insurance – Don't Gel Too Soon

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.

IT’S KIND OF EMBARASSING TO MOVE FROM PETE SEEGER TO PROPERTY VIOLATION BUT SOME ##!!@#$%% BROKE INTO MY CAR!

So last night I came home and parked my car and went to bed. That’s all. At 8:30 this morning my doorbell rang, and outside was our lovely next-door neighbor. I thought she had gotten some of our mail ( this often happens). Silly me. She’d come to tell me that as she walked the dog, she noticed there was NO GLASS in the passenger window of my car. Just shards.

This is what I found when I came outside to look. Of course that’s not the worst of it. Missing:
One 20 G iPod vintage 2004 (loved it’s vintage-ness)
One iPod car charger
One iPod radio cable
One iPod Firewire and cable
One BRAND NEW Garmin GPS and its suction cup thingy

NOT MISSING:
My valet key
All the quarters for parking meters
A Trader Joe’s reusable shopping bag
A fancy purse I bought in Berlin that needs to be repaired

The insurance people were just lovely (of course the deductible means they probably don’t owe us much; it’s going to be a debate about the value of what is now a vintage iPod v an obsolete iPod.) But they helped right away and found a glass company that comes to the house and can come today so I have the car for a big appointment tomorrow and all business is done by Shabbat.

The police came fairly quickly too. And took all the information and called "crime scene" to come and look. They took some photos but basically said there wasn’t much they could do. Which was what I expected.

SO. It could have been much worse. BUT I’M SO PISSED! Of course primarily that I’m so stupid. I took the GPS off the little holder and put it in the glove compartment but the police tell me that THIEVES LOOK ON THE WINDSHIELD FOR THE CIRCLE FROM THE SUCTION CUP!!! It doesn’t matter if you take the machine with you; they’re liable to break in anyway in the hope that you didn’t. IT’S A BUSINESS.

And leaving the damn iPod in the car. How stupid can I be? But this is a sweet little neighborhood, diverse, friendly and generous and with the highest voter turnout in all of DC. It’s just so sad that no matter how hard a community works to be safe, a couple of lemons can screw the whole thing. Apparently these dudes are breaking into cars all over the city. GPSs are big business. Of course the people who buy stolen ones don’t feel like criminals – they leave that up to the guys who break into cars and do the stealing. It’s like drugs I guess- if there were no market people wouldn’t offer the product.

Anyway this is not musical prose but I’m so angry; this is a good place to vent it. Oh and if you have a GPS – take it ALL inside at night. Every night. Damn it.

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.