Widows and Orphans

Repeal and replace Obamacare is a politicism that affects me personally. I’ve talked before about how Obamacare saved my ass – literally. Now the replacement proposal is here. As I said before, this is not political for me. It’s very personal. I’ve heard a few times the health care bill will hurt Donald Trump supporters the most. That is certainly true of South Carolina, which went for Trump. USA Today says that Medicaid cuts are going to hit us harder than most states for a number of reasons.

The Congressional Budget Office (CBO) estimated 14 million people will lose Medicaid by 2026, and 22 million will lose insurance. Republicans who created this bill expect the states to make up the shortfalls, but because of high poverty rates, our state’s budget will not be able to make it up. We’ve been trying for years to come up with money for our roads that are falling apart. We are already second to last in spending per Medicaid and CHIP beneficiary. We are already 42nd in health status overall. If the bill passes with the Medicaid and CHIP cuts, South Carolina will have to come up with an extra $200 million per year over the next ten years. If we can’t do that, we are going to have to make some hard choices. Lynn Bailey, Columbia health care consultant, put it this way.

[C]uts could set the stage for a “Medicaid Hunger Games” where leaders play needy groups against one another — children against the elderly, the chronically ill against the catastrophically ill, the traumatically injured needing rehab against the substance-addicted.

Does that sound overly dramatic? Just look at the numbers.

  • Nearly 1 million South Carolinians are covered by Medicaid or CHIP. Of these, 75% are working families. So don’t give me that “they just don’t want to work” crap.
  • Out of a total of 20,000 nursing home beds, half are funded through Medicaid. Without Medicaid, where will they go?
  • 60% of Medicaid or CHIP patients are pregnant women and children. Don’t call yourself Pro-Life and take away health benefits from pregnant women and born children.
  • 70% of Medicaid budget is spent on the elderly, people with disabilities, and people with mental illness.
  • 12 hospitals across the state will either close or go bankrupt. What’s that? It’s an emergency, and you have to get to the hospital immediately? Sorry, the hospital closed due to lack of funding.
  • Rates of opioid deaths are above national average. Losing Medicaid will mean many trying to free themselves from addiction will lose their chance to get treatment.

I have always heard a society is judged by how they treat the weakest and most vulnerable. The Bible over and over commanded the Israelites and Christians to care for the orphans and widows because they were the most at risk in that culture.

Learn to do good; seek justice, correct oppression; bring justice to the fatherless, plead the widow’s cause (Isa 1:17)

Father of the fatherless and protector of widows is God in his holy habitation (Psa 68:5).

“‘Cursed be anyone who perverts the justice due to the sojourner, the fatherless, and the widow.’ And all the people shall say, ‘Amen’ (Deut 27:19).

Religion that is pure and undefiled before God, the Father, is this: to visit orphans and widows in their affliction, and to keep oneself unstained from the world (Jas 1:27).

You say you believe the Bible. Do you? Who are the most vulnerable in our society? The elderly? People in nursing homes? Recovering addicts? Unemployed veterans? Children? People with disabilities or mental illness? Anyone who is sick and can’t afford healthcare? These are our widows and orphans.

The worst thing about this proposal is they say we have to do this to save money and reduce the deficit, but really, all the savings are going to be spent in tax cuts for people already rich. That’s been their answer to everything. Cut vital benefits and services for the poor and middle class and give tax cuts to the wealthy. That has never worked, it has never produced a balanced budget, and it has never trickled down enough to make up for the losses. The rich get richer, and the sick suffer and die. Is that what a Christian nation does? Is that what Jesus would do? “And he healed all who were sick, except those who were too poor to pay for it.”

Historically, this nation has not done well in providing healthcare for the widow and orphan, metaphorically speaking. The Affordable Care Act, aka Obamacare, attempted to move us toward better care for people who need it most. I know it has problems, but we could solve them if we had a mind to. So the question is do we want to provide quality health care for anyone who needs it, or do we want to follow a political agenda? What would Jesus do?

Obamacare saved my ass. Literally.

I know I may be losing readers if I get political. But this isn’t political for me. It’s very VERY personal. Trump campaigned on repealing and replacing “the disaster known as Obamacare.” At least he said he wanted to replace it. All Congress ever did before him was waste their time voting 60+ times to repeal it, without even mentioning anything to replace it, and knowing Obama would veto it. So since the election, I’ve been nervous because I am one of 25 million Americans who now receives health insurance through this so-called disaster. We’ve lost the firewall protecting us from GOP demolition.

I heard, though, it wouldn’t be immediate. They are not going to just leave 25 million Americans stranded when it comes to health care. The Republicans in Congress said they were (finally) working on a replacement plan. Any repeal will not take effect until after they have something to replace it with. However, the Senate did not wait. Thursday morning, I was watching the cabinet confirmation hearings on CNN when I saw the newsfeed scrawl beneath say late at night, the Senate passed the repeal of Obamacare along party lines. What happened to waiting until you replace it with “something terrific,” as the President-elect said?

Now it goes to the House. Paul Ryan says the repeal won’t take effect until they have something to replace it with, but that does not make me feel much better. What are you going to replace it with? I know some people have some legitimate complaints about Obamacare, but wouldn’t it be easier to fix something already in place rather than throw it away and start over from scratch? If your roof leaks, does it make more sense to fix the roof or burn down the house?

I am amazed I even have to write a post like this. Health care affects everyone, Democrat and Republican. It does not discriminate by politics. There is no such thing as a Democrat heart attack or a Republican cancer. There is no such thing as a liberal childbirth or a conservative stroke. We are all going to need help from medical professionals a few times in our lives. Not only you and me but the people we love as well. If we can’t agree on affordable health care for everyone, how are we ever going to agree on anything?

So before you jump on the Repeal bandwagon (or if you are already on it), I ask you to at least hear my story and others who support and/or rely on Obamacare for our health care. And in spite of whatever else I say in this post, if the end result is that the Republican Congress and president-elect comes up with something that solves the problems some people are having AND allows me to keep my coverage, I will be the first to thank and congratulate them. I’m not optimistic that will happen, but for now we can still hope.

My life before Obamacare

Despite all the preachers who say the Bible promises health and wealth for believers, I have been poor, too poor to afford health insurance. And even if I could, I have some pre-existing conditions that disqualified me from signing up for new insurance. I once had employer-provided insurance, but when I lost that job, I lost my insurance as well. Without an employer, I was not able to get around restrictions of pre-existing conditions. If you are a regular reader of this blog, you already know one of those pre-existing conditions is depression. Here are the others:

  • Irritable Bowel Syndrome (IBS) – Causes intense abdominal pain and diarrhea at unpredictable times. Requires prescription Levsin (or generic Hyoscyamine), cost $80-121/mo.
  • Sleep Apnea – Causes snoring and intermittent stoppages of breathing during sleep, resulting in blood with not enough oxygen. This has been shown to result in damage to all organs: heart, brain, lungs, liver, kidneys, etc, which long term can cause devastating health conditions. Requires C-PAP machine, cost approximately $5000 plus maintenance and regular replacement of various parts.
  • Flat feet – Sounds like a little thing, but it throws off the alignment of your legs so that standing, walking, or running for long periods of time can hurt not only your feet but also your knees and back. You can correct it somewhat with arch supports. I remember my first chiropractor telling me if I didn’t get supports, I would keep undoing all the work he was doing to fix my back. Even with them, my feet would hurt if I was on them for too long.
  • ADD (without hyperactivity) – haven’t been treated in a while.

After Obamacare

When Obamacare was finally implemented, it was a Godsend. Through the Federal Marketplace I was able to find a plan that worked for me and that my Primary Care Provider (PCP) would take. The premium was well beyond my means. Since my state rejected the expansion of Medicaid to help people like me, I had to rely on federal subsidies to afford this or any plan. And under the Affordable Care Act (ACA), a.k.a., Obamacare, you cannot be turned down for pre-existing conditions. So what did that mean for me?

  • IBS – Hyoscyamine now $10/mo. co-pay.
  • Sleep Apnea – C-PAP machine covered (might have been a small co-pay, I don’t remember). Scheduled replacement parts overall about $10-20/mo. co-pay.
  • Flat feet – still using arch supports and staying off my feet when I need to.
  • Depression – recently changed medication to Trintillex, which is not covered on my plan. That’s true for most new meds, especially if there’s a cheaper one available, but for me this has fewer side effects. Right now relying on samples from my PCP.

Post-existing conditions

In addition to these pre-existing conditions, I’ve had other things come up that were totally unexpected. This is where I get into the reason for the title. I developed a cyst right between the butt cheeks. I’m not sure how. I saw it happen to my grandfather in his last few years. After he broke his hip, he had a very hard time walking, so he had to sit practically all day. Maybe all the time I spent sitting to research and write got to me as well. It was easier for me, certainly, to stand and walk than for my grandfather, but when you have flat feet, you can’t stand all day. You have to get off your feet for a significant part of the day, and there are some times when you just have to sit.

Men, let me ask you. Do you like to sit with your wife/girlfriend/significant other next to you, resting her head on your shoulder? Women, do you like to sit like that with your significant other? In order to do that, I had to slide down until my butt was off the couch. It was worth the trouble, but still, I could tell she felt a little awkward.

My doctor said I needed surgery to remove it. I’ll warn you, if you’re squeamish about medical issues related to surgery in the gluteus maximus region, you may want to skip ahead to the next heading.

Turns out these things are not just on the surface, so you can’t just lance it. I scheduled the surgery for a time when my parents were visiting, so they could be on hand to drive me home and help with my recovery. I also had a smaller benign cyst on my neck. It wasn’t painful or urgent, but the surgeon said it would be cheaper overall to have both cysts removed in the same operation. Two for one deal, in other words.

The surgery was successful. But when you have a hole in your butt – besides the natural one, of course – you have to take measures to be sure it heals properly. They said it was a small hole, but that’s relatively speaking. A hole cut into your body is a hole cut into your body. I had to insert gauze into the hole and disinfect, inside and out, every time it needed changing, and then cover it. I say “I,” but actually it was hard for me to reach around to get where I needed, so my mom ended up doing that for the first two or three weeks. There are not many people you can ask to do that for you, so God bless her.

[If you skipped ahead, start here]

Without the insurance I got through the Affordable Care Act, a.k.a., Obamacare, I would have had to pay over $3000 out of pocket and probably would have had to leave the cyst in my neck. With my insurance, my co-pay was about $338, still expensive for me, but I was able to work out a payment plan that terminated in about a year rather than ten years. So after the surgery, I was able to focus on getting back to my life rather than, “Dear God, how am I ever going to pay for this.”

And that is what the Affordable Care Act was about, making health insurance affordable, so that health care could be affordable when you need it. I know some people say it has not worked that way for them. For some, their premiums shot up. Some were not able to keep their doctor under their plan. Some saw their plans leave the Federal Marketplace. I sympathize. I want it to work for you as well as it has worked for me. Thing is, all these problems could be solved if Congress – and all of us – got serious about covering everyone, like every other industrialized nation in the world does. Other nations know 1) it’s the right thing to do, and 2) people are more productive when they are healthy than when they are sick or injured. Why is that so hard for America to understand?

Even those of us who supported ACA knew it was going to need some course corrections after it got started. But the opponents of ACA never talked about how to fix it, just repeal, repeal, repeal. It’s a disaster. Get rid of it. Rolling out Medicare wasn’t entirely smooth in the beginning. If the same people had been in Congress in the 60’s, we wouldn’t have Medicare today. It was not a disaster. It was not Armageddon. It was not a slap in the face to business owners. It was not the death of America. Medicare may not be perfect, but people would fight like hell if Congress threatened to repeal it. So it should have been with Obamacare.

Finally, I have to say something about the hypocrisy of our legislators in all this. Congresspersons and Senators railed about how ACA is socialized medicine while taking the health insurance plan for government employees. So to my two Senators who just voted to repeal Obamacare, a.k.a., my healthcare, and to my Congressman who has pledged to do the same, if you hate socialized medicine, can I have yours?