So Angry

I am so angry that I have to keep reminding myself to breathe. Just breathe.

There was a posting on Facebook that was about a person seen in the emergency room. The article described all the – gasp – negative things about this person: a gold tooth, tattoos, name brand jeans, smokes, etc. The “doctor” writing this post was angry about having to provide care to this person who has MEDICAID!

Really? I am so tired of a person’s worth being tied to things such as gold teeth, tattoos and Medicaid. That person was of no less worth to God than the grandchild of the person who posted it – and by the way, that grandchild was/is on Medicaid. It doesn’t matter – at least to me.

If we are going to talk about how broken the system is, then let’s have this discussion. Is an emergency room physician who spends 5 minutes with a patient, putting in 3 stitches really worth over $900? Or, how about the physician who sees a patient in his office for a 10 minute appointment – and spends 8 of those minutes catching up with a personal friend – then charges the insurance company $800 for a follow-up visit? Or, the physician who sees a person with a common “stomach” virus, and sends the patient on to the hospital for a CT scan – because he has good insurance that will pay for it? Seriously – and we think the problem is a person with Medicaid?

The problems with the system are not at the bottom – they are at the top. The problems are with our legislators who are stuffing their pockets with money – and have forgotten the poor that they are supposed to represent. The problems are with lawyers and bankers on Wall Street, who have taken so much that can never be recovered. The problems are the greedy, the self-righteous, and the bigots.

The problem is not the poor.

Yeah, I am pissed.

 

 

Rose

Rose is almost exactly eight years younger than I am; when I was asked her age last night I guessed her to be at least eight years older than I am. Poverty ages a person. That was one of the first lessons I learned here at the free clinic. People who live in poverty, on average, look about 10 years older than their actual age.

Rose has been a patient here for two years. She is separated from her husband – divorce is a luxury of the middle class and the rich. She lives with her daughter and helps by taking care of her grandkids.

She came to the free clinic with a non-healing sore on her right foot. She had been seen in the emergency room for the wound and was sent here for follow-up. We made referrals to a surgeon and a podiatrist. She was admitted to the hospital for IV antibiotics and surgical debridement of the wound.  Her health history includes diabetes and high blood pressure, as well as chronic kidney disease and anemia. 

She was transferred to one of the larger hospitals outside our area. They diagnosed her with osteomyelitis – an infection in a bone – as well as with peripheral vascular disease. She had a stent placed in the right femoral artery to help with blood flow to her right leg. They also amputated her right little toe as a result of the infection.

Less than a year later, she was back with another non-healing sore on her right foot.  The MRI showed early osteomyelitis. Ugh.

So, for the past year we have been fighting this infection. She saw our podiatrist once a week, and was seen regularly at the clinic. But, ultimately, the sore wasn’t getting any better. The only advice we had to give her was to go to the emergency room at the university hospital that is an hour and a half away. So, that is what she did – she was admitted right away, treated with IV antibiotics…

I cried when I saw her last night. She had a below the knee amputation.

Would it have made a difference if she had healthcare insurance? I don’t know the answer to that, but she would have received the care she needed WHEN she needed it – our clinic is only open one night a week.

How many people have to die, how many limbs have to be lost before our legislators see the need for healthcare for all? Why does everyone pat themselves on the back for supporting the free clinic, but turn their backs on the people in need? I am so frustrated.

And, so sad.

My Prayer for Today

A Four-fold Franciscan Blessing

 May God bless you with a restless discomfort about easy answers, half-truths and superficial relationships, so that you may seek truth boldly and love deep within your heart.

 May God bless you with holy anger at injustice, oppression, and exploitation of people, so that you may tirelessly work for justice, freedom, and peace among all people.

 May God bless you with the gift of tears to shed with those who suffer from pain, rejection, starvation, or the loss of all that they cherish, so that you may reach out your hand to comfort them and transform their pain into joy.

 May God bless you with enough foolishness to believe that you really CAN make a difference in this world, so that you are able, with God's grace, to do what others claim cannot be done.

 And the blessing of God the Supreme Majesty and our Creator, Jesus Christ the Incarnate Word who is our brother and Saviour, and the Holy Spirit, our Advocate and Guide, be with you and remain with you, this day and forevermore

I'm Back!

Thank you for all the thoughts and prayers. My husband is doing well after his surgery; recovery will be slow and take a while, but so thankful to be on the road to recovery!

Now it is time to get back to work. The clinic has been closed for two weeks, and so the uninsured residents of our county have not had access to healthcare.

Our legislators are in the second full week of their vacation. They are enjoying full access to healthcare, but have continued to neglect the poor living and working in the communities they are supposed to represent. So, it is time for us to get back to work and let them know that this is not acceptable. We want Medicaid Expansion for Michigan. If you live and vote in Michigan - please call your state senator, and let them know the time is NOW! We want Medicaid Expansion.

Here is a great article on Medicaid Expansion that I want to share:

Expand Medicaid in Michigan

• Michael P. O’Donnell

 

 

The prestigious Institute of Medicine has estimated that having access to medical coverage would reduce adult mortality by 25 percent. 

 

A subsequent study published in the New England Journal of Medicine showed that expansion of Medicaid eligibility in New York, Maine and Arizona reduced the mortality rate (the number of deaths in a population) among those newly eligible for Medicaid and improved access to care and overall health.

 

How often in a lifetime will any of us have the opportunity to have so much positive impact on another person’s life?

 

The people of the state of Michigan have that opportunity right now.

 

The Affordable Care Act (aka Obamacare) allows the state of Michigan to extend Medicaid access to an estimated 450,000 Michigan residents with incomes up to 133 percent of poverty, ($15,282 for an individual and $31,322 for a family of four), who do not qualify for Medicaid under the rules set by the state of Michigan.

 

Amazingly, we can do this and save the state money for at least a decade.

 

The only thing that stands in our way is the Republican caucus in the Michigan State Senate, which refuses to support the expansion. Our Republican governor, Senate Democrats and our House of Representatives all support expansion.

 

Why does the Senate Republican caucus oppose expansion?

 

It is not about taxes or state budget fiscal responsibility.

A recent study by the Center for Healthcare Research & Transformation (CHRT) estimated that expanding Medicaid eligibility would save the Michigan state government $983 million over the next decade (2014-23).

 

This happens because the federal government pays 100 percent of the cost of the expansion in 2014-16, 95 percent in 2017-19 and 90 percent starting in 2020. There would be a net cost in the second decade, but it would be less than the savings in the first decade.

 

It is not about the impact on employers or local communities.

Hospitals are the largest employers in most towns in Michigan and employ more than 219,000 people; other health care organizations directly employ an additional 210,000.

The nearly 140 hospitals in Michigan will receive several hundred million dollars from the federal government each year if Medicaid is expanded in Michigan.

 

My congressional district around Ann Arbor is projected to receive $182 million a year.

This is critically important because Michigan hospitals provide an estimated $1.9 billion a year in uncompensated care.

 

Historically, some of this uncompensated care has been covered by federal payments but those payments are scheduled to decrease because the federal government assumed all of the states would be expanding Medicaid to low-income residents and would receive offsetting Medicaid payments.

Expanding hospital revenue means more jobs; reducing it means layoffs.

Some of the uncompensated care is passed on to Michigan employers and residents in the form of higher medical charges.

 

The CHRT study estimates that expanding Medicaid in Michigan will reduce costs for employers and residents who purchase insurance by $640 to $985 billion over the next decade.

 

It is not about equity.

Michigan state senators and their families are covered by the state of Michigan health insurance program, which is funded through our taxes.

 

Their monthly premiums range from 0 to 20 percent, depending on the plan they choose.

 

If these senators, who have good-paying jobs, receive government health insurance, does it seem fair that poor people are denied?

 

It is not about religious values.

Every major religion in the world stresses the importance of caring for the poor.

 

So what is it actually about?

It’s partly about politics; about making a stand against Obamacare.

 

But it is mainly about the citizens of the state of Michigan putting up with this behavior. If the citizens of the state of Michigan call their senators to ask them to support Medicaid expansion, it will get done.

 

I am going to call my senator, Randy Richardville, every week until he agrees to support Medicaid expansion. Will you? I will vote for his opponent in the next election if he refuses.

 

Will you?

Michael P. O’Donnell is a clinical professor in the School of Kinesiology and director of the Health Management Research Center at the University of Michigan.

From The Detroit News: http://www.detroitnews.com/article/20130711/OPINION01/307110004#ixzz2ZECj9OTl