Tag Archives: Affordable Care Act

Aged Out

“I hope I die before I get old.”

– “My Generation”, The Who, © 1965

I’ve thought about this scenario: I’m home alone at age 80-something and I have a stroke or some kind of cardiac event.  I can’t get to a phone and I don’t have one of those Life Alert devices.  As a staunchly independent, childless 50-something with few friends, that thought has crossed my mind on more than a few occasions in recent years.  It became even more glaringly realistic this past January, when I told my mother she needed to take a shower.  I realized she had urinated on her bed; a simple of case having fallen asleep and – given her age, I thought – wasn’t able to make it to the bathroom in time.

“I’ll change the sheets,” I told her, before retreating into the hall.  A moment later I saw she was flailing her right arm and leg.  “What’s wrong?” I asked.  “You need to get up and take a shower.”  But then it became clear.

She’d had a stroke.

It apparently had been a brief event and was already starting to heal by the time she’d arrived at the hospital.  But her left side was mostly paralyzed.  I sat beside her in the emergency room, as she gazed blankly into a flickering light panel, and thought, ‘Now what?’

Years ago, when her mental health started to wane, someone asked why I didn’t place her in a “home.”  “She has a home,” I replied.  “It’s the one she’s in now.”

But the now had changed.  And I was forced to contemplate the unthinkable: putting one of my parents into a “home” – whatever the hell that’s supposed to entail.

I had promised my father that I would do everything to ensure he didn’t pass away in a hospital; ensconced in a strange bed with tubes wrapped around him, as if he was a hostage.  And I was able to help him achieve his desire.

But this situation is different – and far more complicated.  After her hospital stay, I had to place my mother into a rehabilitation center.  I found one nearby and was able to tour the facility a few days before she arrived.  It’s an older building that looked like it hadn’t received a fresh paint job in about four presidential administrations.  On that Friday evening I accompanied her to the place, I felt as if I’d swallowed a tree branch – and it was now stuck.  The center looked even more dismal than when I’d first entered.  And that night, as my mother lay in bed, glancing around the room – her left arm and leg still mostly inert – my heart filled with trepidation.  I couldn’t stay that night, so after more than an hour – assuring her things would be alright and consulting with the amiable staff – I departed.  I almost felt like I’d abandoned my mother into a pit of despair.  And, even worse, I’d violated a solemn vow I’d made to my father more than a decade ago: if he should pass away first, I’d take care of my mother.

Looks, indeed, can be deceiving.  While the rehab center was an aged structure, the staff was incredible.  I did have a good feeling from the start, though, when I first spoke with one of their representatives.  But it didn’t take long for me to realize I’d made a great choice.

I brought my mother home in March, as the COVID-19 pandemic gripped the nation.  The startling number of coronavirus deaths in similar facilities alarmed me.  The center had banned visitors a few days earlier, but I had to get her out of there.  As good as the place had been for her, I didn’t she feel she was safe.  And I knew I could care for her just as well as the rehab center and get her back to some semblance of her former self.  I should know by now that far-reaching plans always look great on paper or in dreams.

After only a week, I had to return her to the rehab center.  Her health had deteriorated in that short period.  But, once back at the facility, she improved.  She’d regained some movement on her left side and was alert.  She still didn’t recall what had happened.

But then, matters became even more complex – and aggravatingly unsettling.  My mother’s lengthy stay at the rehab facility had exhausted her Medicare benefits.  They paid 100% for 21 days, when they lowered the rate to 80%.  My mother – and I – was obliged to pay the remainder.  But she didn’t qualify for a supplemental insurance policy – even through Medicare.  Or the Affordable Care Act (ACA).  The requisites for either make the Harvard Law School entrance exam look like a daycare application.

Medicaid was our last option.  Completing the application for that was tantamount to completing one to be a Central Intelligence Agency case officer.  And my mother wasn’t approved.  With her Social Security and two pensions, she earns too much per month; just a “few dollars” too much, the rehab center associate helping navigate the morass informed me.

And what, I inquired privately in my angry cogitations, qualifies as a “few dollars” too much?  I researched a handful of other available and plausible alternatives – enough to fill a tea cup – and could find nothing viable.  Absolutely nothing.  For my mother even to begin to qualify for some semblance of Medicaid coverage to help with her health care expenses, she’d have to cede all of her assets, including this house – the house she and my father worked hard to get and to keep; give it all up to an omnipotent entity that designed the very system to which my parents (and millions of others) annually pay homage and taxes.

And she earns a “few dollars” too much.

By the end of April, the rehab center – the place that had proved life-saving and life-changing – had reached its financial breaking point with us.  They had to let her go.  They had no choice, they told me – and therefore, neither did we.

Fortunately, Medicare does pay for extended hospice care here at the house.  Representatives with the agency I selected have been incredible – even angelic – in their commitment and service.  They’re as concerned with me, also, as my mother.

Still, I seethe at the thought of the financial fiasco in which we’ve now been placed.  We’re in debt to the rehab facility now, as well as to a slew of doctors and the hospital.  My mother is just one of literally millions of Americans in similar straits.  At current rates, the crisis will only deepen nationwide.  The number of Americans aged 65 and older is expected to almost double from 52 million in 2018 to 95 million in 2060; rising from 16% to 23%of the population.

A half-century ago, programs like Medicare and Medicaid were designed to assist the elderly and poor with health care needs.  They’re not just altruistic; they’re vital.  As with the Social Security system a generation earlier, Medicare and Medicaid provided necessary safety nets for many Americans.  The nation had matured into a contemporary society where even the most vulnerable of citizens were not left to fend for themselves.

As usual, social conservatives scoffed at the notion.  Just like with the post-World War II GI Bill, they denounced such aspirations as welfare and socialized medicine.  These were the same fools who demanded people swear allegiance to the United States, be willing to sacrifice their lives to the Constitution, abide by established laws, and blindly pay money to ensure a safe democracy for all.  They still do.  Yet, when people earn a “few dollars” too much…they shrug their shoulders and change the subject to American exceptionalism.

My mother began working for an insurance company in downtown Dallas in the fall of 1952 at the age of 19 and retired from an insurance company in February of 2003 at age 70.  With the exception of taking off 15 months for being pregnant with and caring for me – at a time when maternity leave was more of a concept – she worked for half a century.  Fifty years.  And, as her physical and mental health decline from years of just being alive…she earns a “few dollars” too much.

“Age is just mind over matter,” my father once told me.  “If you don’t mind, who gives a shit?!”

People have told me that, for being a good person, I deserve a “big reward.”  And I’ve also told some they deserve a special place in the “Great Beyond” just for being themselves.  As genuine and thoughtful as those words are, does anyone have to wait until life in some other realm to be appreciated for their actions?  Is it truly necessary to wait until we’re dead to receive the respect we’re due in life?

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Dead Demos

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In some paranormal circles, “dead time” refers to the period when otherworldly spirits are most likely to be active.  Even though it’s not official – and really, nothing in the paranormal realm is considered official – it’s generally believed to occur between midnight and 5 a.m., with the two to four o’clock hours considered the key time.  Nothing in the political arena – especially here in the U.S. – is considered normal either.  But, for those who didn’t vote for Donald Trump in last fall’s presidential elections, dead time started materializing just as Tuesday, November 8 was turning into Wednesday, the 9th, and it appeared the bombastic real estate magnate was going to be our nation’s 45th Chief Executive.  Trump’s entry into the race nearly two years ago surprised few; his name had arisen more than once since the late 1980s as a potential candidate.  But, as he marched forward – taking out one competitor after another – the mainstream Republican Party stood dumbfounded; recoiling as each individual dropped from the race quicker than a Texan would drop a bottle of warm beer.

And, for the second time in sixteen years, Americans found themselves with a president-elect who didn’t win the majority of the popular, but still managed to garner most of the electoral votes.  The vast majority of liberals and moderates were shocked – and appalled – that such an event could happen again within so short a period of time.  As the Democratic National Party scratched its head, people began to question the validity of the Electoral College system that original framers of the U.S. Constitution had created as a means of spreading the generosity of power.

U.S. intelligence had surmised last summer that Russian hackers were trying to infiltrate our voting system.  Now comes proof they actually did manage to sneak their way into it.  Exactly how they were able to do that remains uncertain.  Were votes eliminated, or were votes added?  Was someone in the Electoral College bribed?  Even if no one hacked into the system, would Trump have won anyway?

It’s bad enough that both Hillary Clinton and Donald Trump garnered their respective party’s nominations last summer.  But they plowed through the campaigns with the lowest favorability ratings of any presidential candidates in U.S. history.  In other words, no one really liked either of those fuckers, but felt compelled to vote nonetheless.  Voting is more of a right and a civic duty than it is a privilege or an inconvenience.  I have to admit that – for the first time since I began voting in 1992 – I went rogue and selected Green Party candidate Jill Stein.  I knew Stein had as much of a chance of getting into the White House as I do of going a month without a mixed drink or a glass of wine.  But it’s always the thought that counts, right?

I’ve always liked Bill Clinton, but Hillary never had much appeal to me.  Most of my friends and relatives voted for her.  A few criticized me for choosing Stein over Clinton; emphasizing that I was inadvertently voting for Trump instead.  I don’t care.  Opting for the lesser of two evils isn’t much of a choice.  I did that in 2004, when I voted for John Kerry.  Regardless, I wasn’t going to be swayed by party loyalists this time.  While Trump is atrocious, Clinton is as hollow as the empty bottles of hair dye she leaves on the bathroom floor.

Yet, as the world looks at the United States – that self-proclaimed beacon of democracy and freedom – with a mix of horror and amusement, the Democrats are still patching up their emotional scars and sorting through the morass.  But let’s pretend for a moment that no one had hacked into our voting system, or that any such attempts were successfully uncovered and squelched months before election day and that Trump still managed to win.  The Democratic National Party would still have to undergo some serious soul-searching and understand what they did wrong.  I can help and have narrowed the fiasco down to three primary issues.

 

Affordable Care Act (ACA) – While millions of average Americans were losing their jobs, their homes and their life savings because of the 2008 economic meltdown, the Democrats curiously focused their efforts on one issue: health care.  Yes, it’s great if people don’t have to choose between a flu shot and the light bill.  But ensuring that citizens will have adequate health care is not nearly as significant as ensuring they have gainful employment.  I don’t know why the Democrats went off into an ideological black hole with this issue.  That Democrats seemed more concerned with the ACA than boosting the economy was matched only by the Republicans’ determination to destroy the program.  Both parties operated within a vacuum.  Nothing else – mainly that economic thing – seemed to matter.

Inequality – The “Great Recession” almost completely destroyed the U.S. economy.  So many factors contributed to the calamity, but the USD 8 trillion housing bubble burst was the primary culprit.  More people than ever before were buying homes, which would normally be a good thing.  But, in this case, people were getting into homes with little or sometimes zero money down.  How reasonable does it sound for someone earning roughly USD 30,000 a year to buy a USD 500,000 house without making a down payment of even 5% of the structure’s value?  Such a practice was inconceivable two decades ago.  But that’s exactly what people were doing.  And both financial institutions and homebuilders were part of the fiasco.

When I got laid off in the fall of 2010 (in the midst of a fragile recovery), my top concern was the job market; not whether I could afford to get my teeth cleaned.  By the end of that year, the “Great Recession” was, from a purely technical standpoint, over.  But to those of us trapped in its putrid residue, it was alive and well and sucking up our savings and maxing out our credit cards.

Between the fall of 2008 and the summer of 2009, the U.S. economy lost 8.4 million jobs, or 6.1% of all payroll employment.  It was the worst job loss since the Great Depression.  When people mention inequality, they’re not referring to racial or gender disparities.  They’re talking about the wealth gap; that ever-widening abyss that separates the middle class from the upper class.  After-tax income has been shrinking for the past three decades, while the cost of living has been increasing.  Sen. Bernie Sanders made this a key point of his own bid for the presidency last year, and it certainly gained a great deal of attention.  But the Democrats seemed more intent on denigrating Donald Trump’s character and highlighting his personal foibles.  People working two or three jobs just to stay afloat financially don’t really care if the real estate mogul fondled a young woman at a beauty contest.  They want to know if they’ll ever be able to stop working so hard for so little.

Illegal immigration – For decades politicians have said, if they want to appeal to Hispanics, they have to devise a comprehensive immigration plan; meaning that illegal immigrants from anywhere in Latin America must be treated better than others.  This ideology assumes two things: that most Hispanic-Americans are immigrants and that we only care about providing sanctuary for people who emigrate to the U.S. illegally from Latin America.  Immigration – legal or illegal – is NOT the top priority for most Hispanic-Americans.  As a group we’re concerned about the same things most other Americans are concerned about: jobs and the economy.

Obama’s demeanor – Barack Obama is one of the smartest and most verbally gifted men ever to ascend to the nation’s highest elected office.  He had the right message with the right tone.  There’s absolutely nothing wrong with that.  His demeanor is as remarkable as it is unimposing.  It’s one of his greatest attributes.  But, once in the White House, it became one of his greatest faults.  You’d think someone who came of age in the rugged world of Chicago politics would be a little more forceful.  But I felt Obama was too conciliatory, too nice, and too willing to compromise.  The Republicans made it clear from the moment he won the 2008 contest they were determined to ensure he wouldn’t garner a second term.  Their efforts didn’t pay off: Obama won again four years later.  And, as Obama himself stated in his 2016 ‘State of the Union’ address, there was never any doubt he actually won.  But the level of disrespect and recalcitrance the GOP displayed towards Obama has been unprecedented.  From Rep. Joe Wilson shouting “You lie!” at Obama during the 2009 State of the Union address to Arizona Governor Jan Brewer jutting her finger into Obama’s face (later claiming he intimidated her), I can say without a doubt Obama endured more shit than any of his predecessors.

I’m certain race played a major factor in their behavior.  A gaggle of (mostly) old, White men just couldn’t fathom that a half-blooded Negro actually won the presidency.  So, instead of working on behalf of their constituents (that is, doing their jobs), they opted for the asshole category and tried to stifle Obama at every turn.  If he tried to compromise, he’d be viewed as weak; if he talked back, they’d consider him uppity.  He just couldn’t win no matter what he did.  And I know he could see this.  Therefore, he should have responded accordingly.

Politics in any nation is a blood sport, and the United States leads in the sanguinary nature of this.  Obama needed to get ugly with those clowns.  And not just ugly, but fuck ugly; telling them, ‘Look, I’m president and I run this joint.  You either work with me, or I’ll use my executive powers to slaughter your ass.’  That wouldn’t have earned him any fans among the right-wing crowd.  But he might have earned their respect.  I’ve learned that the hard way; sometimes you just have to stand up and scream at people to get their attention and make them bestow upon you the dignity and deference you deserve.  It’ll definitely piss off some people.  But in politics, like in business, you have to draw the line somewhere and tell people to shut the hell up and listen.  It’s just the nature of both realms.  You may not win any friends like that, but you’ll generally get the job done.

 

Overall, though, I’m satisfied with the Obama years.  One person – even the President of the United States – can only do so much.  History will be kinder to him than his contemporaries.  It’s already treating George W. Bush with more compassion than he deserves.  If the Democratic Party intends to remain relevant in the future, they need to be tougher with their opponents.  But they also need to be more forward-looking and emphasize that we can’t go back in time when things seemed simpler and calmer.  Otherwise, they’ll be digging an early grave for themselves, and only their most devout followers will be in attendance.

Demos.

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Morass

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As of 12:00 A.M. today, October 1, the United States government – for all intents and purposes – has stopped functioning.  I know it seems nothing has changed.  I mean, seriously – is there any difference?  But, the painful reality is that some 2 million government employees will not get paid and national parks have closed.  That’s the immediate effect.  It gets worse if the shutdown continues: military veterans won’t receive their benefits; the Centers for Disease Control and Prevention (CDCP) will have to halt its flu vaccination program – just as flu season approaches; some food safety operations will stop (and in a nation where behemoth butts have become the norm, that spells catastrophe); small business financing will stop; Head Start programs will start closing; disability benefits could be interrupted; funding for disease treatment through the National Institutes of Health could cease.

In the meantime, every member of both houses of Congress will receive their paychecks; their own health care won’t be adversely impacted.  Ironic, though, considering that the Affordable Care Act is the genesis of the squabble between the 2 principal political parties.  Most Republicans – especially the “Tea Party” clowns – despise the ACA, which they’ve derisively called “Obamacare.”  And, in an attempt to stop funding for the President’s signature law, the GOP is willing to risk what little integrity they have in their xenophobic bones and shut down the government.

Over the weekend, one particular “Tea Party” darling, Senator Ted Cruz, launched into a staunch tirade against the ACA.  Hoping to make a name for himself, the Canadian-born, Cuban-Italian Cruz has been campaigning for president since he took office back in January.  Representing my beloved home state of Texas, Cruz has done little else with his time and energy except commandeer the Republican Party’s vitriolic bandwagon and try to obstruct President Obama in any way possible.

Altogether congress has about a 10% approval rating.  I think ptomaine poisoning and getting stranded in the desert without water or cell phone service rank just above them.  Last year I wrote about the ongoing lack of progress from the Senate and the House of Representatives.  My wishful demand was for every elected official in Washington to get impeached, so we – the average, hard-working Americans – can elect more level-headed people to fill the apathetic void.  A million dollars in gold bullion has a greater chance of landing on my doorstep tomorrow morning.

I clearly remember the 1995 – 96 government shutdown in which a beleaguered President Bill Clinton ran head first into a recalcitrant Republican Party (led by the self-righteous Newt Gingrich) – and won.  It was a different time though.  The GOP held strong majorities in both houses of Congress; we weren’t at war; and the economy exploded into profitability for everyone shortly thereafter.  Clinton didn’t back down, thus forcing the GOP into embarrassingly humble defeat.

Today, the U.S. economy is still reeling from the worst downturn in 80 years; we have troops in Afghanistan and Iraq; and Republicans control only the House of Representatives.  Regardless, I’ve lost all respect for our elected officials.  Obama still hasn’t found any steel bars to inject into his spine, and the GOP has let itself be dominated by right-wing extremists.  I’m trying to imagine how things could get any worse.  If they do, colonizing Mars looks better all the time.

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Quote of the Day

“Medicaid is a failed program.  To expand this program is not unlike adding 1,000 people to the Titanic.”

– Texas Gov. Rick Perry, on why Texas won’t participate in portions of the Obama administration’s health reforms.

In a side note, Texas has the highest rate of uninsured children and senior citizens in the nation.

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Quote of the Day

“We are outraged to see the Supreme Court ignoring the constitutional limits the Founders put in place to constrain the federal government’s power over us.  Shame on them!  With this decision they have given a blank check to the federal government, forever altering the constitutional concept of checks and balances that has been so crucial throughout our history.  We wholeheartedly believe we must strive to make health care more affordable for all Americans.  But, it is inconceivable to believe we must infringe on our constitutional rights in order to achieve that.”

Penny Nance, Chief Executive Officer and President of Concerned Women for America, in response to the U.S. Supreme Court’s ruling on President Obama’s Affordable Care Act.

Nance and the menopausal heifers that comprise the CWA gang didn’t seem to mind the Bush Administration infringing upon the will of the American people to invade Iraq and provide unfunded tax cuts to the wealthiest citizens.  But, I guess that kind of warped thinking is one effect of Botox addiction.

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