Universal Sickness

There's a lot of talk about healthcare these days. A lot of it is political rhetoric, most of it is pure nonsense. It's hard to look at it and see what needs to be done.

I think we can all agree that healthcare costs are out of control. For one thing, it's nigh impossible to shop for healthcare based on price. What does your doctor charge for a visit? Don't know? You only pay for a co-pay? Yep, me too.

But here's the thing: if you are a private citizen with no health insurance, you get one price. If you are insured, you pay another. Your insurance has negotiated a price and all charges are based on those negotiations.

For example, I recently got a statement from my doctor. It stated that the charges for a recent visit were $56 of which I paid a $20 co-pay. The insurance company picked up the remaining $36 bucks.

I made a phone call to this same doctor and asked what the price of a visit was without insurance. $95. I called another of his offices (he has two) and inquired there. The price there was $105.

So is the cost of the visit $56, $95, or $105? How much did my insurance save me? Or the reverse of this is why should an uninsured person have a more expensive visit?

I got's tings to do....

So I'm pretty busy here at the ranch.

I've become a regular domestic goddess cooking regular meals, cleaning the house and whatnot. I am an entrepreneur with my new crafting business. I'm making new friends in my Mom's Club group. And I'm a full time mommy and wife.

And blissfully happy. Really. I am incredibly happy. Me. Who thought I'd be bored stiff by the time baby girl was a year old. But it turns out that all this busy-ness suits me.

Baby girl has become a walking champ and roams around the house giggling with me behind her. She's got a mouth full of choppers and has cut all but 1 of her 1 year molars. (I think she's cutting that one now.) She still takes 2 naps a day and of course, she's been sleeping through the night since she was 2-1/2 months old.

I'm going to start talking more about the business here soon. The purpose of this blog has always been as an outlet for me and as entertainment and education for you dear reader. Perhaps you all will educate me as well and let me know what you think of things?

That's it for now. I hope to get around here a little more often. I'm working on a schedule - yes, stay at home moms - NAY - WORK AT HOME MOMS need a schedule for work versus playing with their gorgeous daughters.

New Pics of Baby Girl

We went to get pictures done yesterday.

Yes, birthday pictures a month late.

She was only partially cooperative. She wanted to hold her toy with her fingers in her mouth and didn't really want to smile for the camera at all, but we managed to get a couple of photos.

Why Health Care Reform matters so much to me

My parents were divorced December 1999. In the divorce decree, my dad had to pay for my mother's health insurance through COBRA for 18 months.

Fast forward to the winter of 2001, my mother fell at work and hurt her back. She crushed 2 discs and nearly crushed a third. Her employer had good Worker's Compensation insurance and she was given really great care. Because of the damage done, surgery is ruled out but pain management seemed to keep the pain under control.

Fast forward a few more months: COBRA ends. My mom now tries to find health insurance on her own. Due to preexisting conditions (the bad back and rheumatic heart disease - left over from two bouts of rheumatic fever as an adult but which NEVER bothers her nor does she even take medication for) she is denied by company after company.

Fast forward to Spring 2003: Mom gets a cold.

Over the next few months, the cold progresses to bronchitis. Her doctor wants a chest x-ray. She asks how much an x-ray will cost. $2000 she's told. "I don't have $2,000," she says. She takes a breathing treatment and a script for antibiotics and goes home.

A few weeks later, it's worse. She can barely breathe and after I beg her, she allows me to take her back to the doctor. $300 dollars later, they tell her they think she has pneumonia and still want an x-ray. Still she says she can't afford an x-ray.

Another breathing treatment and more antibiotics and back home.

A few days later, right after Thanksgiving, she calls me at 10PM. "I can't breathe." She pants into the phone. "Can you take me to the hospital?"

She can't afford this either but it's too late for that.

When we get her there, her blood saturation is at 84% and an x-ray shows a left lung almost completely solid white on the screen. It's pneumonia they say. But I can hear in their voice that they think it might be more.

She needs to be admitted. Mom fights back just a little, but she's thankful for the oxygen tank making breathing easier so she doesn't fight too much.

Daily breathing treatments and oxygen make her feel better over the next few days while the doctors run their tests. She's worried about paying for all this but she's told that Medicaid may pay for part or all of it. After all, her only income is worker's comp and a little disability check we were finally able to get for her.

I'm Mom's advocate in this. She's given me power of attorney so I can keep things going and sign whatever needs to be signed. I meet with Medicaid. I come up with TONS of paperwork and copies of bills. It will take a few days to process.

Meanwhile, we've finally got a diagnosis. Pneumonia yes. But also 4th stage small cell cancer. Mom rejects the doctors' advice to take chemo. She wants to feel as good as she can for as long as she can. She comes home for a few days, then needs to go back to the hospital. She gets weaker.

I'm still waiting on a decision on her bills. Mom asks me everyday. I tell her truthfully that I don't know and that I'll call. I leave message after message and get no reply.

Finally, I find out that the caseworker on the case is on maternity leave and they are still sorting through her files. Her replacement is unfamiliar with the case or even with Medicaid cases. He generally works in Child Protective Services but will get back to me in a few days.

The next notice I get is that Mom's case has been denied. She's got too much money. I appeal, including a copy of my mother's checking account statement which shows a balance of just over $1000. I also include a copy of the bills that have come in so far amounting to over $50,000.

Mom, meanwhile is getting worse. Her doctor, who is also my doctor, suggests hospice and gets her into the lovely hospice that is part of the hospital.

Mom seems to hold it together mentally until after the move to hospice, then she deteriorates quickly becoming paranoid and delusional. The cancer, the doctors have told me, has spread to every part of her body including her brain. She is increasingly incoherent, but has occasional lapses of coherency. "Have you taken care of the bills? Did the Medicaid come through?" she asks.

I lied.

I lied to my dying mother and told her that yes, everything is fine.

Meanwhile, I'm worried. The hospice wants to know how they will be paid. The doctors are beginning to send nasty letters. Even the ambulance that took her to the hospice from the hospital are getting antsy.

I lie to my mother every time she comes around enough to understand. Even when she and I talk three days before her death, she brings it up. I lie to her again and tell her, "Everything is taken care of. Just rest."

What else could I do?

Two weeks after her death, I get a letter. The temporary caseworker has been reassigned and the new one on the case approves her care and all the bills disappear almost overnight. I have to send a letter with the case number to a few, but for the most part everything is taken care of.

I don't tell this story to prove why government shouldn't be in charge of our health care. The caseworker who denied Mom's coverage didn't know what he was doing and wasn't even in his proper department. So I don't blame Medicaid. My mother still received the best possible care, I think, because everyone knew that Medicaid would pay.

I tell you this story because I feel that if my mother had had health insurance when she first got sick then she might have gone to the doctor sooner. We might still have the same result - afterall, my mother had smoked for nearly 40 years. But she would have had some assurance that everything was taken care of and I wouldn't have had to lie to my dying mother.

You cannot possibly understand how a situation like this tears your soul apart unless you live through it.

During the grieving process, I attended therapy and one of my biggest problems was the guilt I felt for lying to my mother while she was dying. Now, I just get angry. She should have had another option. There should have been another way.

My mom wasn't a deadbeat. She wasn't someone riding the coat tails of society. She was someone who paid her taxes; who voted in every election; who baked brownies for my class when I was school; who was active in her community; she was just LIKE YOUR MOTHER.

Not making a decision

Moo and I decided way back around November or December of last year that we would wait until after baby girl was a year old to make a decision about whether or not to try to have another child.

It really is strange to phrase it that way. It took us two years of trying to get baby girl. I monitored my cycles using a crazy fertility monitor, tracking software and thermometers for over two years in the hopes of getting pregnant. It finally took reading Taking Charge of Your Fertility by Toni Weschler and a couple of rounds of Glucophage to get pregnant.

So having known my history, you would think that we would have to go through the whole thing again if we want another child. I have to admit, Glucophage was not kind to me. I had really bad gastrointestinal side effects with it and almost gave up on it.

Moo and I have talked about this subject over and over again and I think he's gotten tired of it. His attitude is and always has been that if we are supposed to have children then we will. I have always been more the controlling type - I know you are absolutely shocked to know that I am a control freak. So his relaxed attitude about this of all things drives me round the bend.

So it comes to this: we have decided not to decide. This is quite a feat for me. I, who plotted my cycles, took my temperature every morning, endured that dreadful Glucophage all with my eye on increasing the chances of getting pregnant, have decided to relax and see what happens.

So we aren't doing anything to increase our chances but we aren't doing anything detrimental either.

I put a time limit on this too: no matter what, I'm getting "fixed" in two years or when I deliver another child whichever happens first.

It's strange, but making this decision is strangely freeing. I am still using the TCOYF software because I can plot out my cycles. Otherwise I can never remember dates. Sure other people use a calendar but I'm a gadget person and like this better.

But as I said, it's strangly freeing. I am keeping my mind off of it and this will likely be one of the last times I discuss it - at least until I get spontaneously pregnant or get "fixed".