I read in the newspaper this morning that the NC Senate is considering cutting "optional" Medicaid services as the costs rise.

Sounds reasonable, right? That's until you hear what's optional. The place where my friend Stacie and her best friend, Ashley, live is optional.

That's Stacie in the photo, showing off her beautiful smile. I met her and Ashely five or so years ago when they went to their prom. Although both young women are non-verbal, they have effective ways of communicating with each other and their caregivers. When Stacie thought she was running late for her hair appointment the day of the prom, she tugged on my sleeve, pointed to her watch and touched her hair. I promised her the hairdresser would wait for her.

Stacie and Ashley have lived together since they were small children; they're in their mid-20s now, living at one of three residences at the Irene Wortham Center. Their days are filled with activities and caring people, and they are as close as any two sisters -- there's even a little rivalry between them.

But the NC Senate believes these residences and the services they render are "optional." Extra. Non-essential.

If the funding is cut off, Stacie and Ashley don't have family who can take them in and care for them. They likely will land in separate nursing homes where there is little emotional or physical stimulation.

Liz Huesemann, the executive director of the Irene Wortham Center, doesn't think she will be able to get enough money to continue caring for these two young women -- and 22 other people who are helpless to decide their own fate.

"I'll tell you what will happen," Huesemann said. "They'll wither away and die. They'll just die."

Also optional will be eye care and dental care for adults, and God only knows what else. The story in the newspaper didn't go into much detail. Maybe that's because the people in the NC Senate know people would be upset to know what's about to happen to people with serious disabilities.

Or maybe they figure most people really don't care what happens to less-than-perfect human beings. Historically, their needs have been ignored. They were warehoused in places like Wrentham State School in Massachusetts and Letchworth Village in New York, and they died very young.

Then in the 1960s and 1970s, advocates demanded humane treatment, and things improved. Warehouses became homes, with people grouped in smaller numbers, and even the most profoundly disabled people receiving stimulation and therapy.

We're about to take a huge step back in time. Don't think for a moment people with disabilities don't understand when no value is placed on their lives. Stacie and Ashley know people care about them. They know someone will help them when they need it.

I can't imagine placing them in a nursing home that doesn't have the facilities or the staff to care for them properly.

It matters very much to me. If it matters to you, call your state senator in Raleigh and tell him or her you're watching.

Everyone who knows me understands that I'm an unabashed, unreconstructed, aging hippie, pinko, commie, socialist liberal.

I believe in helping people in trouble, I believe in giving equal opportunity to all, starting with a good education and proper nutrition.

I believe health care should be a basic human right, and quality care should be available to everyone, rich or poor.

I believe in paying people a living wage in exchange for a week's work and that everyone who works full-time should have three or more paid weeks off per year, plus paid sick days and holidays. People should have some power over their own destiny, so collective bargaining should never be denied to workers.

I believe in the inherent dignity of every human being.

But I have no income. Money donated to Life o' Mike goes straight to rent, office supplies and the peer-support program we're trying to build, Patient Pals & Family Friends. It helps me travel to Raleigh to participate in health care advocacy at the state level once every few months.

So, I can't give $5 to help Alan Grayson get elected again, even though I love Alan Grayson and I dearly want to see him elected.

I can't donate to the recall efforts going on in Michigan and Wisconsin. I can't give anything to Credo or Daily Kos or Truthout.org or any of the others. I can't give to the Red Cross to help people in Joplin or Tuscaloosa whose lives have been torn asunder through no fault of their own, although I can be royally pissed off at US House Majority Leader Eric Cantor, who said they shouldn't get any federal aid unless the money gets cut from somewhere else in the budget.

It only makes me feel guilty (we hippie-liberals live with the guilt that we can't fix things) to open my e-mails day after day after day and see all the places my money could go if I had an income.

I can give my time, I can give emotional support, but I can't give money -- not even just $5.

That's part of the problem nowadays. Money is power and most of us working-class people don't have any because of the prolonged attacks on workers' rights.

I do have my big mouth and I'm happy to take to the streets. Maybe it's time for a road trip to Raleigh or to Washington where hundreds of us can get arrested, just like we did in the 1960s.

In a very conservative upstate New York Congressional district, a Democrat won a special election last night.

I like to think it a portent of things to come in 2012. As I've said many times, I don't want to bring politics into this, but looking at the differences in the parties' policies, it is the Republicans who have tried to stop health reform at every turn, and it is Republicans who want to essentially kill Medicare.

Since I don't live in the district and I didn't see the candidates first-hand, I don't know whether Independents considered Kathy Hochul the lesser of two evils, but I do know that at least part of the reason she won was that she targeted the Republicans' threats to Medicare.

People were swayed by the misinformation about health reform in the 2010 elections because it's new and they haven't benefitted from it yet.

But Medicare has been with us since 1964, and it's one of the most popular government programs in the history of this country. People know that their parents need health care and that Medicare provides it efficiently and effectively, and they know they'll need it too.

I think the Tea Party branch of the GOP is about to learn that you can't lie about things people have experienced and loved.

People are watching the budget cuts -- and the job cuts that come with them -- and beginning to understand that they've been lied to about the priorities of those in power.

In North Carolina, we're watching the Tea Party-influenced majority cut things that don't even affect the state budget, such as unemployment compensation, and voters are beginning to see that these policies are just mean-spirited.

Later this week, 12 of my former colleagues at the Asheville Citizen-Times will lose their jobs to corporate greed.

The beat that I covered for years, social justice/nonprofits, will disappear. It won't be anybody's job to tell the stories of how corporate greed and government cuts hurt real people, and how people can get help in their own communities.

Those stories made a difference time and again. When I followed Ethan Gray's family for 10 months, telling the story of how desperately his family needed a little-known Medicaid waiver program, and that they and hundreds of others had been waiting for five years and longer, people took notice and the state changed the way the program was funded to allow more people to get help.

When the state was considering closing all the sheltered workshops that employ people with disabilities and privatizing it, the office in charge of the state program received hundreds of calls before noon the day the story came out with the quote, "We're going ahead with this." The state backed down.

That's just two stories among hundreds, perhaps thousands, that have brought to light  government and corporate missteps and corruption. The press was powerful in its ability to be a watchdog; now, however, most newspapers are nothing more than lapdogs. Their corporate owners have cut staff so thin that no one has time for investigative journalism, or to find the stories of people who are harmed by bad public policy.

My job was to tell the stories that explained public policy to people, and people reacted.

Now a dozen fewer people will be looking out for us in Western North Carolina. The ones who are left will have more to do and less time to tell the stories that matter.

Children First/Communities in Schools of Buncombe County held a summit today to ask what a community without child poverty would look like.

About 150 people showed up to participate in building the vision, bringing their ideas and their enthusiasm.

We talked about a community where a nurse visits every home with a new baby and offers answers to questions and a list of parenting resources within the community. We talked about making health care available to everyone because children don't do well when their parents are sick and they're worried about them.

Our community would have centers where people could go for small help with small emergencies and where they could volunteer and become community leaders themselves; where children could have access to safe places to play and exercise, and how neighboorhoods that have no grocery store could still get fresh fruits and vegetables sold off trucks, and where child care cooperatives help young parents learn the importance of early childhood education and allow them to go to school to better themselves.

Our community would have flexible rules for families in need because each family is different, and help for families in navigating the social services system.

The vision will take bold moves by advocates because we're up against corporate greed that will go to great lengths to keep people down.

But healthy communities can overcome just about anything. It takes people working together to come up with innovative solutions; it takes working inside and outside of established systems and changing those systems bit by bit until they serve the people they were meant to serve. It means reallocating resources to invest in families so we can build healthier communities -- physically, emotionally and financially.

Most of all, it takes all of us being involved.

What can you do to make your community healthier?

The NC House of Representatives postponed its vote on House Bill 115, the industry-friendly bill that would hand off control of the federally mandated insurance marketplace to Big Insurance, most notably, Blue Cross Blue Shield.

Adam Sering, of the NC Justice Center's Health Access Coalition, believes the pressure we have put on legislators to kill the bill is having an effect.

Big insurance companies had hoped to get the bill passed quietly, but some of us advocates took notice. We filled the committee galleries, we called and e-mailed and visited our representatives.

It took a couple weeks of telephone calls and letters, but we even got the media to take notice.

We made sure this thing wasn't going to happen without a stink.

I e-mailed my representative, Tim Moffitt, yesterday morning, and he said he's still undecided. Tim has had to pay out-of-pocket for care before; he has a brother who has a serious disability. I hope he will vote against this bill.

Moffitt told me in an e-mail that since the insurance companies only hold two of 11 voting seats under the proposed law, it didn't seem to be a problem. But insurance brokers, professional groups and several allies in opposition to health reform hold seven of the 11 seats.

I answered that for the insurance industry to have any voting seats on a board that regulates them is a serious conflict of interest, and 69 percent of North Carolinians agreed with me in a poll released Monday.

If you live in North Carolina, it's important to call your representative and talk about the harm this bill would do to health reform. Urge them to kill HB115. Tell them you'll remember how they voted come Election Day.




I don't like to play politics on this blog; I really am open to all proposals to solve the health care access crisis in America.

I am, however, willing to call out a proposal that doesn't work, and that includes Rep. Paul Ryan's idea to privatize Medicare and to offer states block grants to replace Medicaid as we know it.

The proposal for Medicare would be to have government pay part of health insurance premiums to private companies to lower government costs. This would do nothing top lower health care costs overall, but would price many seniors out of the market because they can't afford the ever-increasing premiums, co-pays and deductibles. In other words, this would shift much of the cost from the government to seniors who need care.

A friend of mine who's running for Congress, Cecil Bothwell, suggests we all be allowed to buy into Medicare for whatever the cost is. Since Medicare is an efficient single-payer plan and the basic administrative structure is already there, it would be less expensive to set up than any new system.

This also would allow those who want more bells and whistles with their care to continue to buy insurance on the private market. It also would place some real competition on private insurance companies to rein in their costs. Remember, Medicare spends 97 percent of the money it takes in on direct services. In contrast, 13 of the 14 companies who sell insurance in North Carolina have asked to be able to spend less than 80 percent of what they take in. That would allow them to keep spending billions on lobbyists, executive bonuses and ads to try and make themselves look better.

I don't want to put insurance companies out of business, but they do need real competition to keep them honest, and people deserve a real choice when it comes to health care.

Australia has a similar system. Most people want to get out of the public system and into the private one as soon as they can afford it. But not being able to afford or get private insurance there isn't a death sentence as it is here.

Insurance companies are businesses, and they must turn a profit to stay afloat. Their first obligation is to the bottom line, as it must be. We need a system that puts people first, and allowing people to buy into the public system is a good solution.