Thursday, November 16, 2017

The Samsara of Healthcare



I was scanning through some old posts from a few years ago and noticed one that is particularly relevant -- STILL -- to today. It has to do with government and entitlements and the ongoing threat we face from Republican economic policies and a culture that is all too willing to sacrifice the vulnerable while exalting the already fortunate.

I don't know what to do about this and feel not so much defeated as overwhelmed with the ongoingness of it. I'm currently working with a health insurance broker trying to figure out our 2018 health insurance options as our current plan raised our premium by 39%, making it unaffordable. The capitalists love to talk about "consumers" going "shopping" for health insurance, and "competitive rates," etc. -- all that market talk, reducing us to numbers. I can tell you that scrolling through plan benefits, trying to figure out what coverage would be for Sophie's various needs, reduced me to tears, and I'm no wimp.

I maintain that access to affordable healthcare is a right. I maintain that we shouldn't be looked on as consumers when we access healthcare. I maintain that shopping for healthcare insurance is ridiculous, that despite my college education, formidable intelligence and decades of experience navigating all the systems of care, I am literally overwhelmed by it.

What, really, do I know with my tiny little mother mind™?

If there's anything to substantiate the Buddhist notion of samsara, I guess it would be this.

Here's the post from a few years back, and the article that I referenced in the first paragraph could just as easily be replaced by any number of articles and notices in today's newspapers regarding the threats to Medicare, IHSS and SSI under the current Republican tax reform proposals:



I read this article this afternoon as I languished, a bit sick, at home. For the record, I did do some part time work and home-schooled Oliver in American history and writing. The article was titled Aid to Disabled Kids Surpasses Welfare and states that the amount of federal money going to disabled kids through Supplemental Security Income programs has surpassed traditional welfare programs. You can imagine what this means. There will be people (conservatives) talking about corruption and those who milk the system and rely on government benefits, who don't use their bootstraps properly, who go on vacations when they find out they've qualified for disability and who are otherwise, losers. They will claim that the increasing numbers of children diagnosed with mental health issues, ADHD and other disabilities should actually be parented differently.

There will be people (liberals) blasting the conservatives for once again targeting the vulnerable, blind to white collar corruption and to military expenditures and waste that probably surpass the GDP of most second and third world countries, much less welfare and SSI expenditures. They will talk about the shrinking middle class, how the poor, truly cut off from welfare as it was once known, depend on SSI to even make ends meet.

What you probably won't hear, though, are the voices of those who benefit from SSI programs, many of whom are, literally, without voice. You won't hear about how difficult it is to actually get the benefits, how much education you have to have to parse out the requirements, and in the absence of education, the sheer stamina and persistence  to make sense of the paperwork, to navigate the system, to continue to care for the child with disabilities, to plan for her future with or without you. You won't hear the voices of those who have to continue to make a case for needing the money each year. You will hear that these people are working the system, making up disability so that they don't have to work, that their numbers are growing and America will go bankrupt dealing with them.

First of all, you know that I've a liberal voice, and my voice also happens to be Sophie's voice, since she doesn't have one of her own. Sophie began receiving SSI benefits monthly when she turned 18, the bulk of which I use to pay for the huge drug co-pays that her insurance company doesn't cover, any other medical treatments that her insurance company doesn't cover, her diaper wipes (I pay for her diapers with my own money even though they're covered under MediCal) and various toiletries, occasional clothing and apps for her iPad that she uses at school. Last month, I used part of the money to help pay for her two weeks at communication camp. I realize that some of this is luxury -- she could sit at home in her stroller (also partly paid for by SSI), next to me at my desk as I do my part time work instead of going to camp for three hours. Since I've never found a dentist that provides adequate dental care under Medi-Cal (Sophie receives dental insurance under Medi-Cal but none through our private insurer), I chose to continue to see our family dentist. It's expensive, and in order to keep Sophie's mouth healthy and because it's very difficult to brush her teeth adequately, we pay out of pocket every three months for a cleaning. The SSI money helps with that as well. Sophie's needs are met with a combination of government funds and those earned by her father and me, as well as generous donations toward her care given to us by my parents. I know that there are many, many people out there like us, making ends meet, not abusing the system and grateful for every bit of help -- both private and public. I know that without the combination of funding sources, many of us would have to resort to going into debt, to living far more stressful lives than we already do and to turning our children over to institutional care so that we, their caregivers, can try to find full-time jobs.

I understand that the system will always have corruption, and that some people will take advantage of that system, lie and cheat and steal in order to get something for free. I understand that part of my tax money is going to help the liars and the cheaters and the thieves, but I have a feeling that the vast majority of those that use these funds are doing so responsibly and because they very much need them. I understand that part of my tax money also goes to fund bombs and arms and war apparatus, even if I don't support those wars. It's a sort of price I pay to live in the country that I live in, a democracy where I supposedly vote for the representative that best works in my interest. I understand that people (and I know some of these people) who have millions of dollars but who are also veterans continue to collect what they're "owed," and while I believe that is pretty low-brow, even repellent, I also believe that my taxes go toward far more veterans who, after serving their country, are out of work, homeless, mentally ill, permanently injured or otherwise in need of them. For every Mitt Romney pumping money into tax havens or writing off dressage horses, there are countless businessmen and women getting into their cars and going to work, collecting their paychecks and paying their taxes.

What's the point of this post? Hell, if I know. I guess reading that article sent a frisson of fear into me. The fear is that the difficult job of caring for a person with disabilities in this country will get even more difficult. The fear is that this "difficulty" is really just a cultural construct -- that living in a nation that exalts individual responsibility to the exclusion of community makes my daughter's value recognizable only in dollar terms. The fear is the knowledge that she, and millions like her have to constantly prove their worth. I have certainly been proving her worth for the past nineteen years, and I suppose I'll have the stamina and grit to continue to do so, but damn. It's difficult.

9 comments:

  1. That final paragraph just unraveled me. The ongoingness of it is like something out of Kafka. But that portrait of Sophie is sublime.

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  2. Exactly what Angella said. Kafkaesque.
    And the beauty of your daughter.

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  3. I remember this post well and am so fucking sad that it is still so relevant. I, too, am headed out onto the healthcare exchange (such a benign phrase for such a time-sucking, soul-sucking activity) to parse out options for my family and I know it will take days of weighing costs v. providers plus large leaps of faith (if I choose a plan with a $6000 deductible, will I have that much money to pay upfront if something major happens?) and it pisses me off. Here's hoping that next year will bring a sea change in representation after the clusterfuck that is this year's political landscape. A little relief is definitely in order.

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  4. Access to healthcare (whatever is medically necessary) is not only a right, it is a duty, it underlines the social contract, it is a cornerstone of any society based on equality and solidarity, not *goodness+ and *charity*.

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  5. Criers are not wimps. What causes people to cry is usually something that has revealed stunning hypocrisy, heart wrenching betrayal and the breaking of spirit. That's what this medical system and corrupt government are doing to us. You are no wimp. You may feel like one, but the proof is in.

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  6. Ah - little mother mind and samsara.

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  7. My heart has been, continues to be, heavy. Cold. Broken. My gut has been, continues to be, a knot of dread. Thank you, as always, for your voice.

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  8. I wish you could move to Canada. Our health care is far from wonderful but no co-pay, no shopping, no health care as business. As an underemployed kinda chronically poor single woman, I pay $35/month (most provinces have done away with monthly payments) for doctors, specialists and the odd ER visit. Our big issues here are wait lists for non essential tests and dental care not being covered by our medical premiums. Oh and many meds aren't covered buy many have extended health coverage through their work. That American system breaks you and so many others.

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  9. Having to Prove Value for a Life, any Life, bothers me tremendously. After all, WHO chooses what Lives are Valuable ENOUGH to provide the most basic of needs to even Survive, let alone Thrive? Not just Human Lives, but the Lives of all Living Things has been reduced to what expenditures are necessary to ALLOW them to but LIVE! In my Eyes every Living Thing has tremendous Value and it does not have anything to do with mere dollars and cents... paper and metal is all our currency is... flesh and blood is far more Valuable and relevant. Big Hugs and Happy Thanksgiving!

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