health care – Don't Gel Too Soon

OK So I’m Mad

It’s been a lazy weekend. Both Sunday papers got read. The COSTCO run was made (but not the bed.) We went out for three different meals so cooking was minimal. But the news is really pissing me off.

We’ve reduced the President of the United States to a propaganda tool. I’ve worked in school TV. I know what will happen when the President speaks on Tuesday. Teachers who disagree with Obama will talk during the speech; others will just turn off the TV. Remember the story of the kids in Dallas who cheered when President Kennedy was killed? They were too young to have an informed hatred. It was generated in them. And now, with a President whom we all know faces more danger than most, the President’s enemies are willing to do it again .

OK lets go from there to health care. With a calculated harshness these same people have managed to stir up every frightened, confused voter in the country by convincing them they’re in infinite danger. For the elderly it’s nearly a promise to send them all out to die on an ice flow. For others it’s the promise that they’ll have to wait forever for care, that they’ll never be able to pick their doctors and that their care will lose quality. And let’s not forget the screaming madness that forever polluted the revered American tradition of the town meeting.

I’m writing this as Labor Day draws to a close. Cranky and sad, I wish for a renewed commitment, as we honor those who, mostly, work with their hands, that a miracle will move the battling legislators to “man up” and make something happen so that no worker, or any other American, will spend next Labor Day worrying about what they’ll do if one of their kids falls off his bike on the last day of summer and breaks a leg.

Women’s Health Care Takes the Stage on the Hill

It makes sense. On the heels of the announcement of a new committee (H/T Writes LIke She Talks and Punditmom) to oversee protection of women's rights, the Senate Foreign Relations Subcommittee on International Operations and
Organizations, Human Rights, Democracy, and Global Women's Issues, Rep. Jan Schakowsky (D-IL), U.S. Senator Debbie Stabenow (D-MI) have introduced the “Health Care for Women Resolution.” The resolution outlines a "new framework
for women’s health" and ensure that women’s needs are a key part of the
national health reform debate. At a newsconference today, where they announced the resolution, members of the Columbia
University Mailman School of Public Health released a report that makes it clear why such a resolution is necessary.

The report, “Women’s Health and Health Care Reform: The Key Role of
Comprehensive Reproductive Care,” explores the importance or reproductive health in women’s overall health
and urges that the promotion of reproductive
health be part of any national health plan. Thirty-eight of fifty deans of
schools of public health have endorsed the recommendations in
the report.

At a news conference announcing the resolutions, Rep. Schakowsky said:

"Any debate on national healthcare reform must address the healthcare
needs of women who are often the primary caregivers and decision makers
for their families," said Representative Schakowsky. "We know that
women face exceptional challenges and have a very personal stake in
fixing our broken health care system — they know we need to act now.
The current economic crisis is not an excuse for delay; it is a
persuasive argument for an immediate response.

With new leadership on the Hill and in the White House, let's hope these are the first of many positive developments.

KEEPING OUR EYES ON THE PRIZE: HEALTH CARE, EDUCATION AND ECONOMIC SECURITY: THIS IS A LIFE OR DEATH ELECTION

It’s fun to write about politics; this blog has always been about many things but has pretty much been all politics all the time for the past three months. Even so, once in a while all that handicapping and general outrage and idealism and hope crashes smack into the basic realities of what’s at stake here.

For example, just this month:

I had a medical test which costs money, (and which not all insurance companies cover,) that found and dealt with something that was not important today but, if not detected, could someday have been way more important than I even want to think about.
A friend I really admire was diagnosed with Lupus – costly and complicated to treat.
Another friend’s child was born a month premature, miles away from home during a vacation. After some very scary post-delivery bleeding, she and her baby are fine now. Their health insurance guaranteed easy access to capable, coordinated care.
A story appeared, in various forms in several papers, reporting "Many Cancer Patients Forgo Health Care Due to Soaring Cost of Medication" and including these other facts:

"25 percent of families with a cancer patient spent their lifetime savings for the treatment. The same survey said 10% of these families had to forego some basic needs like food, heat and housing" and

"20% of Americans have big problems paying their medical bills."

Another, in newspapers and Scientific American, reported that "the United States has slipped from 24th to 29th in infant mortality rates in developed countries," meaning that 28 "first world" countries are doing better than we are in keeping newborn infants alive.

This is the reality in our country today. And that’s just one issue in just one month. The same is true for education, climate change and our basic civil rights. And that doesn’t count Iraq, Guantanamo, candidates who want to ban books, threatened legal access to contraception and other women’s rights issues, the growing income gap and the current terrifying economic crises.

I know you know this. As my rabbi likes to say, "I’m talking to myself here" but as we monitor polls and the endless talk show and newscast chatter, we need to remember. As I was awakened by a very lovely nurse offering me cranberry juice, with a view of colorful fall leaves on the trees outside the window of a clean, well-lit recovery room, the first thing that came into my mind was how lucky I was to be there. This election is about winners and losers and parties in control, yes. But even more, this time, it’s life and death.

Oh, and if you want to get upset about the campaign itself anyway, try this.

SAD NEWS; SENATOR TED KENNEDY

Catherine Morgan, star of stage, screen, (well not really, but she should be) and (yes this is true) blogs including Political Voices of Women, has sought posts on the news that Senator Edward Kennedy, seen here with Senator Barack Obama, whom he endorsed, is suffering from a malignant brain tumor. It really is a sad thing. People make jokes about the Senator, some of them really cruel, as I discovered while searching for images for this post. And he’s made mistakes, including those surrounding the tragic events at Chappaquiddick.

But as a great speaker and legislator, he’s used his talents to be a champion of the “downtrodden” and many of the rest of us, for over 40 years. Coal miners, civil rights advocates, children who need better schools, American who need access to health care, soldiers in Iraq and veterans of every war and dozens of other causes; he’s been a mainstay of support for them all, often when not too many people were willing to be.

Since he lost his two brothers, President John Kennedy and Senator Robert Kennedy, to assassins, he’s also been the protector of their children: JFK’s two, John and Caroline, and Bobby’s eleven. He’s buried John’s son and two of Bobby’s. His own son Edward contracted bone cancer and had a leg amputated at the age of 12. Kennedy himself nearly died in a plane crash in 1964. And there’s plenty more; take a look at this Wikipedia entry on the “Kennedy curse” which left him with burdens of care for so many. Weddings, illnesses, even funerals, it was he who was there for them all.

When I first came to Washington, I was a very young researcher in the CBS News Washington Bureau. Because I was so young, I was assigned to call the Kennedy “boiler room girls” – campaign workers who knew the young woman who had died in that car in Chappaquiddick, Mary Jo Kopechne, to see if they would talk to us. I called. All of them. Every day for a year.

Every day for a year they took my call. Every day for a year they were polite, gentle and silent on the subject of the crash. And so they have remained. Since I know many other people who have worked for Teddy and shown a devotion and loyalty seldom seen in public life, I am not surprised; that’s how people are in the Kennedy universe. It says a lot about the Senator and his family and the sort of commitment they inspire.

When I think of the Senator though, it’s not any of that I think about. Or of the fact that he can be hilarious, self-effacing and very kind to those around him. My strongest, and most unambiguous memory, is of his eulogy at the funeral of his brother Bobby* in the summer of 1968. You’ll see why.

*This is audio accompanied by cover footage; I couldn’t locate any video of the speech although I remember it vividly and can see it in my head. Can’t get that up on the Web though, at least not yet.

Scared and Grateful

You know how the US health care system is allegedly dead? Mangled beyond recognition? Well — don’t you believe it. There are places here where the true wonder of good health care is visible in abundance. The best of them, in my opinion, is the Cleveland Clinic. I need to tell you why.

When someone you love – and live with – is sick, it’s scary. When they’ve been through open-heart surgery, a shattered shoulder repair and a lengthy illness, it’s very scary. That’s where I am right now. Scared.

My husband’s heart surgery was in 2002. Five years later, he began to feel sick. Many of the symptoms were similar to those from his initial illness, congestive heart failure caused by a faulty aortic valve. The fear: that his valve was again failing — that the repair had not held. So we went one more time to Cleveland to the remarkable institution where he’d had the surgery, to find out what was wrong.

After many tests, all perfectly scheduled and wonderfully administered, we learned that his heart is in good shape – at least the part that had been repaired. The trouble was that the arrhythmia – irregular heart beat — sometimes very fast — that had also been dealt with in the surgery, had returned. Now he’ll take a medication that, at least initially, is like being kicked by a horse. If medication can get his heart back into rhythm, he can avoid the thing that scares me most. It’s a surgical procedure, far less invasive than heart surgery, but still with some risk. And it’s not fair. He’s had enough to deal with – and frankly – so have I. But apparently, higher powers have declared that not altogether true and this is our next mission. So we’re on it.

The thing I try to remember and I want to tell you though, is how blessed we are to have access to the best that health care can deliver – and how remarkably common-sense a lot of it is. This hospital is declared number one in cardiology every year because it is excellent. The staff standards are high — and the hospital is headed by one of its top surgeons ( who operated on my husband.) His standards are demanding and every surgeon who is hired "from Hopkins or Harvard or anyone else" still is vetted in action by the Director. In addition, the nurses are empowered to make decisions and raise issues with physicians, the morale is positive and energetic and there’s not a nasty or impatient person behind any desk or lab coat.

All of these truths add up to a single truth: there’s no mystery. To get good health care we need a nimble, well-educated, trained and motivated staff and leadership to keep it that way. Of course the equipment and endowment matter too. But somehow in the insurance mess, the malpractice mess, the escalating cost mess – all provoking defensive driving by doctors and hospitals, we’ve weakened quality control and management in service to these other issues. It’s a tragedy — one made far more real to me by our experience with the best – something that used to be true of our health care system altogether and sure isn’t anymore.

I’m desperately grateful for what we are able to do to keep Rick healthy but every time I walk into the Clinic I remember again what’s going on in so many other health care sites and seeing what could makes it all even more tragic.

MIRACLE CENTRAL

I know it says “Miracle Central” up there but this is NOT about religion. At least not exactly. I’m at the Cleveland Clinic – one of the most amazing hospitals in the world — so my husband can have his yearly checkup. Why do we fly to Cleveland every year? Even the Rock and Roll Hall of Fame wouldn’t bring us more than once.

We’re here because at this hospital four years ago a doctor cut open his chest, and then his heart, and saved his life. It pretty much was a miracle. So we like them to get a look at him once a year — to make sure he’s ok. It’s harder for me to walk into the hotel here than it is for him, I think. He was in congestive heart failure and scared but kind of beyond reality the day we arrived, and then he stayed in the hospital while the boys and I stayed at the hotel. After the surgery he was on medications and then struggling to get his strength back. The small details of illness, and families hoping for the best, were lost on him. Two years ago, when we made an extra trip to go through the same surgery with a good friend and his family, we were so focused on the particulars of his situation that the human dramas beyond them faded well into the background.

But tonight, sitting in the “club lounge” of the hotel attached to the hospital, listening to people with cancer and heart disease and weird combinations of neurological and heart problems and their families – and watching them laugh and tease one another and struggle to be brave, I was just knocked out. First of all it’s a beautiful thing to see — we see it every year when we come here — the way families take care of one another and support each other — and the other families they meet over breakfast or coffee — through what is a truly terrifying experience. Until you see a loved one on a gurney, being wheeled down a long hall toward life-and-death surgery, as alone as he will ever be — as you stand with your kids trying to smile for him — you can’t imagine.

Secondly – it’s an outrage to see such magnificent health care and realize how few people get it. This hospital is run so brilliantly and with such pride; each staff member so competent, confident and gracious that you just want to hug all of them. It’s still possible to offer good health care in the US — and it’s as much about good management as it is about money. I wish you could see it. We should NOT be allowing the wonders of American health care to fade away without a fight. If you want to see what we’re losing, come to Cleveland. Don’t give up those miracles without a fight!