Perhaps one of the saddest facets of the healthcare debate has been its distortion of the provision regarding end of life issues. This compassionate piece of the proposed legislation was employed so successfully as a scare tactic, that it has been removed from the pending legislation.
Let’s look at what was actually proposed and why. Hospitals are financially stressed and under-funded. They can rarely afford the luxury of doing anything for a patient, unless they can charge for it and be reimbursed. This is why the President proposed reimbursing hospitals who offered counseling to patients about end of life issues—the range of options available to them in Intensive Care, Supportive Care, Pain treatment, hospital, home care, nursing home care, and Hospice Care.
Anyone who has been admitted to any hospital in the US in the past five years has been asked if they’d be interested in completing an Advanced Directive. This form lays out a patient’s options for handling their last days and hours. As of now, however, there is no financial support for counseling patients and their families about those options. There is no money in the system to help dying people through the process of deciding exactly how they want to die.
My family was lucky. My sister and I had both worked in hospitals for over twenty years. We knew how to negotiate the system; we knew what was available.
My father had been very clear that he did not want to be kept alive artificially for an extended length of time if there was no hope of recovery. He had completed an Advanced Directive before he was admitted to the hospital for shortness of breath. When he ended up on a respirator in Intensive Care, we were able to show the hospital that this was not what my father wanted. The staff at Martha Jefferson honored my father’s wishes. After his breathing tube was removed, he woke up for an hour and was able to talk with us. Then he died quietly with his family around him.
Shortly after my father died, my mother became ill with Lou Gehrig’s disease. Within three months she could not speak, eat or drink, but she neither wanted to die in the hospital, nor be put on artificial life support. She chose Hospice Care, which turned out to be one of the most beautiful and moving experiences any of us had ever had. Mom played cards (and won!) the day before she began losing the ability to swallow and breath. Hospice care eased her pain and panic, and she died quietly, at home, with her children around her.
Supporting hospitals in their efforts to explain end-of-life choices to patients who are not well-informed about their available options is one of the most humane things we can do for each other. Those who so vocally criticized that part of the president’s proposal for health-care reform were either misinformed or were deliberately trying to confuse the debate with unfounded fear.
Let’s have real debate on all healthcare reform options. Let’s not employ any more scare tactics.
Thursday, August 27, 2009
Thursday, August 20, 2009
Health Care Reform and Pre-existing Conditions by Lara Sokoloff
I was listening to one of President Barack Obama's town hall meetings about health care reform on the radio the other day.
This topic is near and dear to my heart. My son is almost three and has multiple developmental delays. He doesn't crawl, walk, talk or chew very well. My son, with his special needs, has to see a lot of specialists We currently have a specially designed stroller that luckily our insurance paid for. Eventually, we will probably need to get him a wheelchair.
My family and I are fortunate because we currently have good coverage, but we live in constant fear of either being dropped because of our son’s pre-existing condition, or losing our insurance entirely (because of job loss), and then being unable to obtain other coverage because of his pre-existing condition.
At this point I, personally, do not really need to worry about health care. For all our financial misfortunes over the years, as a family we have been fortunate enough to have good coverage. Not a so-called "Cadillac" plan, but good enough--maybe more of a "Dodge" plan. We have had a majority of our health care bills taken care of and we have been able to stay out of debt. God willing we will be able to keep this up. However, should my husband lose his job or one of us (god forbid) have a lengthy stay in the hospital then we are done--bankrupt and severely in debt. I suspect that is the truth for many Americans.
. I cannot see into the future. The President’s plan “would require insurance companies to cover all pre-existing conditions so all Americans, regardless of their health status or history, can get comprehensive benefits at fair and stable premiums." I am all for any reform that allows for health care to cover these pre-existing conditions, for without this kind of
Government-mandated coverage for pre-existing conditions, I worry that if my husband or I were to get another job someday with different health insurance benefits, they would look at our son with his underlying health problems and deny him coverage. What would we do then?
I am very concerned that whatever health care "reform" bill makes it through Congress will not include mandated coverage for him. Right now there are several thousand lobbyists working hard to get their own interests and ideas into the various bills under consideration. Come fall, or whenever the congressional staff goes back to work, the bill that may or may not be passed will be so watered down that maybe if we are lucky, some families will have some benefit from it—and who knows whether one of those families will be mine. I worry most of all that, no matter how hard my husband and I work, we will not be able to afford to give our son the health care he needs.
I know that no country has perfect health care, including this one. We may think we do but we don't. How can we when there are literally millions of families and children without any health coverage? How can we when hardworking families can go into debt just by getting sick? In a perfect health care system, this wouldn't happen. Based on my own experience, I believe we need true reform. Call the President’s plan socialism if you want to, but I would just label it as fair.
This topic is near and dear to my heart. My son is almost three and has multiple developmental delays. He doesn't crawl, walk, talk or chew very well. My son, with his special needs, has to see a lot of specialists We currently have a specially designed stroller that luckily our insurance paid for. Eventually, we will probably need to get him a wheelchair.
My family and I are fortunate because we currently have good coverage, but we live in constant fear of either being dropped because of our son’s pre-existing condition, or losing our insurance entirely (because of job loss), and then being unable to obtain other coverage because of his pre-existing condition.
At this point I, personally, do not really need to worry about health care. For all our financial misfortunes over the years, as a family we have been fortunate enough to have good coverage. Not a so-called "Cadillac" plan, but good enough--maybe more of a "Dodge" plan. We have had a majority of our health care bills taken care of and we have been able to stay out of debt. God willing we will be able to keep this up. However, should my husband lose his job or one of us (god forbid) have a lengthy stay in the hospital then we are done--bankrupt and severely in debt. I suspect that is the truth for many Americans.
. I cannot see into the future. The President’s plan “would require insurance companies to cover all pre-existing conditions so all Americans, regardless of their health status or history, can get comprehensive benefits at fair and stable premiums." I am all for any reform that allows for health care to cover these pre-existing conditions, for without this kind of
Government-mandated coverage for pre-existing conditions, I worry that if my husband or I were to get another job someday with different health insurance benefits, they would look at our son with his underlying health problems and deny him coverage. What would we do then?
I am very concerned that whatever health care "reform" bill makes it through Congress will not include mandated coverage for him. Right now there are several thousand lobbyists working hard to get their own interests and ideas into the various bills under consideration. Come fall, or whenever the congressional staff goes back to work, the bill that may or may not be passed will be so watered down that maybe if we are lucky, some families will have some benefit from it—and who knows whether one of those families will be mine. I worry most of all that, no matter how hard my husband and I work, we will not be able to afford to give our son the health care he needs.
I know that no country has perfect health care, including this one. We may think we do but we don't. How can we when there are literally millions of families and children without any health coverage? How can we when hardworking families can go into debt just by getting sick? In a perfect health care system, this wouldn't happen. Based on my own experience, I believe we need true reform. Call the President’s plan socialism if you want to, but I would just label it as fair.
Thursday, August 13, 2009
Word Games by Janet Miller
I wasn't addicted to playing Scrabble on the computer. Thinking it over, the song by Fiona Apple, comes to mind. “It’s not a habit, it’s cool.”
Here are the facts: I played more than 800 games of Scrabble on my computer and won most of them. I didn't play to win, but to put words together, all 86 delicious tiles worth of them. Then I hit the “Play Again” button and started over.
While thinking about Scrabble, I remembered I had another word game icon on my computer. I check my past scores for Bookworm and realize that my non-addiction to Scrabble was preceded by a non-addiction to Bookworm. In this game, the more points I earned and the more books appear on a bookshelf. There were also burning red tiles that popped up at random. If the evil red tiles were not put into words, they caused the entire game board to burn. While I caused a lot of conflagration, I also racked up some pretty high scores.
Yet surely my intense involvement with those word games was nothing to worry about. It wasn't as though I spent all my time or money consuming cigarettes or alcohol, or buying things on eBay.
Then I remember some of the things going on in my life at the time I began seriously playing word games. A relationship that had lasted more than a decade had recently ended. My mother’s breast cancer had returned. I'd discovered that my mother was drinking again and that I had to assume responsibility for keeping her finances and her life in order. I had felt my own world was disintegrating around me. I would manage to do the things that had to be done, but then I'd escaped to my computer and put letter tiles together. Did that mean I was addicted?
I had no real concept of addiction or substance abuse before I became involved with word games. I think I still believed what my father had believed: If you wanted to stop smoking, you just had to make up your mind. He never understood why my mother continued to smoke, and he certainly had no understanding or tolerance for her alcoholism. Neither did I. Yet as the hours spent playing Scrabble and Bookworm mounted, I what it meant to be truly addicted.
So, I find myself with a life lesson. The truth is I spent a lot of time playing games instead of sleeping, and instead of eating real meals. The truth is I used those games to cope with the overwhelming stress I was experiencing at the time. But I am a lucky one. I have close friends who refused to leave me to my own devices. I met someone who helped me realize how fortunate I was to escape an unhealthy long-year relationship that held nothing for me.
So word games did not take over my life forever--just for quite a long-time. Long enough to give an idea of what it means to be completely dependent on something in order to get through the day.
Hello, my name is Janet and I’m not an addict – but I came really close.
Here are the facts: I played more than 800 games of Scrabble on my computer and won most of them. I didn't play to win, but to put words together, all 86 delicious tiles worth of them. Then I hit the “Play Again” button and started over.
While thinking about Scrabble, I remembered I had another word game icon on my computer. I check my past scores for Bookworm and realize that my non-addiction to Scrabble was preceded by a non-addiction to Bookworm. In this game, the more points I earned and the more books appear on a bookshelf. There were also burning red tiles that popped up at random. If the evil red tiles were not put into words, they caused the entire game board to burn. While I caused a lot of conflagration, I also racked up some pretty high scores.
Yet surely my intense involvement with those word games was nothing to worry about. It wasn't as though I spent all my time or money consuming cigarettes or alcohol, or buying things on eBay.
Then I remember some of the things going on in my life at the time I began seriously playing word games. A relationship that had lasted more than a decade had recently ended. My mother’s breast cancer had returned. I'd discovered that my mother was drinking again and that I had to assume responsibility for keeping her finances and her life in order. I had felt my own world was disintegrating around me. I would manage to do the things that had to be done, but then I'd escaped to my computer and put letter tiles together. Did that mean I was addicted?
I had no real concept of addiction or substance abuse before I became involved with word games. I think I still believed what my father had believed: If you wanted to stop smoking, you just had to make up your mind. He never understood why my mother continued to smoke, and he certainly had no understanding or tolerance for her alcoholism. Neither did I. Yet as the hours spent playing Scrabble and Bookworm mounted, I what it meant to be truly addicted.
So, I find myself with a life lesson. The truth is I spent a lot of time playing games instead of sleeping, and instead of eating real meals. The truth is I used those games to cope with the overwhelming stress I was experiencing at the time. But I am a lucky one. I have close friends who refused to leave me to my own devices. I met someone who helped me realize how fortunate I was to escape an unhealthy long-year relationship that held nothing for me.
So word games did not take over my life forever--just for quite a long-time. Long enough to give an idea of what it means to be completely dependent on something in order to get through the day.
Hello, my name is Janet and I’m not an addict – but I came really close.
Thursday, August 6, 2009
Thoughts on Health Care Reform by Larry Stopper
Every day on NPR we hear stories on the questions surrounding health care. Politicians debate it and health policy experts try to decipher for us what the politicians are doing in their committees. I must admit to being painfully frustrated by much of what I hear on the radio and see in ads on TV. It’s time for citizens to raise their voices in the health care debate.
How many times have you heard in the last few weeks about the problem of putting a government bureaucrat between you and your doctor? I get so angry at this supposed problem that my wife has to ask me to stop shouting. Right now every one of us who pays for our own insurance knows full well that we have an insurance bureaucrat between us and our doctor, and their sole purpose is to help make a profit for their company, not keep us healthy.
When my wife left her state job we were forced to purchase our own health insurance. We shopped around and chose a policy with a high deductible, and a reasonably modest monthly premium. One year later, with no claims against our insurance that reached beyond the deductible, our monthly premium was raised by 37%. With no explanation from our insurance company as to why our premium was being raised, we were left to surmise that our sin, in their eyes, was that we were growing older.
Would I be willing to pay the money I send my insurance company to the government as increased taxes to get a health care system where my well being was the primary concern – no question, yes. I would happily join a government run program where the bottom line was health and not the size of the CEO’s bonus. I don’t really care about his boat payment.
How about the other big threat out there – health care rationing. What baloney. We have that right now and everyone who pays for their own insurance knows it. When my insurance company denied my doctors request for an MRI on my injured shoulder what recourse did I have? I could have appealed or even sued – but who has the time or money for that? And if I won and forced the insurance company to pay, we all know that at the next renewal, they would have dropped me like a hot potato. I would have been off searching for another insurance company to take me, and they would not have covered my shoulder because it was a pre-existing condition.
I try to watch the senators on the Sunday morning programs debate health care, but it’s beyond frustrating. Every one of them has a gold plated insurance plan and has nothing to worry about. The drug and insurance companies make huge campaign contributions to make sure that senators like our own Webb and Warner defend the current for profit system and maintain the status quo.
Government run health care is not a panacea, but it works. Look at Medicaid. It’s a huge, government run health system and it does a fine job. Is it perfect – no. Could it be better – of course. But is it a better system for so many of us who don’t have employer based health care – you bet. What we need is a health system that puts health and prevention before profits, and cares about people and not the insurance company’s bottom line.
How many times have you heard in the last few weeks about the problem of putting a government bureaucrat between you and your doctor? I get so angry at this supposed problem that my wife has to ask me to stop shouting. Right now every one of us who pays for our own insurance knows full well that we have an insurance bureaucrat between us and our doctor, and their sole purpose is to help make a profit for their company, not keep us healthy.
When my wife left her state job we were forced to purchase our own health insurance. We shopped around and chose a policy with a high deductible, and a reasonably modest monthly premium. One year later, with no claims against our insurance that reached beyond the deductible, our monthly premium was raised by 37%. With no explanation from our insurance company as to why our premium was being raised, we were left to surmise that our sin, in their eyes, was that we were growing older.
Would I be willing to pay the money I send my insurance company to the government as increased taxes to get a health care system where my well being was the primary concern – no question, yes. I would happily join a government run program where the bottom line was health and not the size of the CEO’s bonus. I don’t really care about his boat payment.
How about the other big threat out there – health care rationing. What baloney. We have that right now and everyone who pays for their own insurance knows it. When my insurance company denied my doctors request for an MRI on my injured shoulder what recourse did I have? I could have appealed or even sued – but who has the time or money for that? And if I won and forced the insurance company to pay, we all know that at the next renewal, they would have dropped me like a hot potato. I would have been off searching for another insurance company to take me, and they would not have covered my shoulder because it was a pre-existing condition.
I try to watch the senators on the Sunday morning programs debate health care, but it’s beyond frustrating. Every one of them has a gold plated insurance plan and has nothing to worry about. The drug and insurance companies make huge campaign contributions to make sure that senators like our own Webb and Warner defend the current for profit system and maintain the status quo.
Government run health care is not a panacea, but it works. Look at Medicaid. It’s a huge, government run health system and it does a fine job. Is it perfect – no. Could it be better – of course. But is it a better system for so many of us who don’t have employer based health care – you bet. What we need is a health system that puts health and prevention before profits, and cares about people and not the insurance company’s bottom line.
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- Most of Martha Woodroof in one place
- I write for lots of different venues, so this blog provides links to those places. Plus, occasionally, stuff that appears no where else . . .