I had an op-ed piece published in the Citizen-Times today. I talked about the fact that 47,000 people die every year because they don't have health insurance -- one every 12 minutes -- and I got an e-mail from a person who believes every American has access to quality health care. He didn't believe anyone dies because they can't get care.

He didn't have anything to back up his claim. I e-mailed back with Mike's story and told him the 45,000 number comes from a study by Harvard Medical School that was published in JAMA.

It wasn't enough. Facts don't exist. I don't know what his source if information is, but it's wrong.

About 50 million Americans don't have insurance and the access to health care that comes with it. That's a fact.

Insurance companies routinely deny or delay tests and treatments to people who do have insurance. That's a fact.

You can deny the facts, but you begin to sound like the old Monty Python sketch about the arguement service, where John Cleese simply disagrees with whatever is said to him.

Or the "Spinal Tap" bit where Christopher Guest's character insists one guitar is better than the others because, "This one goes to 11."

That was one of Mike's favorite sayings. Whenever anyone refused to listen to reason or denied the facts, Mike would shrug and say,"But this one goes to 11."

You can't talk to some people.

It's like saying you don't believe Earth rotates around the sun.

The fact is, it does, whether you recognize it or not.

And this one goes to 47,000 dead every year.

We got a letter from the insurance company today telling us that the insurance company has approved Rob's hospitalization for heart surgery.

What a relief. I was afraid they might refuse it because they hadn't pre-approved it.

You never know. I know a woman whose insurance refused to cover her breast cancer because they said it was a chronic condition.

But there are still some people who say we have to leave it to the free market with no government interference.

When you feel a sense of relief over the insurance company agreeing to cover hospitalization for heart bypass surgery, it's sad indeed.

It was two years ago today that I got the news Mike's cancer was back. The doctors had hoped to give him another year, but the cancer didn't respond to chemo and he died six weeks later, on April 1.

I got the call on my way into work, and Rob and I dropped everything and went out to Cary, about a four-hour drive, to be with him. He was tired and stunned, and for several days, he didn't laugh or crack jokes.

But even that came back to him after a week, and he was playing the "I'm dying" card. We all went along with Mike being Mike, except for chemo days, which reminded us how short his time would be. After two treatments -- four weeks after we discovered the cancer was back -- we found the chemo wasn't working and I brought him home to be with me.

I wanted every moment with him. I wanted him to live as long as we could nurture him along. I knew he was dying, but each day he survived, I thanked God for one more day with him.

My passion to fix this broken health care system is renewed every time I look at his picture. I can almost hear him urging me on.

And then to almost lose my husband to the system last week ... I'm even more determined.

I'm not watching the health care summit today because it' just a dog-and-pony show. What we need is for the Senate to pass the public option through reconciliation. Republicans used it 22 times during the Bush administration, including for two tax cuts and Medicate Part D, which will cost $1 trillion by the end of its first decade.

The Congressional Budget Office has said the public option will cut costs over the next 10 years. It will pay for itself. C'mon, kids, let's put on this show!

It ought to be illegal for an insurance company to stall a vital medical test for 36 hours. Rob came incredibly close to dying because Blue Cross/ Blue Shield insisted on pre-approving a heart stress test for 36 hours.

Rob's doctor had done an EKG that showed irregularities. That meant there was something wrong with his heart, and cardiac problems can kill with little or no warning.

The same with vascular problems.

No mid-level drone with an MBA has any right to stall the process of diagnosis in such dire circumstances.

I'm sure it's worked into their statistical models that some people will be scared enough to have the test done anyway and they can deny payment, thus saving money.

Another small percentage of people will die in the interim and the insurance companies won't have to pay for the test or any treatment.

There ought to be a law, and I'm going to work for one, starting with the state. I'm going to call state legislators from Western North Carolina in the morning and ask that such a bill be introduced.

Blue Cross/Blue Shield will fight it, but I don't plan to give up. Help me spread the word that we need this law.

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Turns out Rob didn't need to come so close to dying last night. His family doctor wanted him to have the stress test Tuesday afternoon or Wednesday morning, but Blue Cross/Blue Shield wanted to review the decision of a doctor who had found a dangerous irregularity in Rob's EKG.

When it comes to heart problems, every hour delay can be life-or-death.

Rob should have had that surgery at least 24 hours before he did. That delay, made so some mid-level insurance flunky with an MBA could second-guess Rob's doctor, very, very nearly cost him his life.

Rob's primary care doc read the surgery report today and was shocked at how close he had come to dying. She called me to say how glad she is that his surgeon was skilled enough to save his life.

Me too. But it's time to put a stop to their abuses. I've had it with how big money is allowed to prey on American citizens every day.

Anyone who has been laid off a job in the last year has gotten some help in paying health insurance premiums through COBRA, the law that allows employees who are covered by insurance at work to continue getting coverage by paying their own premiums for up to 18 months.
The problem is that those premiums are so expensive, few out-of-work people can afford them.
Last year, the federal government stepped in with assistance, allowing people to pay one-third of the premium instead of the whole thing, giving more people the ability to maintain access to health care for at least another 18 months.
But the subsidy expires at the end of this month, meaning that people who lose their jobs as of March 1 once again will have to pay the full premium, which averages 83 percent o unemployment benefits; in some states it averages more than 100 percent of unemployment benefits.
We're still deep in this recession. It is the worst since the Great Depression, and the millions of people who are unemployed need that help. Economic recovery from a recession this deep takes at least two years. If Congress doesn't extend this subsidy, more people will fall through the cracks, and more people will die unnecessarily.
The House of Representatives has passed the bill, but the Senate hasn't. It's another thing that the Right wants to block, even though it's what Americans want and need.
Once again, we need to write to our senators and urge them to get this done NOW. To find your senators, use the tool on our main page. Call, write and e-mail. Time is running out.
To learn more, visit www.familiesusa.org . 

We moved most of our stuff into the office Saturday, despite the snow and ice. The desk is one heavy piece of furniture, but we got it in and set up. I still have to put together the bookcase and hang pictures, get the little pedestal table and the file cabinet ...

But we have a physical address now, and everyone is welcome to visit we're in the Downtown Market Building on South French Broad -- across from the United Way bulding. Please call first (828-243-6712) to make sure I'm here. We'll have an office-warming soon.

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The NC Health Care Coalition, part of the NC Justice Center, released a report today on charity care in the state's hospitals. The executive summary is at http://www.ncjustice.org/?q=node/446, and that page has a link to the full report.

In fiscal year 2008, the state's hospitals provided almost $700 million in free care.

That's good news for our statye, which is particularly hard-hit by the recession. The unemployment rate is still over 10 percent, and many, many unemployed people lost their health insurance with their jobs.

"Because the state has shed thousands of jobs, North Carolina had the nation’s largest jump in the percentage of the population without insurance from 2007 to 2009. According to one estimate the recession has increased the number of uninsured in North Carolina to nearly 1.8 million," the report says.

The report calls on the state's 112 hospitals to  post comprehensive charity care policies online -- 39 hospitals already do, and 72 hospitals in all post some information.

"An examination of posted charity care policies shows that financial assistance programs vary widely across he state," the report says. "We can see that Winston-Salem- and Charlotte-based Novant Health has the most sound and clear policy of any hospital system in North Carolina. At Novant any uninsured patient with an income less than 300 percent of the federal poverty level, or $66,150 for a family of four, qualifies for a 100 percent discount on hospital bills. This policy recognizes the realities of modern family finances."

But, the report says, no hospital should put isself in danger of bankruptcy with its policies.

In other words, hopsitals are doing a lot to get care to people who need it, but the need is too great for hospitals to do it all.

We need reform and we need it now.

As a newspaper reporter, I followed North Carolina's mental health reform since its inception. It was like watching a multi-car pileup on an icy highway in slow motion.

The "reform" began by closing down the existing system. Mental health centers that served people with psychiatric illnesses, people with developmental disabilities and addiction, were closed. These centers had one-stop services, all provided by the state.

But reform promised choice. The sunny new day would offer an array of private services, managed by new agencies called local management entities, or LMEs.

It all sounded great, except the state was in such a rush, there were as yet no service definitions or rates when the old area programs closed. Those amount to job descriptions and pay scales. Still, the state expected private companies to flock to the new system.

It didn't happen. Several of the old agencies spun off their service arms into nonprofits that could see people until more service providers emerged. Few did. And the nonprofits began to fail because of cash-flow problems.

The new LMEs scrambled to find agencies to provide services, and people fell through the cracks. People began to die because there was no cohesive system for people coming out of psychiatric hospitals, which were a mess already because of staff shortages and forced overtime for staff.

Management by then-DHHS Secretary Carmen Hooker Odom was incompetent at best. She dictated change after change to the system, never giving it the time to stabilize. She moved some of the LMEs responsibilities to a national for-profit company based in Virginia and slashed the LMEs' budgets by one-third. She ignored a legislative oversight committee's demands for a report on what the new system needed.

As a result, North Carolina's system fell from among the top half in the country to very near the bottom.

And all this was before the economic meltdown and massive budget shortfalls.

Today the system is truly broken. The current Department of Health and Human Services secretary, Lanier Cansler, has his hands tied by severe cuts in his budget. He inherited a mess and there's little he can do to clean it up.

We need to roll care for people with psychiatric illnesses, developmental and other disabilities and addiction into the main health care system as we move forward on fixing it.

Many of the 45,000 people who die each year from lack of insurance lost it because of mental illnesses. When these chronic brain illnesses aren't treated, they get worse, just like any other chronic illness. The problem is, people can't get into the system until they reach the crisis point.

This part of the system is even more broken than the rest. It's a waste of human potential and it's just plain wrong to ignore it.