Dear Mr. Biden....

One American’s Tale – From Dreamer to Beggar--

Health UnCare in America

 

Children Have Dreams...
Adults Should Too...

 

“The middle-class is where optimism lives.  The truly poor have given up and the wealthy have no need of it.”

 

 

Mr. Joseph Biden, Vice-President
The White House
1600 Pennsylvania Ave., NW
Washington DC, 20501

 

                                                                                                             June 23, 2013
 
 
Dear Mr. Biden;

  Yes, I voted for your ticket.  And yes, I expected little in return.  Haven’t for many a year.  We elect leaders on ideals and then watch in dismay as the partisan brigands of both parties render the office impotent.  I, like millions, perhaps billions of other Americans hired you folks to do a job.  You have failed terribly at that task – worse yet, we, as a people have proven to be unworthy custodians of the principles sanctified by the founders of this democratic republic.  So if one is to point a finger, establish the crime, let it start with me.  For I too let the Republic down, for I traded my political activism -- born of the 60’s -- for the comfort of my parent’s middle-class lifestyle.  One earned, not bought.  This is a story of doing the right thing in America, only to discover the obsolescence of that grand ideal.

  "On the dole:"  The term originated in the UK about 1919.  Referred to those folks collecting 'unemployment' payments.  Not welfare, general assistance, disability, aid to dependent children, food stamps, heating subsidies...rusty nail soup or coffee boiled in a paper bag.  Unemployment.

 

Strike I

I began working at age 13, some fifty-odd years ago.  Left home at 16 to work in Alaska.  Never looked back -- only forward.  Managed farms, shod horses...can tell you how much a railroad-tie or a bale of alfalfa weighs by just looking at it.  Why?  Because I've picked up 3 or 4000 of them.  Can also tell you how much a horse weighs, one foot at a time, 10 or 15 times on a good day.  For the most part, I was self-taught, self-motivated…believed strongly that my efforts would bear not riches, but fruit  But then, I can also show you my radiographs, the last MRI and recount line for line the skepticism on my doctor's face.  But then...I don't see my doctor anymore.  See, my health insurance...all that was affordable around 1985...had a mystery cap.  At least to me.  The fine print casually revealed once the spinal surgeon has finished his work.  So basically the hospital took what little hope I had left, along with pretty much everything else I had managed to build over 25-years.  Bitter?  I suppose.  But then, I did have a bunch of Percodans to blur those few conscious moments.  And as a caveat, while I was still bed-ridden, the insurance company cancelled my policy.  Two months later my wife was diagnosed with cervical cancer.  I was told by a very nice social worker that the best thing I could do was divorce her.  That way she could file for public assistance and the possibility of treatment.  Didn’t matter really.  Most marriages cannot survive those kind of stresses anyway.  And gee, we had just closed escrow on our own little farm…nice place, that American Dream I heard so much about.  Wonder who lives there now?

 

Strike II

 

Fast forward:  Got off the pity-pot, went back to school, earned a couple degrees, went bankrupt again in the process and finally insane.  My other field, feature writing for newspapers and periodicals – my great fall-back craft, well…publishing managed to tank-out via corporate buy-outs, the internet and the sorry fact that honest journalism could no longer sell newspapers.  Age-discrimination also became fashionable in America, self-esteem expendable.  So I took time out to become a drunk, failed at that...reclaimed my clarity; and since my legs weren’t much good for walking anymore -- went to driving large buses full of angry former middle-class people forced to work and shop at Wal-Mart.  And yeah, along the way I ended up in the bug house a couple of times.  The police kind of frown on people who wait for a southbound train without a ticket, baggage or any clothes on.  Still, life rolled on...sort of, the ever-weary Phoenix -- the hopeless optimist, one of America’s many myopic Don Quixote’s.  See, I actually listened to Kennedy’s speeches, believed in the ethic of hard work, a compassionate heart and the ultimate rewards of doing the right thing.  Yeah, just another naïve slob headed to the packing house.

 
Of course, I never could acquire affordable health insurance after that.  Not because I was insane...hell they insure maniacs if they can pay the premiums. But my employers were often small companies, often family operated, and when you are employed in that $10-20 an hour range of income...well, you can't afford the premiums or the doctors.  So I had no medical care for 20 years...like so many Americans that work hard and cross their fingers that nothing happens -- wildly assuming that some magic bullet will show up down the road.  And it usually does.  It is called death or ruination.

 

Strike III

 

So in 2009, my body starting phoning my brain...you know, like when your laptop sends you an 'error message.'  Already had a spine full of popcorn and assorted ruptured discs, disinterested nerves and faulty wiring.  Previous surgery had compromised my feet.  My right knee had been destroyed a few times leaving the leg crooked.  Left wrist broken three times.  Pain was a regular routine, not something you bothered to question or cure.  Then suddenly, I began losing the nerves in my hands, my feet…it crept up to my knees and elbows.  The company I worked for had just been bought out by a large corporation the previous year.  Being big, they could negotiate for affordable benefits for their employees.  By splitting the costs, we both won a little.  Healthier employees meant less absenteeism, hence more profitable operations.  So I was insured...for just long enough to find out that my body was failing.  See, I could no longer find the brake-peddle...which my 40 or so passengers would probably not appreciate...if they knew.  Trouble was, I did.  So I stopped.  Turned in my medical card on my commercial licenses.  I could not, in any form of good conscience, risk others...even as I watched my personal sense of security (and my stupid male pride), abandon the room.

  Strike IV

 

First, it was treated as job related.  So I was thrown into the arena of 'workmen's compensation' which operates health care like a runaway puppy mill.  They profit only if the problem is work-related, which means they will not explore systemic causes...subsequently, the patient's concerns, opinions, doubts...well, they remain secondary to the need of conducting eight-weeks of physical therapy on a diagnosis that failed the diagnostic model.  So, in the interim, the situation progresses.  Refuse the diagnosis or treatment, you are deemed fit for work.  Can't work...termination for non-performance.  Fortunately, you have one appeal for a second opinion...after 8 weeks of costly and unproductive nonsense billed to the states Workmen's Compensation program.  Eight weeks later...finally a second look.  Bottom line:  unchecked metabolic problem, vascular anomaly that would have killed me within a month and peripheral nerve damage that was both aggressive, progressive and not fixable.  Hmm.  And then the fear sets in...along with the wishful thinking.

 
The job vanishes.  However, they are happy to inform you that you can continue your health insurance for 3 months by paying the entire premium yourself.  Sure.  With what?  State Disability will kick in...eventually, and after a good fight.  But it might amount to half of your previous income.  Rent, utilities remain the same, Safeway isn't offering free dinners...and you need surgery...sooner, not later.  Oh...and an additional matter gets disclosed: vascular necrosis of the left hip, four fractures.  Well, maybe later on that one because if I'm already dead...well, you get it.  So do they.  The mysterious ‘they’ that seem to run this show.

 

Helpful friends tell you to apply for a Cobra extension.  Ah...great.  Oh, I see.  For a fifty-something male, it is higher than my rent.  And since my State Disability is based on a $15 an hour income versus $60-80k?  You can do the math.  Thirty days later, I am officially terminated and my health insurance is cancelled.  Oh yeah...I'm still dwelling on the 30-day death sentence on the other matter...and sure, I'm rational...kinda, sorta.  And I'm paying for these life-saving medications out of pocket.  No, out of savings and the food budget.  And the State Disability folks are gambling on me dropping dead before they need to make a decision.  And even if they do, it is merely a one-year reprieve.  Resources become strained because at $15 an hour the rainy day savings fund is based on your tax refund.  Year-end bonus -- the only one the middle-class sees anymore. 

 

Finally, I find a county health-care program.  Yearly membership fee, lots of co-pays and while standing in the insufferably long lines at the County Hospital, you notice that English is the fifth...maybe sixth language of choice.  Do I resent it?  Yes.  Is my resentment legitimate?  Well, no.  See, my mother was a war bride.  A damn foreigner as we unholy patriots like to say.  Contradicting the minor matter of this nation being founded by immigrants, and all that rosy bullshit printed on the Statue of Liberty.  Except that today, it is about race, not just ethnicity.  And the sorry truth is that now, today, this country cannot afford the generosity of its expansionist past.  And unlike my mother escaping the vulgar intentions of ordinary people in Nazi Germany --  these 'tired and weary' folks cannot outrun their skin color, their language or the fact that they make a convenient target for problems not of their making.  And they too are in for a surprise.  The great dream left this place a long time ago.

 

Oh...almost forgot.  In order to gain access to this county program, I was forced to give up my primary care doctor.  That, after her thoroughness, her dedication to her profession...caring a little more than most...caught the problem that should have killed me.  So I owe her my life and reward that good work by being forced to fire her.  Ah, but it does get worse.

 

Strike V

 

 It takes six months to arrange the surgery.  Try waking up every morning for six long months and being surprised that you are alive.  Meanwhile, the other problems progress.  State Disability (California) runs one year -- at that point it is then up to the Feds.  If you think the state process is tedious, the Federal version will turn suicide into a business plan.  Again, the idea seems to be centered on promoting death over duty.  Now, try to remember that for the past year you have been trying to live on $1200 a month.  You learn things about shopping that would appall your own mother.  And because you are sick, a little old...you need to eat healthy and well.  But 'healthy and well’ is expensive.  That is why most of America's major health issues can be traced to the $1 menu at McDonalds.  The most caloric bang for the buck.  Pun intended.

 
So...you figure with Federal Disability you can focus on maybe trying to get better...you were almost on the street, but outran the bullet this time.  Guess again.  They calculate your Social Security Disability based on the fact you were still on State Disability when they finally determined you were finished working for the moment.  That happened on the last month under State benefits.  So, they send you $737 a month…period.  You protest, you holler....no human can be found.  It is now 4 months later.  The phone is off, the vehicle is unlicensed, the auto insurance lapsed, your 'life-saving' meds have run out.  Heat is next...then the roof.  Your meager savings are long gone and if you still had any bad habits, you couldn't afford them anyway.  Oh...and since the Feds took over the disability, the county threw you off their health care program.  As in, "don't slam the gate on your way...."

 
Right away you assume that maybe MediCare, MedicAid...something might be out there.  Sorry.  The age game.  You get the miserly disability payments, but no access to health care. Today, most physicians/clinics won't even deal with MedicAid.  The system is broken, reimbursements very, very slow and the paperwork abominable.  At 62-years of age...I'm too young for MediCare and even with a declared disability, I would have to wait 18 months to qualify.  If I retire outright, 3 years to wait. And in the middle of this, I moved from California to Oregon to cut my living costs – living here like a king in a trailer that is probably smaller than a Senator’s bathroom.  This necessary in light of the fact that I no longer have access to medical care in the sunnier south – which was my home.  So that leaves the emergency room...which is exactly the kind of health care that is bankrupting most hospitals.  And it is 150 miles away....and well, the car is unlicensed, uninsured and probably shouldn't drive when you are having one of those near-death moments.  911?  Phone’s off. 


Now, just so this doesn't sound overly whiney -- yeah, some of this is my responsibility.  Should have been greedier, more selfish...invested better.  Oh.  Forgot.  The reason we have Social Security is because the last time people invested in their own future, the Wall Street brigands did a little exclusive piracy with their retirement.  Gee, how quickly we forget.  But yes.  We are all responsible for our lives, worse yet, our sense of hope.  But the hard reality is that my life is not too much different than many others.  Ups, downs, happiness, death, bills, bad and good decisions.  And I completely agree that it is not the government's responsibility to take care of me or anybody else.  But it is the government's responsibility to maintain a system sufficiently so that we just might have that ability ourselves.  That is the core value of any democratic system and a social conscience is not only mandatory, but a fundamental right of the governed.  Otherwise, these lofty ideals, the banner held high, the doctrine we claim to champion on this restless planet, ring hollow and cold.  And like so many other Americans today, I am simply tossed in the garbage like a used diaper.

   *********

I wrote Social Security Disability a letter the other day.  I said, “Why don’t you just send me a check for $100,000 and we’ll call it a day.”  My thinking?  Two things really. The first is that I can get a hip transplant in France for $15,000 – all inclusive.  France is ranked #1 in the world for the quality of their healthcare.  The US is #34 behind Morocco and Costa Rica.  And because the attorneys and bean-counters run medicine in this country, no hospital could even provide me with a quote, a guesstimate or even a wild premonition.  My vet can tell me that it will cost me $150 to neuter my cat.  Why can’t our hospitals do that?   After all, it is a service.  But never mind, it is a rhetorical question anyway.  I was just musing over the idea of ever walking again.  Seemed like it might be a good place to start the conversation.

 

"What, soup again?"

Secondly, I’d use the remaining money to begin anew…this time with two legs instead of one.  See, it is going to cost the taxpayers that much money no matter which way you juggle the numbers, and probably substantially more to leave me permanently nailed inside this economic box.  Which is nothing more than forced, institutionalized poverty with no available options….no road back to productivity.  Just more cynicism followed by an unremarkable death.  This is the new Gulag for America’s middle-class.  This is where I live.  This is where millions of other Americans live.  And this, Mr. Biden, is your constituency.

 
Best wishes;

  

Andy Juell

  

 

cc: Kathleen Sebelius,

Director,DHHS