Man, Monster, Human?

My adoptive father has died.  Strangely coincidentally, he died in a bathtub as did my biological father.  My adoptive father was 79.  He planned on living to 120.  As they say, "Man plans, God laughs."

I met my adoptive father shortly after my mother did.  It was 1966 and we lived in Berkeley California.  What a time to live in Berkeley.  People's Park, the Black Panthers, PoorBoy Suits and GoGo boots.  My father was a good friend of my mother's roommate from college at the University of Illinois.  He met my mother on a whirlwind visit with her roommate on his way to visit his mother in Phoenix.  He first came in August.  My mother married him in the Episcopal Church on November 8, 1966.  She was a radical, a civil rights activitist, a folk singer.  He was a conservative former GI from the Midwest.  An Atheist.  They were Polar Opposites.

We first lived in Athens, Ohio where he was an Associate Professor at the University there.  We lived there until the end of the following summer when we moved to Portales, New Mexico.  As my parents were polar opposites, so were Portales and Berkeley.  My father's lace-up oxfords, suit pants, and button down blue shirts were a sharp contrast to the cowboy boots, jeans and western shirts of the parents of my classmates.

When my sister and I met my father, we were 6 and 8 respectively.  My sister was cute, I was quiet.  Our father was a Geography Professor.  He introduced us to all kinds of geolological formations: flatirons, mesas, alluvial sands, buttes. To clouds: thunderheads, cirrus, cumulus, stratus, nimbus.  We saved a snapping turtle from the road.  Kept it in a box.  Fed it hamburger and crickets.  We caught and touched bull snakes, hog nosed snakes.  At the family farm in Illinois, the outhouse was completely wall papered with living Daddy Long Leg Spiders.  They pulsed.  We bathed in an outside tub.

We travelled.  Mammoth Cave.  Zion National Park. Yellowstone National Park. The Grand canyon, Bryce Canyon, Vicksburg National Military Park, Natchez Trace, Palo Duro Canyon and closer to home White Sands National Monument, the Catwalk in the Gila Wilderness and Oasis State Park.

We did chores.  We had tropical fish, gerbils and outdoors cats.  When I was 10, I was given a Daisy Bee Bee gun.  I was a crack shot with it, as well as with the long bow that was later bought for me.  In summer, I was dragged from my books and forced to take swimming and tennis lessons alongside my more athletic younger sister.  I didn't drown, I hit the ball, but I didn't excel.  My sister was a firecracker.  Better at all things physical.  She bought a skateboard and excelled at it.  I struggled to stay on my gangly feet that were too far away from my head.  My sister got boobs.  I did not.

Things changed the year we went to Colorado.  We had a new baby sister.  Things were tense.  There were fights and silences between my mother and father, my mother and sister.  I later would find out that this was when my father began his 'love affair' with my younger sister at the age of 12.

My mother got her doctorate and we never lived as a family again.  My parents divorced in 1976.  My father was awarded custody of my sister with whom he was having an incestuous relationship.  She did not escape his grasp until 1978 when she graduated from College in 2 years, Summa Cum Laude.  One year before I did.

My sister went on to work for Livermore Laboratories where she met her husband, ultimately doing post-doctoral work in bio-medical Chemistry.  She had a daughter and a son.  And then she confronted the family with her story at the age of 30.

My father never denied the relationship.  Instead, he claimed his steadfast love for her and claimed that she was the one that "cheated" and started dating others.  This, despite the fact that he married a beautiful woman whom I believe he chereished in 1984.  He respected her, loved her, shared his knowledge with.  This marriage was much different from that with my mother.  His wife blossomed, went to school and ultimately became an R.N. and a person in her own right.

I know that my adoptive father was twisted in some way.  Yet he loved and cherished.  Above all he was a teacher and shared his knowledge with any one who would listen.  He was broken.  He loved perfectly and imperfectly.  He  cheated my sister of her youth and innocence.

My father died December 22, 2013.  May he rest in the peace which eluded him in life.

I Dance Because I Am

I am....4...years old.  I hop, I skip, I dance.  I believe in Magic.  I drink tea made of sugar cubes and water in enameled tin tea cups.  We hold our pinkies out, because that is the way it is done.  I pull out my vowels, I enunciate my consonants.  Because that is what you do...when you are a LADY.

I sit in a lap.  My mother's.  There is music by firelight.  Guitars, voice, song...rising to the heavens.  Song, Joy, Wonder.  I live in a brownstone in Georgetown.  In the Basement next door...a folk/blues nightclub.  I sit on the front stoop.  I am only five.  I watch...the world.  I talk.  I ask.  I wonder.  The artists cross the street, walk down the stairs.  I am a child.  All is possible...so...I...five go to a nightclub, next door to watch my "neighbor" sing and strum the guitar.

I am five. I hear...music.  My heart soars.  My brain cavorts.  My limbs wave....I dance.  I am joy.  I am music.  I am wonder.

I am eight. I am with friends on a back porch in Berkeley.   The Beatles are playing on the radio.  I dance.  My friends laugh.  I stop.  I hurt.  It feels wrong.

In my home.  It is safe.  Music plays.  I dance.  It is a party.  My mother loves me.  I dance.  I am the "center of attention".  All is good.  Never dance for your friends.  Only adults are safe.

I am 16.  It is my "Senior Prom".  I live in a Southern Baptist Town.  Apparently, dancing is a sin, only allowed when you are a senior.  But...We dance the Maypole instead of a Senior Trip.  Do they realize that the Maypole is a Fertility Rite?  I rise up on toes, I waltz with my crush.  Rise, step, step.  Hold the ribbon, step, step, step, under, step, step,step, over.  Dancing, but so regimented.  Girls in pastels, boys in tuxedos.

Senior Prom.  I cannot dance.  Humiliation will ensue.  My "crush" is here with his date.  He grabs my hand.  I drag back.  ZZTop  La Grange plays in my future.  My crush pulls my hand.  ZZtop enters my soul, enters my hands, I open up.  I am swallowed I dance.

I am in college.  I am at a party.  I dance.  I open up my soul.  My hands move.  My partner asks me "why do you move your hands?"  "I am dancing.."  I reply.

I am a mother.  I hold my child to my chest.  Music skirls through the air.  We are dancing.  Step two three.  Rise two three.  We are dancing.

My soul rises.  My soul sings.  My soul dances.  I dance.  I am. 

How Do You Fix Crazy?

I have just hung up the phone from my Mom.  She is 79 and suffering from short-term memory loss.  When she first started becoming confused, she reacted with anger.  This included biting remarks, head-on attacks and just general meanness.  This.  is. NOT. my Mom.  She can get very angry.  Righteous indignation is not out of her realm.  But...just plain mean.  Not her.

My Mom is now "pleasantly confused".  She knows that she does not remember things.  She remembers going to events, but she does not remember specifics.  She knows that this past June, she went to France, but beyond her pictures and some moments of wonderment, she does not get more than feelings of joy and satisfaction that she has gone.

I have a sister that is 14 years younger than me.  She moved with her husband and toddler daughter to Australia 14 years ago.  They moved because my sister had "multiple chemical sensitivity".  I did not fully understand this at the time.  However, in 2002, I had an allergic mold exposure.  People at my workplace in the "newly remodeled" basement of a major hospital began complaining of headaches, nausea and allergic reactions when they would come into their workplace, which would resolve when they would leave that environment.  They began filing "occupational health claims" throughout 2002.  I was one of the last to do so, because, with my Fibromyalgia, I had exhibited all of the above symptoms prior to moving into the newly renovated environment.  However, from January through August of 2002 I was on antibiotics for "Sinus Infection".  Then I started feeling exhausted.  When I would do patient transfers, a standard for Occupational Therapists working in Rehabilitation, I would break out into a profuse all-body sweat.  I would be exhausted and unable to recover.  I was fatigued even during my August vacation.  I had extreme bowel problems,  extreme bowel pain, exhaustion and difficulty with everything, home or work related.  I quit working and sought out an allergist with two other co-workers.  They quit work in December.  They recovered.  I did not.

So...My mother is calling because her granddaughter, my 16 year old niece, is now being paid by the "state", Australia, to take care of her parents.  My sister who is now 40 and her husband who is 47? (not sure of his age).  My mother is outraged.  I am sad.  She says that they are both hypochondriacs.  Both my mother and my sister were diagnosed as having Chronic Fatigue Syndrome in the early 90's.  My sister was 16 at the time.  I remember being somewhat sympathetic, but concerned at the complete lack of activity and engagement in life of the both of them.  My mother had a 12 year remission which collapsed when she was left with the major responsibility of a move from New Hampshire to North Carolina in 2008.  She has deteriorated both physically and mentally since then.

My mother called for a sympathetic ear.  I told her it was awful, outrageous, but what could we do?  My sister had placed a legal "no contact" order against my mother when my niece was 4.  At that time, she also severed all communications with me.  We are Facebook friends  now, but no more than that.  She initiated contact through Facebook, but has not responded to any "Messages" that I have left.  I will see an occasional "like" from her.  I have befriended my niece, but sightings are fleeting.  In a moment of grace, I apparently friended my sister's husband.  His interactions are long-winded diatribes about once a year on random postings on my wall.

My mother wants more.  I tell her that I cannot judge them, as they claim to also have Fibromyalgia and Chronic Fatigue Syndrome, which I have.  I will say that it is not right that their 16 y.o. daughter is their caretaker.  My mother is distraught that 5 generations of college educated women have ended in "this".  I remind her that I was 16 when I graduated from High School and started college.  She then becomes caught up in apologies, "if I had known" that I was running from a household in which my sister was being sexually victimized by my father.

But that is not my point.  I remind her that she has other grandchildren who are amazing, both male and female.  That her Australian grandchild is only at the beginning of her leap into adulthood (I think our family begins this at 16 rather than 18).  I tell her to not write her off.

My mother says, "Well...I called you for sympathy."  Again, I tell her that I cannot judge on the hypochondria, but that to make my niece the caretaker of my sister and her husband is wrong.  Neither one of us is in communication with or has any influence whatsoever with my sister and her husband.  I have gone through weeks, months, years of counseling to get to the point where I have had to let go of what I have no influence over.  My mother needs more.  She forgets that earlier in the conversation, I have already condemned their treatment of my niece, her granddaughter.

My mother hangs up.  Sigh...I hang up the phone on the dial tone.  I let go of the receiver.  I let go.  And then I remember that we had this same conversation 6 months ago when my mother found out that my niece had quit school to take care of her parents.

Place Yourself in Life's Way

I have been thinking.  Always a dangerous proposition, especially when I am coming out of back to back "comas" (deep sleeps which I cannot arouse from) triggered by my food intolerances.  It is in these recovery times from these "comas" that I cannot do anything but sit, and read and surf through Facebook.

I have discovered a disturbing sub-culture through Facebook.  It is a portion of the population who have an opinion about everything, but most often about the less fortunate of our society. Their opinions are stark and judgemental and seemed to be fueled by sound bites, bits of life captured by Facebook and opinion masquerading as "unbiased news" on Fox News.

I have been fortunate in my life to have been exposed to a multitude of lifestyles throughout my childhood and adult life.

As a child I was exposed to:

• life as a minority.  I was involved in sit-ins in whites only restaurants in mixed race groups at the age of five 

•  I heard Martin Luther King's "I have a Dream" speech in the Lincoln Memorial

• Life in Poverty.  When I was four and five, we lived in Housing Projects in Washington, D.C.  I distinctly remember the smell in the hallways:  mold, mildew, natural gas and old food.  In my memory, this is the smell of poverty, though I have been chastised by others who thought differently. 

As a young adult, I was exposed to:

•  Life again as a minority.  I was a Teacher's Aide in High School in a Kindergarten class that was 100% Hispanic and Spanish Language dominant.
• Life in the Education System as a Teacher's Aide.
• Pushing gender stereotypes as a young woman riding a motorcycle as her primary means of transportation.

Post High School I experienced:

•  The challenges  of being female in a male dominated society.  In my dating, I was constantly thwarting off sexual advances with varied success as I wore my heart on my sleeve.
• continued experience in the classroom with as many as 35 students, bilingual and multi-racial, predominantly Hispanic,

• being a waitperson at a restaurant.
• date rape

In the Peace Corps, I experienced:

•  Life in a third world country
• the Education System in a third world country
• extreme poverty
• political instability
• the resilience of human nature

Post Peace Corps, I experienced:

•  Life as a common manual laborer
•  Life as a Teacher of Special Needs Children
• familiarity with migrant workers
• Life in extreme poverty.  My students lived in the Colonias, illegal outposts with no infrastructure, no road maintenance, no electricity, no water.  They lived in school buses and refrigerator boxes.  If they were really lucky they lived in sparse adobe walls with electricity, but no municipal services such as garbage, and water.

As a post-graduate School Occupational Therapist I:

• worked with children with special needs and their families.  By the time I stopped working, 85% of the children I worked with were Autistic Spectrum Disorder or manifested autistic like behaviors. 
•  Acted as an Advocate for the families with Special Needs Children in their interface with the Public School System and in some cases with the legal system.

Because of all these experiences, I believe I am rich.  I have experienced so much personally, that I feel that I can speak wisely and with a familiarity that is lacking in many people about a variety of subjects.  The greater the variety of experiences one has the more they know the hearts of others.  The more they know the hearts of others, the possibility of compassion and empathy is increased.  Much of the information that is shared on the following subjects is hearsay and often just plain wrong.  I think that in the following areas, a more open mind and a wiser, more considered opinion can be obtained with fair ease that will end up increasing your life experiences which is only to the greater good, personally and as a citizen of the world.

Welfare  EVERYBODY has an opinion about welfare.  I have heard the same damn story of the woman in line with T-bones and two lobsters, getting into her Escalade while talking on her I-Phone, so many times I could just puke.  Yes there is abuse.  Trafficking of food stamps is at an all-time low of 1.3cents to the dollar.  The average monthly SNAP benefit per person is $133.85, or less than $1.50 per person, per meal.  www.feedingamerica.org.

A Little Welfare History:

• In 1996, the welfare system was given back to the individual states.
• TANF (Temporary Assistance for Needy Families...welfare) requires all recipients must find work within 2 yrs. of receiving aid.  Single parents must work 30 hrs./wk, 2 parent families are required to work 35-55 hrs./wk.
• The type and amount of aid available to individuals and dependent children varies from state so there is no longer one source nor one set of requirements.
• Most states offer basic aid such as health care, food stamps, child care assistance.

People receiving assistance are NOT living in luxury.  I would encourage you to investigate your individual state's requirements before you "Like" that Facebook page that requires drug testing to receive Food Stamps, which indeed Florida does.  Florida's cost for drug testing potential welfare recipients was  $118,146.  The benefits that would have been paid to those who failed drug testing was $72,360.00.  (No Savings Are Found From Welfare Drug Tests By LIZETTE ALVAREZ  NY Times, Published: April 17, 2012)  Not a very good return on the investment.

Education:  
As I was a teacher, I truly do not know what the "real" opinion regarding teachers is, though we all know the Meme "Those who can, do.  Those who can't, teach."  Anybody who has gone through our education system and had a gifted teacher, knows that a real teacher is born, not created by the educational system..  

My personal concern about teaching is that because education is considered a political football, scant attention is paid to the tons of research on how the brain learns.  Money and time are devoted to measuring educational gains.  Personally, I don't think real education can be measured.  What you end up measuring is collections of facts.  

To really understand education, and be knowledgeable in the discussion, I think everybody could benefit by volunteering in their neighborhood school, then volunteer in its financially polar opposite.  Then you will understand how economics drives education in this country.  And there is no greater ambassador for comprehending economics than the children themselves.  The benefit of volunteering is two fold, creating an understanding of what it takes to educate a child, and a true comprehension of whom we are asking teachers to educate.  The educational challenges have changed monumentally as learning disabilities and the educationally challenged are absorbed into and have changed the face of our educational system.

Racism
Unless you are in the minority, I don't think you can understand racism, and how it is still ingrained in our society.  Even if you yourself are considered a "minority",  that doesn't mean that you can't be as insular and nationalistic as we whites can be. To this end, I suggest the following: make yourself uncomfortable. Go to the part of town, the state, the country where you will be a minority.  Go to ethnic fairs.  Be brave.  Be bold.  I promise you will learn something.  We live in a part of the country I call white bread.  We made it a point of honor when our kids were growing up that we would travel as much as possible so that the only faces they saw weren't just white ones.  And here I come to something that is a volatile and uncomfortable discussion for Americans.  Our own special brand of racism toward and disdain for Native Americans.  We have a fair population in our town, safely ensconced in the poorer part of town.  Travelling through the towns in the heart of the reservations is very discouraging.  I just ask that you open your mind regarding this.  The government is supposed to provide health care and education.  On all statistical measurements we as a government have failed our native populations.  Despite the casinos, power plants and the random fancy hotels, there is not the occupational diversity on the reservations that builds a thriving and self-sufficient community.  Alcoholism, rape and sexual assaults, suicides, poverty, high school drop-outs, automobile deaths, all are at unacceptable rates.  

General Compassion and Courtesy
So, unrelated to class, economics, race, geography, is one's general attitudes and manner towards those in the service industry who wait on us.  As a former waitress, I have always felt that every person should be a waitress or waiter for at least one day in there lives.  Perhaps this should be expanded to all in the service industry.  I don't understand people who are rude and demanding to people in this category of employment.  If you are truly an American, than you are supposedly a staunch supporter of egalitarianism:  a belief in human equality especially with respect to social, political, and economic affairs.  If you are secure in your own ego and humanity, you do not need to lord it over others, to demean those just because they are waiting on you.  There is a growing movement to remove the practice of tipping from eating establishments, to include tips in the price of the food items, therefore the financial benefits are given to the cook, the dishwasher as well as the waitperson.  In restaurants where this is tried, service from the cook on down improved.

Read and Question:  Don't accept what you read at face value.  Go to other sources.  And question, question, question.

And of course Travel:  The more you travel, the more you expose yourself to different climates, different foods, different cultures.  New synapses are formed in your brain when exposed to the different and new.  You understand that your way is not the only way.  Your view of the world perhaps narrow.

I challenge you to maximize your life's experience.  Go to different places, think a different way.  Place yourself in the way of life so that you are embraced by it.

Namaste
Kismet
September 2013

Fear, Loathing and ObamaCare

I am sitting at a table surrounded by women, nibbling on a brownie.  Tonight is "Ladies Night Out".  It began with a gorgeous antipasto plate with asparagus wrapped in black forest Ham, prosciutto, pepperoni, Kalamata Olives and artichoke hearts.  Next was meatball & spinach soup.  My waistband started to feel a little tight once I had ingested the Raviolis and some form of sausage/meatball with sauce.  And of course wine:  Pinot Grigio with the Antipasto, and Coppola Merlot with the saucy dishes.  I am replete.  I sigh, contented and laughing as the hostess describes being caught unawares while attending to private business in the head (bathroom to you landlubbers) of her boyfriend's sailboat.  All was fine, until the boat sharply heeled and all of a sudden all the screws on the toilet popped off.  Surprise!  Too much information!

Somehow, the conversation turns Medical Care in the United States.  I state that 75% of bankruptcies in the U.S. are Medical Bankruptcies (I was wrong it's 60% or 3 out of every 5).  And inevitably...it comes up...Obamacare.  I swear it wasn't me!  Paula, the 60+ cook extraordinaire who cooked everything except the Tirramasou, states, "Even Nancy Pelosi said that they didn't know what was in the law when they passed it.  How can it help anybody if they don't know what's in it."

"They know now," I say.  "There's websites for it, just google The Affordable Health Care Act."  Everybody rolls their eyes and groans.  

"Like you can get through it."  says Paula.

"No really."  I say.  "When I was canvassing for the Democratic Party this last fall, I had people attacking me about 'ObamaCare'.  I was able to get down the pertinent facts on 2 index cards back to back (I was wrong, it was 3)."

"Yeah, but how small was your writing?"  laughs Vicky.

"I had to use a magnifying glass," I laugh, "And then if anybody threatened me, I was going to tear them into small strips and swallow them."  We all laugh.

Unfortunately, we are unable to keep on laughing.  Two of the attendees are students, one of them has a small child.  The hostess works 3 jobs, but is covered by her ex-husband's Tri-Care insurance.  I am on disability and receive Medicare, Brenda and her husband are also on Medicare.  The two students are mad, angry, steaming and afraid.  They're sure that they're going to have to pay the penalty fee for not buying health insurance that they can't afford.  "The fee is only $95."  I say.  They're sure I'm lying.  I encourage them to read the website.

Tricia, the student with a child pipes up "UPS is going to lay off a lot of their employees because they can't afford   Obama Care."  she states.  She is really angry.  

"I find that very hard to believe."  I say.  "I have friends who work for UPS and they have always provided excellent benefits.  I can't imagine Obamacare asking them to provide more than they're already giving.  I'd be interested in reading that article."  

The party starts breaking up.  Tricia is going outside to say good-bye to Brenda and the other student.  "I know you just think I'm a stupid student," she says, " but I've read the Healthcare Act and I'm going to get screwed."  

I'm aghast.  I feel terrible that she thinks that's what I think of her.  "I don't think you're stupid at all," I say, "just misinformed and scared."

I am frustrated.  The two students are the very people that "ObamaCare" is intended to insure, those who don't qualify for Medicaid, CHIPs or Medicare.  These are the two that are the most angry and the most sure that they are going to have to pay the penalty/fee for non-insurance.  

Tricia comes back in.  We start drinking Cherry Daiquiris and telling silly stories.  We laugh.  Tricia is still talking to me.  When I leave,  I hug everybody, including Tricia, good-bye.

Throughout the discussion, I kept encouraging everyone to go to the official government website which is: 
www.healthcare.gov/law/timeline/index.html  "There are so many lies out there." I say.  "Don't let them terrify you with lies, ascertain the facts."  I encourage you, the reader to do the same.

Most Prevalent Lies

• "UPS is going to lay off a large part of their workforce because they can't afford to provide the insurance at the level that ObamaCare requires."  UPS is not laying anybody off because of ObamaCare.  They're not cutting health insurance.  What they are doing is no longer providing insurance for employee's spouses who are employed and already covered by their own employer's insurance.  This is a cost-saving move that a number of companies have already been implementing far prior to ObamaCare.  UPS, for whatever reason, is saying that the implementation is required because of ObamaCare and the expected increased in health expenses.  (Steven Greenhouse,  The New York Times, Business Day, August 21, 2013)
• "Obama Care is going to establish death panels and choose who receives expensive life-saving medical interventions."  Boards/Panels are going to be formed that having nothing to do with choosing who lives and who dies.  These "panels"  will be made up of appointees consisting of health care practitioners, medical experts, and consumers to identify procedures and interventions that engage in "Best Practice" techniques and procedures which improve patient outcomes, increase efficiency and reduce costs.  They will make these "Best Practices" known to all health care facilities and practitioners.
• "I am going to have to pay a fine because I can't afford health insurance."  The Affordable Health Care Act is designed for those people who could not previously afford Health Care Insurance and did not qualify for Medicaid or Medicare.  Expansion of Medicaid and CHIP will cover a lot more people who previously did not qualify.  If you live in a state that has chosen not to expand Medicaid and you would have been covered, you will not be penalized.  Between Medicaid expansion and the Health Care Exchanges, most previously uninsured people will be covered.  If you still cannot qualify for Medicaid and can't afford Health Care Insurance, you will be exempt from the penalties.  The Fine is 1% of yearly income or $95/yr, $47.50/per child but no more than $285.00 per family.  This is only for people who CAN AFFORD INSURANCE BUT CHOOSE NOT TO.  In addition, they must pay for all their own health care.
•  "Congress isn't going to participate in ObamaCare."  As part of the AHCA, members of congress will be getting health insurance through the Marketplace (Health Insurance Exchange) in 2014.  This is part of the law itself.

 If you do not qualify for Medicaid, Medicare, CHIPS and are not covered by your employer's insurance, or can't afford your employer's insurance, you can purchase your health care insurance on the exchange starting October 1, 2013.  Coverage is required January 1, 2014.  Enrollment for Health Insurance closes March 31, 2014.  Additionally,   in early July, the White House and the Treasury Department announced a one-year delay in a major Obamacare provision that would have required employers with at least 50 full-time workers to provide health insurance or pay a penalty beginning in 2014.  Employees that would have been covered under this provision are exempted from the penalties.  They can also purchase health insurance on the Marketplace if they wish or can afford to.

I have provided that information from my 3 index cards on "ObamaCare" below.  It is taken from the website listed above.  Since we're in CyberSpace, you won't even have to tear up the cards and eat them should naysayers challenge you.  You can just refer them to the same website. 

In Place Now

• 50% Discount for name-brand drugs in Medicare Donut Hole - some coverage for generic drugs
• Expands coverage of parental insurance for dependants to 26 yrs.
• Small business tax credits
• Increases matching Federal funds for Medicaid (The 14 states that are not participating in the expansion are:  Alabama, Georgia, Idaho, Iowa, Louisiana, Maine, Mississippi, North Carolina,Oklahoma,Pennsylvania, South Carolina, South Dakota, Texas and Wisconsin. The 11 states that have not officially declared their intentions are: Alaska, Indiana, Kansas, Kentucky, Nebraska, New York, Tennessee, Utah, Virginia, West Virginia and Wyoming.)
  
  • $250.00 rebate for Seniors in Medicare Donut Hole
  • Changes in Medicare, Medicaid billing has recovered more than $2.5 billion in fraudulent charges
  • Expands coverage for early retirees
  • Online Consumer Info.
  • Preventive Services Covered:   16 for Adults, 22 for Women/Pregnant Women, 27 for children  
  • Prohibits Insurance Companies from Rescinding Coverage
  • Provides for Appeals & External Reviews
  • Eliminates Lifetime Limits
  • Regulates Annual Limits
  • Insurance companies have to justify premium increases of more than 10%  to qualify for $250 million in new grants and participation in Affordable Insurance Exchange 2014.
  • Increased availability of Primary Care Workforce
  • Federal Grants for Consumer Assistance Programs
  • $15 Billion for prevention and Public Health Programs
  • New funding for constructing and expanding community Health Centers
  • Increased payments to rural health care providers
  • Free Preventive Care under Medicare
  • Employer Insurance must spend at least 85% of profit on health care services, 80% for Individual plans, or refund difference to policy holders.  I received such a refund a year ago.
  • Eliminates discrepancies between Original Medicare and Medicare Advantage to $1000 more per individual.
  • Tests new methods to increase quality and decrease growth in costs
  • Community Care Transition Programs, coordinates care, connects patients to community services, and avoids unnecessary re admissions.
  • Individual Advisory Board decreases costs, increases health outcomes, and increase access to high-quality care by submitting proposals to Congress and the President.  This is the supposed Death Panel.
  • More home and Community based services for the Disabled through Medicaid rather than Nursing Homes
  • Provides Physician incentives to coordinate patient care, increases quality of care, prevents disease and illness and decreases hospital admissions.
  • Decreases disparities due to race, ethnicity and language
  • Provides Cash benefits to adults who  become disabled
  • Decreases paperwork and Administrative Costs starting 10/1/12
  • Starting 10/1/12 link payment to quality outcomes
  • Increases preventive coverage to  state Medicaid programs
  • Increases Medicaid payment for Primary Care Doctors
  • Bundles payment to deliver healthcare more efficiently and increase quality of care in Medicare.
  • Expands funding for CHIP to 10/1/13
  
  
  Starting January 1, 2014
  •  Establishes Affordable Insurance Exchanges
  • The Individual is required to buy Basic Health Insurance or pay a fee.  If affordable coverage is not available they are exempt from requirement to buy insurance.  If you are insured, receive Medicare, Medicaid, CHIPS, are covered by Tri-Care or are a member of a federally recognized Tribe, you will not be assessed a fee.
  • Workers who cannot afford employer coverage can take employer funds to purchase a more affordable plan from the Insurance Exchange.
  • Raises Income Requirement for Medicaid to $14,000 for the individual, to $29,000 for a family of 4, 100% federal funding for the first three years to 90% after 2013.
  • Advanceable tax credits for income between 100% and 400% of poverty line for those ineligible for affordable coverage.  This credit is advanceable and can be applied immediately so that it lowers the monthly premium payment and you don't have to wait until taxes are filed in order to receive it.
  • Members of Congress will be getting their health insurance through the market place.
  • Eliminates Annual Limits
  • Ensures coverage for individuals in clinical trials
  • Ensures coverage for individuals with pre-existing conditions
  Starting January 1, 2015
  • Businesses employing more than 50 persons required to provide affordable health care coverage to employees
  • Payments linked to quality of care, not volume.

   
  Admittedly, this is not perfect.  It does not address inequities in billing nor the outrageous costs of Medical Care in this country, but it does try to address access to medical care, inequities in access and delivery and continuity of care.  If all we do is gnash our teeth and tear our hair or refuse to do anything because the proposed changes are not perfect, nothing will ever change.  A journey of a thousand miles starts with the first step.
   
  Namaste'
   
  Kismet  

   Copyright August 2013

Sometimes Life is NOT the Schizz

I am lying in bed.  I'm trying to sleep, but my body has other ideas.  When I lie down, my neck tenses up.  My shoulders tighten, rising up to my ears; a commuter in pain.  My neck feels as if it is enduring the French Revolution.  I am being guillotened over and over again;  a ring of sharp pain.  What is supposed to be a position of relaxation, is a position of torture, of pain.  I struggle to keep my eyes closed.  "Sleep."  I tell myself.  "Breathe, in/out.  Relax."  I lie still.   I become aware of a burning, a pain centered in my knees.  Fire ants on a rampage. They throw a lifeline to the pain in my neck.  It becomes unbearable.  If I were alone and not in bed with my husband, I would be curled up in a fetal position; a knotted mess, rocking back and forth, crying.  In pain.  In tears.  My body burns with pain.  Shoulders tight, onfire.   Forearms singing.  I sit up.

Because I am a mess, I cannot remember what I should be doing.  My stomach growls.  Empty.  I sit on the edge of the bed.  What's next?  "Stand up!" my brain shouts to my body.  I stand.  I am at a loss.  I am standing, at the edge of a world with possibilties, but I cannot think of what comes next.  I am upright; a stanchion against gravity.  I sway.  "Walk!"  says my brain.  "Hungry!'   says my stomach.  "Full!" says my bladder.  "Bathroom" thinks my brain.  I am stiff.  I am the farmer's horse, going to market; hobbledy, hoy.  Hobbledy hoy!  I have reached the bathroom. "What's next?"  we all ask.   Slowly from somewhere, "Pee!"  I sit.  I relieve myself.  Fortunately, movement is programmed in my muscles.  I complete all the necessary hygienic tasks of urinating.  I stand, lost in front of the wash basin.  "Wash your hands."  whispers my brain.   I wash.  I dry.  I stand in front of my towels.  I lean my head forward, against the towel racks trying to plumb my brain for the next step.  "Ah!  Breakfast!" shouts my stomach.  Slowly, I collect the ingredients for an omelet.  I write myself notes:  breakfast, meds, clothes.  Otherwise, I am lost, adrift in an ocean of forgetten intentions.  Circling, always circling.  Moving, but not forward.

I sit.  I eat.  I read.  I breathe.  Thank God there is ONE thing I can do without thinking about it.  I sigh.  No ambition, no knowledge, no thinking.  I just am.  Living, breathing, sitting on the couch.  This is all I can do right now.  All I can be.  I am.  If I am me, it is a grace from God.

I close my eyes.  "Maybe tomorrow will be a better day,"  I think.  The bits and pieces of me are in hiding.  I sigh.  I know that with rest, with energy, I can be myself.  I can do more than just survive.  But for right now, it is all I can do, all I can be.  I just exist.  Me on the couch.  Breathing.  Existing.  Tomorrow WILL be a better day.  Maybe tomorrow, I can LIVE!  But for today, I just survive.  I am alive...but barely.

Namaste.

Kismet

Copyright August 2013

Why "Big Government" and Regulation are the Only Idea

The Tea Party and many Conservatives speak of the evils of Big Government.  They espouse the virtues of Free Enterprise and eschew regulation as stifling economic growth and financial independence.

I have lived in a country that would be called Third World.  They have a minimalist government supported mostly by Financial Aid from Developed Countries.  There is iffy infrastructure.  Things that are considered necessities by Americans, are luxuries in third world countries.  Life is shorter, harder, more dangerous.  Education is not free and conducted in crowded classrooms in temperature extremes with no heating, cooling and often no electricity.  Anybody who has served in any capacity in the Peace Corps, deployed to Iraq or Afghanistan with the military, with NGO's in third world or developing nations, will recognize that what Americans take for granted are not present in much of the world.  These are things that are present and paid for by our taxes and often present only because of regulations which are in place in large part to protect the public and consumer.

Let us walk through a day which is only possible because of "Big Government", taxation and regulation.

The alarm rings.  The electricity is consistent because of oversight by the Public Utilities Commission.  You sigh and put your feet down on the fire retardant rug which is mandated by manufacturing requirements.  The infrastructure of your house is safe and sound, lead free due to manufacturing regulations and oversight by government entities.  If there should be a natural disaster, you will receive support and funds if the Government declares it a Federal Disaster.  You will be able to rebuild if you have purchased Federally sponsored Insurance (both guaranteed by taxation and regulation.)

You stagger to the bathroom and drink out of the faucet.  The pipes from the water treatment plant are built and maintained by taxes.  You can safely drink the water out of the faucet because of minimal standards and regulation by both state and federal entities.  If you've traveled in anywhere outside of the U.S., Canada, the UK and Europe, you know that you NEVER drink the water.  In fact you don't even eat fruits or vegetables because they have been watered with untreated and unsafe water.  You know that there are still places in the United States where clean water is not available and has to be hauled many miles in large tanks on the backs of pick-ups.  You put on make-up and lotion that will not sicken you because it is manufactured under regulations and testing deeming it safe for human use and consumption.  You eat food that has been prepared, grown, cleaned, packaged in settings that are examined regularly for minimal cleanliness and health requirements.  If you have allergies, you can check the labels for ingredients because that food product requires full disclosure of the ingredients as well as allergies.  You know that the factory/processing plant is regularly inspected for cleanliness and safe handling techniques.  You gently strap your infant into the car seat that is required by State Law and manufactured under minimal "regulated requirements", and buckle your school age children into their seat belts.   You get in your vehicle and fasten your seat belt.  The car has been engineered and crash tested to meet Federally Mandated Requirements.  You have a seat belt and air bags because of this.  If you were born before 1975, you remember when cars didn't even have seat belts.  You drive down the road paid for by fuel taxes, cleaned and plowed by City, County, State and Federal Funds.  The street lights (provided by city, state and federal taxes) light the way.  You are thankful for road reflectors (State and Federal regulation) this rainy morning guiding the way to the Day Care Center.  You place your infant in the hands of a licensed and trained caregiver/teacher in a licensed facility.  You drop off your school age children at their school (city, state, federal taxes.)  You are confident that the teachers are qualified (state and federal regulations) as you know that a teaching degree is required and obtained at Private or Public Universities (fully or partially supported by tax dollars.)  Curriculum is mandated and regulated by the State.  You wish perhaps that educational requirements were more consistent state to state, recalling when you taught that children from California are notoriously a full year behind in educational training.  As you get out of your car, you take a big breath and murmur thanks for air is much cleaner and clearer than you  remembered as a child before Minimal Air Standards were put into place.  You remember the year in your childhood when the river caught fire because of the pollutants and manufacturing wastes.  The river now has fish in it due to reclamation through the Environmental Protection Agency.

You catch lunch at a restaurant that is regularly inspected by Health Officials where employees are required to wash their hands between customers and after bathroom visits.  You note the fire exits which are required by law and must be labelled and easily identified.  You ponder the tragedy of the textile workers trapped in the factory fire in Bangladesh.  You watch the news that there is a collapse of a shopping mall constructed with inferior building materials and no oversight in some remote country in Asia.  You can eat your lunch safe in the knowledge that your food has been inspected and prepared to Public Health Standards.

You stop by the Human Resources office back at work to arrange for your Family Medical Leave during your anticipated Pregnancy Leave; secure in the knowledge that you will have a job to return to following the birth of your anticipated child.  After work, you visit your Obstetrician at the Women's Health Center that is supported partially by state and Federal Funds.  You are seen by a Licensed Physician who received his training at a Medical School adhering to guidelines established by Federal and State regulation and overseen by the American Medical Association.  You are thankful for the medical insurance now required by the Affordable Healthcare Act.

On the way home to pick up your children, you stop by the Public Library (city taxes) to pick up a movie, a CD and a couple of books for yourself and the kids.  You make a mental note to download that new bestseller from the library (state funds) onto your e-reader.  At home you pick up the mail in the mailbox (federal taxes).  You think fondly back to last summer and lazy summer evenings spent mosquito and weed free (county weed and mosquito management).

Every part of your day and life benefits from licensing requirements,regulations and tax-supported funding.  You have benefited from all of these if you have ever:

• visited a city, state or National Park
• Hiked on a trail in the National Forest
• bought a car (protected by the lemon law)
• fished in a stream protected from manufacturing waste and run-off
• boated in a public waterway
• hunted on public or private lands
• attended public or private schools
• gone to the emergency room
• served in the military, Peace Corps, UN, USAID
• bought or worn clothing manufactured in the U.S.
• purachased any of a variety of consumer products that are regulated for safety
• you are protected as a consumer from faulty or defective products by regulation
• are injured on the job (workmans compensation), federally state funded Vocational Rehabilitation
• worked anywhere covered by the Occupational Safety and Health Administration
• taken medication (FDA oversight/regulation)
• ridden on Amtrak or commuter trains
• flown on an airplane (minimal safety requirements, Federally Paid Air Traffic Controllers)

You feel safe in the community in which you live because of their well-trained police force and Fire Fighting personnel (city taxes/bonds).

You have only to look in the Blue Pages of the phone book to have impressed upon you the variety and scope of services which are part of local, state and federal government and supported by your tax dollars.  When you retire or if you become disabled you will receive Social Security Benefits and Medicare.  If you become destitute you know that you can apply for SNAP(food stamps) and TANF (Temporary Assistance for Needy Families) if you have children.

There are myriad services that we utilize everyday which we consider essential and are there under the auspices of "government".  Our food, water, air, houses, hospitals, consumer products are safer and functional because of regulation.  So take a moment to allow yourself to imagine what life would be like without these "necessities".  Which regulations would you rescind.  Which service supported by our taxes would you eliminate?  

Ode for a Lost Soul

As a parent, we all have them.  That child, that as your children are growing up, you don't want your child to associate with.  Their life is too chaotic, their behavior out of control enough, that once sucked in to that child's orbit, your child is subjected to the same experiences and punishments.  That child is like a black hole sucking children into his wake and everyone along for the ride suffers.  For us, this child lived right around the corner.  He was in the same grade as my son who is now 19 years old.  This child, Levi, had a very rough beginning.  His parents were divorced.  Levi and his mother lived on the streets in some unknown large city until he was rescued by his father and stepmother just before Kindergarten.  We do not know, but can only imagine the things that child went through during his most formative years.  Rumor had it that his mother was a drug addict.

Because Levi lived just around the corner, attended the same school, was in the same classrooms, contact  with Levi for my son was inevitable.  Unsurprisingly, Levi had Attention Deficit Hyperactivity Disorder.  Play dates with Levi were fraught with activities that pushed the edge of acceptable.  Stories about Levi that were brought home by my empathetic son were disturbing and uncomfortable.  One memorable visit with Levi and a female relative of his when all were in third grade ended up with his cousin getting bit on the face by the normally very friendly dog next door. We had never seen this child before, but she was in tow with Levi.  THAT was an uncomfortable phone call to his parents!  His father was gruff and defensive.  His stepmother, a teacher at the local High School, was sweet and understanding.  

Fourth Grade was a terrible year for my son.  By now, it was established that Levi could be a bully.  My son associated a lot with Levi that year, mostly because they were in the same classroom.  It was a constant litany of phone calls, time outs, threatened school suspensions, visits with teacher and Principal.  I was aghast.  This had never happened to my son before.  He was usually the model of good behavior.  My son is so mindful, that he tattles on himself.  I was told by the Principal that I should forbid my son to play or otherwise associate with Levi if I didn't want my son to be in constant trouble.  That angered me.  Clearly, Levi was struggling and could use all the positive influences that he could get, and the school's solution was to ostracize this child even more?

Fourth Grade struggled on.  There was a neighbor that called the cops on Levi and my son purportedly for throwing rocks at the headlights of his wreck of a pick-up parked like an abandoned vehicle in the alley.  There was the loss of a very expensive skateboard from our mudroom.  My son confessed that Levi knew the location of our stash key.  Phone calls to Levi's father netted total denial of the skateboard's existence.

We all got through Fourth Grade.  By fifth grade, my son was completely out of Levi's circle of influence.  They were in different classrooms.  By Middle School, we lost Levi.  At this point, it was rumored that Levi was in a private school in an attempt to manage his behaviors and improve his educational experience.  My brief encounter as a parent whose child was treated like Levi was scary and disturbing.  There were accusations of bullying that included the small circle of friends surrounding Levi.  The counselor held regular sessions with this circle to try to problem solve and counteract these incidences.  But, the interactions with other school personnel, teacher, principal were disheartening; accusatory and not supportive.  I struggled between wanting to help Levi and wanting to protect my son.

By 10th grade, we had completely lost Levi.  He was no longer in the public education system, though he and his family still lived around the corner.  His mother still taught at the High School which both my children attended.  My son brought home a story of Levi in a bad way; drugs, alcohol, run-ins with the law.

My son graduated from High School in 2012.  Levi was not in his Graduation class.  Two weeks ago, my son informed me that there were postings on Facebook.  Levi was missing.  He was purportedly last seen traveling between two towns in eastern Montana.  His family was begging for information on his whereabouts.  Last Thursday, Levi's body  was found.  Death was by self-inflicted gunshot.

So many questions.  Was this child destined to be lost?  Was there no way to change where he was going?  Did his time on the streets destine him to failure?  I found his stepmother sympathetic and supportive.  She wanted to do anything she could to help and guide Levi.  Our brief sojourn as a family treated like Levi was frustrating and heartbreaking.  The school's solution seemed to further ostracize a child struggling with friendships, behavior and limits.  Is there no other ending for the Levi's of the world?  Depression in children with ADHD is at 40%.  In a recent study, the incidence of death from suicide was nearly 5 times higher among adults who had had childhood ADHD compared with control participants. (Medscape, Pediatrics. Published online March 4, 2013.)    Was the death of this 19 year old, the only outcome?  I have blogged before about the incidences of depression, drop-out rates, imprisonment for individuals with ADHD.  This loss of a child has brought this tragedy of lives lost or destroyed too close to home.

I know that this is a multi-factorial tragedy.  I know that this family tried everything within their power.  Different schools, counseling, interventions.  But we all, as a society, our educational system, somehow, we failed Levi.  How many Levi's do we have to lose before we change the way we educate and treat our children with ADHD?  How many suicides, imprisonments, lives destroyed, families traumatized?

I have no answers, only questions, but I will keep asking this question.  I charge you, the reader to ask this question.  Ask teachers, principals, lawmakers, prison officials.  We need to change.  No more Levi's.  No more Adam Lanza's.  

Namaste.

Kismet
Copyright July 2013