Universal Health Care, It's for the Birds, the Really Old Ones

Mr. Smith is a friendly man in his seventies with soft, dignified manners. He is a retired machinist and was a preacher in the southern baptist church for a time. He removes his hat and glances down at his feet as he walks into the office, placing the hat gently in his lap as he sits down. He is here to have a deed prepared. His request, spoken hesitantly, is to convey a small percentage interest in a rental property he owns to his daughter. This seems an odd request to me, especially when he specifically says only a 1 percent interest. After several probing questions, Mr. Smith is still having a hard time verbalizing what he is trying to accomplish through this peculiar transaction. As I ask about his wife, his situation became crystal clear, and heartbreakingly sad. Mr. Smith's wife has dimentia and, a stroke last year has made it difficult for her to walk. He has been caring for her full time at home for the last two years. But her condition has deteriorated and he is no longer strong enough to help lift her out of her recliner. After months of grappling with the decision, Mr. Smith has finally decided that the only way his wife can get adequate care is for her to go to a local nursing home.

After Mrs. Smith's move into the facility it quickly becames clear that Mr. Smith's decision to move his wife is not only going to break his heart, it's going to break him financially as well. The cost of her care (which will not be paid by Medicare or health insurance), is $6,500 per month.

Now, the Smiths aren't paupers. Mr. Smith has a respectable pension of $1,200 per month. Mrs. Smith is a retired school teacher with a much smaller, but still helpful, pension of $600 per month. And their combined Social Security payment is $1,200. A few years ago they used most of their savings to buy the run-down house next door, fixed it up a little and began to rent it out for the rock bottom price of $700 per month, utilities included. Their combined total monthly income is $3,700 a month, just under $45,000 per year. Fortunatley, they still have about $50,000 from their life savings. Mr. and Mrs. Smith are the prototype for a middle-income, retired couple.

But one year of care for her will cost $78,000, even before paying the monthly $400 co-pays for her various prescriptions, let alone his. All of their savings will be gone in a year. And if Mr. Smith is able to sell the rental property in the present market, he will lose the monthly income from the rent and the entire purchase price will be gone in less than 2 years. At the very best, Mr. Smith can hope to provide adequate health care for his wife for less than 3 years before being forced to sell his home. They have decided to apply for Long Term Care Medicaid to try to avoid losing everything they have.

I can feel myself fighting back tears at the corners of my eyes when I ask Mr. Smith if he needs this deed drawn so that he can apply for Medicaid for his wife's care, and he hesitantly says yes, looking at the ground. When he looks up and meets my eyes he is looking for my reaction, he expects to see my disapproval.

And I am heartbroken. I am ashamed of my country for making this good, honorable man feel embarrased. I am ashamed of my country for ripping Mr. Smith's dignity away from him. He has never asked his country to do anything for him, and he is embarrased to be asking for a handout now, at 73 years old. I am ashamed that this has become the status-quo in the richest nation on earth.

Is this really what we intended? Did we intend to design a system that wretches every last penny away from middle-class families who have worked and saved their whole lives just like we told them to?

If Congress converts Medicaid to a block-grant funded program as Paul Ryan has recommended, states will be forced to decide which Medicaid programs will be cut to accommodate the drastic funding reductions. In 2004, 1/3 of all Medicaid spending in North Carolina was for long term care, and that amounted to a whopping $2.3 billion! It is impossible to think that this would not be one of the first areas of Medcaid spending to be cut, or at least to see its eligibility drastically reduced. And I suspect that just as happened with the stystematic dismanteling of our state mental health system, our streets will be flooded with the homeless, but this time they won't be crazy, they will be old, infirm and disabled.

Cutting entitlement spending sounds great when it is just a soundbyte that can be associated with the mental image of a welfare mother in tattered clothes with disheveled hair, a cigarette hanging out of her mouth and a baby wearing only a diaper propped on her hip. But when you have to actually think about the real lives that are affected by "entitlement reforms" and realize that some of those people might be your own parents or grandparents, it quickly loses it's appeal.

Balancing our national budget will not be done by eliminating entitlement spending. It must be done with a common sense approach that includes drastically reducing military spending; eliminating wasteful government spending (such as the USDA program devoted solely to procuring contracts for cheese manufacturers. I mean, seriously?); raising taxes on the mega-rich; raising the tax rate on dividends; and vastly simplifying the tax code. And we must return to carrying on civil debate with one another that involves actual facts, rather than bantying about catch-phrases and soundbytes without ever really discussing anything of significance.

I for one find the issue of whether or not millions of grandparents across the country will have to be homeless instead of receiving adequate medical treatment to be a rather significant issue that is deserving of more consideration than a 60 second snippit devoted to "entitlement spending" on a 24-hour news network. Ultimately, I believe my government is capable of carrying out justice. And it is certainly not just to watch the elderly middle-class be drained of its every last dime in order to continue living without additional physical suffering. Wake-up Congress! Your constituents are demanding that you act, that you show that you still possess a conscience, that you quit arguing and quit campaigning and start addressing the problem!

How's this thing work?

So, I've read a couple of blogs recently for the first time and I find myself very inspired. It seems incredibly cathartic to be able to just put it all out there. So I thought maybe I'd give it a shot and share with the world some of this crazy, hectic, amazing life of mine.

At the moment, I have become increasingly disgusted with my physical health. I quit smoking last year and promptly gained 35 pounds! Gross! And in the process I've become less flexible, less agile, more tired, and much, much more "muffin-toppy." Double-gross! So, with a little inspiration from a few new-mommy friends, I'm jumping back on this weight loss band wagon. Two years ago, when I hit roughly the same weight I am now, and was equally disgusted, I started Weight Watchers. I lost 30 pounds and kept it off for over a year until I quit smoking. And now I've surpassed my previous weight record and it is seriously affecting my mood and my mental health.

And it's not like I'm a pig. I'm just really, really busy. No, seriously, I'm really busy! Single mom of two, full time paralegal, part time student taking 2 classes a semester at UNCA, minute-taker for Black Mountain Board of Aldermen, Secretary/Treasurer/Scheduling coordinator for local baseball/softball league, softball coach, and somewhere in there I try to maintain a social life and a relationship.

So, a typical day goes something like this,
6:30am - up, shower, wake up kids (about 8 trips to Dylan's room to accomplish this), pack lunches, drive kids to school
8:30am - work
10:30am - leave work, drive to UNCA, class until 12:00, scarf down food in the car on the way back to work
12:30pm - work until 5:30
5:30pm - pick up the kids, stop at the grocery store, go home
6:30pm - get kids started on homework, start a load of laundry, start dinner, help with homework, eat dinner, clean up from dinner (truthfully, sometimes this happens and sometimes the dishes just hang out on the kitchen counter until somebody else cleans them up. Thank God for Alicia!). Switch the laundry, kids in the shower, bedtime story, kids tucked in.
9:30pm - start on homework, get interrupted about 8 times for drinks of water and "I can't sleep."s.
11:00pm - finished with homework and realizing just how mentally and physically exhausted I am, I turn on the Daily Show, log onto Facebook and mindlessly play stupid Zynga games that require absolutely no complex reasoning or conversational skills!

My dilemma of course is where exactly I am supposed to cram exercise into that schedule. In theory I could go walk after work and pick the kids up at 7:00, but that means I only see them for 2 hours before they go to bed and that two hours is filled only with homework and chores. I could get up half an hour earlier in the mornings and work out then, but. I. Can't. Do. It! I want to. I really do. But my body has this visceral reaction that I cannot control to the sound of an alarm before 6:30 in the morning. My nervous sytem kicks into autopilot and doesn't just snooze the alarm. Oh no, we kill the alarm. So my good intention of getting up early to work out turns into oversleeping and running around the house like a mad person trying to get me and two kids out the door in all of 15 minutes. I have tried working out on my lunch break, but then I'm all sweaty and sticky and that's just unpleasant for me, my coworkers and my clients. Yuck! So, what to do? At the moment I have committed myself to an aquafit class at UNCA on Thursday nights. This means that one night/week I have to drive straight from work to UNCA for a fitness class and I won't be able to pick the kids up until after 7:00. That makes two nights per week really since I have an actual class on Tuesday nights which means I don't get to pick them up until after 9:00. I am going to commit to walking one day per week with Courtney at the lake after work. If I leave work at 5:00 and go walk, I could still pick the kids up by just after 6:00, not too bad. And I have all day Saturday to work with, so maybe I just need to start planning a 90 minute work-out on Saturdays. Ewww!

In addition to being busy, I really love food. I'm not a sweets fanatic, although I can totally kill an ice cream cone or a piece of cheese cake, and I endulge in the occassional candy bar. I love cheese. I love Mexican food and Italian food smothered in cheese, lots of it. I also know that I drink too much. I'm not an alcoholic by any means, but I consume way too many empty calories in glasses of wine and bottles of beer.

So, I recognize that I need to reduce the amount of calories, the amount of fat, and the overall portion size of what I am eating, and I really just need to make smarter food choices. I started working on it last week and I just have to keep working at it. I went grocery shopping and bought healthy snacks, stuff with whole grains, no high fructose corn syrup, around 100 calories and less than 5 grams of fat per serving, and lots of fish instead of read meats.

Today was: Breakfast - English muffin with 1 tbsp grape jelly, 2 cups of coffee with cream and sugar; Lunch - PB&J on whole wheat bread, 1/2 C grapes, 6 mini rice cakes (cheese flavored of course); Snack - 6 slices of Havarti Fennel cheese, 12 sesame Toasted crackers; Dinner - Turker burger with cheese and bacon, 1/2 C mac & cheese, 2 glasses of red wine.

I have scheduled an appointment with a personal trainer at Ascending Fitness in Black Mountain next week. I am still trying to get set up with the dietician at UNCA who can help me work out meal plans. I'm signed up for Aquafit and I'm meeting Courtnery to walk tomorrow. I have seriously got to lose at least 40 pounds. My clothes don't fit and I feel awful every time I put on a pair of blue jeans. So I'm going to try to make use of every resourse available to me and hope beyond hope that something works. So my short term weight loss plan is this:

Breakfast every day with less than 200 calories
Pack lunch for work - sandwich, fruit, and one 100 calorie snack
Snack - 100 calorie snack
Dinner - chicken, turkey, or fish, with vegetable and rice/beans/pasta.
Limit to 2 drinks per day, no more than 10 per week
Exercise at least 2.5 hours per week, hopefully broken up into 4 sessions.
Drink 2 bottles of water every day.

Here goes nothin.