more than one individual of the same sex from any other state or foreign jurisdiction." In other words, if a gay couple and the child they adopted in, say, California or Maryland moved to Oklahoma or simply drove through Oklahoma on vacation, they would not be treated as a legally recognized family by any Oklahoma official -- whether a police officer, public school teacher or judge.
Sounds un-American, doesn't it? It's also unconstitutional. That's what a federal court of appeals told Oklahoma on Aug. 3 in striking down the law. A panel of three judges -- all of them Republican appointees -- of the 10th Circuit Court of Appeals agreed with a lower court ruling that Oklahoma's anti-family law violated the U.S. Constitution's Full Faith and Credit Clause, which requires states to honor one another's judicial judgments, including adoptions.
I mean, if Okalahoma wants to hate on gay people (which they do), then fine. I don't know who in their right fucking mind would want to live in that ugly-ass, wasteland, vacuum of a state anyway, but to intentionally target little kids to suffer is just pathological. You seriously can't get much lower than that. That's like being mad at someone, so you decide to torture their cat to get revenge.
Beyond that, I'm actually left a little speechless.
...that's what Oklahoma lawmakers were striving for in 2004 with their chillingly titled "Adoption Invalidation Law," which targeted adopted children with gay parents.
That wrongheaded statute declared that Oklahoma would refuse to recognize "an adoption by more than one individual of the same sex from any other state or foreign jurisdiction." In other words, if a gay couple and the child they adopted in, say, California or Maryland moved to Oklahoma or simply drove through Oklahoma on vacation, they would not be treated as a legally recognized family by any Oklahoma official -- whether a police officer, public school teacher or judge.
Sounds un-American, doesn't it? It's also unconstitutional. That's what a federal court of appeals told Oklahoma on Aug. 3 in striking down the law. A panel of three judges -- all of them Republican appointees -- of the 10th Circuit Court of Appeals agreed with a lower court ruling that Oklahoma's anti-family law violated the U.S. Constitution's Full Faith and Credit Clause, which requires states to honor one another's judicial judgments, including adoptions.
I mean, if Okalahoma wants to hate on gay people (which they do), then fine. I don't know who in their right fucking mind would want to live in that ugly-ass, wasteland, vacuum of a state anyway, but to intentionally target little kids to suffer is just pathological. You seriously can't get much lower than that. That's like being mad at someone, so you decide to torture their cat to get revenge.
Beyond that, I'm actually left a little speechless.
Wednesday, August 08, 2007
Tipping point? I doubt it.
But it gives me chills that the subject of healthcare is even becoming such a critical factor in this presidential election. Forgive me for being cynical, but if there's one thing the Bush Legacy of Terror has taught us about politics, it's that not only does the will of the people not have to translate to political action, but with a minimal amount of coercion, the lazy American public can fairly easily be convinced to vote against their own best interests.
Nevertheless, the people are angry. And that's as good a start as any.
Nevertheless, the people are angry. And that's as good a start as any.
Wednesday, August 01, 2007
One more (BIG) strike against Hillary
At one point, even just a couple of months ago, I said I would never, ever vote for Hillary Clinton for president, no matter what. Well, in that time, she has gone on to dissuade my fear a bit, and she's actually said and done some things I really liked. However, I read on Politico today that Obama favors lifting a ban on federal money for needle exchange programs, while Clinton still wants to stick to the safe status-quo:
Obama was quick to say at his July appearance he supports lifting the ban on federal funding for needle exchange. Clinton, by contrast, performed what King called "an interesting waffle" at her April 23 event.
The differences in their answers reflect their different relationships to a hot-button issue of the 1990s, which has since cooled and faded from the public debate. Clinton linked herself to her husband's 1998 compromise between public health activists and anti-drug crusaders, while Obama sided solidly with the advocates of what are seen as "preventive" services.
In the unusual 1998 compromise, Clinton Health and Human Services Secretary Donna Shalala announced that the administration's scientific review had found needle exchanges safe and effective -- but that the administration would nonetheless maintain a federal ban on funding them.
That reveals so much about them both, doesn't it? I'm impressed with Obama. This more than makes up for his pretty skittish (dare I say "spineless") committment to human rights. I like to call myself a 3-issue voter: environment, health care, and "human rights," i.e., gay rights. Probably in that order. And everything that those things entail.
This is a huge boon to Obama in my book. Way to go.
PREVIUOSLY: Needle Exchange
Obama was quick to say at his July appearance he supports lifting the ban on federal funding for needle exchange. Clinton, by contrast, performed what King called "an interesting waffle" at her April 23 event.
The differences in their answers reflect their different relationships to a hot-button issue of the 1990s, which has since cooled and faded from the public debate. Clinton linked herself to her husband's 1998 compromise between public health activists and anti-drug crusaders, while Obama sided solidly with the advocates of what are seen as "preventive" services.
In the unusual 1998 compromise, Clinton Health and Human Services Secretary Donna Shalala announced that the administration's scientific review had found needle exchanges safe and effective -- but that the administration would nonetheless maintain a federal ban on funding them.
That reveals so much about them both, doesn't it? I'm impressed with Obama. This more than makes up for his pretty skittish (dare I say "spineless") committment to human rights. I like to call myself a 3-issue voter: environment, health care, and "human rights," i.e., gay rights. Probably in that order. And everything that those things entail.
This is a huge boon to Obama in my book. Way to go.
PREVIUOSLY: Needle Exchange
Tuesday, May 29, 2007
Needle Exchange
Washington DC is the only city in the country barred from using local tax money to help finance needle exchange programs. Today in the NYT, there's an article about Ron Daniels, an ex-drug user himself who works with an annual budget of $385,000 from private donations running his own needle exchange program in DC. He is also HIV positive, which 1 in 20 people in DC also are, making it the city in the United States with the highest infection rate.
Among men, using infected needles to shoot drugs is the second most common way of contracting HIV, behind sex, and for women, it's the number one method. The infection rate is going up, though, especially for hetersexual black women, who are the fastest growing segment of the population to become infected. Many people attribute this to there still being such a large stigma against homosexuality in the black community, so many black men are still very closeted and in relationships with women, while having sex with men on the side. It's called "being on the down low." There have even been movies made about it.
I don't know that I've ever really given much thought to needle exchange programs, but after working in an AIDS hospice for over a year now, they seem pretty necessary. The majority of the residents we have in there are not middle-aged or young gay men, as one might expect. They're mostly very, very poor black people, usually from the street or direct from prison, and most of them are heterosexual drug users. Some are clean when they come to us, some aren't. A lot of the women have been prostitutes, and there are more women than you'd think. And they're all black. At least ever since I've been there.
Back at the Winnebago, Yvonne Zywusko, a 39-year-old prostitute, climbed on board, shaking in withdrawal from not having used heroin in over a day.
“Look at me,” she said as she dropped two used needles in the bucket. “I wasn’t raised this way. I went to Catholic school. My family had a lot to offer me, and I missed out.”
Reaching out to prostitutes is an especially high priority of Mr. Daniels’s program, since they have great potential to spread H.I.V.
Seeming disgusted with herself, Ms. Zywusko described how she sold her body and slept in stairwells, but she began shaking her head as she added that she was still not ready or able to kick her addiction.
She added that the one line she was trying not to cross is sharing needles. “I got checked in January. It was negative,” she said about her last H.I.V. test. “I’m lucky.”
UPDATE: Texas is the only state in the whole country(!) that doesn't allow needle exhange programs of any kind, despite being the state with the 4th highest drug-related AIDS infection rate. Apparently, just this past week, a Texas House committee, led by chairwoman Dianne White Delisi (R - Temple), killed a bill that would have made it legal. The bill's author was Sen. Bob Deuell, R - Greenville.
As of 2001, there was an underground needle exchange program operating out of an unmarked van. I wonder if they're still around.
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