March 5, 2007 - Gang Member

Several months ago, I wrote of what it felt like to be turned down for supplemental life insurance, due to my recent medical history. An article in today's New York Times reminds me of an even more dire consequence I could have experienced, but – thankfully – haven't: losing my medical insurance.

The story is about a North Carolina woman named Vicki H. Readling, who's exactly my age: 50. She's a real-estate agent, whose income is about $60,000 a year. Even though she works for a large brokerage firm (Century 21), she's considered an independent contractor, and is therefore not eligible for any group medical insurance.

In 2005, Vicki had surgery for breast cancer. Early in 2006, her medical insurance – a continuation of a policy from her prior job at a furniture company, for which she'd been paying the premiums – ran out. She tried to buy a new, stand-alone policy, but found out that – due to her cancer history – it would cost her $27,000 a year with a $5,000 annual deductible.


So, she's doing without insurance. She's supposed to take pills to protect against recurrence of her cancer. These cost $300 a month. She spaces them out, taking a pill every other day, instead of daily, as prescribed. She also forces herself to get by with fewer visits to the doctor.

More than that, Vicki – who was engaged to be married in June – has decided to postpone marriage, because her fiancé could potentially be liable for her medical costs. He owns a house; she does not. If she were to face catastrophic medical bills, his house could be seized to pay off the debt.

Vicki describes how she feels, every time she stands in front of a medical receptionist's window, unable to produce an insurance card:

"When you go to any medical person and they ask for your insurance card, you are so ashamed because you have to say, ‘I don't have insurance.' You just feel like you are dirt.... What did I do wrong? Why am I being punished? I just don't understand how I could have fallen through this horrible, horrible crack."

So, that's how we treat the sick in this country: like dirt. Our broken health-care funding system forces sick people to extreme measures, like diluting the strength of their prescriptions, postponing doctor's appointments and forgoing marriage. It's beyond unfair. It's immoral.

There, but for the grace of God – and the Presbyterian Pension and Benefits Plan – go I. Tomorrow, I go for a PET/CT fusion scan, with an accompanying set of CT scans. I've been having tests like these every three months. The cost of tomorrow's scans will wipe out my 2007 medical deductible in one fell swoop: I'll pay out hundreds of dollars, all at once. But, I'm one of the lucky ones. It could be many thousands (the actual cost of the tests) - unless I were to do as Vicki has been doing, and decide I simply couldn't afford them.

I'm fortunate because, unlike Vicki, I belong to a gang. It's called Highmark Blue Cross/Blue Shield. From time to time, my gang sends some of their muscle over to my doctor, the local hospital and the outpatient radiology place, and "suggests" how much they ought to charge people like me. Fearing the loss of a big chunk of their business, the medical providers knuckle under. Then, they turn around and raise the rates for individual patients like Vicki, who have nobody to do the "negotiating" for them.

It's a corrupt system. That's the only way to describe it. We're so afraid of universal health care in this country, that we've turned the health-care marketplace over to gangs.

It's not the medical providers' fault. It's the whole system.

It's time for a change. Let's all write our Senators and Representatives. And, the next time we vote, let's remember people like Vicki Readling.

March 2, 2007 - The Write Way To Heal

Today, I run across a news article about a Harvard medical researcher named Susan Bauer-Wu, who’s been working with cancer patients. She’s discovered the exercise of journaling to be therapeutic for the people she’s working with. She calls it “expressive writing” or “journal therapy.”

It’s simple, and about as low-tech as you can get: the only equipment needed is a pen and a notebook. From the article:

“The research suggests that by spending 30 minutes each day for four days to write out their innermost thoughts and feelings, patients can significantly boost mental and physical health.

And experts say nearly everyone who tries journal therapy stands to benefit.

‘Many people are so surprised at how it really works,’ said Bauer-Wu, director of the Cantor Center for Nursing and Patient Care Research at the Dana Farber Cancer Institute in Boston. ‘Even people who were reluctant to do it, who say, “I’m not a good writer, I can't write well, or I don't like to.” They'll go through the process and have that “A-ha” moment. They'll tell us – “Wow, I never realized this about myself, or about this disease – it just came out onto the paper.”’

Expressive writing therapy is just that: Patients are encouraged to express whatever is on their mind, letting their hopes and fears flow out in a natural, unrestrained way. It’s akin to keeping a journal, but more focused on the things that might be bothering you or triggering stress.”

I wonder if maybe that’s what I’ve been doing, in keeping this online journal. My approach is a bit more high-tech than pen and paper, but it’s not all that different. Bauer-Wu is right: I have found it therapeutic to keep a written record of the things I’ve been going through. I doubt if I would ever have begun it, though, were I writing simply for myself. The thought that others (family, friends, and various and sundry web-surfers) might find my ruminations helpful has kept me going, lo these many months.

Some experts are claiming, the article goes on to say, that journal-writing reduces stress and boosts the immune system. Well, I’ve got a cancer of the immune system. It’s not hard to understand why that would be helpful.

Interesting stuff. Now, if I could only get my medical insurance to reimburse me for the cost of my internet access....