healthcare

How can we best care for all people?
How can we best care for all people without spending money government doesn’t have?

I’d like to write about healthcare today. But truthfully, the Intramuralist is a little leery. I want to talk about the ins and outs, facts and effects, good things and bad. I want to wrestle with what’s good and true and right — and what’s not. I want to navigate through the varied opinions and approaches. I want to analyze and assess what could be effective. But I’m hesitant. I’m hesitant due to the current rhetorical climate and the potential onslaught of masses telling me there’s only one right way to think about this. I’m hesitant due to the vocal number who no longer see value in objective analysis… or… who are convinced they are objective. It’s far quicker to point fingers, denigrate and demean than it is to sift through the wisdom on all sides of this important debate.

Let me be clear… 

I don’t believe our legislators as a whole, on either side, are evil. I don’t believe they are motivated by evil. And I don’t believe the motives of either party are entirely impure nor solely designed to assure re-election, financially reward their supporters, or are a part of some grander, nefarious conspiracy to take over the world and put Lex Luther in charge.

What I do believe is that there exist varied approaches to maintain and improve the mental and physical care of the American people. I also believe there exists sincere disagreement with those approaches. Consistent with the mantra of this blog, it’s ok and often healthy for disagreement to exist.

But currently, it’s incredibly difficult to even wrestle through the disagreement and objections because the rhetoric is getting in our way.

I wish people would quit obstructing us… Stop proclaiming why one side is more honorable. Stop proclaiming why one side has handled this so wisely…

 Besides both parties being less than transparent in the development of their approach, representatives from both have also either lied or said some untrue things (… “If you like your doctor, you can keep your doctor”… “Nobody on Medicaid is going to be taken away…”). Both have said some awful things (… the establishing of the Democrats’ “death panels”… the Republicans paying with “blood money”…). This sensational rhetoric skews objectivity and keeps far too many from impartially sifting through what is wise and what is not. Let’s be clear: no party these days seems to have cornered the market on wisdom.

The Intramuralist believes in the healthcare debate, both of the above-offered objectives should be pursued:

1. How to care best for all people.
And 2. How to care best for all people without spending money government doesn’t have.

I will admit, no less, to again being leery of the numbers of people who will attempt to exclaim that only one of the above motives is compassionate…

To care for all people — such as the teen in my community, tragically struck by lightning four years ago, who now has hundreds of thousands of medical bills annually — that is a compassionate motive.

To care without bankrupting government — preserving and planning for the other thousands of programs that aid and abet American workers, farmers, students, etc. that need financial support — that is a compassionate motive. Different approaches can be compassionate. Different does not equate to “mean” nor “cruel.”

But when partisans utilize such false or inflaming rhetoric, they no longer aid and abet the American people. They do not trust us to sort through what’s wise, discern effective solution, nor make our own conclusions.

Recently someone asked me what I’d most like to see happen in this whole healthcare debate. My response was that I’d like to see persons from all sides gather, have some coffee/a beer/whatever together, roll up their sleeves, and work together in crafting a bipartisan approach. Respect each other. Respect the compassion in another’s different approach. Find a way to care for all people without continuing to overspend. I believe we’d be better served if our leaders worked better together.

But I also desire our leaders and legislators to quit attacking the other party as so less honorable than they are. I’d like for the rest of us, too, to quit being seduced by their rhetorical lure. Yes, I desire more respect for one another… and more objectivity in the analysis.

Respectfully…
AR

using words wisely

The following sad story caught my attention — for its unique, potential legal precedent — and — for its broader application…

A young Massachusetts woman, Michelle Carter, who was 17 at the time of the incident, was found guilty Friday of involuntary manslaughter in the suicidal death of her boyfriend, Conrad Roy III. Both struggled with depression, and Roy had prior suicide attempts. And when Roy was set to attempt it again, he had stepped out of his truck filled with carbon monoxide, but was in touch with Carter, who encouraged him to get back in.

The case, as noted by observing legal experts, hinged primarily on hundreds of text messages between the two. For example:

Carter: “If you want it as bad as you say you do, it’s time to do it today.”

Roy: “Yup. No more waiting.”

Carter: “Okay. I’m serious. Like you can’t even wait ‘till tonight. You have to do it when you get back from your walk.”

In a trial where the 6th Amendment’s right to a jury was waived, the judge held those words against Michelle Carter. Said the judge, “She admits in … texts that she did nothing; she did not call the police or Mr. Roy’s family. And, finally, she did not issue a simple additional instruction: get out of the truck.”

Her words were viewed as a weapon.

As I ponder the tragedy of the families involved above, I can’t help but focus on that perspective: her words were used as a weapon. The court saw it as such. Said Massachusetts ACLU lawyer, Matthew Segal: “This is saying that what she did is killing him, that her words literally killed him, that the murder weapon here was her words.”

Pause here for a moment.

Think not simply of our teens and tweens.

Think of us.

How many times have we seen on social media especially (where it’s easier to boldly rant without looking your audience in the eye) where we use our words as a weapon? Where we rant, rave, insult, judge, assert how evil or idiotic another is, or tell someone to go [expletive-inserted-here] themselves?

 We — not just our teens — are using our words as a weapon.

Friends, using words as a weapon doesn’t make another want to be like us. Beating another up with a vicious, rhetorical two-by-four is not an effective means of winning friends and influencing people. Beating them up only injures further.

Said international speaker and author Yehuda Berg:

“Words are singularly the most powerful force available to humanity. We can choose to use this force constructively with words of encouragement, or destructively using words of despair. Words have energy and power with the ability to help, to heal, to hinder, to hurt, to harm, to humiliate and to humble.”

In other words, whether on Facebook or face-to-face, we have a choice in how to use our words. We can use them to build up or tear down. We can use them to affirm or insult. We can use them to reflect upon self or point fingers at another. The wisdom in our words depends on how we use them.

As Michelle Carter awaits an August sentencing, there is no doubt her situation is a sad story with no easy answers. It’s heartbreaking. Unfortunately, what’s currently playing out on social media and elsewhere — between adults not necessarily suffering from depression — is also, often, equally sad.

May we use our words wisely… always.

Respectfully…
AR

deserving to be shot?

Over the weekend, Democratic pollster and former Bill Clinton consultant, Doug Schoen, wrote an insightful, analytical piece about Democrats and Republicans increasingly “loathing” one another. Can it be fixed? “Can anyone lead us to compromise?” Or do too many no longer associate any kind of compromise with wisdom?

Schoen began by detailing last week’s intentional gunfire directed at Republicans only. What was scary about the shooter is that he was not an “extremist.” Like many of us, he did “make a habit of criticizing [in this case] conservative viewpoints and projecting his own militantly liberal ideas across social media. His spiral downward into violence is a blatant depiction of the extreme rage that now permeates both extremes of the American political spectrum.”

Schoen asserts that even though America’s history has not always been peaceful, “we are approaching uncharted waters in terms of the stark ideological polarization in our country. Wednesday morning’s tragedy was a manifestation of the aggressive hatred that is fueling the schism between the left and the right.” The middle ground is gone.

Schoen then shares the data over the past two decades, sharing how increasingly more engrained partisan loyalty has become… how significantly fewer identify as “moderate”… how many would be deeply unhappy if their son/daughter married someone from the other party. We even think less of the other party. As the NY Times summarized last week, “Americans in 1960 were more likely to allow that members of the other party were intelligent, and they were less likely to describe opposing partisans as selfish.’”

No more. We are so judgmental now. Writes Schoen: “What these people fail to realize is that their own accusation towards the opposing party is, in itself, a threat to the well-being of our nation. The alienation of fellow Americans and their ideology discourages discourse, it discourages understanding, and it discourages unity. Disagreement is perfectly healthy. The two parties, with different philosophies, are bound to present different plans for health care reform, and to have different tax priorities, and to approach paying for infrastructure differently. But the idea that these differences are unbridgeable, that the two sets of ideals are so alien to one another that it is simply impossible to negotiate with our fellow Americans, is absurd. We have a common philosophical foundation. We are not Sunnis and Shiites, or Fascists and Communists.

Or are we? As we saw on Wednesday, incessant, dehumanizing intolerance shown towards opposing ideologies breeds something closer to blind hate. [Shooter James] Hodgkinson made a target of the Republican baseball practice, acting on his expressions of displeasure regarding the current administration’s values. An unspeakable act of violence stemmed from a simple difference of opinion.”

Can we no longer handle differences of opinion? Are those opinion holders stupid? Are they evil? Do they deserve to be shot?

The Intramuralist, for one, has been pleased with the pleas for unity and bipartisanship after the shooting, but let me be clear: I want it to happen for more than one week. I want it to happen consistently. I want change from our leaders — change from us. I want us to listen to one another. As Schoen advocates, “We will not move forward as a country if we cannot find a middle ground. I say this not as a political analyst offering advice, but as an angered citizen, hopeful about everything that this nation could do and be.”

Both parties/partisans take turns resisting and refusing, with adults even resurrecting the old playground mantra that because “they did it first,” it must be ok.

Presidents, leaders, and legislators from both parties have contributed to this political divide. Many have also called to heal it. Again, as said by Schoen: “[Trump’s] response to Wednesday’s shooting, however, was a step in the right direction. Trump made a powerful statement that demonstrated that he has the capability of leading a united coalition against partisan hostility. He said that ‘We may have our differences, but we do well in times like these to remember that everyone who serves in our nation’s capital is here because, above all, we love our country.’

And it wasn’t just the President that suggested a message of unity. Politicians from both sides of the aisle corroborated the importance of reduced polarization. Speaker Paul Ryan urged his colleagues ‘to show the country — show the world — that we are one House. The people’s House — united in our humanity.’ Soon after, Nancy Pelosi, Minority Leader, echoed the words of Ryan, her political opponent, calling his statement ‘beautiful’ and exclaiming that the shooting was ‘an injury in the family.’”

But Schoen’s final point is perhaps his strongest. While last week’s bipartisan pleas were healthy, the current election process for presidents and House representatives specifically magnifies the division; the divisions are growing. Hence, Schoen’s point is that we must stop blaming those who represent us and look first to ourselves…

“If the American people continue to drift further and further apart, it will be impossible for our elected officials to genuinely represent the extremism of those constituent opinions while also compromising to the extent necessary to enact bipartisan policy.

When a democratic government loses touch with its constituents to the extent that the United States government has, a sense of public betrayal is inevitable. Party leaders need to take more responsibility to represent their electorate in a way that moves the country forward…

Without popular support and some degree of trust, government faces a tragic crisis of legitimacy. As we saw on Wednesday, this can manifest itself in inexcusable ways. It is absolutely imperative that our country disrupt our current trajectory towards further polarization, division, and hate. We must come together as the United States; our country depends on it, our well-being depends on it, and our children’s future depends on it.”

We can no longer excuse the inexcusable. The rhetoric. The disrespect. The judgment. It starts with us.

Respectfully…
AR

what are we doing?

On Wednesday, as most know, a man who belonged to multiple anti-Republican groups, including one called “Terminate the Republican Party,” opened fire on Republican lawmakers, who were practicing for a charity softball game.

Let’s start here. Let’s start by omitting the words “Republican” and “Democrat,” for if any believe that only the Republicans or only the Democrats are contributing to the reckless rhetorical climate, than they — we — are more part of the problem than we think. What are we doing?

The Intramuralist believes we need to be clear in how we speak of this. It is not the rhetoric or a Facebook group or another association that is responsible for the violent acts; the people who choose the violent acts are the people responsible for the violent acts. However, we are contributing to a climate which makes the violent acts more likely; we are feeding a culture that encourages the equating of ideological difference holders to enemies; sometimes our elected leaders have even referred to political others as the “enemy.” That is the basis for today’s question. By definition, an “enemy” is seen as bad. Wrong. And sometimes even necessary to shoot and kill. We are contributing to an unhealthy, morally-digressing climate that encourages some to shoot and kill.

One of the things I appreciate after the resulting shock and pause of horrific events, is the positive use of “we”… “We are all Americans” after 9/11… “We are Orlando” after the Pulse night club shootings…. And “we are all sons and daughters of God” — a frequent, articulated truth that is perhaps the only “we,” we actually always are. In the wake of tragedy, no less, we turn the “me” into a “we” — focusing most on what we have in common. There is no assertion that the “other” is the “enemy.”

But with all due respect, save for in the wake of those horrific events, my sense is we currently, collectively stink at that. We stink at including others in our “we.” We tend to focus most on what we don’t have in common, as opposed to what we do. We pit our values, belief systems, identities, etc. against someone or something else. We pick teams, separate groups, and create intentional division. We utilize terms such as “resistance,” “war” and “destroy” — terms each partisan group takes turns embracing… sometimes shouting.

As former Sen. Evan Bayh (D-IN) said this week, “Angry, divisive words are setting the stage for the unhinged to act out.” The reality is that our leaders and “we” are the ones using those angry, divisive words.

How many call now — or called before — for either Donald Trump or Barack Obama to be destroyed?

And how many justify it? … maybe, most likely, only for one?

Again, this week’s shooter is responsible for this week’s shooting. But we have created a climate in which a person lacking in wisdom or discernment feels like “destroy” actually means “to destroy.” The softball field shooter went to do exactly that.

While there is nothing wrong with respectful, passionate opposition, we have been seduced as a society into believing that it’s ok for policy attacks to become personal. We have been fooled into believing that another’s policy differences equate that person with idiocy or evil.

And then we fight.
The man at the softball field went to fight.

Will we come together to recognize that we really are all Americans?

Will we stop this reckless rhetoric that encourages hate towards someone?

Will our leaders courageously lead, stopping the call to resist and destroy, even though the firm stance tends to rile up the people (and secure more future votes)? 

Will we stop attacking the person — especially, referring to them as the “enemy”?

And — perhaps the bottom line question for today — will we embrace wisdom first and foremost — or will we continue to be seduced into something lesser?

Back to Sen. Bayh… “Let’s hear more reconciliation in our political debate. Let’s rethink our propensity to make every disagreement apocalyptic. Let’s resist the temptation to infer the worst motives to our adversaries. In the end, the American values that unite us are much stronger than those tearing us apart. Let’s remember that.”

Yes… let’s remember.

What are we doing, friends?

Respectfully…
AR

serious

He was described by one LA Times pop music critic as follows: Chris Cornell “was one of the great rock ’n’ roll singers — an octave-jumping belter who rose to fame as part of the 1990s’ scruffy grunge scene but whose powerful instrument put him in league with the grandstanding rock icons of an earlier era, including the Who’s Roger Daltrey and Robert Plant of Led Zeppelin… Almost as impressive as Cornell’s voice was his musical curiosity, an open-minded spirit that set him apart…”

Cornell, talented as he was, reportedly took his own life last Wednesday at the age of 52.

Closer to home, multiple teens in my town, also reportedly took their own lives last week… one on the last day of his last year in high school… another at the end of only year one.

My heart grieves when one intentionally ends a life… another’s or their own.

Let me clearly state that the Intramuralist is no expert. I am thankful to have peers and professionals who actually are experts in dealing with suicide prevention and mental illness, some who have advised me regarding the contents of this post. This post is not enough; it won’t come anywhere close to doing the topic of suicide prevention justice. But one of those peers boldly encourages us to “speak 2 save” (see www.speak2save.org for more info), empowering people to speak up in order to prevent suicide. With a sobered heart, for at least now, this is a humble attempt to speak up…

First, this is serious. On average, there are 121 suicides each day in this country. For every death, 25 more attempt it. Suicide is now the tenth leading cause of death in the U.S. With something this prominent and this serious, we need to be talking about it. We need to share the God-honest, sobering truth. And we need to especially be talking to the young people around us.

Second, there is no place here for shame. For those who struggle with mental illness — or for friends and families who have numbingly walked through this gut-wrenching heartache, they do not need nor merit any shame. What they need are our fervent prayers, our generous grace, and a willingness to walk alongside them, whatever that may look like.

And third, so many say they “had no idea” intentionally ending one’s life was even an option for their loved one. According to the American Foundation for Suicide Prevention, we need to watch another’s talk, behavior, and mood…

If they talk about…

  • Being a burden to others
  • Feeling trapped
  • Experiencing unbearable pain
  • Having no reason to live
  • Killing themselves

If they behave like…

  • Increased use of alcohol or drugs
  • Looking for a way to kill themselves, such as searching online for materials or means
  • Acting recklessly
  • Withdrawing from activities
  • Isolating from family and friends
  • Sleeping too much or too little
  • Visiting or calling people to say goodbye
  • Giving away prized possessions
  • Aggression

And if they display moods such as…

  • Depression
  • Loss of interest
  • Rage
  • Irritability
  • Humiliation
  • Anxiety

We need to be aware of various, significant suicidal risk factors — health, environmental, and historical factors. These include mental health conditions, stressful life events, and exposure to the suicide attempt(s) of another.

This is hard. Time to speak up.

Respectfully…
AR

contempt

Many have valid, current concerns, but the Intramuralist’s primary concern is not with any singular person.

Let me say more; there are significant reasons to be concerned in today’s socio-political climate, but my chief concern rests with no one person or one party. It rests with something bigger. It rests with us.

Said by American Enterprise Institute President Arthur Brooks at Harvard Kennedy School this week, sharing a a lesson from the Dalai Lama in overcoming political polarization…

“We don’t have an anger problem in American politics. We have a contempt problem in American politics.

Contempt is defined by social psychologists as ‘the utter conviction of the worthlessness of another human being.’

If you listen to people talk to each other in political life today, they talk to each other with pure contempt. When somebody around you treats you with contempt, you never quite forget it.

So if we want to solve the problem of polarization today, we have to solve the contempt problem.

I sometimes write with the Dalai Lama. I was thinking about this contempt problem, and I said, ‘Your Holiness, what do I do when I feel contempt?’

And he said, ‘Practice warm heartedness.’

And I started thinking about it, and it’s true. When I do that, when we do that, when we have leaders who can do that, it’s utterly world-changing.

Catch yourself. You can show true strength, if next time you hear contempt, you answer with warm heartedness. Every single one of us is going to have an opportunity on social media, or in-person to answer somebody’s contempt. Are you going to do the right thing? And make the world a little bit better, and show your strength, and make your enemies your friends?

Or are you going to make the problem worse?

That’s a question each of us gets to answer, probably in the next 24 hours.”

That is sobering…

… incredibly sobering. Are we going to make this problem worse?

Truth is, right now way too many are justifying contempt. Way too many are justifying — consciously or not — to conclude that another is utterly worthless. And way too many are insulated by listening only to the likeminded. The truth also is, that most of the rest of us are weary of hearing the contempt holders scream. In fact, it’s often very hard to actually hear them.

It is totally reasonable to be concerned, but when in our concern, we justify concluding that another human being is worthless, I soberly state we are missing what is wisest.

Heed the wisdom of Arthur Brooks and the Dalai Lama.

Want to solve the polarization problem? Want to quit feeding the foolishness? Then start with self. Start with no one else. Catch yourself. Attempt to catch no one else. Quit pointing fingers. Practice warm heartedness instead of contempt.

Such is a true, contagious showing of strength.

Respectfully…
AR

we’ve got something — how ’bout you?

There was a great cheer when I was in high school (and no, we will not discuss today how actual long ago that was). But I remember being somewhat enthralled with the “we’ve got spirit — yes, we do” line, to which the perceived opposing side took their turn chanting the same…

“We’ve got spirit — yes, we do! We’ve got spirit; how ‘bout you?!”

The chants would continue for a seemingly prolonged amount of time — loudly, in unison, joined by a plethora of finger pointing at the other team. As the pointing and shouting lost a bit of their vocal luster, one side would alter their intonation by instead shouting simply, “We’ve got more! We’ve got more!”

To which the adolescents — not wanting the other to have the last word — would immediately retort, “That’s what they all say! That’s what they all say!”

Many days I wonder how much we’ve actually grown; let me say it another way… Many days I wonder how many patterns repeat themselves and how adolescent/teen behavior is contemporarily made manifest, although the adults involved now use bigger words, a few more syllables, have a little more money, and dress maybe more maturely.

True, we don’t seem to hear chants of one societal group having far more spirit than another, but we do hear less rhythmic refrains, such as…

“We’ve got compassion, yes, we do! We’ve got compassion; how ‘bout you?”

And we then certainly hear the…

“We’ve got more! We’ve got more!”

And…

“That’s what they all say!”

Maybe it’s verbalized; maybe it’s not. Yet one could easily argue the compassion self-assessment is generously implied… and the rest of the onlookers, watching at the so-called game, get lured into believing that only one side is motivated by compassion.

Think about the current refugee resettlement situation, for example…

I so admire those who desire to love the refugee well, exemplifying the message of “The New Colossus,” the words engraved inside the pedestal’s lower level on the Statue of Liberty. “… Give me your tired, your poor, your huddled masses yearning to breathe free…” I see such compassion, in wanting to care for the person who has less than we, wanting to share what we have and give them what they need.

I also so admire those who desire to care for our citizens well, exemplifying the message of the Constitution, the words articulated in the introductory Preamble… wanting to “… insure domestic tranquility, provide for the common defence, promote the general welfare” of the American people. I see such compassion, in wanting to care for the people with whom we live, wanting to be more scrutinizing of those who come from terrorist-harboring countries.

Here’s the unpopular reality. Both of those above two motives are full of compassion. They simply prioritize which group of people to show the most perceived compassion to.

Hence, it’s inaccurate to chant “we’ve got compassion — yes, we do” while assuming another side has none. Yet sometimes we’re so busy shouting and pointing fingers, that we make such careless assumptions.

There is simply no logical place for the “we’ve got more” chants…

… even if that’s what they all say.

Respectfully…
AR

the pendulum

Oh, how the pendulum swings…

First to one side
Then to the other
Extreme on both ends

One goes higher
The next goes faster
Boasts of higher and faster swell

Oh, how the pendulum swings…

Constantly in motion
Never staying long in the opposite ends
Seemingly most stable in the middle

Yes, oh, how the pendulum swings.

I had a great conversation with a new friend the other day; I loved it… instantly authentic, lots of truth, active listening, deep topics, no offense, with the highly valued bonus of great wit and exceptionally well-timed sarcasm… yes, my kind of conversation.

We discussed the challenge of current political climate — a climate full of falsehoods and “fake-ness,” minimal truth, limited listening, all sorts of mountain-out-of-molehill topics, and ample offense… with unfortunately, no added wit nor sarcasm.

And we talked about the political pendulum.

Some find relief in the recent pattern of 4/8 years of one ideology more promoted and accepted, then 4/8 years of an opposite ideology, with the political pendulum swinging back and forth from the extremes. The idea is that if a person can persevere through the presidency and prominence of one for a limited number of years, the pendulum will soon be back to a place more desired to that individual… granted, again, for only a limited number of years. The pendulum never lasts at the extreme.

On one hand, that gives people peace, as no one person or party can be — will be — in control for all time. On another hand, the idea is great cause for concern, as each time the pendulum seems to swing “higher and faster,” so-to-speak. Each polar opposite end vows to pick up the steam. And because they focus seemingly most on the sins of another as opposed to the sins of self (both which exist), they justify all sorts of less than honorable behavior. The extremes justify:

… falsehood and fake-ness…
… minimal truth…
… limited listening…

They also justify:

… disrespect…
… obstruction…
… and devaluing of relationship.

Add arrogance, too — even subtly or unknowingly — as it’s way too easy to feel we are so wise and omniscient, forgetting the need and benefit to submit both our thinking and emotion to divine wisdom. No, none of us have this all figured out.

The problem with the pendulum is that as the weight swings to the polar opposite side, unethical behaviors are justified. And the behaviors seems to keep getting worse, as we hear popular refrains, such as, “Well, they did this, so we must do this.” The focus seems always on the sins of the other.

Oh, how the pendulum swings…

And yes, that’s concerning.

Respectfully…
AR

a tale of two testimonies

In regard to healthcare, I found the following two, recent testimonies fascinating. This is a little lengthier post than usual; however, the contrast is striking and insightful… two people, reacting to the exact same thing. First, from Lisa Morse…

“In 2010, at the age of 30, I ran my first half-marathon. A year later I ran my first full marathon (4:25:10 — you never honestly forget your first marathon time). I was in the best shape of my life. Although I gave myself a few months off from long-distance running, I started planning for my next half-marathon. Unfortunately, I began having intense joint pain in my hands, wrists, hips, knees, ankles, and feet. I was only 31 years old but felt like I was 80 — simply getting out of bed in the morning was a physically painful endeavor. Turning the pages of a book could cause ridiculously excruciating pain. It felt like my joints were being stabbed repeatedly with a knife that was on fire. Imagine going from running a marathon to just a few months later struggling to open a car door.

Numerous Google searches told me I most likely had psoriatic arthritis. I made an appointment with my doctor and the testing began. Because psoriatic arthritis isn’t something you can directly test for, I had to be tested for everything else that it might be. Blood tests ruled out rheumatoid arthritis, lyme disease, and parvovirus. I was then referred to a rheumatologist and officially diagnosed with psoriatic arthritis. Psoriatic arthritis is an inflammatory arthritis in which an overactive immune system attacks the connective tissue in the joints. If it is not treated, it can lead to irreversible joint damage. 15-30 percent of long-time psoriasis sufferers (I have had it since the age of 14) develop psoriatic arthritis, and I am one of the lucky ones. My rheumatologist prescribed hydroxychloroquine, a form of quinine, which suppresses the immune system. It provided some relief and life became a little bit easier — I even started running again — but my immune system still wasn’t working properly and I needed frequent doses of Aleve.
In 2014, my insurance plan changed and the rheumatologist I had been seeing for the past two years was no longer an in-network provider, so I had to change doctors. Although I grumbled about it at the time, it was probably one of the best things to happen to me medically since the pain began. My new doctor was astounded by the swelling in my ankles and in addition to telling me that I should absolutely not go on any more 10-mile runs (unless I wanted to start talking about ankle replacement surgery), he wanted to pursue a much more aggressive treatment plan. He prescribed Humira for me and the life-changing effects were almost immediate. My psoriasis cleared up entirely, the joint pain eased considerably, my energy levels increased, and I started to feel pretty good again. Humira is another immuno-suppressant. Although it sounds counter-intuitive, with a suppressed immune system I am sick much less often and much less severely than I was prior to Humira. In the two or three times a year I get sick now, I can usually work through it: pre-Humira I was sick once a month (or more) during the flu season and would miss at least three days of work at a time. Humira allows me to be a more productive, tax-paying member of society.

My two medications retail for $4,900/month and $175/month, which annually amounts to the cost of approximately 87 iPhones.

My experience with psoriatic arthritis and Humira have taken place entirely within the timeframe that Obamacare has been in effect. I do not have a job that provides health insurance. For the past 14 years, I have worked for a sole-practitioner attorney. I am his only full-time assistant. I serve as receptionist, office manager, paralegal, and more. My boss has always treated me well and is, quite honestly, much like family. I have helped to build his law practice into the success that it is today. My husband is a self-employed public policy consultant. We purchase our insurance on the marketplace and rely on the Obamacare subsidy to make ends meet. For our family of three, our silver plan premium (without the subsidy) is about $840/month. Our premium will increase substantially next year, especially if the ACA is repealed, and we will be paying more money for less coverage. If we lose our subsidy and our rate increases the 20-30 percent that is projected, our premium will be unaffordable for us. Without insurance, my two medications retail for $4,900/month (Humira) and $175/month (hydroxychloroquine—generic), which annually amounts to the cost of approximately 87 iPhones. On a side note, Humira was $3,200/month when I was initially prescribed it two and a half years ago—the drug has been on the market for 16 years, so the research and development has been done and over with for a long time. This mark-up should shock the conscience of anyone with a soul.

Thanks to Obamacare, my insurance cannot drop me or charge me more due to my condition. I have worked, paid taxes, and been insured my entire adult life. I am college-educated. Aside from the Obamacare subsidy I receive, I have never relied on public assistance. Psoriatic arthritis is not the result of unhealthy choices or stupid life decisions. I realize I am expensive to treat medically, but I am also a valuable member of society, as are many other similarly-situated people. No one is an island, and despite Ayn Rand’s writings to the contrary, civilized society requires a bit of compassion.”

And second, from Mary Katherine Ham…

“You may know me as a political pundit and writer who has spoken publicly about how the Affordable Care Act negatively affected my family. What you might not know is two years ago, I was a seven-month-pregnant widow with one toddler who got a letter two weeks after my husband died, informing me I’d lost my third or fourth health insurance plan since the Affordable Care Act passed. If you’ll remember, the promise was that I could keep my plan if I liked it. I could not.
I predicted what would happen to my family’s insurance, and to much less fortunate people subjected to the exchanges with us, many of whom have seen doubled premiums and tripled deductibles. If you’ll remember, the promise was everyone’s premiums would go down. They did not. For predicting it, I was routinely called a lying hack in public. It’s a hazard of the job, but I wasn’t lying. I was right. I also thought it was improbable the federal and state governments could handle building these exchanges and that they’d likely blow up and be inoperable, thereby preventing people like me from actually purchasing the new plans the ACA required we purchase. Again, I was not lying for partisan gain.

ACA has helped people. I know some of them well! I have two friends with serious health challenges, one of whom I can say was probably kept alive by Obamacare; the other by the fact she was able to keep her grandfathered pre-ACA plan. I am not in the habit of asserting any piece of health legislation is either perfect or a tool of evil designed by hateful actors. They’re not. I will not assert either of these fundamentally shallow and manipulative things about either ACA or adjustments to it (and, yes, this piece of House legislation is an adjustment or a reform, not a repeal, which would change dramatically in the Senate if taken up and change again before eventual passage).

It has come to my attention that, even among those who should know, or assert they know a lot about health care policy and the market, many don’t know that people like me exist. But there are many of us, many with far fewer resources than I, who now have much more expensive, less effective, junkier, nearly unusable plans than we had back when our allegedly “junk” plans were outlawed. Again, we are not the only ACA story. But we are part of the story, we were sold a bill of goods, and we’re often overlooked.
There aren’t a lot of good answers, here. There are many reasons for that, which start in the mid-20th century with a fundamental distortion of health-care markets through wage-and-price controls, and then a tax benefit that incentivized employer-based health insurance. ACA was not a good answer. AHCA likely isn’t a super one either.
In any system, and any change to a system, there will be people who come out on both the good and bad sides of the deal. When Obamacare supporters denied this truth applied to ACA, it was wrong. There’s the possibility of marginal improvement to it, but not if you do nothing, as insurers and customers alike pull out of exchanges because they can’t afford to stay in them. Yet another major provider announced this week it will drop out of the Virginia exchange. Republicans were elected several elections over to address just this problem.

Most people who aren’t in the individual market, which is the one most affected by ACA, have no idea what the plans look like. It is a market where the costs of the bill’s mandates are more visible, even when subsidized. When I cite exorbitant deductibles, folks tell me to suck it up and pay $3,000. I laugh at a $3,000 deductible. What in the old system was considered a very high deductible is now among the lower available, and premiums for any kind of deductible are high, even with subsidies. Many families have to hit $12,700, and they’re paying a mortgage-sized premium. For many, the purchase becomes hard to justify or supplants an actual mortgage or similar outlays.
Arguing about this as if beneficiaries of ACA don’t exist isn’t right. Arguing about it as if people like me don’t is also not right. ACA was never the panacea it was sold as and it remains distinctly un-utopian in its results. Lazy characterizations of things you like as perfect—and of people you oppose as big fans of people dying—are not particularly helpful to actual people.
So if you’re weaving a utopian or dystopian scenario for Facebook, remember reality is almost always less extreme and more nuanced than you’re asserting, and you probably know a real human on both sides of every imperfect adjustment to our Frankenstein system.
One of them was a pregnant widow who had to spend her 32nd week of pregnancy and the first week after her husband’s funeral calling midwives, doctors, insurance companies, and help lines to make sure she’d still have the third plan she was promised she could keep.

My family may be the trade-off that was worth it for you to implement ACA. And I’m actually fine with you thinking that, as long as you don’t pretend we and the rest of the people like us don’t exist. We’re probably never going to stop arguing about this, but arguing responsibly and empathetically is better.”

Striking, isn’t it? … how for some, the Affordable Care Act has been helpful, and for others, the exact same law has been hurtful.

I’m thinking most of us need to broaden our perspective… maybe… just maybe.

Respectfully…
AR

before healthcare

I really want to talk about healthcare. I see it as an important issue, worthy of respectful discussion, but finger pointing currently seems more prominent than fixing. Partisanship has surpassed any semblance of panacea. So before we can wrestle with what seemingly prompts the unhinged, sky-is-falling emotion from far too many, we need to wrestle with partisanship first. Why? Because partisanship is impeding solution.

So many emotions — coinciding within the far left, far right, Obama lovers, Trump lovers, Obama haters, and Trump haters camps — are killing conversation. This polarization then impairs our ability to solve what needs it… i.e. healthcare.

I’m reminded of “Common Ground,” a great read directed at stopping the “partisan war that is destroying America,” co-authored by liberal columnist Bob Beckel and conservative columnist Cal Thomas. They call out the hypocrisy within issues, organizations, and individuals that have deepened the partisan divide, so-to-speak, and they encourage the rest of us not to be seduced into such thinking. Yes, the intelligent are being seduced. Partisans are successfully playing to our emotions. They are luring us in.

Think about it…

This past week the House repealed Obamacare; barring any perceived more significant current events, I’d like to talk about this more later in the week. But note as some have pointed out, some/many who voted to repeal/replace, did not actually read the legislation (…hear an Intramuralist “geeeeesh” here…). That should concern us all.

Here’s an additional fact: some/many who passed the original Affordable Care Act also didn’t read the legislation (… the geeeeesh continues…). Friends, our congressmen/women, who represent us, need to read what they are voting upon — whether that is “yea” or “nay.” But here’s what happens: partisanship and polarized thinking has seduced us into believing that not reading the legislation was ok one of those times. In other words, the end justifies the means, so if a person likes the result, it’s ok that this time, the legislator didn’t read what he was voting on. That acceptance of less than honorable behavior is a direct result of partisanship and the coinciding emotions.

Where did this severe level of partisan seduction begin?

Some attribute the less than honorable behavior to Sen. Mitch McConnell’s stated strategy to oppose anything and everything then Pres. Obama put forth. Others attribute it to Obama’s forceful push through of Obamacare, ignoring conservative input and changing Senate rules to eventually ratify. Still more attribute it to the Republicans fervor in insuring Pres. Clinton paid for his personal indiscretions. And still more blame it on the Democrats response to the not so articulate Pres. George W. Bush and those perceived weapons of mass destruction.

Beckel and Thomas actually go back further than the past four administrations; they also blame no singular party nor individual. They go back to the late 1970’s, when laws regarding lobbyists were eased. Lobbyists were given more access to current congressmen — more opportunity to interact with those actually crafting current law. Remember that the goal of a lobbyist is to get their law passed; they don’t care about the totality of laws; they care about their law.

Hence, when the lobbyist laws were eased, legislators began socializing with lobbyists. Previously they had socialized with one another — regardless of party. All of a sudden, however, instead of our representatives working together during the day and enjoying time and life together in the evening, they started separating in the evening. Restaurants and bars became known as hangouts of the left or the right — as opposed to places where they would hang out together. Hanging out together helps people realize how reasonable another is, despite deep political and policy differences.

Fascinating… when we stop hanging out with those who think differently, even in all of our intelligence, we lose sight of another’s reason. That is hurting us. Said James Q. Wilson, over 10 years ago in “Commentary” Magazine, who believes in spite of most of us being centrists, we are becoming a polarized nation, “By polarization I do not have in mind partisan disagreements alone. These have always been with us… By polarization I mean something else: an intense commitment to a candidate, a culture, or an ideology that sets people in one group definitively apart from people in another, rival group. Such a condition is revealed when a candidate for public office is regarded by a competitor and his supporters not simply as wrong but as corrupt or wicked; when one way of thinking about the world is assumed to be morally superior to any other way; when one set of political beliefs is considered to be entirely correct and a rival set wholly wrong.”

This one way of thinking, one set of beliefs, one set of what’s right… it’s killing conversation and impeding solution.

Respectfully…
AR