Saturday, March 26, 2016

The Ironic Cherry Reads...

The Good Death
by Ann Neumann

I haven't read a book about death and dying for awhile since my husband died.  I guess I needed a break.  But I continued to age, and think and talk from time to time about the aging and inevitable dying and death.  So while the review in The New York Times Book Review of The Good Death by Ann Neumann was not enough for me to add it to my enormous list of books-to-read, running across it on the shelf at the library made it destiny.

I'm glad I did.  Yes, this book is informative and exhaustive, but it personal, and it is also a page turner.  Neumann talks about so many aspects of death and dying that I would never have thought of, and she does it by combining journalism with personal anecdotes.  The people with whom she engages us speak louder than any essay about the issues she covers.

And she covers a lot of issues.

She begins with her own experience of her father's last days, which motivates her to volunteer for hospice care.  From there she talks about our society's ambivalence about hospice, which is also society's ambivalence about pain and punishment.  She delves into the communion of those who are against the aid in dying movement with the anti-abortion movement, with those with severe disabilities who see aid in dying as a veiled threat against their own desire to live.  And she talks about the confused morality of the prison hospice system, and the insanity of the death sentence.

It is times like this that I really wish I could write.  Because I would be able to describe for you in this short blog post just how incredible this book is.  I can say that it moved me as much as the groundbreaking Being Mortal by Atul Gawande.

 Let me just say that if you know anyone who is getting old and dying, or if you think you might get old and die, you should read this short but amazing book.

Thursday, March 24, 2016

Why I Talk about Money

A few days ago, I wrote a blog post about my frustrating efforts to get information in anticipation of my upcoming switch to Medicare.  In that post I talked dollars and cents regarding the costs of Medicare Part B, and specifically the way our Congress has increased the cost to new recipients, while avoiding the shitstorm they might have had if people already enrolled could see how much the premium and deductible had gone up.

My purpose in writing the blog was not just to describe how difficult it is to maneuver the complexities of Medicare, or even to expose all the unconscionable costs that seniors are now expected to pay for health insurance.  I really wanted to leave readers with the awareness that this is very likely to be the future of Obamacare, which is currently affordable and comprehensive.

Since I wrote the blog, I have had a number of conversations with people where we have actually talked in dollars and cents.  It is amazing how many intelligent and aware people do not know or understand all the various components of their health insurance, who just pay what they are billed and are thankful that they are covered.  Which is just the way Congress and the health care industry want it.

I have found, in my life, that we are more comfortable talking about our sex lives than about money.  I was told when I was in my twenties, by a far more sophisticated friend, that it is impolite to talk about money.  We don't want to brag and we sure don't want to beg.  We don't want sympathy, and we don't want scorn.

So we don't talk about our income.  If we were more comfortable sharing information about money, Lilly Ledbetter might not have been in the dark about being subject to wage discrimination.  We might all learn about bad financial deals and all those scams like car buying and loans.  We might exchange good information about tax breaks and government programs to which we are entitled.  We would be far more aware of how the republican right has worked with corporations and billionaires to manipulate our incomes and expenses.

Actually, not talking about money makes about as much sense to me as not talking about age.  It makes a big secret out of something that should be merely a sharing of information.  Really, who cares that I am 64?  It doesn't mean I'm going to die sooner, or look younger.  I believe people will judge me on far more than my age, and knowing how old I am is just a small piece of information that I provide.

Talking about costs is important to me, not because I need for people to know how much I personally live on, but because we all need to know more about how we all survive in this really bad plutocracy.  Absence of information makes us all vulnerable.  That is why corporations fight so hard to hide financial data; that is also why they are working so hard to collect data from all of us.

Here is another thing.  Since the Post and Courier published an article about serious problems with well water on Wadmalaw Island, a number of concerned people asked me how I was faring.  Fact is, I live in a relatively new development, the well is only about 25 years old, and there are people living with wells that were drilled in the 60's and 70's.  But, I add, there is a low income grant that qualifies me for a new well, so I am fortunate on that account as well.

Most people, I think, are uncomfortable learning that I qualify for a new well based on my income.  None of us really want to know that our friends are struggling financially, do we?  And then there are probably those who get their backs up just a bit over their tax dollars paying for my well.  If I end up with a new well and I am not obviously struggling, isn't that wrong?  After all, it wasn't long ago that the right-wingnuts in Congress were saying that you weren't poor if you had a refrigerator.

It's okay for tax dollars to pay for Boeing's success, and it's okay for corporate farms and pharmaceuticals to get huge subsidies from the government.  I recently heard a building contractor, when asked what he thought about Trump, reply, "If he becomes president, I'll be right there putting in a bid to build that wall."  There are acceptable ways to take government money and having a low income just isn't one of them.

I wrestled with agreeing to have that new well built.  I knew there were people far worse off than me.  But I was also told that if something happened to my current system, it would cost $6,000 to drill that new well.  So I agreed.

A businessman getting offered a good deal by the government would hardly turn it down.  But we individuals are made to feel like beggars and sponges if we accept a good deal.  Many, many people do not apply for financial assistance or food stamps because of the stigma, which our right-wing government is all too happy to magnify, by adding regulations from more frequent income checks to required proof of job-seeking to drug tests.

When the housing market collapsed not too long ago, hard working middle class people who believed in our capitalist system were thrown out on the street.  Congress fought over whether people who were unsuccessful looking for jobs should have their unemployment benefits extended.

There is an enormous myth that persists that if you work hard you will not need to turn to the government for help.  And yet those who are in government and trying to cut the benefits we deserve and depend upon are all to happy to take what the government gives them.  Our right-wing majority in Congress, and in too many of our statehouses, insist that people should work two jobs, mothers should work rather than stay home with children.  Meanwhile, members of the US House of Representatives, with full pay and benefits, are scheduled to work 111 days this year.

So let's not be polite about money.  We may think we don't know anyone who is struggling, or we may just think we don't know anyone who is struggling as much as we are.  Fact is, too many of us are in that same shaky boat, while the Koch brothers are in the yacht that is making all the waves. 

Saturday, March 19, 2016

Keep an Eye on Obamacare

When my husband died a year and a few months ago, I was surprised and relieved to find that the health insurance of the Affordable Care Act really was affordable.  I figured I might just keep it as my private insurance when I became eligible for Medicare.


When you become age-eligible for Medicare, I have since found out, you cannot keep your Obamacare.  Your options become dizzying, and not in a good way.

I turn 65 in July, so for the past few months I have poured over Medicare books and stared at my computer screen for hours before becoming discouraged and just quitting for the day.  When I take it up again, the bad news starts to sink in, but it doesn't get any better.

But I am not here to whine.  I am here to bitch about the politics of health care for seniors.

I have had a hard time finding out what was available even a few years ago before Part D -- the prescription drug plan -- was enacted into law, so I can't tell you how much better Medicare was in years past.  But my guess is that the republicans -- with some Democratic compliance -- have been chipping away at Medicare for decades now.  Their preference, of course, is to privatize it entirely, but they are content -- as much as such a bunch of malcontents can be -- with destroying it one step at a time.

Let's start with the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.  It may be that there was no drug coverage before 2003 (I can't even get that info on Wikipedia, so if any of you out there can enlighten us as to what people did for prescription drugs before W came into town and got his hands all over it I would be very appreciative.).  From 2003, the drug component -- Part D -- of Medicare proved to be a real boon -- for the pharmaceutical companies.  And there was a sadistic element to the bill that one has to admire.

First of all, it is purchased from private pharmaceutical companies, with the government subsidizing some of the cost.  But you are not required to buy this coverage.  HOWEVER, each year that you do not buy Part D coverage, your cost for when you do decide you need it goes up.  Each year.  It is called a "late enrollment penalty," and this is the way Medicare explains it:

 Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($34.10 in 2016) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.
I imagine the drug companies were tickled at those terms.  But wait!  There's more.

You may have heard of the "donut hole," which Medicare more civilly refers to as "the coverage gap."  Not civil either way you look at it.  This bizarre rule means that -- while you continue to pay your monthly premiums, and after your deductible and copays -- if your pharmaceutical needs are so great that your drug cost reaches $3,310 in 2016, your coverage stops  Then you pay out-of-pocket until you have paid $4,850, when your "catastrophic coverage" kicks in.  By that time, your life if not your health can truly be considered catastrophic, so at least that is aptly named.

I still have to stop and let my mouth drop open when I consider those two key provisions of this totally shitful law.

 After you have contemplated Medicare Part D for a few minutes, we can move on to the truly brilliant way the republican Congress has managed to screw up Medicare with barely a ripple of outrage.

Effective for new Medicare recipients, beginning this year, the monthly premium has gone up from $104.90 per month to the astounding $121.80.  And the deductible has gone up for new recipients from $147 to $166.  This is despite the fact that in 2016 there was no corresponding cost-of-living adjustment to social security benefits.  And there was no COLA because Congress determined that the cost of living had not gone up because gas prices went down.  And then proceeded to raise the cost of living by significantly raising Medicare costs.

Slipping this change in for new enrollees means that most of us just pay what we are told, without realizing just how much the cost has gone up.  By not requiring people already enrolled to pay the increase they manage to stem what would probably have been a shitstorm.

Here's something else to consider.  Our less-than-esteemed members of Congress don't have to deal with this at all.  In one of a very few exceptions, they are allowed to keep their government subsidized health care after they retire.  Pretty cool, isn't it?  As Fred Astaire said, "Nice work if you can get it."

I could go on about Medicare, but I really want to end with some thoughts about Obamacare.

I imagine that we are not allowed to keep Obamacare after we hit 65 because it is, so far, a truly affordable and comprehensive health insurance program.  The government pays steeply for this, but the savings are also tremendous and -- hey -- it actually keeps more people healthy.

Those republicans, fat and happy and with their own pretty damned good government health insurance, will lose sleep over the fact that the government is paying for other people to get good, affordable health care.  They will not rest until they have chipped away at Obamacare the way they have done with Medicare.  Over the years to come, as long as we let them, they will increase out of pocket costs and cut the government subsidy until, just as with Medicare, those who are living on a tight budget, will just have to go without needed health care while they pay mandated costs.

And even at that point our elected officials will resent the fact that we are at all able to continue to breathe their air.

So, forewarned, keep an eye on our Obamacare, and let's not let the right wingnuts put this over on us.  Again.

Thursday, March 10, 2016

H 3114

I always write my best words in the early morning hours.  Unfortunately, I write them in my head as I lay in bed wishing I could catch another hour's sleep.  This morning, I was writing words of anger at the fact -- the fact -- of the obscene twenty-week abortion ban, the obscenely named "Pain-Capable Unborn Child Protection Act" becoming law.

In a state that continues to rank above average in infant mortality, in which our governor has proudly fought federal health care for the poor, our legislature continues to waste our time and precious dollars on bills that would force women to turn their reproductive health over to the government.

In a state where gun violence rules families and neighborhoods, bills promoting the unabashed toting of weapons are as plentiful as, well, as anti-abortion bills.

But over the past years there has been a growing movement, voices that will be heard over the misogynists that have run amok over our state governments.

The headlines began in 2012 with two women representatives being banned from the Michigan House floor after Lisa Brown said the word "vagina" while speaking. 

In 2013 a woman in the Texas legislature, Wendy Davis, in pink sneakers, filibustered an anti-abortion bill that would close abortion clinics throughout the state.

Over these past years, women have come forward to talk about their abortions, no longer hiding from public opinion, realizing that unless we can put faces to the right to have an abortion, that right will be lost.

And each indignity, each lie, has added fuel to our fire.  From Hobby Lobby claiming religious freedom as the principle from which they could deny an employee contraceptive care, to the false identities used to film and edit a meeting with representatives of Planned Parenthood, women are realizing they have had enough and they are fighting back.  The younger generation, those who do not have memories from before Roe v. Wade, are aware that this important freedom is being jeopardized.  And they are pissed off.

Not too long ago, I worried that young woman, because they had always had this right, would not see that it was at risk.  I was wrong.  You can see it all over the media these days.

There is Amy Schumer's "ask your doctor" video and Samantha Bee's segment on Texas' attacks on abortion clinics ("How does removing access to health care improve health care?").  And John Oliver recently turned his pen to a scathing indictment of Texas HB 2, that bill that Wendy Davis filibustered against in 2013 and which is now being challenged in the Supreme Court.  

I have often whined about the failure of movies to show abortion as a normal medical option, but that is happening too.  Grandma, with Lily Tomlin, is a breath of fresh air and a paean to the strength of women who have had to endure the pressure and the venom of the anti-abortionist while making such an important and personal decision.

Yes, I think we have all had it.  Right now it is the Supreme Court hearing regarding that awful Texas bill that has closed most clinics in the state for reasons having nothing to do with women's safety and everything to do with limiting access.  But it is also the fact that more women (and girls), denied access to safe abortions, are seeking information on how to self-abort.  It has come down to life and death, to the days of coat hangars and back alleys, once again.

And because of this, woman are willing to fight, for themselves, for their daughters and their mothers.  Men are standing up and fighting for the women that they love and respect, who should have the right to the best health care and to make the best choices without government interference.

So while my sleep-riddled words this morning were variations on the angry and mocking words I have written before, as I became fully awake it occurred to me that H 3114 is one more step towards taking our bodies and our rights back.  We have fought hard and learned that there is no way that reason can influence those mean-spirited and intellectually limited narcissists in our state legislatures.  But armies of women can make enough noise, as we have before, and change those legislatures.

I am looking forward to women, young and old, standing up to run against the tyrants, with loud and fearless voices.  They may not have the corporate money of the right-wing, but they have the power of the cause.  I have said before that when we take back our government and our rights, it will not be with candidates who are cautious and try not to ruffle the electorate.  We are the electorate, and there really are more of us that want our rights protected.  If we aren't afraid to fight, we will eventually win.

So just as the Texas bill was weaseled into law, so goes H 3114.  But that is not the end of the fight.  It is a battle that has energized those of us who truly value life and freedom, and we will not let it go so easily.

Saturday, March 5, 2016

It All Comes Back to Politics

On Thursday, Charleston County Democratic Women hosted three young women who spoke about their greatest concerns.  The talks were informative and inspiring.  And most interesting was that they in fact, intertwined.

Savannah Frierson, Ali Titus, Monica Tanouye
Savannah Frierson spoke to issues of racism, and how they are reinforced in our politics and our lives.  She brought up the drinking water in Flint, and in fact, problems with drinking water on our own Wadmalaw Island.  Environmental problems hit the poor and rural areas first.  Monica Tanouye spoke about the environment, not as a "tree hugger," but as someone who sees our environment as a resource that we need to maintain, in order to maintain our lives on earth and in our communities.  Finally, Ali Titus spoke passionately about obesity and the blame-the-victim mentality that is so prevalent in our society.  She pointed out that the same big corporations that made fortunes selling foods that lead to obesity also share in huge profits from the health problems and dieting regimens caused by obesity.

As the women spoke, and for these days afterwards, I have been thinking about how all these issues relate to one:  capitalism as political power, and political power run amok.

With all the Tea Party talk about reducing the deficit, big agra continues to profit from huge government subsidies:  subsidies to grow sugar and corn, the latter used not as a healthy vegetable but as corn syrup.  Meanwhile, our local farmers struggle against the extreme weather conditions of global climate change with little aid that only comes when those extremes cannot be ignored, as with our October floods.  This means healthy produce grown locally is far more expensive than McDonald's or a bag of cookies.  Note that here in South Carolina food stamps cannot be used at many farms or farmers markets.

With all the light shone on Flint's water crisis, it has become more than apparent that decisions were made to cut corners in a town where the poverty rate is the second highest in the country.  It was easy to do this because Michigan has an "emergency manager" law that allows the governor to appoint someone to run the city, bypassing voters' choices.  And as we all know, the main function of government these days is to cut costs, and it is especially easy to do so when the people are too poor to fight back.

It's all politics, and politics has gotten so convoluted that the good guys have to run the same cons as the bad guys.

Take Wadmalaw Island, where I live.  As Savannah spoke Thursday night, someone near me mumbled that that wasn't true that Wadmalaw had bad water.  In fact, it is not true for me, because I live in a development that is only about 25 years old.  A couple of years ago, based on my low income, I even qualified for a new well, which was dug last week.  I know that there were also people who qualified that had bad wells that were fifty years old.

But suppose you don't qualify?  Suppose you work hard enough to fall just above the federal poverty line?  The assumption is that you can pay that $6,000 for the new well.  And whatever other problems there are that need to be corrected for the water to be potable.  Impossible for so many.

And yet, I am fortunate that I qualified for that federal grant.  I imagine I can thank Democrats like US Representative Jim Clyburn, the late Senator Clementa Pinckney and Representative Robert L. Brown.  I imagine County Councilwoman Anna Johnson pulled some strings as well.  There has to be a reason, in fact, that while South Carolina skinflints in the Statehouse refuse to raise the gas tax to repair bad roads, the two main roads on Wadmalaw have been repaved twice in the seventeen years I have lived here.

But for republican strongholds, politics is all about money and influence.  And for wealthy donors, politicians will spend whatever of our tax dollars it takes to keep them happy.  If the air or water gets bad where they are, if a hurricane blows their home away, they move to higher ground, build a bigger newer home with the insurance money.

Meanwhile, the working poor get made promises of more jobs while being sidetracked with messages of refugee and immigrant invasions.  The poor, a high percentage minority, are victimized by government decisions to cut what little aid they get, and by inadequate services.  When you aren't allowed time off from work, or you don't have a car, when getting to a supermarket is a hurtle, not only do you not get out to vote, you don't really see that it makes a difference.

For those who are living in the shaky middle class, they live with financial insecurity that makes them vulnerable to the fearmongers that convince them that the EPA, immigrants and unions will cost them their livelihood.  Financial insecurity for the right wing is political gold.

I would like very much to invite our three speakers back.  I would like for them to maybe be a panel that addresses political solutions to the huge problems that they posed to us.  I would like to keep this conversation going.

And I want to thank them for opening it up for us.