Coffee heat rising

Health care

Some days it’s not worth getting out of bed…

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{sigh}

Yesterday Costco had two new pairs of glasses ready: a new pair of progressives plus what the optician described as “intermediate” lenses.

I’d asked him to clone the pair of ancient close-ups I use to grope around the house, because my new close-up prescription is way too strong: I can’t see my feet through them, and so it’s unsafe for me to walk when I have them on. The old pair was perfect: I could see to walk around, but they sufficed to read most kinds of copy.

But no. He (being a man and so therefore certain he knew better than the little woman, eh?) insisted on making an “intermediate” pair that he thought would be better.

Apparently, the people who make glasses assume most wearers do only three things in life: watch television, drive, and sit down to eat at a restaurant. Evidently most people don’t read. For the life of me, I can not make these people understand that I need to be able to see more than one or two lines at a time, and that my livelihood depends on being able to see an entire sheet of paper! They just. don’t. get. it.

The progressives are good for those sorts of basic tasks: watching the television (yeah! like I do a lot of that!), driving, and forking food into my mouth. They’re useless for computer work, and they’re just barely adequate for short bursts of reading things like newspapers. Also, I thought it was odd that when the optician’s assistant marked these spots on the progressives where some part of the gradation was supposed to go, she kept getting the one on the right about 1/4-inch higher than the one of the left. She remeasured twice, and every time that’s what she got.

And as I suspected, the lenses on the progressives are not coordinated. When I try to read an 8½ x 11 sheet of music in the half-light of the choir loft, I can see the score OK (sort of) with my left eye, but everything’s a blur out of my right eye.

The intermediates are OK for reading a few things, but not for the variety of copy I read. Neither of them allows me to see enough of a page to parse out more than a three or four words at a time (I read a line or two or even three at a time), and  I can’t even begin to make out the photocopies of photocopies of music that probably was set in hot type. Microscopic hot type!

So this morning at rehearsal, I couldn’t sing because I couldn’t follow the music. I couldn’t see the stuff at all. I finally gave up and came home.

Guess I could have grabbed my bifocals and raced back to the Cult Headquarters—I could’ve made it just in time for the procession. But by the time I got home my mascara had run all over my face, because I cried all the way home, mostly out of frustration. I would have had to wash my face, remove the gunk around my eyes, and reapply make-up. Adding those tasks would have made me late.

Oh, damn it, how I hate that. Once I start to cry, all the loneliness and despair that haunt the corners of my life come bounding out into full daylight, and then I can’t stop crying.

Welp. Let’s get out of these uncomfortable clothes, wash the paint off the face, take the dog for a walk, stop crying, and grade some student papers.

Love in the time of influenza

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Feed me, Seymour! Influenza A viruses
Feed me, Seymour!

People are dropping to the left of us and dropping to the right of us. We seem to have a serious flu epidemic going on in our parts. Last night on the Evening Play-Nooz we heard thousands of cases have been diagnosed in Arizona, and a number of people have died. Given that most people can’t afford to go to the doctor with a case of the flu, the figures are undoubtedly just a fraction of the real number of victims.

For the first time in recorded memory, our choir director didn’t show up for midweek practice. He fell ill immediately the morning after the wedding for which we sang and ended up flat on his back. His doctor told him to stay in bed for seven days, and absolutely not to leave the house.

A vigorous and healthy man, this guy hasn’t missed work as long as I’ve known him, which has been a while. If he’s laid low, we frail old bats haven’t got a chance. The fancy private school attached to the old-money church is awash in flu (attendance down more than a third, one mother claimed), and since he also leads the children’s choir, that’s likely where he picked up the bug. At least one public school, I heard in passing, is threatened with closing because so many kids are sick.

Speaking of sick old bats, as I walked up to the checkout stand at the Safeway I noticed the clerk, one of the regulars who clings to the job despite reduced pay and slashed hours, looked like she’d been banging on Death’s door but they wouldn’t let her in. When I asked, by way of greeting, how she was doing, she said she wasn’t feeling so good.

“You have the same look I get when I have a terrible headache,” I said.

“Yeah, except the headache started a week ago. This has been building up all week. First the headache. Then my back and legs started to ache, and now every muscle in my whole body hurts!” And not only that, but half the rest of the store’s employees are already out sick.

Naturally, because I had a bandaid on my thumb I hadn’t been able to squitch open the damn plastic bags in the produce department, so I’d just picked up a few things, unbagged, and carried them to the cash register. While she’s telling me this story, she’s handling the parsley, the green onions, the tomatoes, my Safeway card, a pen for me to sign the credit-card receipt… Urk!

I suggested she should go home, if she was that sick.

She said she was trying to go home: that she’d been calling a manager for the past hour to tell him she needed to leave, but he wasn’t answering. She said quite a few of the store’s clerks were out sick, and she hated to leave him even more short-handed.

More likely, she hated to forego the pay: in a right-to-work state like Arizona, grocery store clerks are grossly underpaid and often have little or no sick leave. If she stays home with the flu, she may go without her pay. And since many low-income workers live from paycheck to paycheck, she has to weigh the benefit of not exposing customers to the flu against her next meal.

If the way our good cashier appeared to feel, if the way our choir director evidently felt is what authorities are calling “mild” in describing swine flu, we don’t even want to know what “severe” may be. Steer clear of this little guy, folks:

  • Wash your hands frequently.
  • Wash all fresh produce and anything else that doesn’t get thoroughly cooked before consuming it.
  • Get your flu shots!
  • Get your kids immunized!
  • Stay out of public places as much as possible.

Take care of yourselves!

Image: Dr. Erskine Palmer, Influenza A virus, Centers for Disease Control and Prevention Public Health Image Library

“Socialist” health care beats out private insurance

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SDXB—after having delivered another long tirade about the evils of health care reform and how we’re all going to pay lots more for lots less, watch our inviolable American liberties slide away, and ride to Hell on a socialist handcart—recommended that I drop by a CVS pharmacy or a Fry’s grocery store to get a flu shot, since The Great Desert University has quit offering employees free flu vaccine.

So, after checking where the flu clinics were scheduled for that day, I dropped by the CVS around the corner.

The “nurse” who was dispensing the shots had gone to lunch, but her sidekick was there, reading a copy of People magazine. I presented my health insurance card, by way of finding out how much I would have to pay for an immunization. She looked at the card and said she’d never heard of it. Then she plowed through a 50- or 60-page guide, searching several 8 1/2- x 11-inch fine-print pages for some clue. She did find that some Beech Street plans cover the Mollen Clinic’s flu and pneumonia shots, but she couldn’t tell whether the State of Arizona’s plan is among them.

So I asked her if the Cigna plan I’m being switched to next month would cover it. With only a week to go, it would probably be worth waiting to save the thirty bucks charged to members of the unwashed public who have no insurance. She repeated her time-consuming, eye-straining search. Again, she couldn’t tell: some Cigna plans were covered, but…now… Get this! Cigna customers were to provide a credit card number, which would be sent to the insurer. Cigna would then decide if and how much they would cover, charging the balance to the card.

I said I didn’t think I’d like to give out my credit card number and carte blanche to charge an unknown amount to it. She agreed that would not be the best of all possible ideas.

Moving on… I decided not to waste any more time waiting for the “nurse” to come back, since another site, a Fry’s grocery store, was on my way to the various errands I had to run.

There I again presented the Beech Street/RANAMN card. Again the customer service assistant had never heard of RAN-AMN. So, not wanting to drive 15 miles out of my way, pay for parking, and hike around trying to find the clinics for downtown state employees, I paid the $30 to get the damn shot. Before getting to that point, though, I had to fill out two legal-sized pages of forms detailing personal information that’s no one’s business.

It was, in short, an expensive hassle. At least it was better than the $86 my doctor “friend” tried to charge me for a flu shot last fall.

On my way out, I mentioned that next year I’ll be on Medicare and asked whether Medigap insurance would cover the shots.

“Oh, no,” she said. “Medicare Part B covers flu shots. They’re free. And you don’t have to fill out the form then—all you have to do is sign this line” (indicates a blank on the two-page form) “and you’re done!”

ohhh brother… that soooooocialist health care system
sure is gunna make our lives rough, eh?

Earth to GOP: Define health-care “rationing”…rationally, please

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I see the Republicans’ latest maneuver to obstruct Obama’s health care plan is to flamboozle us senior citizens into thinking a public option for health care will mean “rationing.” It would be awfully nice if the GOP would explain, please, how it is that we don’t have health care rationing right now.

If you’ve had any ailment more dire than a runny nose, about your only option for obtaining health insurance is through a full-time job with a company large enough to afford a plan for its employees, or through marriage to someone who has access to such a plan. This lets out self-employment; it lets out buying an individual policy on the open market; it lets out working for most small businesses. Sometimes you don’t even know a “diagnosis” exists until an insurer informs you it will not cover you.

Refusing to cover people for this, that, or the other ailment—or setting up an obstacle course that causes people to avoid seeking medical care for fear of putting a metaphorical black blot on their records—amounts to health care rationing. If you can’t get insurance, you can’t get health care, because no one but the very wealthy can afford to pay out of pocket for a trip to the doctor.

A while ago, the State of Arizona offered only one health plan, which most of my doctors would not accept. Because I did not care to go to just any quack some company bureaucrat ordered me to see, I decided to buy an individual policy.

A year or so prior to that, I had visited my doctor for a routine physical. Delivering the usual clean bill of health, he asked if anything that we hadn’t covered was bothering me. I reminded him of the supposed neuroma on my right foot and remarked that I was tired of the choice of footwear the chronic pain left me: hiking boots or Dansko clodhoppers. He sent me to an orthopedic colleague, who had the foot X-rayed, did an examination, and said there was no evidence of a neuroma, nothing that he could see was wrong, and I should just learn to live with the foot discomfort.

So, a year or two later when I went to apply for this insurance policy, Blue Cross informed me that it would not cover me for any broken bones or for any back problems of any kind.

Say what?

Asked why, their bureaucrat said it was because I had “osteopenia.” I said I’d never heard of any such thing, no one had ever made any such diagnosis, and I didn’t even know what it was. He said there it was in my records.

Looking into this, I discovered it had been stuck there by the orthopedist, who thought the X-ray of my foot showed a slight thinning of the bones. Osteopenia is considered to be a precursor to osteoporosis, although that opinion is dubious.

At this point I trotted to my gynecologist, since at the time I was premenopausal. He ordered a complete body scan. When this returned, he said I did not have osteopenia, and in fact, my bones were stronger than those of most women my age.

By then, open enrollment had passed, I’d missed the chance to get private insurance, and I was forced to buy a health plan through GDU that I did not want and that did not cover the doctors of my choice.

So what we have here is insurance companies telling you…

• you will not be covered (therefore can not have medical care) for certain issues, whether or not those issues are related to the “diagnosis” the company dislikes;
• this limitation is based on a decision made by someone outside the doctor-patient relationship; and
• you may only go to certain doctors, none of whom are doctors of your choice.

If that’s not rationing, I’d like to know what it is.

If you’re older than about 50 and lose your job or decide to start your own enterprise, you’ve got a snowball’s chance of obtaining healthcare coverage. Whatever policy you can land will except every ailment even remotely related to any symptoms that have appeared in your doctor’s records, and the cost of whatever policy you can obtain will be prohibitive. Because of the costs, you likely will be herded into an HMO, where you will have no choice of doctors, where the doc who does see you will have about 10 minutes to make a snap decision about any problem that arises, and where some bureaucrat will say what treatment options you have and don’t have and what medications you may and may not buy.

The Republicans are trying to convince us that we don’t already have health care rationing, when obviously we do. Then they’re trying to whip up hysteria by telling us that the precious full choice we supposedly have now is going to go away. Evidently they think enough of us are morons that spreading stupidity will block any progress toward meaningful health care coverage for all Americans—and given the number of people who bought into that idiot Palin’s “death panel” fantasy, they may be right.

How did the Republican Party become the party of jerks, fools, and scoundrels?

I used to be a Goldwater Girl, believe it or not. Barry Goldwater signed my first straight-A report card at the University of Arizona. I’d just received it in the mail, and as I reached the top of the stairs coming up from the Student Union’s basement mailroom, there was The Man himself, strolling through the building with only one or two sidekicks in tow. In an instant’s whim I barged up to him and asked if he’d put his autograph on it. Amazingly enough, he did.

If Barry Goldwater were alive today, he would be so revolted by the state of the party he would change his registration. Indeed, near the end of his life, he was heard to use the a****** word about the faction that was then just beginning to assume power in the party, whom he regarded as “a bunch of kooks.”

How right he was.

😀 In our hearts, we knew he was right. 😀

Of interest, along these lines
And this update

Retirement healthcare update

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A new development in the hoop-jumping contest that is figuring out how to get full coverage under Medicare:

The volunteer snail-mailed two thick brochures on Medigap—over a hundred pages, to go along with the hundred pages or so of data to be mastered before signing up for Medicare. Took an hour to shovel through the new stuff.

She apparently was wrong on two counts: First, COBRA is regarded as “credible creditable (!) coverage,” meaning that if you continue your employer’s coverage through COBRA between the time you’re terminated and the time you reach age 65, Medigap carriers can’t refuse to cover you for pre-existing conditions. And second, she didn’t know that attained age premiums (which start low but rise as you age, ending up costing more than you would have paid if you’d selected a pricier product to start with) are illegal in Arizona.

{sigh}

Well, I’m glad I finally got my hands on what appears to be definitive information. It’s a shame elderly people are expected to plow through over two hundred pages of dizzingly complex and confusing material just to sign up for something as basic as health insurance. And mighty annoying that the only people you can get on the phone are unpaid volunteers who themselves are a bit confused!

😯

Flaws in WHOSE health care system???

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Have you seen this AP story? In it, the reporter uses the swine flu episode to highlight the shortcomings of Mexico’s health care system (which, as anyone who has been injured or fallen ill in Mexico can attest, does have its challenges). As I was reading through it, I thought…this stuff sure sounds familiar…

Mexicans will do almost anything to avoid a public hospital emergency room, where ailing patients may languish for hours slumped on cracked linoleum floors that smell of sweat, sickness and pine-scented disinfectant.

Let’s tweak that to reflect the experience of citizens of another large North American country:

Americans will do almost anything to avoid a public hospital emergency room, where ailing patients may languish for hours slumped on cracked linoleum floors that smell of sweat, sickness and pine-scented disinfectant.

Exactly my experience. When I was suffering from acute appendicitis, I went to the ER of a major urban medical center, where I waited for hours—in exactly the conditions described above. After four hours of excruciating pain, I gave up, called some friends, and (at midnight) asked them to drive me home. I knew what was wrong with me, but figured I’d rather die in my bed than huddled on a concrete bench outside the ER in the winter cold. In that entire time, I never saw a doctor or a triage nurse and encountered only some surly staff who gave me a dirty look when I threw up into the bucket I’d brought. I sat next to a young woman who was miscarrying a pregnancy; she also had been there over four hours with exactly zero medical attention. There was no place inside to sit, and the floors were too filthy to sit or lie down on.

Many don’t see doctors at all, heading instead to the clerk at the corner pharmacy for advice on coping with a cold or a flu.

Good luck trying to get in to see a doctor for something as minor as a cold or flu! American access to medical care pretty much forces you to head for the corner Walgreen’s or the local naturopath to ask for over-the-counter nostrums.

Some patients suspected of having swine flu told The Associated Press that public hospitals turned them away or forced them to wait for hours for treatment even after the government declared a national emergency.

Some people at the ER where I waited had been sitting in the waiting room for eight hours. I was told the typical wait was six hours. No tweaking needed here to make this apply to the US experience.

“If someone is sick, he can’t simply say, ‘I’m going to the doctor’ or ‘I’m going to the hospital,’ because it depends on whether he has Social Security…”

Uh huh:

“If [an American] is sick, he can’t simply say, ‘I’m going to the doctor’ or ‘I’m going to the hospital,’ because it depends on whether he has Medicare or health insurance…”

And…

While access to health care is a right enshrined in the Mexican constitution, millions of Mexicans have no health insurance at all.

Heee!

Access to health care is most certainly not regarded as a constitutional right, and millions of Americans have no health insurance at all.

And, annoyingly enough:

Mexico spends only 6.6 percent of its gross domestic product on health care — less than half the U.S. figure. No country in the 30-nation Organization for Economic Cooperation and Development puts a smaller share of public money into its health care system.

Think of that. We have a healthcare system that in many ways, for the average Joe and Jane on the street, functions on a par with that of the most underfunded system in the OECD. What’s wrong with this picture?