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Self Care, Preventative Care, Pre-Existing Conditions: How Some Are Coping

Posted by DR. CLARISSA PINKOLA ESTÉS, Deputy Managing Editor, Columnist in Economy, Education, Health, Politics, Science & Technology, Society.
Aug 17th, 2009 | Comments

In the past, we literally had to sell our house to pay a huge hospital bill. The hospital sent the bloodhounds. My husband had just lost his job. I was near death.

Afterward, anything related to that crisis was big red lettered ‘pre-existing condition,” by any and every insurer we’d ever had… and although undertaking scrupulous selfcare (dont drink dont smoke, dont do illegal drugs, dont lay-about, ok ok, well some layabout in order to read books.. and eat fresh fruit til I could break out in cherry blossoms, beef is a treat maybe once a month, omega 3, vits and supps daily; whey prot. and etc. … and a few generic meddies to keep me alive)…

I havent yet been able to build blood centrifuges and testing machines that will moniter whether my blood levels on several points dive to life-threatening red-line. This leaves me two choices, go to the local lab four times a year and pay $500 a round, plus physicians’ fees to write orders. Or don’t go and not know when, for instance, I need life-giving iron infusions IV.

Here’s another soul who’s concerned about ‘pre-existing conditions’ knocking him off the rolls of ‘worthy to be helped if in critical need’… Whose Gonna Take the Weight? He also has a unique method of intervention and self care now.

I wonder if the current universal health care bill will cover what some deem ‘alternative medicine,’ –will this be reimbursible under the preventative care clause?

From a deeply ethnic family in the boondocks who had no ready connections to competent doctors, drugs and machines and hospitals, I tend to think a combination of whatever works very well, most quickly, and most inexpensively, with least horrible side effects… is the first way to go– but then in whatever other ways… old fashioned remedies that work, alternative medicine that works, western medicine that works… these each person has to weigh risk vs benefit from there. Hopefully with an able advisor of great experience. And time-tested efficacy of interventions.

For some of us, (Jerry Remmers my coblogger here as well who has written about the frustrations of insurance on his chronic illness…) just trying to stay “well-enough” is often a trial when the ’supplies’ for staying well, are so ungodly costly, and when many are on fixed incomes and have to decide to go without in order to absorb the escalating costs/ copays/ out of pocket pays for much-needed supplies… and the insurance, whether medicaid, medicare, medi-anything, keeps booming “Pre-existing condition. Eat it.”

Dont tell me I shoulda coulda taken better care before my health was fragile. I was born this way. Nearly didnt make month one, let alone year one. I have to work with what I’ve been given. And am grateful to Creator that I somehow still manage to be alive. Cant make everything all better by following the public pap about how everyone is morally deficient if they cannot know, afford, find, follow basic helps…

Just saying: There seems no use in trying to shame or beat up people for trying to stay healthy, when they cannot always afford to have/take/do/be whatever it takes to do so. Will is one thing. Got that. Dedication is one thing. Got that. Devotion is one thing. Have that too. Commitment is one thing. Have it in spades. Discipline is one thing. Have it most all the time.

But I and others have no control whatsoever over the huge cost of interventive preventative care now… and if WORKABLE clauses on such are not clearly scribed into the newest health care bill… intervening preventative care will only escalate in larger and larger costs to the consumer/patient/person… (Jerry Remmers and I spoke publicly at TMV about how the cost of a simple supply of one small box of blood testing plastic strips for diabetics (1/2 inch long ea) costs over $100 cash, plus often enough the cost of a doctor visit to renew the Rx from time to time). Out of pocket.

It would make no sense to pass a health care bill that left people on their own to pay and pay and pay… who have already, via insurance companies’ policies’ been exiled and on their own anyway all these decades past.. and who have paid and paid and paid out of pocket to try to stay/ remain/ regain health.

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tidbits

The problem you describe, dr. e, is not uncommon or unnoticed. The US Dep't of Health and Human Services notes the following: 1) 41% of non-elderly adults have accumulated medical debt or had difficulty paying their medical bills last year...61% of those households had medical insurance. 2) 71% of those in high cost houeholds had one or more chronic conditions. 3) Women and older, non-elderly, adults were affected disporportionately. 4) Middle class families with high out of pocket medical expenses spend an average of 21% of their household income on health care services...in addition to their health insurance premiums. The report notes the contribution to the problem from refusal to insure, or exclusion of, pre-existing conditions.

While HHS may have a bias, the sources for their information are listed on the site and can be viewed separately for confirmation of the statistics. See http://www.healthreform.gov/reports/out_of_pock... .

Whether the final health care bill will address chronic preventive care, pre-existing conditions or alternative medicine is yet to be determined. If it doesn't, it won't be because the problem(s) weren't recognized.

D. E.Rodriguez

I hear, read and see heartbreaking stories such as these--and worse--all too often.

I have often said that I "have no dog in this fight," as my family and I have, and have always had, the best possible medical care our government can provide.

But, call it stupidity, call it compassion--I don't care--I would want every American to have the same health care. And, call it stupidity or whatever, I am willing to pay a few more dollars in taxes to see this come about.

I understand--albeit I find it morally questionable--that others who are fortunate to be in a financial position to have good medical care whenever they need it, would not want others to be as fortunate, for whatever reasons: they want to hold on to the money they worked so hard for; or they don't want bigger government, bigger deficits, or they don't want "socialism," etc., etc.

That, I can understand---I may not approve of it, but, then again, it is not up to me to approve or disapprove.

But what I don't understand is the philosophy of those who don't have insurance, don't have health care, don't have the financial resources--oftentimes have already bankrupted themselves and their families--who would badmouth and even reject a health care reform that, at the very least, would bring some much-needed medical care into their lives.

If it is self-reliance, pride, stoicism, independence, etc., etc. then I understand and salute them.

But, there must be more to it...

SteveK

Dorian, You're 100% correct in your opinion and assessment of the morally questionable positions being taken by **some** of those who have their own. Even the amount of support the health industries are receiving from those actually losing under the current system is just illogical EXCEPT...

... EXCEPT when you hear that a anti-health care reform group (nameless?.. Faceless?..) ran one television ad 115 times over a day and a half before the President arrived... IN MONTANA... ONE AD... ONE HUNDRED AND FIFTY TIMES... IN A DAY AND A HALF.

And at the same time Republican legislators continue repeating BALD-FACE LIES... Death Panels!.. Euthanasia!.. Government panels that are going to kill Grannie... LIES... LIES... LIES.

It's not just health care reform they're after... they're after Obama. Some people just can not stand the fact that a smart, black Democrat is President of the United States.

Mike Lupica at the New York Daily News has nailed it: President Obama is the real target of health care protesters, not policy
"Yes, there were a few protesters en route. But the Montanans who were excited to hear the President far outnumbered the fringe groups."

Then she said this about Obama: "He was smart, fair, funny."

So this wasn't an occasion when people with legitimate concerns and legitimate points to make were overwhelmed by the wing nuts and screamers who take their marching orders from right-wing radio and television and the Internet.

Those idiots come to these town hall meetings more to be seen than heard, and think creating chaos makes them great Americans.

[...]

The most violent opposition isn't directed at his ideas about health care reform. It is directed at him. It is about him. They couldn't make enough of a majority to beat the Harvard-educated black guy out of the White House, so they will beat him on an issue where they see him as being most vulnerable.

[...]

With that kind of zealotry, screaming about government programs as if Medicare isn't one. It is why so many of them, all these wild-eyed red faces in the crowd, look completely certifiable, screaming about how Obama wants to kill Grandma, as if he's suddenly turned into Jack Kevorkian.

[...]

Even in Montana, the Swift Boaters who would line up against any health care plan endorsed by Barack Obama ran one television ad 115 times over a day and a half before the President arrived.

"Every time we are in sight of health insurance reform, the special interests fight back with everything they've got," the President said outside Bozeman. "They use their influence and run their ads. They use their political allies to scare the American people."

He is right about that. But the special interests aren't fighting the reform, in a system that cries out for reform, as much as they are fighting him. They see their first real good opening and they go for it.

They don't just want to hijack this debate, they want to hijack his presidency. The rest of it, about your coverage and everything else, is just the cover story.

Polimom

If it is self-reliance, pride, stoicism, independence, etc., etc. then I understand and salute them.

But, there must be more to it...

Why does there have to be more to it?

D. E.Rodriguez

Polimom:

"Why does there have to be more to it?"

Steve K, just above your comment, may have just found the "more to it"

ordinarysparrow

Does every American have the right to health care?. . . Then we can answer the questions of how we can afford it or how we afford not to have it. . .

Dorian's " there must be more to it.". . .i wonder about that often???. . .Is it American tribalism masking in modern garb banishing their weapons and being lead by the Shock Jocks. . .instead of being founded by poppies and heroine. . .the leaders are funded by advertisement of male enhancers and remedies for restoring hair loss. . .

In my small world this month concerning the issue of self-care. . . this is how some are coping. . .

two men have come knocking on my door with severe tooth problems. . .fever and abscess. . . one was able to get relief from a bottle of hydrogen peroxide. . . the other tried the hydrogen peroxide, the ambesol, the pain relievers dissolved into the tooth, but to no significant relief. . .i called every clinic for him but found there was a two month wait. . .so the guy got drunk and pulled it himself, in spite of the warning to do so could cause sepis. . .both of these guy served in the military. . .working in jobs without insurance. . .

another woman came looking for antibiotics or alternatives. . .she makes 7 $ a hour in a Deli. . .trying to feed a family of five. . no insurance. . .partner laid off. . .

another guy came to tell me he had just been notified he had hepatitis C. . .he was laid off a few months back and had made the decision to sell his plasma to buy food. . .the first several times he went his tests where clear, but this last time, was informed he had contacted hepatitis C. . .he is not a druggie. . .but probably got it from selling the plasma. . . he was feeling really low but needed to be pushed into going to a doctor because he did not have away to pay. . .

have yet to meet any of those people that are just looking for something for nothing. . .every person i know in these situations have to move through layers of shame for needing help and having to ask the gov to provide care. . .

it is only mid month. . .in the past couple of years i would say this is a typical month. . .people are hurting out here. . .and many do not know how to get help. . they think they have fewer options than they do even. .

i would vote in a nano second. . . down with the layers upon layers of greed and economical self interest. . .let's slay the dragon and get Universal Health Care. .

i often ask them how is your situation different than the corporate privileged that have coverage and entitlements that pay for their health care?. . .they see their corporate health care as privilege and prestige it does not come out of their pockets. . . but for the working poor. . .they are to be shamed for the gov. providing care. . .

perhaps three of the hatchets of health reform are. . .tribalism. . .class(ism). . . and greed. . .

archangel

dear sparrow re "both of these guy served in the military. . .working in jobs without insurance" please contact me as soon as possible if I can help. If they were honorably discharged, they are due veteran's med and Tricare insurance immediately. Pull own teeth? welfare mother. Been there. Pain unbelievable. Just make sure they keep rinsing with antiseptic since self-extraction, peroxide watered will work. Again, contact me if I can help. They need their discharge numbers.

hang in there, and your sis is still in our prayers.
dr.e

ordinarysparrow

Thanks Dr. E. i shall check tomorrow. . . one has gone to V.A. for Mental health issues and i will ask him if he knows that he can get dental there. . the one that extracted his tooth has an OTH. . . i do not know if that is the same as dishonarble?. . .

thanks for the prayers Dr. E. for my sister. . .

EEllis

OTH is not the same as dishonorable but they are not able to receive any benefits or VA care (outside of conditions directly related to their service). You have bad conduct and dishonorable that are worse but both of those are punishment discharges. OTH is for getting a civilian conviction, committing adultery with another solder or spouse of a soldier. Sometimes as a plea bargain.

Tell the one that pulled his tooth to go to the ER of the county hospital or almost any catholic hospital and they will check it out, give him antibiotics, and limited pain pills. If it goes bad it can happen quick, less than a day, and should be taken very serious unless he is already feeling better. Don't forget local dental collages as a way to get low cost exams.

archangel

thank you EEllis for the careful differentiation. (Some in the law are questioning discharges for civil offenses that also strip person of benefits after having served a considerable time in military, as unjust. It is not yet settled. )

Add also to EEllis' list, with care, Lutheran, Seven Day Adventist, Presbyterian hospitals, any that have a religious mission who are not also part owned or managed by an outside for-profit corporation. Also, any Catholic clinica; at the Catholic hosp where I teach they have a fund for emergency care for people who cannot afford even a few dollars, and once in program they are adjudicated for a year of care, and then re-eval'd. Same hospital, nuns bought themselves back from outside corporate that ran their hospital for a while. Reason: lack of compassionate care offered to the poorest of the poor. Much better now. Sisters of Charity. Leavenworth.

Other nun groups run hospitals throughout US... the number is huge. Some speak of taxing churches of all kinds. I think they may not realize the vast hospital system across the US funded by religious would fall... some estimate that nearly half the hospital, hospice, clinica, systems would collapse.

Of many notables: I've never heard any hospital nun in direct service of touching the poor, brag about what they do. They just do it, like others dedicated to helping and healing, religious or not... with such patience, knowing, and love.

dr.e

ordinarysparrow

Thanks EEllis and Dr. E. . will pass this information and did not know an emergency room would take a dental issue. . .i did check the local dental school. . .and there was a waiting list. . .

we do need health care reform. . . all the concern for cost important . . . but once again even with this tooth removal situation it could of turned into something so much more costly than it ever needed to be. . . part of the needed reform is education. . .

Thanks for pointing out other options. . .much appreciated. . . these suggestions will make a difference. . .i often feel frustrated in the choices i know. . .

mariaycorazon

I think it is criminal that the United States ranks so low in health care in comparison to other countries. We have actually been compared to third world countries....all in the name of medical care for profit. Kaiser Permanente (of which I am a member) actually has posted profits for the past several years. They have slowly raised their co-pays for doctor's visits and prescriptions and the case load of patients for health care professionals is outrageous The insurance companies and medical profession are running monopolies in the absence of competition to lower the costs.. It is truly ignorance when the general public fails to see through all the shabby excuses of those opposing universal health care.

D. E.Rodriguez

Thank you Steve K and ordinarysparrow for your thoughtful comments, and dr. e et al. for suggesting ways to help those veterans.

ordinarysparrow, at the very beginnning of her post asked "Does every American have the right to health care?"

My almost reflexive answer is, not only yes, but hell yes.

A country that can spend almost a trillion dollares on an elective war, surely can spend that much on non-elective health care for its citizens, including those who have served in those elective wars.

People who can spend millions/billions on private yachts, airplanes, palaces, etc., etc., (yes, they have worked hard for them) can certainly spare a few hundred/thousand more dollars to take care of the less fortunate ones (Yes, I know, those poor bas*#rds could have worked just a hard, too).

Need I go on?

newtothis

Teaching hospitals are another care option. I work at a teaching hospital in Georgia, and we have a large indigent population.

archangel

dear Sparrow, regarding dental at ER; just anecdotal from long ago, because the situ is often caused by an abscess at the root, that means infection... and clinica can dispense antibiotic that will help very much (used to be (sp?) Erythrymyacin), and even two days worth of pain meds (such as Tylenol 3, which is Rx only) will help immeasurably giving a person time to find next help for root canal/ extraction. Self extraction is the norm not the oddity among the poor, I know what you mean. Hang in there. Everywhere, everywhere there is too much red tape, not enough bandages.
dr.e

ordinarysparrow

dear Dr. E. . . i just talked to the one with V.A. coverage, he works at the apartment complex so i asked if he knew he could get dental care from the V.A.. . .he thought they only provided for severe oral surgery. . .so shared the information and then went online and looked at the services for our local V.A.. . .and sure enough it looks like they do provided dental care. . . a big smile came upon his face. . .and he is going to call today. . .

on the other one i think he is okay. . it was about 10 days ago. . .and we were able to gather up six antibiotics after he took the tooth out. . .and he did continue with the hydrogen peroxide. . .i am sure there are one that will cringe at the self-care antibiotics. . .but this is how people cope. . .rarely is a full script taken because people want to leave a few for emergencies. . .

Thanks Dr. E.. . . .much appreciated. . .

archangel

you're welcome sparrow and good job on your part in helping others. I do understand perfectly about 'batching' the antibiotics... the miracle is, they often work just fine. Some say NEVER use hydrogen pyroxide as it kills healthy tissue, but our experience long ago was first of all, it was one of the few things we could often beg a store to give us for free (it was under a dollar a bottle back then) and when watered down a bit, it did just fine and didnt kill the edges of the wound, but only killed infection starting or helped infection already taken hold... wherever the hp 'bubbled up.'

When you think sometimes of the few cents a thing actuallly costs to manufacture whether it be hp or anitbiotics or aceteminicides, it really might take only a few cents to treat a potentially perilous condition... if one had the cents to begin with.

dr.e

EEllis

"Self extraction is the norm not the oddity among the poor"

I really have to disagree. The "Poor" are normally very used to being that way and are normally adept at navigating the process to get needed services. No one in a sizable metropolitan area is in any danger of doing without food, shelter, or medical care thru lack of money if they know the system and are willing to "jump thru hoops", as I like to say, to get it. Now the "working" class poor and recent immigrants have a tougher time navigating, and in some cases being willing to accept, the "system, but it's there. Those in rural settings have much more trouble because even with insurance or programs many just don't have reasonable access to care.

archangel

dear EEllis. Thanks. I was speaking about my own layer of the poor that I grew up in, and lived in for many years as an adult, and for a time as a so-called 'welfare mother' by necessity. Indeed, until we were well near thirty years old, we had NO idea about where there was any help. My family was one of non-literate but wise in many ways, immigrants and refuges... and for miles around, the poor made do. The parishes were p.poor and many families in our boondocks had no phones, no television. Just speaking from my own experience also from working with mining families from WV, the deep poor in 'the valley' as we call it here; and the homeless. Once a year my hubby, who is a partially disabled vet... and his cohorts vets in various physical conditions go out into the highways, bridges and roads, and "bring in" the vets who are wandering, to help them sign up for their veterans' benefits, for they are either too confused, too deeply 'gone' in one way or another, embittered, broken hearted... and have no idea what is available to them not only now, but for the last many decades in return for their years of service. I wrote about this at TMV last time they went out. They'll be going again on search before the snow flies.

I should mention, that many of the men and women in the hills and under the bridges, definitely are their own extractive dentists. The savage way of need dictates, sadly so.

Dr. E

newtothis

I'm glad you're still here dr. e. I will pray for you. I used to work on a diabetic floor and i know first hand how insidious the disease of diabetes can be.

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