Tag Archives: Affordable Care Act

“This is an ex-parrot”, Hippocrates and Cancer

There are words received via text that shatter your heart.  Sent from a friend during their latest round of chemotherapy more than 5100 miles and multiple time zones away these are debilitating words. #notadamnthingIcando words. I respond to each line of text, being present without being physically there. In truth, it feels beyond inadequate. I want to jump on a plane and just sit next to him while he has these poisons dripped into his body via a port in his chest – and not only does he not want that, but I can’t. I scan hundreds of YouTube videos and send these as a possible lightening of spirit parrotor at least distraction but he can’t watch them because the noise in the room where he sits with other cancer patients is loud. Very loud. A man sitting someplace behind my friend was evidently screaming from the pain of his infusion for hours. The time before last a woman was bitching non-stop, unnerving everyone around her and especially her family.  (He survives this assault to the psyche earning platitudes from the son for his ability to crack jokes, and generally lighten the environment of suffering around him.)

The last time I was (physically) present to a chemotherapy session was more than sixteen years ago; the brother of my best friend, the uncle to her children, the husband of another dear friend and dad of three kids the youngest of whom was a toddler at the time, brother to another brother, uncle to his three kids, son, friend, et al. I haven’t been in the Beverly Hills Cancer Center (BHCC) to witness first-hand what I perceive as being the antithesis to luxury on which so much of Beverly Hills reputation rests but I was present at the Wilmot Cancer Center at Strong Memorial (Rochester, NY) and the contrast between the two care environments couldn’t be clearer to me.  Sixteen years ago Mike was surrounded by family and friends, shifts of love floating in and out of the room like sunbeams streaming through clouds, there was raucous camaraderie (he being a former Major League Baseball player, the baseball coach of the local Jesuit high school, a widely and much-beloved friend) and I recall at least six people being in the (memory driven) seemingly private room besides myself and Mike.  I could not tell you why I was there.  As Jeffrey describes it BHCC is a ‘factory’, 12 reclining chairs crammed into a single visually sterile room with half walls separating patients, everything everyone says can be heard by every other person in the room, all the bitchingmoaningandcomplaining, the comings and goings of the staff and their commentary.

I didn’t think of this last night as I responded to the texts, but I had two vastly different dreams about those treatment rooms after I went to bed. And it strikes me that the experiences of these two men hang not simply on the distance of years and geography but also insurance coverage.  Mike had robust private insurance and friends and family offsetting some of the costs, my friend Jeffrey was ‘covered’ by Molina Health as part of its participation in an Affordable Care Act Exchange.

The other component is two decades ago, regardless of the circumstances, we were as a nation and as individuals more compassionate toward one another.  That compassion manifest in Rochester in an environment that was calmer and more conducive to healing. The perception of Beverly Hills Cancer Center I have gained through my texts and conversations with Jeffrey reflects an odd dichotomy, on occasion extraordinary but all too often disconnected from the very compassion which Hippocrates advocated and swore to uphold. His first oncologist failed to speak a single word to him in the first nine hippocratesweeks after his diagnosis. His current oncologist, though certainly mending Jeffrey’s body and on a scale, infinitely more attentive, had the most outrageous response imaginable to Jeffrey expressing that he didn’t like the smell of his own burning flesh from the cauterizing knife used to install the port (replacing the defunct PICC line). My head is still reeling from the quote in the text I received on Thursday night.  Compassion. Seriously. Lacking. (Say nothing rather than do harm.)

It pains my heart, my psyche and every aspect of my humanity that Jeffrey’s experience is a mere glimpse into a state of being under-insured in the United States. That “the haves”, those with robust private insurance, and the “have-nots” relying upon a broken system commandeered by shareholder value are somehow less human, less entitled to care and more inclined to be denied basic human dignity, less likely to be approved for the very treatments that they need to get healthy despite paying the disproportionate percentages of their wages to have insurance.

Let’s be clear, as of 1 September my friend Jeffrey is no longer insured by Molina Health, his Screen Actors Guild Blue Cross and Blue Shield coverage went live at 12:01 AM. I think about something one of his doctors said about Molina Health’s consistent position to deny coverage first and then if the patient gets loud about it, or the doctor treating chooses to advocate on behalf of the patient, then approve and eventually pay out. This seems like a path to protecting golden parachutes and seven figure salaries and double or triple digit earnings; to me, this seems more like a Ponzi scheme than health insurance. This strips the humanity from Molina Health’s employees and isn’t a terribly efficient manner of running a company given the human resource cycles of answering phones and ensuing paperwork.

Societies have always been measured by how they care for their most vulnerable citizens, it’s clear we are failing. The three hundred year expansion, supreme dominion, the subsequent decline of the Roman Empire and the resulting Dark Ages seem as though they could be minor in contrast to whom we are becoming.  Maybe a tiny private room for receiving chemotherapy is insignificant in the grand scheme of things but the dignity such affords seems as important to healing illness as putting the ‘civil’ back in service.

This is the fourth instalment in my series on having cancer in America.

 

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This is “Matt”. Matt is Every Single One of Us.

Jeff

This is “Matt”. Matt is the guy down the street whose kid plays Little League with yours.  He is courteous and helpful.  So, of course, he works at getting your ‘shades of blue’ reconciled in the paint department at Lowe’s.  Matt could be your neighbor, or you.  The truth is that Matt is every single one of us.  “Matt” is actually my friend Jeffrey, an actor living in Los Angeles, a very funny comedian, an intellectual pundit (when he chooses to be) and a man with a laugh that fills rooms with joy.  Jeffrey has been diagnosed with cancer, stage 2 lymphoma to be precise, and at present he is being squeezed in the middle like a tube of toothpaste by a grossly negligent ‘system’ and the people employed by it who have zero sense of humanity. I am mad as Hell over all of it.

The name of his insurance company matters, it’s Molina Health.  With ‘our’ shareholder, profit-driven, horribly broken, healthcare system in the United States the truth is that what is happening to Jeffrey could happen to any of us and our loved ones. It also matters that his insurance company hangs up on him. It matters that the administrative staff tell him that his premium will quadruple if he ‘wants’ home care for changing the dressing on the tube sticking out of his arm (sepsis being a real possibility) where he is hooked up to receive his chemo. It matters that I escalate and help seems imminent only to have some drone of an administrative staff person deflect and say it will take two weeks. It matters that appointments are made and cancelled due to software, and human errors and then the humans charged with delivering this news are devoid of humanity. It matters because the stress of dealing with getting healthy on your own (even with a supportive tribe) is enormous. It matters that his first oncologist failed to speak a single word to him in the nine weeks immediately following his diagnosis and never prescribed anti-nausea pills with the host of others which he did prescribe.  Jeffrey’s second oncologist is amazing. Despite the fact that I am a non-relation he has taken my call to problem solve aspects related to Jeffrey’s treatment from Sweden where I am currently.

Which brings me to two components of the health insurance storyline in the United States; employer supported efforts like those which “Matt” as an employee of Lowe’s enjoys (really amazing benefits which should prompt all of you reading this to vote with your wallet and shop at your local Lowe’s ‘just because’) and the idea of a single-payer system such as our Canadian neighbors and those in the Nordics enjoy. On this day, with TrumpCare effectively dead, the reality of a single-payer health care system in the United States has risen like Fawkes in Harry Potter.

Let me remove any ambiguity, I have a couple of issues with the Affordable Care Act (aka ObamaCare) but neither have to do with the fact that it came to fruition under our 44th President; the first is that it didn’t go far enough and the second being its mandate to be purchased under penalty.  If we have sufficient financial resources to wage seemingly endless war across the planet then Americans of every stripe should have universal healthcare on par with what our federally elected officials enjoy. And if that can’t be done then our elected officials should have that benefit voided.

How do we get to a single-payer health care system to the universal benefit of 330 million Americans and put the United States on par with other first world nations? Well, California, where my friend Jeffrey lives, ever the ‘test the water’ state for public policy adoption has a viable solution called The Healthy California Act. Evidently this legislation has broad support on both sides of the political aisle in La-La Land but one man has blocked it from advancing, and there is a reason for that. Actually there are about 475,000 reasons in the form of contributions from the Political Action Committees of health insurance companies and their executives to Speaker of the Assembly Anthony Redon re-election campaign.  Redon is a perfect example of the systemic violation of the masses by a corrupt politician bought and paid for by the highest bidders for his favor.

SB-562 The Healthy California Act.

The passage of a single-payer system in California, or nationally, wouldn’t put insurers out of business but the resulting shifts in the market would demand agility that insurance companies are not generally known to possess. A model which offers premium coverage in lieu of, or as a supplement to, a single-payer system would still provide considerable revenue – with a healthier demographic contributing to shareholder value.  Policies which would allow customers choices in taking advantage of medical tourism opportunities around the world should also be considered. The increasing perception of health insurers places them at odds with the humankind they are supposed to be serving – essentially sentencing their policy holders to death when costs become inconvenient and expensive. When we make a conscious choice to deny protection and participation by our most vulnerable we can no longer claim to be an advanced or civil society. The costs are too high when we lose our compassion and willingness to step forward and be part of the solution rather than remain part of the problem.

Critically we need to dislodge ourselves from the ‘us vs. them’ mindset that is so pervasive in any conversation about health insurance, healthcare and providing a path forward for all of our citizens. Universal peace of mind around the most fragile aspect of living our lives fully and completely should not even be a question in 2017.

If you enjoy my blog please consider ‘buying me a cup of tea’ in your currency via PayPal to livelikeadog@gmail.com and then, please do share the blog with your friends on Facebook, Google+ and Twitter – I am @TeresaFritschiTo order my book, please click on the cover art of my book below, thank you!