The Broad is Back!

March 22, 2018

Autoimmune Disease Awareness Month

I’m one of the over 50 million Americans who has an autoimmune disease, and even I didn’t know that March was Autoimmune Disease Awareness Month till someone I follow posted it on Twitter. There are over a hundred autoimmune diseases, and some of them are pretty nasty. I have one of the middling nasty ones, Sjögren’s syndrome, which does make life difficult some days.

An autoimmune disease is the result of the body’s own immune system attacking itself.  The different diseases attack different organs or systems, and that’s the main difference between them. But there is a lot of overlap.

Many people I love are in the same autoimmune boat, with diseases ranging from type 1 diabetes to lupus to psoriasis to Hashimoto’s disease.  We have some different symptoms, but the one thing we all have in common is that our diseases are invisible.

Most of the time we don’t look sick, but believe me, there are days when the pain is close to unbearable. And I’m used to a lot of pain because I had endometriosis for over 30 years. While the endo is not seen as an autoimmune disease, women who have had it are at a higher risk for the autoimmune diseases lupus, Sjögren’s, multiple sclerosis, and rheumatoid arthritis.

I learned in high school to get up, dress up, show up and live. My friends know that the brighter my lipstick, the worse I feel. Many days during my fertile years, I was tempted to stay in bed, curled into a ball. But how much life would I have missed had I done that? Oh, there were days that I didn’t get out of bed, but not as many as I would have liked.

I also know, though, that I have been blessed with a high pain tolerance and a strong sense of “get on with it.” As I joke, my mom went to the “Attila the Hun School of Mothering.” Seriously, though, we were taught to never complain, never make excuses, never drop the ball. It was difficult, and it wouldn’t pass muster as a parenting ideal today, but it made me who I am.

But that doesn’t mean I raised my son the same way, and it doesn’t mean I am unsympathetic to those who take a day off and stay in bed. In fact, one of the things I’ve had to learn is self-care.

Because many of our diseases are invisible, when you see us out on the street, you probably don’t know we’re sick.

That’s why I love the young celebrities who are talking about what’s wrong with them. When Daisy Ridley announced she had endometriosis, I was so sorry for her (it’s a pretty horrible disease that took me six years to get diagnosed), but happy that she put a face on the illness. Lena Dunham also has endo and has also raised awareness.

Selena Gomez has suffered greatly from her lupus, but being open about it has helped many young people understand more about it. Other public figures who talk about their lupus are Lady Gaga, Toni Braxton, and Seal, Sjögren’s is very close to lupus, so now when I say, “it’s like lupus,” more people know what I’m talking about.

Venus Williams, one of the greatest tennis players ever, is a fellow Sjögren’s patient. I keep telling myself, look at Venus. If she can do it…. Of course, she’s 20 years younger than me with a body that’s a well-honed instrument.

One reason that it’s important to raise awareness is that these are diseases that can take a very long time to diagnose. It takes an average of about three years for a Sjögren’s diagnosis. I was diagnosed in less than a year, only because I had an early lifetime of doctor’s poo-pooing my symptoms. Young people who complain of pain are routinely ignored. Women who complain of pain are routinely ignored.

My doctor did send me for a Hashimoto test because I’m overweight, and my brother has it, but when that test came back negative, as did a diabetes test, he thought I was just depressed. Depression is a symptom of many autoimmune diseases, but I’ve been depressed, and that wasn’t my main problem. I was so tired that I was falling asleep driving. That’s not depression.

I was relentless and kept pushing him. He finally sent me to a psychiatrist (for the depression), who asked me about four questions, and said, “You have Sjögren’s syndrome.” Symptoms my GP had chalked off to other things were immediately spotted by Dr. Atkinson.

He was an older doctor, so more experienced, but he also gets sent many autoimmune disease sufferers when their doctors can’t find a cause and get frustrated.

I don’t actually blame my GP for not spotting what was wrong with me. But he did get annoyed with me, and he did give up on me, and for that I’m a little more unforgiving.

Insurance companies make it difficult to root out autoimmune diseases, as well. Once something comes up positive, they are more than happy to stop looking, even though the cause of the illness isn’t found. It’s easy to say we have depression or exhaustion or or or.

I’m sure you haven’t read this far if you don’t suspect you have an autoimmune disease. If you think that, be relentless with your doctors. Know that it may take years to get a diagnosis. But most important, know that you are not alone.

September 20, 2017

Oligarchy is Real & Love Doesn’t Make Money

The Graham-Cassidy bill is out and has people in a frenzy.

I keep seeing social media postings of parents telling the stories of their seriously ill children. “Are you willing to let my child die?” they ask in one form or another. Short answer: yes.

Prolonging the lives of the sick and dying who can’t be saved or cured is a waste of money and resources.

Did I just say that? Yes I did. Do I believe that? Logically? Yes. Do I think it’s morally right so something we should allow? NO!

And that’s the difference between me and the people in charge. I put human life at a higher value than wealth. Many of us still do.

But we will never change minds about our moral stance unless we can back it up with less emotional reasons than “my child will die”. Appealing to law makers’ humanity is a waste of time. Their standards are not ours.

Even when they profess to be Christian, it’s a different Christianity. Bet you dollars to donuts they come from a Calvinist strain, where financial reward is an outward sign of being one of the elect. While not all Calvinists are less than Jesus-like in their approach to the poor, there is a strong idea of “deserving poor” in this country. And fewer and fewer are falling into that category.

I went looking, quickly, I admit, at the net for real information about it, and most are against it for good reasons. FamiliesUSA: the voice for health care consumers posted “12 Facts About the Graham-Cassidy Repeal Bill” which, while written by a biased organization, pulls in information from non-biased sources like the Congressional Budget Office as well as other biased sources like AARP, the AMA, and Children’s Hospital Alliance.

From all I’ve read, and I’ve been reading a lot these days, it looks like an awful bill.

So yes, I’ve written and called and made my voice known. And yes, I’m shaking in anger. It’s no secret that I have a pre-existing condition as does my son. And it’s no secret that I am in medical debt up to my ears. This year alone, and it’s not over yet, I have a stack of bills totaling $8000. That’s not a lot considering what our health care needs have been this year, but put in context, I make a little over $27k a year. I made less the year before. I’ll pay, but it’s taking a while.

Now, part of that was a choice to live in a lower paying state so I could live with my mom and pay reduced rent. If it weren’t for my 85 year old mom living on a pension, I’d be in much worse shape. Now that I’m back in NYC, my salary has gone up, but so have my expenses.  And I’m still part time. So no health care and no guarantee I’ll be working in the spring. I think I will. I have hopes I will. I’m a damn good teacher and schools usually want to keep me because I am cheap as an adjunct, but nothing is guaranteed in this life.

But that’s a problem for another time. Yes, I have a sad story. Millions and millions of us do. My son is literally alive thanks to the ACA and my mother’s help. He had a crisis, it’s over, we know the problem, and blood monitoring 4-5 times a year should keep him healthy and back in the workforce. I’m at the start of my chronic illness, but if I take care of myself stringently and luck and God remain on my side, I should be able to work for another 25 years, which is the plan. I’ll be 81 when I retire, but I work with many people in their 80s who are still teaching.

So how to change minds, then? There’s the problem of living in an oligarchy. The Koch brothers have warned Congress: no more money till there are changes in health care, changes that save insurers money, not the insured. Google it. It’s been in the news since March. Now while I applaud their criminal justice reforms, the Koch brothers and the rest of our wealthiest citizens should not be running our country. That’s not democracy when the rich can buy the kind of country they want at the expense of the poor.

So we can vote Blue or Green or anything but Red and vote out the people in charge of the law, but they will be replaced by other people who can be bought and sold. As long as we have an oligarchy, we have a problem.

We’d think people would revolt against this, but they are held in check by that other bogeyman, socialism.  When I hear people talk of socialism, their fear and disgust is palpable. They collect their social security checks, but socialism is bad!

Socialism, I’m told, gives us Death Panels that decide who lives or dies.

That’s what insurance companies basically are doing now.

How many times have I donated to a crowd-funding campaign to help people I know get through devastating illness? I don’t mind at all, and I am happy to give, and frankly, I think we should care for each other. Many people think that this is how it should be done–communities and churches should help one another, not the government.

I get it–the frontier spirit of the Americans and our “I’ll do it myself” attitude. I believe that, too, but this is the 21st century. The world has changed radically since the days of the American frontier.

And they will say that they do support the sick, but they want to be able to choose who gets their money. That’s fair. I can understand that.

But often their money is earmarked for the “deserving poor,” and they are the ones who decide who is getting help or who isn’t.

And that’s the Catch-22.

I’ve lived in two countries with national health. It had problems, but it had benefits. I’ve lived in Switzerland, which had excellent health care which was mandatory, but expensive. But it was honestly the best medical care I’ve had in my life. But for mental health? It was terrible. So there’s that.

This current crisis will pass. I’m hoping that Graham-Cassidy will go down in flames, but I have a sick, sinking feeling that it won’t. It will be a shallow victory, though, because I’m thinking that this might just be the straw that breaks the camel’s back. Take away people’s health care, take money from their pockets and food from their mouths in dire emergencies, and then all Hell truly will break loose.


January 27, 2017

Too Big to Fail

When the financial crisis of ’07-08 was addressed by incoming president Barack Obama, many Americans were unhappy with the resolution. Yes, we got “back on track,” and things did get better for many. But banks were declared “too big to fail” and were bailed out.  That, I think, was one of the seeds that led to our current president.

For good reason, people blamed the banks. When banks got help and no punishment, many Americans who had lost homes, cars, jobs, and even a lifetime’s work got rightfully angry. And for the next six years that anger brewed.

Sure we got the ACA, which to me will always be Romneycare as I first encountered in when I came back to the US in ’07 and lived in Massachusetts, but I know people who literally had to choose between insurance and food. Even the subsidies through the ACA were not enough. It depends, of course. When I came back to the US the second time, I used the ACA because I had no health care in my part time jobs. I paid a lot but got excellent coverage. My subsidy was about $500 a month, but since I literally paid more into the government in taxes than American Airlines, United Continental, and Hewlitt-Packard, and now it seems, President Trump, my conscience is clear. I have always paid every penny of taxes due, and I am willing to pay them to cover things like medical care and roads and so on.

So in spite of the ACA, we have millions of people who realized that they were unimportant to the government in spite of all its propaganda. Protecting the banks was protecting them, we were told, because if the big banks failed, the economy would suffer.

Well, you know what else is too big to fail? The United States of America. And failing we are.

We have a sitting president who is totally unfit for the job. Yes, he is a businessman who gets things done, (including bankrupting himself and many, many small businesses left in his wake) but countries are not businesses. It’s not about the bottom line. It’s about people’s lives. He has not divested himself from his businesses. He has named unfit people for almost every position in his Cabinet. Most are now in the position to make the very wealthy even wealthier. Many of them have outright conflicts of interest.

Many don’t know a thing about the departments they’ve been nominated to head. I could see Ben Carson as Attorney General. I wouldn’t like it, but the man is a physician. But as head of HHD? No experience. And don’t get me started on Betsy DeVos. As a career professor, I am appalled. I have been teaching students who have suffered at the hands of federal interference in education for decades. I’ve seen the steady decline in knowledge and skills. Not intelligence—preparedness. The thought of her policies literally makes me shudder. And I know the meaning of literal.

Ironically, in light of people’s growing fears of more wars, I think one of his best picks for a Cabinet position is Gen. James Mattis as Secretary of Defense. While more hawkish than I’d like, he has the experience needed and is respected by folks in the Pentagon.

But the worst thing I see is the polarization between every day Americans. It’s been growing since the 2016 election cycle started, but instead of calming down, it’s getting worse. We are hating like we haven’t in a long while. We’re mean, petty, bitter, snide, personal, not only to people in government, but to one another.

We call each other names, generalize and stereotype. We’re more openly prejudiced than we have been in the past 50 years, not just against race but against one another based on political beliefs. I was never a fan of being “politically correct,” but I have always been a fan of trying not to offend people. I try to use non-gendered and people first language. I try to use the identifiers people prefer. To me, that’s just good manners and a fulfillment of the Golden Rule. Many quip that the new Golden Rule is “He who has the gold makes the rules.” Not a quip, the truth, and always has been the truth. But if we say we are the best country on earth, let’s treat each other with respect and humanity. Let’s act like the nicest people on earth. Bullying and hatred are not parts of greatness.

Don’t like someone’s choices? Think their life is a sin? Fine. But don’t curse them, threaten them, harm them or kill them. That’s not acceptable. And I’m not looking at one side or another or another here. I see people on ALL sides of the political spectrum acting unacceptably.

The true core values of our country, democracy, equality, and freedom, have eroded at a pace that frightens me. America is the only thing that’s too big to fail. And we are. America is an idea. And ideal, really. And because we are no longer living up to our ideals, because democracy was trampled on for decades, because corporations have the same rights as citizens, we’ve been a functional oligarchy for a long time. Equality in this country is a joke. Some lives are just worth less. Many see this on color lines, but I believe it’s more on wealth lines. The poor of this country have been abused, manipulated, lied to, and used as tools of the ruling powers since the beginning.

Race is also a problem. A middle class person of color does face stereotypes and prejudice. I am not unaware of the problem, and I’m not stupid. My own son identifies as “non-White” and has faced prejudice both from law enforcement and regular folks. But a poor white person has more problems and inherent difficulties than that middle class person of color. I live in a predominantly white place and the problems of poverty I see are only slightly different than the ones I saw in NYC. Drugs, poor education, lack of family structure (I’m not saying a traditional family is necessary, but when mom and dad are meth dealers, life is nowhere near normal), poor nutrition, poor medical care, and the list goes on.

This economic disparity, this racism, this throwback to “traditional Christian values” of intolerance and hatred for those who choose to live outside one’s ideas of Christianity, these are also seeds that led to Trump’s shocking victory.

Folks like to argue that race is the only reason he’s president, but that’s balderdash. Back in ’92, Bill Clinton’s famous campaign reminder was “it’s the economy, stupid” hasn’t changed these 24 years later. We allowed the oligarchy to grow, and now the White House has become the Palace of Versailles, especially the gilded New York White House in Trump Tower. Cronies and supporters are put into positions of power, regardless of ability, and dissent is harshly treated.

I’m not buying into Trump’s rhetoric of “make America great again.” It has needed work my entire life, but it’s always been a great country. Things are possible here. I am the daughter of a construction worker who earned a PhD. I have taught young people who have literally gone on to change the world, young people who grew up in poverty, or were immigrants, or were people of color, or all of the above. They are America. I love my country, and I love its people. We are what’s made America great, but America has failed too many because money rules.

Greed is not one of America’s values. We’re too great to fail, and this is something that needs to be addressed. I am not calling for communism. That was tried and failed in the USSR and China, among other places. I’m calling for competence in government, experts in charge of departments, not political cronies, corporations losing the rights of citizens, and support for measures that give a leg up. I’m calling for democracy to come back, unhindered by lobbyists, restrictive voting laws and outside manipulation, for freedom to come back through solid educations so that people can make good choices and for humans to live as they wish as long as they remember that their rights extend no further than the tip of their noses. That’s what I learned in 7th grade social studies. My rights are for me, and I can not force others to do what I think is right unless it’s something protected by the Constitution. And finally equality. No human being is born better than another. There is one race, the human race. Because of my personal beliefs, I believe we are all brothers and sisters, and I should treat you as I would a sibling. You may infuriate me, you may test me, but at the end of the day, I do love you. But you do not have to share my beliefs. Believe me, most people don’t as I don’t identify as any specific religion. But as members of the same race, we have to work together.

And that, my brothers and sisters, is my manifesto, I guess. We’re too big to fail. We’re an experiment in democracy that needs to backtrack a bit and see where we went wrong. I’m pretty sure I know where that was. Who will join me?

October 2, 2013

Another Fine Mess You’ve Gotten Us Into

Sequestration. That’s a rather benign sounding word, isn’t it? Doesn’t sound like it could hurt a fly. Automatic budget cuts that put some people temporarily out of work and cut services doesn’t quite have the same ring to it.

And as everyone here in the US knows, we’re in day two of sequestration. Laissez les bons temps rouler!

On Tuesday morning, I found myself steaming mad. Why? Because a small, and I mean small, core of hard line Republicans are holding America hostage because they don’t like a law that was passed by both houses, signed by the president and decided upon by the Supreme Court of the United States. Welcome to democracy, folks. Welcome to the “three ringed circus” that is American federal government.  Checks and balances. Sometimes you don’t always get what you want.

Maybe it’s not a great law. It’s certainly not perfect. But bad laws have been passed before. Then even repealed sometimes. But the repeal didn’t come from playground level hissy fits. It came through getting out to the people and changing their minds. Engaging in discussion that leads to change. Instead of winning the people, theoretically the most powerful force in a democracy (but I’m not an idiot. I know the reality of that scenario), most Americans are now livid with all of the government.

Personally, I’m glad.  We need to be mad. We need to be hopping, spitting, crazy mad.  And we need to channel that anger, hone it to a fine point and use it to say “Enough! We the people are taking, no, wresting back our government!  Because obviously the people we’ve elected are not fit to lead.”

I pray that this comes to pass.

As Thomas Jefferson famously wrote, “Where the press is free, and every man able to read, all is safe.” The press is this country is freer than in many, I admit. But it’s tamed. My first career was as a reporter, a legislative correspondent in Albany, NY, to be precise. That was 30 years ago. A lifetime ago. Pulitzer Prize winning journalist Seymour Hirsh just wrote about the decline in the quality of the American press. He called it “pathetic,” which sums it up from my view. Very interesting reading, and you can find it here, ironically in The Guardian, a British paper!

The whole point of this blog is that I left America for 14 years, but now I’m back, so I comment on the changes. One of the huge changes is the quality of the news media. While I was gone 9/11 happened, and that event, terrible and evil, has done more to change American cultural values than I care to admit.  The Internet has changed people, as well. Because of it and jumps in technology, ideas about personal privacy are shifting at an alarming speed.

Whistle-blowers are vilified and praised. That’s a topic for another day, one I don’t find myself ready to discuss.  But we have truly undergone a cultural sea-change.

And then there’s education. This, as faithful readers know, is my personal bailiwick. I am a professor. I teach writing and literature, but mostly writing these days because few students can write well and even fewer can read. I teach college level students, but I’m teaching skills I learned in 6th-10th grade. If I had to guess, I would say the average reading level of my students is 8th-9th grade. They struggle to read The New York Times, a paper routinely read in American high schools. I do not teach stupid people. I teach bright people, lovely people, hardworking people. But they have been very poorly educated in New York City’s public schools.

When my parents attended New York City’s public schools, they were the finest in the nation. In fact, my mother remembers observers coming from all around the world to see how excellent public education was run. She graduated reading adult level works, in two languages, with a third language at conversational level. Sure, she was a smart cookie and worked at it, but she went to the neighborhood PS4 and Long Island City High School. Now I’m not saying New York City doesn’t still have some fine schools, some of the finest in the nation. But statistically speaking, over 50% of New York City high school graduates are not prepared for college level work or an entry level job when they leave school. And that comes from the city’s own reports.

Sure, there are a lot of challenges facing New York, and I’m not picking on New York, but I’d guess that about 80% of the students I teach are from New York City high schools, so it’s what I know best. About 5% are from other places in America and the rest are from foreign schools. I had a class last term with a student from Italy, one from France and one from Germany. I almost wept with joy as their academic skills were so strong. Until I wept with pain that their American peers were so weak.

And I do spend time from students from other places and even at other schools, good schools, Ivy Leagues, even. And I am amazed, constantly, at what they don’t know that I know I knew when I was their age. This is what happens when as a culture we glorify stupidity and are proud of ignorance.

And sometimes, in the dark recesses of my slightly Orwellian soul, I do hear whispers of “This is not a terrible mistake.” And Orwell’s whispers are joined by Huxley’s ruminations in Brave New World. There are times I think the brave new world is now. (Though to be perfectly honest, I do not believe in a huge government conspiracy. A huge corporate conspiracy is much more likely. As far as I can see Congress is the lap dog of corporate interest in this country. Corporations really don’t want you educated. Why educate a slave race? That was Hitler’s view. It’s rather pragmatic when striving for world domination.)

So, we live in a populace without a truly free press and with men, and women, since it’s the 21st century now, who are unable to read. We are not safe. We have much to fear.

If our government is so easily hijacked, it needs to be replaced. If the people ruling this country are so weak and ineffective that a tiny minority can close down government, well, I can’t see why they are staying in office. With pay yet.

Many have called for their pay to be docked. We the people are their employers. Fire them. And if we don’t do that, at least don’t pay them. Not that I think the predominantly wealthy people who run this country will suffer much with the loss of a month’s salary or so.  But how many of the federal workers who are now sitting home, effectively out of work, are living pay check to pay check? How much do support staff, park rangers, computer tech people make?

I realized yesterday that I had to do more than tweet my anger, that 140 characters weren’t enough. Well, I’m about to hit 1200 words, and all I can really say is please, Americans, let’s join together to stop the madness. Even if we’re of different parties we have to realize that what’s happening in America is a case of cutting off your nose to spite your face. It’s stupid, pig headed stupid, and we deserve better than that!


March 9, 2010

The Contemplative Broad is Edging her way Back

It’s been a long time since I’ve really written, and I surely do have wonderful reasons for that.  I work too much.  Thanks to my wonderful sense of timing, I came back to America during a time of economic downturn, shall we say.  Because I want to live in New York City, where my family has lived for four generations now, I’m reduced to teaching part time, but I can’t live on one part time job, so for the three terms since I’ve been back in New York, I had three. Or four. In order to make less money than I need to live on. Welcome back, Broad.

But the other night it hit me that there might be another reason why I’m not writing about American culture anymore.  I’m too much a part of it again, and that makes it difficult.  One of the reasons I seem to thrive as an ex-pat, not something that everyone can manage, is that I prefer living life as a tourist.  I’m there; I’m participating; but I don’t belong.  The writer in me loves to be the observer, watching from the edges, dipping my toes in a bit, but never fully committing. I realized the other night that I feel like this emotionally much of the time.  That sounds ghastly, and I don’t mean it as such. I have a full and rich emotional life with friends and family I love deeply, but everyone who knows me well knows I need large chunks of time alone, as does anyone who spends a lot of time living an alternate life in created worlds.  So sometimes I pull back and think, “what interesting creatures.”  And it’s easier to do this pulling back when one is on the other side of the ocean or the globe itself.

So I find myself wanting to leave. I want to go back to my cocoon of geographical isolation.  When I lived abroad, I used to jokingly comment that in America people saw me as an oddball, and so I was just odd.  In Europe and Asia, my oddness is chalked up to my Americaness and thus given more of a pass.  It’s easier to have a reason for one’s oddness sometimes, so I prefer living abroad.  Many’s a truth told in jest.

But my biggest problem about writing is the longer I am back in America, the more appalled I become.  The educational system was bad when I left in 1995.  Now I’m back, teaching students who mostly weren’t in even school when I left the States, and their education has deteriorated to the point of farce.  For many years they’ve been taught to useless tests. There are more and more tests and less and less gym and arts and creativity and thinking.  But the tests are full of useless information.  When I get them as college freshmen, they can’t write, most have no basic grasp of grammar, and when it comes to having an idea of their own cultural context? Well, forget it.  My friends who are public school teachers are just as frustrated as I am.  And elsewhere in this column, I’ve written about problems with our students and education, so obviously this is something I am worried about.

I do not blame the students.  They are just as bright, just as savvy, just as eager as the crop I started with in the 80s, but what have they learned?  And sure, I teach at a NYC community college for the most part, but I’ve taught at very competetive schools, and I see problems across the class lines. 

But now I’m on the inside, and I just want to fix things immediately.  Passive observational columns don’t meet that need.

Health care is a huge debate, a mess really.  My son is one of the millions of uncovered Americans.  But after seeing the state of Sweden’s national health, I am very leery of nationalizing health care.  The best system I experienced was Geneva’s.  Health care was mandatory, but there was a very affordable government option for those who had no other choice.  My son was in the local cantonal hospital, and the care was good.  They misdiagnosed my kid, but I felt like they were earnestly trying to find answers, at least.  And I’ve written about the health care mess as well, but the more I see, the more disheartened I become.

And politics in this country.  I don’t even know where to begin.  I know that there was never a “golden era” of American politics, of politics anywhere, but, well. I’m speechless.  Luckily, Kurt Andersen isn’t, and he wrote the brilliant analysis “Is Democracy Killing Democracy” in New York Magazine in February.  I encourage you to read his article, but one statistic he gave got me thinking:

So part of the problem is most likely under-representation (though how on earth could we manage with 2100 senators, I don’t know), but another part is tied in with poor schooling, a lack of civic spirit on the parts of many, and so much else.  Believe me. It’s much easier to write explanatory essays for non-Americans than to figure out what’s going on in the here and now.
No, that’s not true.  I see things. I think of solutions, none of which are very politically correct, frankly.  I have much to say, but I don’t say it because it just would take too much time now that I’m so fully invested.  And as I said in the beginning, time is what I don’t have.
But now I’m going to try to write more frequently.  I think it’s good discipline, and oddly, people have been asking me to write.  So perhaps the Broad is back yet again.

September 10, 2009

Good one, Mr. President. Will people listen?

Last night, President Obama gave a 40 minute speech to the Congress making a plea for his health care plan and vowing to be the last President to deal with the crisis.

Overall, the president kicked some Congressional butt, called liars liars and cleared up the confusion that has reigned for many Americans, myself included.  This is the first time I feel like I have a clear picture of what is being proposed.

He clearly listed the points of his proposals and pointed out the lies and rumors put about by the competition.

He even told us the projected cost of the project over the next 10 years–$900 billion.  Sounds like a lot, but “less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration.”

He also warned that he won’t “waste time” on political games nor will he allow fear mongers to muddy the waters.  It was encouraging to see a show of backbone from him.  Too many times in the recent months it’s looked like the president was holding back from showing his mettle.

He ended the speech quiet brilliantly by reminding Americans of what makes us Americans:

One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government. And figuring out the appropriate size and role of government has always been a source of rigorous and, yes, sometimes angry debate. That’s our history.

He quoted a letter from Teddy Kennedy and mentioned how some Americans thought Kennedy had a passion for big government for the sake of big government.  But the president countered that Kennedy’s motivation was always based in a large-heartedness–a concern and care for others, and that’s something shared by all Americans:

That large-heartedness — that concern and regard for the plight of others — is not a partisan feeling. It’s not a Republican or a Democratic feeling. It, too, is part of the American character — our ability to stand in other people’s shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise.

When put like that, it makes anyone fighting against health care reform look mean-spirited.

And the president was careful to give credit to Republicans on more than one point–to John McCain for his ideas, to the Bush Administration, to the Republican party’s push for limiting malpractice claims.

I’m sure some of my Republican friends may beg to differ, but I thought he tried hard to make this look like a bipartisan effort blocked by extremists on both sides of the political spectrum–the difference being that the people on the Left were called “progressives” instead of Democrats–though, yes, I admit, the Republicans took more hits than the Progressives.  Of course, that’s Washington for you.

But his point is that Democrats and other people on the Left holding out for national health or nothing are also jeopardizing the chances for health care reform.

For those who missed it, the NY Times has posted an interactive video of the speech along with transcript and commentary here.

One major drawback for me was that there was too much self-applause and self-congratulation on the part of Congree for my tastes.  Too many standing ovations, especially since nothing has been done yet.

Clap when the job seekers have jobs, when the businesses thrive, when the homeowners don’t default on their mortgages, not when the government promises to help.  Clap when we have some meaningful reform on the health care issue.

I do understand that speeches to Congress are political theater.  No one was standing because he or she supports the President.  It’s theater for the voters back home.  “See me stand?  This is good.  See me sit and scowl? This is bad.” This is all part of the political game, and it has been since the very first Congress convened, but it’s tiresome.

Of course, Rep Joe Wilson probably shot himself in the foot with his outburst of “You lie.” He broke protocol beyond the Pale, and what’s worse, he’s wrong.

It’s quite clear from this blog’s past posts that I do support President Obama, but I like to flatter myself by thinking that I’m not a blind follower–I listen, I weigh his words, I think for myself.  And I encourage all of my readers to do the same.  It’s the American way, after all.

As the president pointed out, “Our collective failure to meet this challenge — year after year, decade after decade — has led us to the breaking point.” And I think Americans are at a breaking point, at least when it comes to patience with this matter.

But the facts are scary. “We are the only democracy — the only advanced democracy on Earth — the only wealthy nation — that allows such hardship for millions of its people. There are now more than 30 million American citizens who cannot get coverage.”

We are a wealthy nation. Some people call us a Christian nation.  Do wealthy people, people who call themselves Christian, allow others to go without health care?

Well, yes, obviously.  People are afraid to give up the freedom that the president talked about.  They are more afraid of paying more money or losing insurance benefits they already have.  Thirty million people sounds like a lot, but it’s less than 10% of the population.  That means 90% of Americans do have health care.  Put like that, it doesn’t sound too bad.

But 30 million is a lot, percentages bedamned. And to stop change, people have been reverting to fear mongering and lies–the worst of Washington, as the president noted.

But what we’ve also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have towards their own government. Instead of honest debate, we’ve seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned.

Hopefully people watched or listened to the speech, or at least paid attention to some of the commentary.  Technically speaking, it was a good speech.  As a former public speaking teacher, I’d give it an A.

But at the end, it was just a speech. Nothing is set in stone.  The proposals for bills are just that–proposals.  The fate of American health care reform drags on.

August 15, 2009

A Few (thousand) Words on Health Care Reform

“People are very open-minded about new things – as long as they’re exactly like the old ones.” ~~Charles Kettering

The health care debate has been raging all summer, and lucky me, I’ve been ignoring it.  I’ve been too busy working to pay attention, but that doesn’t mean I don’t care.  I very much care, as my son and I are part of the over 46 million Americans without health insurance.  I haven’t been able to find full time work for the past year, so I’ve been working three part time jobs.  That keeps the roof over our heads and the bare minimum bills paid. I pay the car insurance (because I can’t get out of my lease), but I can’t afford private health insurance.  I make too much for Medicaid, but now that my son is over 18, he can apply for coverage.  And now, thanks to my strong union, I will be eligible for health care through my employer in the fall.

But in the time I spent overseas, I lived in two countries with national health and one with mandatory health insurance.  Taiwan and Sweden were the national health countries, and in Switzerland, insurance is mandatory. If one isn’t covered through an employer, there is an affordable option available through the government.

Sweden is often held up as the exemplar for national health, and while I wouldn’t go that far, I can say that in most instances, it was fine.  My son is an epileptic, and as a child under 18, all of his medical care was covered.  When we came to America, even with the insurance I had the first year, my co-pay was over $300 on an office visit and some blood work.  And he’s supposed to see the doctor twice a year.

Of course, on the flip side of that, my taxes in Sweden ran close to 50%.  Through taxes, I paid for the care there, as well, but when my husband and I were out of work, my son still got the care he needed.  I checked some policies, and private health insurance for myself alone would cost about 25% of my yearly income; for the two of us, about 44% of my income.  Add my taxes to 44% and I’d be paying well over 50% of my income, so cheaper in Sweden.

One major problem with the Swedish system is that it’s overtaxed. Unemployment is high—about 10%–and with an ageing population, there’s too much going out and not enough coming in. And Sweden only has a population of nine million people.  Administrative costs are relatively low.

Swedes also register with the government and are assigned doctors, whether you like them or trust them or not.  I was very lucky with my son’s doctor, but terribly unfortunate with the “specialist” I was assigned.  To be perfectly blunt, she was inept at treating my disease and prescribed something no longer prescribed, in fact, something contraindicated.  When I balked, so did she and my care went downhill from there.

I can’t see Americans enjoying registering with the government and being assigned doctors.  According to the White House, this isn’t even something on the table, so I can relax about that.

America has fine health care, but it’s just not affordable.  And one thing alone is not going to fix the mess we’re in.  America’s health care woes are caused by many factors: profit-driven insurance and pharmaceutical companies, foolish laws, core ideals about personal responsibility and American’s poor health habits.  And frankly, labels don’t help. Am I left or right? Am I socialist or capitalist? Am I liberal or conservative? Throw out the labels and just think.

Insurance rates are high for doctors.  People sue for huge damages, so doctors have to have the insurance.  On the other hand, I’ve seen firsthand the devastation that can happen to families in which there has been a medical mistake.  Friends who are unable to sue for damages because their state has a statute of limitations have faced bankruptcy while caring for their son who incorrectly treated following his premature birth.

But the insurance industry in this country is not a nice group of kindly folks, no matter what image their PR firms try to show.  Michael Moore’s Sicko was typical Moore showboating, but it did point out some hard, if obvious, truths.  People in healthcare shouldn’t be profit-driven. But in a capitalist society, that’s how it works.

Insurance companies lobbied for laws so that doctors could not charge people without insurance lower fees.  They got the law. Sounds fair at first glance, but in reality, doctors rarely get the billed amount sent to insurance companies.  They are usually sent a percentage.  So when I walk in the door without insurance, I have to pay the full amount, but the person next to me, with insurance, pays a co-pay, and the insurance company pays “the rest”. But the insurance company doesn’t always pay all of it, so I’m stuck paying a larger price. Also insurance groups often get “group rates,” something the non-insured can’t get.

Insurance companies have also pretty much killed off the idea of a lone doctor practicing out of his basement.  When I was growing up, and I’m not yet 50, my doctor practiced from home, as did most of the doctors in town.  And I grew up in suburban New York, so not exactly the “boonies”.  When I moved back to my mother’s in the 90s, my same old doctor was still practicing.  He was a wonderful physician, and he apologized that an office visit was now $35.  The doctor I’d had just a few years earlier in “upstate” New York charged $50 for a routine office visit. This week I paid $95 for an office visit for my son and was shocked it was so low.

One reason for the cost is that now thanks to insurance companies, doctors spend small fortunes on paperwork alone. Couple this with sky high malpractice insurance premium, and you have a recipe for disaster.

A friend of mine who is a veterinarian has complained about the mark-up medical doctors give to supplies—vets and “human” docs use the same materials in most instances.  She has a point, but then I thought of the costs associated with running a physician’s office.  Most people don’t have pet insurance—the number is growing, but it’s considerably less than human insurance—so there’s no one who has to do that paperwork.  And vets do have malpractice insurance, but as much as we love our pets, they aren’t human.  There are no lost wages or multi-million dollar settlements made on pet care errors.  So for physicians, the cost of insurance has to be covered somehow.

I really don’t mind physicians getting a large salary.  Most made years of sacrifice and paid through the nose for their educations, and they hold my life in their hands.  I would love to be making what they are (the average US general practitioner, internist or pediatrician makes just under $150,000 a year according to the website since I have as much education, and I hold the future of the country in my hands, but that’s another story.  Of course, that’s the average salary.  That means that there are selfless physicians working for $30K in America’s rural and urban poverty centers while there are profit-driven folks raking in obscene amounts. But that’s capitalism.

Doctors today are major employers—they have nurses, LPNs, office staff and so on.  Physicians have to pay salaries and often benefits, as well.  All that is reflected in the price of a visit. I get that, as well.

Many states also succumb to pressure groups, making insurance companies cover all sorts of things on minimum plans.  Boston Globe columnist Jeff Jacoby wrote a very enlightening piece on this “Healthcare: Do we need the Lexus?” that I highly recommend.  Let me include one very eye-opening paragraph:

Forty years ago, there were only a handful of benefits that health policies were required by law to cover. Today, the Council for Affordable Health Insurance identifies an astonishing 1,961 mandated benefits and providers. While any one mandate may not add appreciably to the price of an insurance policy, in the aggregate their cost is huge. The Cato Institute, citing the Congressional Budget Office, estimates that state regulations increase the cost of health insurance by 15 percent. And since “each percentage-point rise in health insurance costs increases the number of uninsured by 300,000 people,’’ as scholars John Cogan, Glenn Hubbard, and Daniel Kessler point out, it is clear that the proliferation of insurance mandates is one reason why millions of Americans are uninsured.

Frankly, if the insurance mess was cleaned up, there would be a lot more affordable private insurance that would be available for people to purchase.

I haven’t even treated pharmaceutical companies here.  One example: my son’s epilepsy medicine costs me about $170/month.  I just discovered, after 23 months in this country, that the generic version is less than $12/month. Don’t get me started on advertising drugs on the TV and in magazines.  I am a very educated, pro-active patient, I research (and not on Wikipedia, but in medical databases—I’m a doctor, too.  Not a medical doctor, but research is research).  Americans for the most part have wised up about the over prescribing of antibiotics, but we still love to medicate ourselves.  I’m not anti-medicine. But I do think we overprescribe and just generally overmedicate. Learning about all the new drugs while watching the after dinner TV shows is too much.  I went to the pharmacy in Switzerland to get children’s cold medicine for my son and the pharmacist handed me some homeopathic tablets. They worked fine and were cheap.

Alternate treatments are marginalized here.  I’ve ingested thousands and thousands of dollars of harsh drugs that have left me with permanent side effects because I have stage IV endometriosis.  In Sweden I tried acupuncture, and it worked. I was off pain medications for years thanks to that treatment.  It’s not for everyone, but it works.  My American doctors laughed at the notion (so did my Swedish doctor, but once I had my run in with her, I was on my own for health care).  My Swiss doctor, who is a world famous researcher of endometriosis, prescribed hypnotherapy and massage therapy, as well as herbal treatments, all of which provided relief.  On a whole, Swiss doctors, along with many other European doctors, are not threatened by blending traditions.

And finally, the thing I am seeing get in the way of discussion so that we can’t even make a small change is America’s core values.  As many have correctly pointed out, health care is not something to be provided for by the government. The Constitution and Bill of Rights don’t mention health care at all.  Of course, in 1776, health care was a pretty rudimentary item. Catastrophic medical bills weren’t an issue.

America also likes to pride itself on being a caring country. Some people claim that we are a Christian country, and while I don’t agree, our culture, like all of Western culture, is solidly based on Judeo-Christian-Islamic values (all three are sons of Abraham, following the same basic rules given to Moses).  Just about any religious value system includes caring for the sick, so that’s at odds with our capitalist values on some levels.

Of course, we say that people have the right to life, liberty and the pursuit of happiness. I guess health care falls under the life part.  So it can get sticky.

When we discuss issues that involve core values, things can get heated.  We see this by the knee jerk reactions on both sides of the discussion.  People are no longer discussing health care—they are discussing what it means to be an American.  They don’t articulate it, but that’s what it is.  In America, the word “socialist” is a bad word, but we have Social Security and Medicaid and Medicare.

As you can tell by the previous 2000 words, this is a complex issue.  As the New York Times notes in its helpful article “A Primer on the Details of Health Care Reform:”

Each side hopes to win ground by boiling down one of the most complex policy discussions in history into digestible nuggets.

Not only are the sides turning this complex discussion into sound bites, most Americans seem to be perfectly happy with looking no further than those sound bites.  When I started really looking into President Obama’s health care reform, I found it confusing and amorphous. And I have 20 years of experience reading freshman compositions.  I am not being facetious. Most students today have incredibly weak logic skills, yet I read their papers and ferret out meaning.  Before I was a teacher I was a legislative correspondent. That’s a fancy term for being a reporter in the state capitol, reporting on legal stuff.  I’ve read more bills and laws than most non-lawyers.  I’m not a neophyte at this.

At the end of the day, I do wish there was a way I could afford health care for my son.  I don’t mind paying premiums at all, but I can not afford to pay 44% of my salary to cover us both.  As President Obama rightly points out, health care costs in this country are out of control. Something should be done.  Now we have to see exactly what gets put on the table. It all seems unformed still.

One final point: Americans have to take responsibility for their health. Americans are some of the fattest people in the world, and even many who are thin have deplorable diets.  I’ve written about this before, what and how Americans eat, but we need to take control of our lives.  When I am a rich philanthropist, my ultimate goal in life, I want to teach nutritious cooking to young people and young mothers. And I mean real nutrition, not the government-sponsored ideas of nutrition.  I’m overweight myself, and I work at getting thinner, but I do know that my diet is relatively better than the average American.

Drunk driving is also something Americans do more than most places I’ve ever lived.  In Sweden, a country known for massive drinking, people simply don’t drink and drive.  Not just because there are stricter laws; driving while drunk is stupid, and almost every Swede I’ve ever met at parties, where I was the designated driver, has asked why Americans are stupid enough to drink and drive.  Answering that we have the freedom to do what we want just doesn’t sound right.  How many millions does drunk driving cost in medical bills per year?

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