Medicaid, Medicare, and the Affordable Health Care Act

"We should defund Obamacare."

If we truly care about caring for those who can't care for themselves, America would fully fund the expansion of medical social services.  There are right now millions of Americans being denied medical attention, and the care that they eventually seek is the most expensive possible, at the ER.  It is costing us too much now not to do more.

I was disabled after a drunk driver decided I didn't need to play basketball anymore.  After a spinal cord injury to C-4,5, and 6, I am now a quadriplegic confined to a wheelchair.  Because I technically worked, and payed into social security before my accident, I qualified for Social Security Disability. In Texas, this means I qualify for Medicaid- Full Medical, One Eye Visit a year, and 3 prescriptions a month.  That's cool, I can get by.

Recently, my Dad was diagnosed with cancer, and was so diminished physically that he to now qualified for this same Disability Program.  Concurrently, I now qualified for another benefits program, as a survivor or beneficiary of someone who is disabled, which means $75 more each month.  This had a negative effect on my status in the Texas system.  I was simply no longer qualified for the Medicaid program, but I could re-apply.  This process takes from between 30-45 days, AND the program I am applying for doesn't cover prescriptions or eye exams, both of which I utilize.  The 'good' news that in November of 2014 I qualify for Medicare, which costs $100, and only covers 80% and no prescriptions.  As of July 31st I am without coverage of any kind...all because my Dad got cancer.  (*ETA:  I just found out that I qualify for another program that will return me to my original coverage, but now I have to re-apply every year, and failing to do so in a timely manner could again endanger my coverage.)

We've got a great system!  Unfortunately, I find myself in a crack.  The Affordable Health Care Act is intended to have states expand Medicaid and fill in these cracks, but MY Congressman, Mac Thornberry voted some 40 times to abolish it.  My next door neighbor, newly elected to the Texas State Legislature winner of the Most Conservative  Republican, Drew Springer, has not responded in a manner that leads me to believe he cares about amending things either.

In places where the Act is being used, rates are falling, people are getting rebate checks back, and more claims are being paid out.  It is all because there are now more people's premiums going into the kitty, and the AHCA forces health insurance companies to pay out 80% in claims.  Among others changes, it also  forces companies to cover pre-existing conditions, which means terminally ill-patients won't show up at ER's for treatment.

If republicans are pro-life, why aren't they pro-health care?

When Nationwide is NOT on My Side

"Please be advised I will not be accepting your last settlement offer to settle your bodily injury claim at $30,000.00. -Nationwide"

Here's my "insurance settlement narrative letter"...NOT "a better liberal argument."  :)

      07-12-13

Nationwide

One Nationwide Plaza
Columbus, Ohio 43215-2220

ATTENTION:  Claims Department, Claim # XXXXXXXX

To Whom it May Concern:

On April 22, 2013, my body and my life took a big hit and a meaningful setback.  *Driver's Name*omit* error cost me months of pain and a loss of my personal independence.  

At impact the airbag deployed, striking my inner right shoulder, as I was attempting to brake, so it took the full force of the airbag deployment.  The immediate result was a numbness and a ringing in my ears, as though I had just been near an explosion.  When the EMT's arrived, I was still numb and my ears were ringing, but I didn't feel as though I had a concussion.  Having played contact sports in high school, I was no stranger to that state.  My immediate worry was that I had another spinal cord injury, but after closely checking all my motor skills, I surmised I was fine, after all, there was no blood.  My first mistake was refusing to go to the ER with the medics.

Home was only about 15 minutes away, and when I arrived there I did as I would normally do.  I started cooking dinner after washing up.  About half way through my preparations, I began to feel really sore, as the numbness wore off.  I took a couple of ibuprofen, ate, and then went to bed.  When I woke up the next day I felt like I had played the longest hardest football game of my life.  I made an immediate appointment to see my general practitioner, who was out for the day, so I  saw one of her colleagues.  At this point it hurt to move both my head and arms.  She wanted to inject me with steroids, but I suffer an ocular condition that causes my retinas to leak if I am administered them, so I elected for a "Toredol" shot, which she assured me would have similar restorative properties.  She instructed me not to use it, continue taking ibuprofen, and ice and compress it when possible.

Last semester, I took an Injuries: Care & Prevention class, and I made an "A,"  I also logged 6+ years of varsity team sports through out my life.  Not including my spinal cord injury, this one has been the hardest to rehab.  When you twist an ankle, you simply use crutches.  When you break a collar bone, you wear some sort of suspension apparatus, and you don't use it; injure your hand, and you get a splint.  Each one of these are intended to immobilize and rest the afflicted area.  In most cases, bracing is available and thusly utilized.  This injury offered no such remedy.  In order to 'properly' care for this injury, in my opinion, I should have been checked into a rehab facility and had someone else lift me in and out of my chair.  I should have had my arm in a sling, and done no weight bearing for a minimum of 4 weeks.  Given I was in the last weeks of a full schedule of criminal justice studies, wherein I had all "A's," checking into a hospital was just not a viable option.  

Instead, I employed as medically instructed, over the counter anti-inflammatories, clinically administered non-steroidal injections, sliding boards (a loading aid), help from my partner, ice packs, and an ace bandage.  One month to the day of the accident, my regular physician and I decided to take drastic measures and inject steroids directly into the joint.  This posed a hazard to the joint itself and my very eyesight.  We decided to do so because other options were even more dramatic and evasive.  The NP employed 3 syringes each containing about 10 cc of Cortisone.  These injections were intended to both damage the tissue and inject medicine to induce healing.  

I went to bed that night feeling little to no pain, unless I utilized my right arm.  I awoke the following morning feeling like I had a new shoulder.  I rolled over and up, reached for my chair, and it may have been because it was still dark or my chair may have been on top of a pair of jeans, but my chair began to tip and as soon as I tried to catch myself and put weight on my shoulder…it was like there was nothing there.  It could hold no weight what so ever.  I fell straight to the floor as the full weight of my body crushed my twisted left foot beneath me.  My ankle popped and I rolled backwards and off of it.  I slowly dragged myself to the living room and did my best to roll up and unto the couch. There I received help to ice my ankle, that was now beginning to swell.  I eventually summoned the strength and went to the ER, had it x-rayed, and they sent me home with an Unna-boot treatment and a new ace bandage.  It was just severely sprained not broken.

Transferring was now however more difficult than ever.  Not only would my shoulder hold little to none of my weight, buy my left ankle was also recoiling from any pressure or weight bearing.  I took the next few weeks and stayed completely away from any undue transfers except for my transportation to and from physical therapy.  I neglected my grape vines, social outings, and other outside duties as my world shrank to the size of a small 4 room apartment.  The month of June was mostly spent icing both my ankle and my shoulder and going nowhere.

The month of July has seen new feats of both strength and range of motion.  No more do I wake up aching. I can do most of my transfers now, independently and sans any load aiding devices.  The only pain I encounter is when I try to reach straight up, or if I tried to get from the ground directly into my wheelchair.  Feeling like my final healing was at hand and my therapy was drawing to a close, I offered to settle my personal injuries portion alongside my property damages claim.  I sought to offer what I found to be an industry standard of 3X the medical costs incurred up to July 1st, but this offer was initially rejected before I eventually rescinded it.  

After another week of what I deemed successful therapy, and feeling almost entirely pain free, on July 12, I attempted to return to my normal gardening activities.  So, I went outside and tried to hoe a few weeds from around my peppers, when my shoulder began to ache tremendously, so much so that I had to stop the activity within a minute or so.  I've noted that I am in a wheelchair, but I may not have said where my paralysis starts?  Just at my pectoral region I have no muscle control below there, so I sort of sit atop a jelly stump.  Before my accident I was right handed, but since the paralysis now affects it, I use my right hand to 'hold me up.'  No sooner than I took 4 or 5 good swings with my left hoe hand, that my brace acting right handed shoulder began to hurt.  It was the jarring impacts that I was just not yet ready for… 

This letter is intended to provide Nationwide with a clear understanding of exactly what kind of injury I received, the treatments I have had administered, and the effect this event has had on my life and my body.  While I have improved with therapy, what I fear is that my shoulder joint itself may never be as impact resistant or wear tolerant as it once was.  

When I began preparing my settlement offer, I looked to the Internet for guidance and direction as to how to affix a value to one's pains and suffering.  There were of course no hard and set in stone rules or clear guidelines for specific injuries.  Settlement offers can range from 2X to 6X medical damages, but do any of these reflect actual damage to specific people's lives or bodies?  The maximum amount Nationwide is required by your policy holder's limits to pay is $30,000.  If a starting NFL quarterback was hit like this, would a mere $30,000 come anywhere near covering the loss of his livelihood?  Is that hypothetical shoulder more or less valuable than my own now?

Imagine, if you could possibly, having no use of your legs, and then sustaining an impact injury to half of your remaining operative limbs?  I can not begin to tell you how arduous the path back to personal independence was after my accident back in 1994.  Losing it again now, even if only for a matter of weeks, is a burden I wish for no one, but it seems to me almost obtuse to try to affix a cash value to these sincere losses.  Do you know what it is like to be stuck on the floor for hours…waiting for help or assistance to arrive?  Have you ever been limited to a room or a house for weeks without the ability to move about pain free?  What is that worth in dollars and cents per hour or per day, and is it the same for everyone?  

This accident has cost me greatly.  I lost the one thing I invested everything in, and my body itself suffered periods where I was unable to function independently, safely.  I am even now, unable to return to my normal daily functions without pain, some two and a half months after the accident.  What is this 'worth' in actual cash value, generally or specifically speaking?  

To be honest, I don't believe Nationwide is in business to fully appreciate people's losses, and return them or their property to pre-accident levels.  I think it is more likely that you act on behalf of your shareholders and their bottom line.  With both of those notions in mind, I'd like to request, nah demand, that Nationwide ignore these 2X or 6X medical bills industry standards that clearly don't apply to my specific damages, and award me the maximum limit (*$30,000) within *Driver's Name*omit* policy in an effort to see me as a person who suffered truly incalculable losses of liberty and freedom as well as both great pain and suffering.  While $30,000 isn't in any way 'equal' to my losses, it would serve as an attempt to give me back a portion of what I lost, that is so precious to me…the sheer ability to get out and live life.  Moreover, my therapeutic needs may well extend beyond the $10,000 in PIP my policy offers, then what?  My Medicaid coverage does not extend to automobile accidents, so this settlement agreement would help to cover such future needs.

The FACT is that because of your client's actions, my world is now smaller, and I can get out and do less with more pain.  Even though I have gotten better, I may have received damage that I will never fully recover from, nor will I have coverage to pay for future treatments.  I seek an immediate settlement, please respond to this settlement offer within 15 days of receipt of this letter.

Thank You,

XX
---

Their last offer:  $8300.

:(

Stand Your Ground = Might Makes Right

"People have a right to defend themselves with deadly force IF they feel like their life or body is threatened."

The latest trial of George Zimmerman, its results, and the other 16 like cases in Florida where someone shot someone, and were acquitted, herald back to the days of the Wild West.  In these cases justice was dealt out by a single person acting as the judge, jury, and executioner upon an individual who may or may not have presented a real or imagined threat.  The flaw is not within jury findings, but in the law itself.

George Zimmerman killed Trayvon Martin.  Only one version of the how and why it happened came in the form in inconsistent statements to police and investigators.  In a statement George Zimmerman made to Sean Hannity, he said that Trayvon was running away from him...seemingly because he 'feared' George Zimmerman.  So, if Trayvon had attacked George, with the intent to defend HIMSELF, and he had killed George Zimmerman...he'd have been 'right,' or according to Florida Law, completely justified.

The law's flaw is that it provides untrained, paranoid, or even delusional 'personal feelings' to justify the slaying of someone not charged with a crime.  Seemingly, the person who carries the biggest gun, knife, or stick, and has quickest draw wins.  It would seem that the Florida Legislature missed the days of history class when the merits and pitfalls of yesteryear were discussed.  Allowing people to use deadly force to resolve disputes is a step backwards.

I sincerely fear for the citizens of Florida.  You have every reason to fear your fellow Floridian.  I do not recommend you bring Skittles to a gun fight.  Trayvon was right to attack George, but his legal failure was losing the physical battle.  This law endangers the unarmed and the physically diminished, who merely appear threatening, or act in a manner that might frighten the neighborhood gunslinger.

This law is fundamentally flawed and should be abolished.

Social Media Matters

"Capitalism is better than Socialism."

On the contrary, I don't believe Capitalism works without Socialism.  We are social beings, who exist within a social contract that is literally the very fabric of our world.  We need and depend on each other, and the more social we are, the more connected, and understanding of each others' wants and needs, the better off we will all be.  Social Media today is the saving grace of Capitalism.

I have in the past run aground with a sales associate or two.  Maybe he or she had a bad day, maybe I had a bad day, maybe there was just a misunderstanding of the agreement.  In local instances, a word with the Manager is usually sufficient.  However, when that he or she is a Manager, then things are different.  Having worked in retail myself, and living with someone with more than two decades of experience behind the counter, I can tell you customer service can be difficult at the best of times.  What I experienced in the past beyond the Managerial level, was lengthy.  You could write a letter or send an e-mail, but you usually never heard anything back.  If you were lucky, you might get a letter with a coupon, but good luck getting wrongful charges reversed!

Today, we live in a world much more reactive, because we have this social web, "the intertubes," or whatever the our inter-connectivity is to be nick-named tomorrow...  Our Social-Sharing and reaction to each others losses IS the thing that causes marketplace changes.  We lacked this even 10 years ago.  "Times, they are a changing."

Just last week, I posted a blog and a reddit.com piece about a bad experience I had with Enterprise Rent-a-Car.  It took less than 72 hours and 20,000 hits for them to respond accordingly.  In less than a week, they resolved the issue fully with me, and all is right between us.  Truly, I have never in my 37 years seen such a quick positive reaction to a customer complaint.  Granted, I had good grounds in which to complain, but still, 6 days...!  That is amazing, astounding, utterly astonishing.

With that, I would like to thank both Reddit.com and Enterprise.  You have both given me faith in Socialism and hope for Capitalism.

Troubles in the Marketplace

"Capitalism works, bad acting companies are weeded out, and those who treat their customers well will be those who remain."

This might be true if it weren't for advertising and public relations departments.  Most established corporations can easily overcome a little bad press with a few individuals.  Even BP after its gulf oil spill doesn't have a disapproval rating as low as Congress'.

The example I'd like to present here is Enterprise Rent-a-Car.  This company was founded in 1957.  Everyone knows what it is, and what they do.  They have paid to feature happy people getting in and out of their vehicles on television for decades.  Business Week magazine listed it as a "Customer Service Champ" in '07, '08, '09, and '10.  It also won Budget Travel's Reader's Choice award in '10 and '11.  They have annual revenues of over $12 billion and almost 70,000 employees.  However, it is a privately held company, meaning it doesn't answer to stock holders or 'the public,' just their bottom line.

So, what we have is the illusion of a perfect example of a great American business model.  Clearly, this company acts in good faith, or they wouldn't be so popular with their customers, right!?

In reality, this car rental company is horrible.  Do a search on customer reviews.  They get a 1 out of 10, on most I found.  They log thousands of complaints about the outright fraud perpetrated every day with their hidden insurance fee agreements, damage accusations, and unauthorized charges to credit cards. However, unless you go looking for this information, or it has happened to you...then you probably have no knowledge of such things and so have a positive image of this company.

I am in a wheelchair, so car rentals are a whole other headache for me.  I have portable hand controls that bolt in and out of any automatic in about 5 minutes.  All that I really need is a 2-door coupe, because the door opens to a wider area in which to get my wheelchair through.  However, I can't just show up and expect perfect service anywhere.  I have to call ahead, make special requests from their homepage, then call ahead and make sure the local office received my special request, blah blah blah...  Which I did here, with great efficiency.

I was in a collision wherein the other driver was at-fault on a Monday around 5:00 pm, and I needed to be in class the next day, so I put in the 2-door request that night.  Tuesday morning I called to see if the local branch had received the special request and if they were working on it.  The associate said they had, they were, but they would know more that evening or the next day.  On Wednesday I was told they had several cars from which to choose, but that they had no 2-door cars in their fleet and that if I'd like they could send me to another company.  Having rented from this company before, I knew that there were lots of 2-door coupes available in Enterprise's 1 million car stockpile.  So, I took the sedan, but requested that as soon as they get a coupe, to call me.

After about a month I had to take the sedan back.  The awkward transfer in an out was keeping my injured shoulder from healing, so I returned it only to find out that Enterprise had maxed out my credit card with a daily insurance fee.  Initially, I had paid for the rental and insurance fees, but after the other driver's insurance "picked up the contract," because they finally accepted liability, I thought those charges had stopped, and that both me and my card would be reimbursed.  I should have known something was amiss when I was provided the hand-written receipt for the cash portion of my payment.  In total, to drive a car I didn't request for one month cost me $1161.91, when in fact I only owed a mere  $258.79.

Undeterred I followed up, made another special request for a 2-door coupe, and sought to remedy wrongful charges through the local office.  I was met with incompetency and an arrogant disregard for me and my situation.  I was hung up on and repeatedly told a vehicle was 'on the way,' but after almost 11 days, I began to lose hope.  They finally stuck me in tiny coupe, but still refuse to reverse the charges...

My story is not unusual or out of place.  Talk to anyone who's dealt directly with this company and you'll hear similar stories.  The problem is that as individual consumers, we lack the resources to affect any positive change here, and capitalism is failing us.  My next stop is small claims court and possibly a Title III complaint, but honestly I can't say I have confidence in remedy through those options either.

Surprise, We're Listening...

"Big Brother, i.e. Big Government is watching you."

So it would seem, the NSA is, has been, and will continue to look at everything we do to the best of it's ability.  They scan every broadcast, and every exchange about everything we are doing, every minute of the day.  It would seem that there is plenty of room for abuse and it has occurred.  I wish that I could say I was surprised.  We live in a world were communications exchanges leave traces.  Those charged with our protection wouldn't be doing their job if they ignored 'terrorist communications' about some in suing threat, that was out there floating around.

Knowing this, as a liberal, what I expect is adequate Congressional oversight.  I want elongated hearings, reports, and actual representative supervision adequate to the task at hand.  Congress is claiming this never happened, but there are records of some supervision or reporting, but all of this came about after they re-authorized the Patriot Act.  So, who is really to blame?

In the end, I side with Benjamin Franklin who said something in the order of, "They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety."  After 9/11, everyone was all too wiling to let the government do anything and everything in its power to protect us.  It was called the Patriot Act, and we supported those who voted for it overwhelmingly.  In the end, this is a democratic republic wherein we get the government we deserve.

Our apathy has beget us these problems.

Tornado Alley- "Raise Building Standards"

"Climate change has not been scientifically proven."

Is there a more deluded statement that could be made in the face of absolutely horrific tornadic results  in Moore Oklahoma.  Cars were strewn into piles like so many toys in a flooded sandbox.  Buildings, houses, and entire neighborhoods utterly flattened, three times now, all in the last two decades!?

Tornados are now commonly larger and spread further east than in years past.  These are not predictions, they are on the ground cold hardened facts.  People are dying in greater numbers, and tornados are causing more damage, much more often.  We have to adapt or continue to die needlessly.

If you live in hurricane prone areas, building standards do require that your structure be able to withstand 200 mph winds.  Doesn't it make sense to require safe rooms for tornado prone areas?  Earthquake prone areas include standards that would help prevent quake injuries and damage, right?  So, where are the appropriate levels of government oversight and regulation here?

Tornado alley is getting bigger and more violent, it is well past time to admit to this fact and begin to take action to counter its effects.