Yesterday, as the Supreme Court heard arguments on the Affordable Care Act, opponents stood outside and lied about the law.
Since most people don't keep a copy of the law on their computer desktops, as I do, they won't ever realize the outright lies being told to turn people away from something that is in their best interest.
Take, for example, the so-called "death panels" that supposedly will decide what treatments your doctor will be allowed to give you.
There are committees that will be looking at best practices. With some illnesses, different doctors will offer different treatments. How can you tell which treatment works best? Well, right now you would have to dig into the research -- if any exists. It can get very confusing if you don't know how to read medical studies -- and most people don't know how to read medical studies.
These panels will look at all the scientific evidence for you. If treatment B works just as well as treatment A but at a fraction of the cost, that information will be available to you through these panels. The law forbids forcing a doctor to use one treatment over another. Let's say treatment A, although less expensive, has more adverse side effects than treatment B. It's up to you and your doctor to decide which is best for you.
No government panel will make that decision; the law forbids it.
Let me repeat that: No government panel will make that decision.
Insurance companies, however, are free to deny you treatment A and insist on only approving treatment B because it's cheaper. So you have to deal with a little more discomfort from the side effects; they don't care.
Then there's the Independent Payment Advisory Board. This body will research Medicare cost-control proposals, which opponents say will then be used to cut benefits and ration care.
The Affordable Care Act specifically prohibits any such thing. "The proposal shall not include any recommendation to ration health care," raise premiums, increase deductibles or other out-of-pocket costs, limit Medicare benefits, or change the eligibility requirements for the program, the law says.
So, the advisory board's research can NOT be used to cut benefits, raise prices or ration care.
Then there's the rumor that anyone over age 75 won't be treated if they get cancer.
There's an anti-age-discrimination clause in the law. If you're sick you will be treated.
However, there comes a time when aggressive treatment isn't doing the patient any good. If that happens, patients will be able to get counseling and Hospice care.
Better access to health care is a good thing, so opponents have to twist the truth and spread outright lies to get people to believe it isn't.
I've decided to stop calling them "myths." They're deliberate lies and people are dying because of them.
I suppose Mike would've called it playing the dead kid card.
French Broad Chocolate Lounge, purveyors of fabulous, decadent chocolate, had a contest on Facebook, asking people what makes chocolate special to them.
I answered with two memories, one about my father and one about Mike, and I won one of the boxes of chocolate.
I got my love of fine chocolate from my father, who hoarded the good stuff and let us eat Tootsie Rolls. We knew where he kept it, though, and we all sneaked a piece now and again. Then on his birthday and at Christmas, we each bought him a pound or two to replace what we had stolen.
My father died the first week of January in 1990, two weeks after Christmas. As we sat around the big dining room table the night he died, my sister Sally sighed and said, "I used to steal his chocolate. I got him two pounds of dark chocolate buttercreams for Christmas to replace what I took."
One by one, our eyes lit up. We all had done the same thing.
We found about 7 pounds of good chocolates. My stepmother arranged them lovingly on a huge platter and held it high over her head.
"Lester," she said, "you're gonna share."
We dove in like seagulls at a beach picnic, poking holes in the bottoms of the candies to see if they were what we wanted, and if they weren't, putting them back on the platter. We finished off the platter in an hour.
In 2008, chocolate was one of the last things Mike could eat. In fact, it was the last thing he ate.
The night before he died, we sat together, watching "Star Trek: Deep Space 9" and nibbling really expensive dark chocolate. The Star Trek episode was from the fourth season, the one where Worf arrived on the station.
"You know, Mom," he said, "I'm having a really good time here."
He weighed about 85 pounds, his body was wracked with pain and broken in so many ways. He had been neglected by our broken health care system, treated as though he wasn't worthy of saving and left to die before the doctors at Duke University Medical Center took him in. By then it was too late to save him.
He was just 33, and the way I saw it, robbed of 50 years.
But he was happy to have the chocolate, Star Trek and me.
I treasure that memory because it exemplifies who Mike was. He lived in the moment and appreciated each bit of joy that came his way, especially if it came in the form of chocolate.
I wish I could share this box of chocolate with Mike and my dad, but I'll have to keep it all to myself. Damn.
Clerks from the Supreme Court say they don't think the justices will overturn the Affordable Care Act. I hope they're right.
Insurance companies and other members of the Medical Industrial Complex have fought hard to keep access to health care limited to the wealthiest and healthiest among us, but the fight may be nearing an end.
Don't get me wrong -- of the high court strikes down the ACA, I'll be right back on the front lines fighting for access to care for everyone.
As it is, the law doesn't go far enough, which is part of the reason for its low approval rating. Only about half of Americans are happy with the law; the rest believe the system is fine the way it is or they want a public option or a single-payer system.
In the beginning, opponents of the law chanted, "repeal and replace." You'll notice the replace part of that chant is gone now.
The opponents of reform have a ton of money to fight the implementation of this law.
But things are happening already that they can't deny:
- 2.5 million young adults are covered on their parents' policies until age 26.
- 54 million Americans are receiving preventive care with no co-pay.
- 51 million Medicare recipients have saved $3.2 billion on prescriptions.
- 20.4 million insured women no longer have to fork over a co-pay for mammograms.
- Insurance companies have to spend 80 to 85 percent of money they collect in premiums on direct services.
- Children no longer can be denied coverage because of birth defects or other pre-existing conditions.
- More than 50,000 Americans with pre-existing conditions are covered affordably in high-risk insurance pools.
That's just some of what's happening, and we still have more than a year and a half to go before the beginning of the health benefits exchanges that will allow people to shop for affordable insurance. Those who can't afford insurance -- up to 400 percent of the federal poverty level -- will get subsidies.
Opponents want to stop all this from happening. Insurance companies don't want to be regulated; they want free reign to deny coverage to anyone who might get sick and to charge whatever they please.
The Supreme Court is stacked with conservatives, but I still have hope that even they will see that 45,000-plus deaths every year from lack of access to care is un-American and unconstitutional, not to mention immoral.
Today is the second anniversary of the Affordable Care Act, and with a year and a half before its biggest component takes effect, parts of the law are in effect and helping millions of people get access to care.
- More than 2 million young adults between ages 21 and 26 are insured through their parents' insurance policies.
- Small businesses are getting tax credits to cover employees.
- The Early-Retiree Insurance Program helps people keep their insurance if they retire before they are eligible for Medicare.
- People with pre-existing conditions can get insurance through state or federal programs.
- People with insurance no longer have to pay anything for diagnostic tests such as mammogram or colonoscopy.
- It is now illegal to terminate people's insurance when they get sick.
- Consumers now have a way to fight insurance companies' denials.
- Insurance companies no longer can set lifetime coverage limits, and annual limits are restricted and will be eliminated in 2014.
- Children no longer can be denied coverage because of pre-existing conditions such as birth defects.
- Scholarships and other incentives to build the capacity of primary care.
- Consumer-assistance programs have been set up to help people navigate the insurance market.
- Prescription discounts to help seniors who have reached the "doughnut hole" in Medicare coverage.
These are just some of the things that have taken effect already, and among people who are benefiting from the law already, it's pretty popular.
For example, Vicki Meath can afford coverage for her daughter, who was diagnosed with a chronic illness when she was 4.
Carolyn Comeau can buy coverage through her state's high-risk pool so she'll be covered if her breast cancer comes back.
I happen to love these things.
In the end, 30 million of America's 50 million uninsured will have coverage. That's a big improvement, although we still need to do more so everyone will have access to quality care.
So, why is the law still not wildly popular? It's the lies being told by the law's opponents, and the lies are getting worse and worse as full implementation approaches.
I STILL hear that older Americans won't be able to get treatment for cancer. That is not in the law. In fact, there's a non-age-discrimination clause in the law (it's on Page 616 in the law). That means you can't be refused care because of your age. I have posted that here and on Facebook, but I still hear from people who say the "death panel" won't allow anything but palliative care for people who are over 75.
Which brings us to the next big lie: so-called death panels. There are none. I promise you. The panel they're talking about is one that will look for best practices -- things that work and are cost-effective. Right now, insurance company death panels decide who will get lifesaving treatments. Most likely, if they're new and innovative, they'll be denied.
Next: Costs will go through the roof. Wrong. The nonpartisan Congressional Budget Office has estimated and actual reduction in the deficit over the next 10 years because of the law. Contrary to what opponents of the law say, the CBO is not President Obama's puppet. It is nonpartisan. And, if everyone is in the pool, care becomes less expensive because the rates are more fair, and people are more likely to get care and management for chronic illnesses.
Then there's this: Insurance companies will raise their rates through the roof. Well, the law actually punishes insurance companies for rate hikes beyond what is needed and forces them to refund the difference to customers. It also caps their profits by demanding they spend 80 to 85 percent on what they take in on actual services (by comparison, Medicare spends 97 percent of what it takes in on services).
So happy birthday, Affordable Care Act.
My friend Mike says he used to wonder whether he truly would be a Good Samaritan if push came to shove. Would he be able to stop what he was doing, divert from where he was going, to help someone no one else wanted to help?
He got his answer last night when a stranger knocked at his door. The young man was tall and disheveled. He has paranoid schizophrenia and had lost his medication, and he was hoping someone could help him out, since he was in crisis.
The man was carrying several possessions: a sword, a bottle of liquor, some pills and a high school wrestling trophy. Mike sat down on the front steps with him and tried to calm him. He asked if the young man had family who might be worried about him, and they tried calling. No one answered.
Mike didn't know what else to do, so he called 911 to get help. When sheriff's deputies arrived, the young man was so terrified he couldn't move. Together, Mike and the sheriff's deputies spent three hours on Mike's front porch calming the man. Finally, they reached his family.
"So, did I pass the test?" Mike asked on a Facebook post this morning.
I would say he certainly passed the test. But he could have done one thing differently. Instead of 911, he could have called 211 and a mobile crisis stabilization unit would have been dispatched. It probably would have been less frightening than seeing a squad car pull up.
Fortunately, this story has a good ending; the man's family was finally reached and he is safe at home.
Most people with mental illnesses aren't dangerous. When they're in crisis, though, they are frightened, and many people are frightened when faced with them. Mike's good instincts led him to be a calming influence.
"You were the only person who would help me," the young man said to Mike, leading Mike to wonder how many doors the man had knocked on before someone was willing to talk to him.
Apparently, the man was released from a psychiatric hospital before he was completely stabilized and without adequate planning for his care. This has been a problem in North Carolina for awhile, and probably in many other states. Cuts to mental health budgets have meant the closing of entire hospitals, and there aren't enough crisis beds in community hospitals to carry the load. Providers are closing because they can't afford to treat people on what the state is willing to pay, and most people with a serious mental illness don't have insurance. Since mental illnesses are chronic, they need care and management, and too many people have lost access to that.
More and more, people in crisis are being arrested and treated in jail, which is far more expensive and far less appropriate than a bed in a crisis stabilization unit. Like this young man Mike helped last night, they wind up untreated and in crisis, terrified of what is happening to them.
We can do better. New methods of treating people with mental illnesses are allowing them to live normal lives and to be functioning members of their communities. People are using a recovery method in which they learn what triggers their crises and learn to manage their illness in a way similar in many respects to addiction recovery.
But until we as a society care about what happens to people with psychiatric illnesses, not enough of them will have access to these treatments -- or any treatment at all.
I love that my friend was able to help someone he didn't know through a very frightening evening.
Thanks, Mike, you definitely pass the Good Samaritan test.
Once again, the rumor is circulating that older Americans won't get treatment for illnesses such as cancer. Well, that just isn't true. I went back to the bill (I keep a pdf of it on my computer desktop), and there on page 166 is this:
"SEC. 1557 ø42 U.S.C. 18116¿. NONDISCRIMINATION.
(a) IN GENERAL.—Except as otherwise provided for in this title
(or an amendment made by this title), an individual shall not, on
the ground prohibited under title VI of the Civil Rights Act of 1964
(42 U.S.C. 2000d et seq.), title IX of the Education Amendments of
1972 (20 U.S.C. 1681 et seq.), the Age Discrimination Act of 1975
(42 U.S.C. 6101 et seq.), or section 504 of the Rehabilitation Act of
1973 (29 U.S.C. 794), be excluded from participation in, be denied
the benefits of, or be subjected to discrimination under, any health
program or activity, any part of which is receiving Federal financial
assistance, including credits, subsidies, or contracts of insurance, or
under any program or activity that is administered by an Executive
Agency or any entity established under this title (or amendments).
The enforcement mechanisms provided for and available under
such title VI, title IX, section 504, or such Age Discrimination Act
shall apply for purposes of violations of this subsection."
OK, it's a little convoluted, but it says no one will face discrimination in treatment because of race or age.
So, if you're over 65 and you get cancer, you will get treatment under Medicare. However, if the cancer is terminal and there is nothing more that can be done, you will get counseling and palliative care.
There does come a time with cancer that it no longer makes sense to treat the patient. Mike was sent home four years ago yesterday because the chemo wasn't doing any good and he was to spend what few days remained to him in comfort and surrounded by family and friends. It didn't matter what his age was; there was nothing more that could be done to extend his life.
Mike got to that point, though, because the free market HAS been allowed to discriminate against people who might get sick, denying coverage to people based on a birth defect or a vulnerability to illness. Because he had a "pre-existing condition" (a birth defect) that left him vulnerable to colon cancer, he couldn't get insurance. That left him without access to the annual colonoscopies he needed, and he was denied care until it was too late to save his life.
On the other hand, my daughter-in-law's grandfather received aggressive treatment for his colon cancer, even though he was over 75. He lived several years after he was diagnosed, and in the end, after the chemo stopped working, he received hospice care. He died peacefully at his home. He got that excellent care because of a government-run, single-payer program called Medicare.
Medicare will continue offering treatment to older Americans. It will not change. It will continue to be one of the most efficient, highly rated, most popular single-payer systems in the world.
I sure would love to be able to buy into it.
You may want to start packing lunch for your kids.
Pink slime, the nasty ground beef filler that even McDonald's has decided to stop using, is going to be in your kids' school lunches.
This isn't edible beef. In fact, it's made from parts of the cow that used to be considered inedible for humans. It's ground, then it's decontaminated with ammonia because it's very likely to be contamined with e.Coli bactreria.
Beef shouldn't have to be treated with ammonia, but industrial-farmed beef often is because it's cheaper to feed cattle a mixture of grains and cattle parts, which is not their natural diet. Then, they're kept in filthy feed lots, often up to their ankles in their own excrement, and the filth often gets into the meat.
Since industrial-farmed cattle are injected with huge amounts of antibiotics, the e.Coli bacteria in their excrement are stronger and more resistant to the antibiotics we use to combat them.
Chef Jamie Oliver brought the issue into the public eye and McDonald's, Burger King and Taco Bell all have agreed to stop using the substance in its meat. But 70 percent of the hamburger sold in grocery stores still contains pink slime, and the US Department of Agriculture approves its use. That means it's on school lunch menus.
So, how can one avoid pink slime?
You can grind your own beef using a hand-powered grinder. It's easy to use one, and it's no more expensive than buying ground beef. That beef will contain antibiotics and probably growth hormones, though, unless you go out of your way to get beef that's antibiotic- and hormone-free. I buy from a local farm. It's more expensive, but that means I eat less meat, which isn't a bad thing. Grass-fed beef also is lower in cholesterol and saturated fat, and I think it's more flavorful.
So, can you afford to spend a little more on beef?
Or more importantly, can you afford not to?
Nearly two-thirds of Americans support the provision in the Affordable Care Act that insurance companies must provide contraception to women at no cost, according to a new survey by the Kaiser Family Foundation.
In addition, half of Americans think the only reason this is an issue is because this is an election year. And why wouldn't they? Republicans Mitt Romney and Mike Huckabee both signed laws in their respective states making the same plan law. The disagreement with it didn't arise until a month or so ago, when President Obama offered the compromise saying religious institutions can opt out of covering the expense, but insurance companies must do so.
As an aside, since I've seen so many Facebook posts claiming they're making the government use taxpayer money to pay for contraceptives, that is not the case except for women who would get it on Medicaid. Nothing changes there, especially since the Roman Catholic Church doesn't pay taxes. If you object as a taxpayer, all I can say is that I no longer want my tax money to pay for wars, but I can't opt out. That's just the way it is. This is not a country where individuals get to pick and choose what their taxes fund unless they can get people who agree with them elected as a majority.
This whole religious freedom flap is nothing more than politics. As evidence: The only place the issue scored below 50 percent was among Republicans, both men and women.
If your religion forbids the use of contraceptives, then you don't have to use them. Your tax money isn't going to pay for this.
Again, presidential candidate Rick Santorum shows his extremism. Again, this is not about politics but respect for women as human beings.
Santorum said that if his mother was gang-raped and a pregnancy resulted, he would welcome that sibling and love it. That's all fine and good, but nowhere does he even wonder how his mother would feel.
In Virginia and Alabama, laws have been proposed that a woman undergo a transvaginal ultrasound before an abortion. That's an expensive and invasive procedure and government has no business requiring it. And one wouldn't expect the party that supposedly hates invasive, intrusive laws to write one that requires women to have a procedure they don't need or want, and that their physicians don't recommend.
What's that they're saying about freedom? I can't hear it over the shrill calls for intrusion into a woman's most private decisions.
Although the transvaginal reguirement has been dropped in Virginia, a woman still has to have an ultrasound and the doctor is required to describe the fetus to her.
This isn't about health care; it's about a lack of respect for women's abilities to make decisions about their own bodies. It's a lack of consideration for women as adults.
And what if a woman decides to keep the baby? Is there any help for her? No.
The attitude is: "If she opens her legs, she should suffer the consequences."
Rush Limbaugh even went so far as to call a law student, who was refused a chance to testify in front of Rep. Daryll Issa's panel, a slut and a prostituite. I won't go into his value system here, but he certainly shouldn't be casting stones at anyone, let alone a private citizen who wanted nothing more than to talk about how women's health is an important issue that shouldn't be decided by men alone.
Some of this whole birth control flap -- an impingment on freedom of religion, for example -- is nothing more than efforts to try and repeal the Affordable Care Act, piece by piece. First they attack women's health care by complaining about a compromise that several Republican governors -- including Mitt Romney and Mike Huckabee -- signed into law themselves in their own states. You could look it up.
This isn't about smaller government; it's about reducing the availability of preventive care for women because some old white men don't believe women should have the right to make their own reproduvtive choices.
This isn't about religion, either. If we have freedom of religion in this country, then I shouldn't have to follow your religious convictions when it comes to deciding on the size of my family.
And although Rush Limbaugh thinks that makes me a slut, well, I guess I'll take that as a compliment.