goingplaceslivinglife

Travel, Food, and Slices of Life


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Learning Along The Pathway

When I was growing up my Dad would often drive into town and pick up the Sunday New York Times. As I got older I enjoyed reading not only the magazine but I started perusing the classified, looking for my “someday” job and apartment. Oh, the dreams I had of what could be……and then life took another pathway.

I’ve had a checkered past. I earned a degree in geography and urban planning, but  my first job out of college was for the Tennessee Supreme Court in the court administrator’s office. They were starting a judicial PLANNING division and so, since I had a degree in urban PLANNING, I was hired. It was fun but as I realized I was getting further from my education, I looked for and moved to the planning job.  For three and a half years I actually worked for a planning and engineering company and really enjoyed it. But again……life took another pathway.

There was a death in my husband’s family. His mother asked us to move to Connecticut to take care of the estate issues. We lived in the house rent free and would until it was sold. One of my tasks was to determine the market value of the property and in doing so, we listed it for sale and boom! we needed to move within a couple of months. I was looking for work as a planner but we were in the middle of a recession then and jobs were scarce. So… life took another pathway.

I started working as an real estate agent for the broker who had listed the house. While I did well, I didn’t particularly enjoy it. Showing houses was a challenge because I did not know the area well and there were no apps with a talking GPS (hey, no cell phones at all)  in those days so I had to rely on paper maps, all the time portraying an image of competence to the buyers.  That was stressful enough but the part that made me more uncomfortable was listening to a homeowner extol the cost of the renovations he had made when it looked like a piece of incompetent amateur construction.  And then Baby #1 was born and I no longer wanted to put in the long hours needed in that kind of sales position.  Once again…. life took another pathway.

 

When I told the broker I was going to let my sales license go he persuaded me to start an appraisal division of his company. I built the reputation and business started coming in nicely and then I needed to hire some staff. The broker told me he was moving to California and was selling the real estate business, including the appraisal division. I said no way, it may be your name but it was my blood, sweat and tears. He very much understood and so, I soon owned it. I got a partner who had the bookkeeping kind of background and so we went on, growing during the 1980s real estate boom to 12 employees. (Although I planned longer, I only was able to take off one week when Baby #2 was born.) And then there was another blip in the financial market and property values started to decline. Where there is no room for a second mortgage or a current home value did not support getting the mortgage refinanced, there are no appraisals. We closed the business and…… life took another pathway.

By this time I had had baby #3 and no income. My husband got laid off. We ended up moving from Connecticut to Tennessee where I stayed home with the baby. Then my husband was diagnosed with brain cancer and after surgery, radiation and chemo I got a job at Vanderbilt Medical Center, working for one of my husband’s eye doctors. I had looked for a managerial position at Vanderbilt and when HR asked me what salary I wanted I thought about what I had made in the good years in Connecticut and then made a “cost of living” adjustment and said $30,000. They laughed…too high apparently. Anything lower would not help the family so I changed my resume to administration instead and ended up taking that first position as an AA for $18,000. I figured if I was not going to earn enough money I might as well not be in charge of anything. And so….. life took another pathway.Image result for vanderbilt university medical center

After five years of learning eye health jargon, things changed when the doctor in charge left. My position was eliminated but I was not, so HR moved me to another place in the hospital. The boss was, to put it nicely, a challenged individual. I left and move over to the university side of Vanderbilt to the Department of French & Italian. More new things to learn and master. And then my husband died and there I was a widow with a young child. Graham entered my life and I sure made him work to woo both of us. And there I was again….my life took another pathway.

My kiddo and I joined Graham when he went on sabbatical to Colorado for six months. I thought a start together in a neutral location would be good. We made friends and when it looked like he might be offered a job there I started looking for work. I had a sweet sweet double interview with the statewide blood bank and they offered me a position for a beautiful salary. I came home from that interview to be told we were moving back to West Virginia.  Ha ha…guess what….. my life took another pathway.

Looking for work in the Rust Belt was a challenge. I finally was hired as a practice manager for a financial adviser. Since it was a start-up I accepted a lower than desired salary with the promise of bonuses that would boost it to the sky (dream on, eh?). That never happened. After three years of building that business into something sustainable, I asked for a $10,000 raise and he basically countered with 50 cents an hour. I resigned. This time, definitely my choice…..my life took another pathway.

I started to build up my book selling business that I had been running on a small scale for about 12 years to provide additional income. I was able to match that prior salary for the next two years while having the time to also get involved in the farm-to-table movement and helping build The Wild Ramp. All the time, we were planning for my husband to retire when my kiddo left for college and so……my life took another pathway.

We moved to Oregon just about four years ago. I applied to about 50 jobs, making sure each cover letter and each resume was custom tailored to each specific job. I never heard from 46 place, but had four interviews. One had the grace to tell me I was overqualified and they were sure I would be bored and quit. I countered with an comment (I had nothing to lose)  that at this age I would love a job I could do with one hand behind my back. But no job was offered. (Ageism is one more hurdle to getting a job that needs to be fixed.  Date of birth information can no longer be asked, but they can and do asked for education information, including year of graduation. I think you agree, most of us complete high school at age 18, so extrapolation is easy.) So feeling ready to do anything….. life took another pathway.

I took a summer job as a farm hand. Yes, me. I never ate so much ibuprofen in my life but I did it and learned a lot more. In all my effort with The Wild Ramp I had probably visited 100 farms and had heard their stories. Now I got to get a (very small) taste of the life farmers live.  And the experience confirmed something I already suspected: I am not a farmer. But I need my farmers (we all do) and respect them highly. And so, taking a plunge……my life took another pathway.

I started up the commercial food processing business, Can-Do Real Food, to support local farmers by preserving their surplus produce by canning and dehydrating. (This gives the farmer another income, provides consumers a way to have a taste of the local summer harvest any time during the year, and reduces food waste.)  When we moved to Oregon I learned to can, so I had one year of canning at home. Other people have forgotten more than I have learned but it has been a pretty amazing experience. You can read more about it at the Can-Do Real Food blog. 

In the past year I had been dealing with a knee that has been injured but there is nothing surgical that can be done to fix it. It forces me to walk a bit wonky which has now affected my hip joint on the other side. I am in a new world of hurt and so…..I suspect my life is about to take another pathway again.

Through all these years (63 and counting) I have received continual education. The first part is one we all are fed K through  12. The next was the narrowing down of a field of study (college). And since then, through work and seminars and conferences and self teaching, the learning has continued and increased.  I urge everyone I love to never stop exploring, never be afraid of change.

I know jargon related to the legal profession, the medical profession, the academic profession, and now food processing (and government regulation thereof).  I wonder what’s next!  Whatever it is, I strongly doubt I will ever live in New York City!

 

 

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All That is New…..

Yesterday I realized that I have not written anything on this blog for about a month. Just now “what” to write hit me, thanks to a conversation on Facebook. No, for a change, this will NOT be about politics.

It is about my new life as a pothead. Well, actually not quite a pothead. One of my Oregon friends thinks I may be the only cannabis user in Oregon who is not driving under the influence.  This may (does)  have its pleasurable effects, but this is not a recreational activity for me.

I was a senior in high school when someone close to me (who will remain nameless and blameless) introduced me to weed. That definitely was recreational.

In college the drug of choice was booze and that was illegal enough thank you.  But I was an RA and would knock on the doors of the rooms where smoking was obviously happening and instruct them on how to use a wet towel.  That was definitely pro-user activity.

In the late 1970s I lived in a city in the South and a friend invited me to his family’s home to watch Superman when it was first shown in HBO. He lit up a joint and offered it to me. I enjoyed the show and I don’t remember if I was uncomfortable driving home after, but since there is no memory about it, it must have been fine.

In the mid 1980s a friend and I went on a weekend getaway to her family’s vacation home in New England without any husbands or kids.  Another friend handed me a small gift, as it was my birthday and told me to open it when we got to our destination. Inside a Sucrets lozenge box, several joints. It was a chocolate weekend.

That is not all, but the jist of my prior life with pot. Not regular at all. Never enjoyed when responsible sobriety was needed. Definitely recreational.

Since then I heard sometimes that people with cancer smoked marijuana and it helped. It helped with nausea was one thing and when we were dealing with nausea from chemo issues in the 1990s, the meds the doctor gave took care of it, so no need to search out the underground market…probably available next door, right?

And then we moved to Oregon and they already had medicinal cannabis. The dispensaries were established and things were regulated.  The referendum for recreational use passed with 56% of the votes.  I suspect there were as many “yes” votes among the Baby Boomers as there were in the Millenials.

The legal requirements for legal grow operations, laboratories for testing, kitchens for preparing edibles, and shops for selling had to be worked out, so it took over a year after the law was passed before the recreational shops were open.

Today, some shops sell only recreational pot. Some sell only to people who have medical cannabis cards. Some sell both rec and medical. The medical side has different recordkeeping to meet the legal requirements of that early law.  I prefer to go to a dispensary that sells both as I am, at this point in my life, using the cannabis to help a medical condition.

I have not asked my doctor for a medical card. It is at least a 3-step process including an appointment with another doctor and can cost $800 altogether for people like me (not a veteran,  on disability and elderly-I’m too young. LOL). The benefit: no sales tax. In Oregon we do not have a sales tax……except on recreational marijuana. (It probably was THIS benefit to the state financial coffers that convinced the “weed is evil” side to vote yes.  After all, they can enjoy thinking the stoners are paying for their sin.)  Since I do not use a lot of pot over the year a card would be valid, I did not think the little bit of additional in tax would offset the fees.

So when I realized the last bit of cannabutter was used up, it was time to go purchase something.  Asking three different friends which dispensary they preferred gave me three places to check out. (There are about 8 within 10 miles, but only 1 state-run liquor store. The dispensaries were not really busy while that liquor store is always crowded.)

Anyone my age who purchased weed in the 70s and early 80s purchased a sandwich bag (ounce) for $10. The pot in late 1970 was $40 for the baggie and was a strain known as Acapulco  Gold.  The baggies had leaf, stems, some seeds generally.

Now you can buy seeds, you can buy bud, sometimes you can buy leaf (shake), you can buy pre-rolls. You can buy extract, you can buy creams and salves. You can buy candy. You can buy infused products like tea or oil. The bud is the most popular. The strains sell for about $200-400 an ounce (that sandwich baggie) so most people buy a few grams, sort of like heading to the store for a 6-pack.

Me, I bought half an ounce. I prepared the canna butter yesterday and the gingered pear bars are out of the oven now, aroma wafting through the house.

Why do I turn to cannabis? Two reasons.

Simply, I am in pain almost all the time now. My stupid ski accident at age 19 was exacerbated by the bacterial meningitis I worked through about 15 years ago. The pain in the knee started the next year and the doctor assured me it was “only” arthritis. For years advil was my help. Then I switched to glucosamine in all its combinations. When we moved here almost 4 years ago, I started getting acupuncture and that helped me be pain-free for 10 days. But last June I twisted my knee and have minor meniscus and ACL involvement. Two docs say it is “only” arthritis. But a year later, I am not back to where I was before the knee twist and now having sympathetic pain on my other leg because of my screwed up gait. Again, if you are about my age, you may be feeling some joints now too. I hope not.

Second, my asthma. I have been concerned with the Congressional shenanigans. I promised it will NOT be a political rant, but I feel I’ve been on the “am I going to die because I can’t afford medical insurance” roller coaster.  My two medications that help me breathe cost $1000 a month out of pocket. Simply can’t do that. Can’t afford it.  And THEN I started hearing how inhaling pot helps asthma.  That’s insane! People with lung disease like asthma can not smoke!! That’s why I make edibles! Smoke pot to help me breathe? Yes, it dilates the bronchi; in fact I read a medical research extract dumbed down for non-medical readers that said it was the THC specifically that helps the deeper sections of lung also dilate.

Being Oregon, I got into a short discussion about pot at the UFO Festival in May. The guy handed me a joint telling me it will help. (Yes, I love Oregon) Over 3 days I tested the concept and yes, within a short time I could draw a deep breath without any “pulling” tightness. The next morning, still good.

Then my friends stepped in with their recommendations. One vapes. One gave me a bong. Decision made.

So, why did I write this? Because medical marijuana is available in 29 states, while recreational pot can be (or will be able to be once they get it set up) in 8 states.  And, of course, your neighbor still buys his from his coworker’s cousin, just like he always has. In other words, marijuana is around you.

And yes, there are people smoking to get high or stoned. Just like there are people getting drunk or pissed on booze. And just as others seek their escape in street drugs.

But there are more people of all ages using the beneficial aspects of cannabis for a medical reason.

 


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What’s the Right Way?

What’s the right way to challenge someone you know…someone you love or respect…when something that person says makes your bullshit meter twinge?  How do you behave when someone you know…someone you love or respect….announces something that you know is based on air and ego?

I once worked for a man, a terrific man, one of the best. I worked for him and saw how capable he is, how truly wonderful. He did great things, the best things. Really. You would be proud to call him your friend.

I knew him to be gentle and caring and smart. Very smart. Went to several of the best schools and got great grades, superior grades. Better than almost everyone else.

But he had this one teeny tiny habit. He made up statistics. And I knew it.

I challenged him once….in private.  He grinned and asked me who would know. I told him I would know. The others who worked with us might know. And he would know.

And he smiled.

Now this man is not self serving and malicious.  On the contrary, he recognizes that he was given chances in life and now, because he is in a position to do so, he wants to help others.

I love this man. Do not misunderstand me.

But I see when good men can also lie, we are in trouble.

We have a President who does not know how to admit he does not know something. We have a President who is so unsure about himself that he must make up information. He lies.

He lies so much that when he is caught and understands it is a lie, he blames it on others.

This man has no moral compass.

So how do we deal with the small lies we hear from people we love and respect?

I don’t know about you, but I will continue to let that person know I recognize what he did.  I will continue to offer a level of privacy….for a time. But if the lies continue, it has to be stopped.

As soon as we as a society get accustom to the level of lying that goes on, it will increase.

Or perhaps, it already has because we let it go. We ourselves lie at times. And when we let it go with people we know, how can we hold people we do not know accountable?  It used to be that a person’s word was what made their reputation. 

It starts with each one of us.  No more embellishing. No more lying by omission. No more painting the picture better than it is.

It means admitting you don’t know. That you need more info. That you need some help.

When I was working my very first job out of college I did not know a lot of what I was doing.  (I suspect many people play act as I did). I tried to carry it off, but I felt there was a big neon sign flashing over my head “fraud”. It took maturity to understand that it is perfectly okay if I do not know something. That level of maturity helped me a lot when I started visiting farms and had no idea of the value or benefits of corn feeding or grass feeding cattle. The rancher was patient and I actually found everyone was patient. They enjoyed talking about something that they knew. And so I learned.

And I also learned that I didn’t need to bullshit any more. 

 

 

 


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Buy American

Early in my blog writing a woman who I really didn’t know messaged me “don’t yell. No one listens to someone who is shouting at them.” Or something like that. She became one of my best friends and I trust her judgement often and always.

But it is apparent that many people don’t listen to anything that involves thinking and change.

I will try again, though. I am Taurus = stubborn.

So we have the start of the growing season here. The earth is warming and food crops are being planted. In large mechanized commercial farms, much of planting can be done by machines with one worker covering a large field. And some food crops can be harvested mechanically also.  However, many require hands-on. And that needs a work force.   Part of our national history is the transition from an agrarian economy to an industrial and now a post-industrial economy.  Almost 200 years ago most people living in the United States were involved with farming. You can see what has happened over time. 

In the past twenty years more and more of these farm jobs have gone empty until filled by migrant workers. Many are Latino and here in the Willamette Valley of Oregon we very much recognize that our vineyards, orchards and large commercial food farms need these workers.

It’s hard work. I know. I took a farm hand job three summers ago. Me. At 60 years of age, overweight, arthritic and with a bad back. The high school worker was heading back to school in August and the farmer needed someone until the end of the season. I never had done this kind of work and my body let me know. But this is not impossible work. So anyone who can walk, can bend, can use their hands, can do this work.

However, it seems that in most areas of the country, white people do not want to do this work so much. And so, others fill in. They are not taking jobs away. They are helping feed us. Some are not legal workers. 

Trump ran for President hollering (hey! he yelled and people listened……or maybe they didn’t, but that’s a different blog) that it was important to put America first. That we needed to get rid of all the bad hombres and that has translated into all people who are here without full legal status, no matter the agreements in the past.  Trump supporters have not yet woken up to the fact that when the work force is removed, something will happen.

In this case, it means the food raised here on large farms in the United States most likely will not be successfully harvested. One farmer we know lost his work crew last year when the blueberries matured early. His strawberries matured late. All that is because of the weather. But it meant his picking crew went off to attack the blueberries, which are easier picking than strawberries. He lost thousands of dollars and many of his strawberries rotted on the plants because there was no one to pick them.  This situation will happen again more and more in more places, not necessarily because of the weather but because of a shortage of willing workers.

Trump’s policies are convincing many people without family roots to head back south to their native lands. The risk of imprisonment and deportation is high. So, many people are leaving. There are also many people who are not leaving because they have been here for 20 or more years. Part of their family was born here. Others may have legal status.  The undocumented workers are still here, but there are fewer than before and many are not taking jobs because of the risk of being arrested.

As this situation will exist in the coming months everyone, including Trump and his supporters, are going to feel it. They may be cheering now, but the time is going to come when they realize there may have been a better way. They’re already feeling it in southern California and in Florida where harvests happen several times during the year.

How?

  • Prices will go up. To keep your business and their profits supermarket chains will contract for produce from other countries.
  • Flavor will go down. That long distance produce gets harvested a bit early, a bit green or immature, to give time to the transportation process before it starts to rot. Flavor just does not develop that way. If you buy produce from overseas, you miss the flavor of how it really should taste.
  • Farmers here in the United States will not be able to continue to farm. Or at least to farm food. (Much of the Willamette Valley farmland is used for wine grapes, hops, hazelnuts and landscaping plants.) Farms will fail financially, and the land will go fallow. That will have a ripple effect on the economy, too.

So, Southern and Central California are where the bulk of supermarket produce is grown. And harvested. Or not harvested…and then not shipped to your grocery store. 

So, why do I say BUY AMERICAN when I also am saying food raised here in the US is going to have smaller harvests and higher prices?  Because if we don’t support American farmers we are going to see our food production, like our manufacturing, move offshore.

There are ways to buy produce at affordable prices but it means a commitment to change your shopping pattern. Only you can decide if giving your children and grandchildren a chance to buy American food is important.

Am I exaggerating? Unfortunately, no.  I remember my parents complaining that it was getting harder to buy American made when they replaced our black and white television with a color model in the late 1960s. At that time, Magnavox was only one of a few and they are still in business today.  All the other tvs that are manufactured here are by Asian corporations who have built factories here to save on shipping and other costs.  How did this happen?  Simple-we consumers like to buy based on price, not patriotism.

Yet I bet you believe you are a patriotic American.  Demonstrate it by investing in America’s economy.  This is a consumer driven industry! Buy locally raised food. Go to a website like Localharvest.com to identify when your farmers markets are, where the farms are near you that offer CSAs, where you can pick your own produce. Perhaps this whole discussion is meaningless as most Americans do not eat a lot of fresh fruits and vegetables, but if you do try to eat in a healthy way, this will affect you unless you also grow your own food. 

And get those teenagers to take summer jobs working on farms….they’ll buff up, tone up, and get a great tan!

 

 


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Okay…So Now I Know

Have you ever wondered how you are going to die?

Back in the late 1960s my father’s sister developed breast cancer. If you are old enough, you probably remember that cancer was so horrific with few cures in those days that most people never said the word. It was the Big C. If it was uttered, it was in a whisper. Watching her decline, I assumed I would get breast cancer.

My mom and all her side of the family died from issues related to heart disease. No doubt in my mind that I have a genetic disposition for that.

I am not a morbid person. This is not anything that fills my waking hours with dread. I am not afraid of dying; I just have a lot of living yet to do, so I don’t want to go before my time. But recently, very recently, I have been staring at a new death option.  And it makes me angry.

With the threats/promises to repeal the Affordable Care Act, the Republicans in our lives have also threatened and promised to kill 20 to 30 million people in this nation. We, the ones with the death sentences, are your neighbors and your family members.

Why will we die?  In my case, I  will suffocate.  I have chronic asthma. It is well maintained with two medicines that currently cost me $100 a month. Their out of pocket cost, without insurance, is close to $1000 a month. Guess what? I can’t afford that.

So, very simply, if Congress in their infinite wisdom think it is more important to destroy the law because it was implemented by Obama, instead of fixing it (good luck with that if you want to keep the insurance companies in charge, but that’s another story and blog) I will die.

So now the question is, will you also die?  Will people you know, people you love, also be murdered by Republicans?  aca-congressional-district

That sounds harsh, but think about it. There are two components in the ACA that help people.  First,  the insurance premium (set by the insurance companies, not the ACA) is reduced based on income. This is part of the benefit that will be removed. The premium I need to pay is $535 a month. Before the reduction, which is based on my income, my premium would be $875 a month.

Secondly, the ACA eliminated discrimination insurance companies had based on pre-existing conditions. I was diagnosed with asthma when I was 5 years old. This is a pre-existing condition that before changes in the law meant I had to wait 12-18 months when changing medical insurance companies (because of a change in jobs) to be covered. I was fortunate that my breathing issues were pretty minor until I moved to West Virginia in 2007. The Ohio River Valley is one of the areas in this country with a high cluster of breathing problems. After decades of heavy industrial air pollution and the way the air currents flow, the environment caused a major decline in my ability to breathe. My health issues were covered at the time because of a change in the law back in the 1990s: employer offered health insurance would not have the pre-existing restriction if the employer had more than 100 employees. My husband worked at one of the state universities, so we had a state employee health plan.  So, I was able to be treated for the asthma while we were living there.

But in anticipation of my husband’s retirement, the question of my healthcare once again raised its head. His retirement package included an extension of my health insurance coverage but that would run out before I would become eligible for Medicare. I anticipated a major gap of coverage and was very pleased when the Supreme Court ruled the ACA could be implemented.  And so, I have been able to continue to have insurance. I have written about my lifelong experience with my health insurance coverage in January. I did that not to elicit sympathy but to share what I believe is common situation. Many of us have known people who have had someone with a major illness and our American  healthcare insurance coverage has always been a factor in the rising number of bankruptcies in this country. aca-repeal-gop

When we talk about “millions of people will die” if the Affordable Care Act is repealed the number is hard to understand it. Recently, a health-care analyst broke the statistics down to Congressional districts. In other words, if Congress decides to erase our health care, they will lose this many people (voters)  in their own districts. I now know I am one of almost 80,000 that will be affected in my Congressional District. The difference between me and you? I know my Congresswoman, Suzanne Bonamici is one that is working to keep the program. What about YOUR representative?

Take a look at this effort to provide the information on a scale where we can realize how many of our neighbors will be dead if Congress moves forward on their promise/threat. All because its nickname is Obamacare.

And you know what?  There is a huge group of people in this country who love their health care coverage through the Affordable Care Act but despise Obamacare. Their lack of comprehension is a sign that we have a major problem with people who no longer know how to think. But that’s another blog……

 

 


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They are Making THEIR Choice Known – What’s YOUR Choice?

Back in the late 90s I worked as an administrative assistant in the Vanderbilt Hospital office that maintained the electronic machines that go beep, among other things. One of the technicians had the opportunity to go to a training seminar out of state and was excited about that until he realized he would have to rent a car to get from the airport to the training site. (No uber or lyft in those days.)  He asked if I could arrange to get the department credit card for that expense. I presented his request to the supervisor who had an interesting reaction.

He not only immediately said no, as he was wont to do anytime anyone asked anything “nice” of him, but he then went on a demeaning rant about how anyone could be so inept with their own personal finances that they could not float a $500 expense that might take a month to get reimbursed. He not only had no understanding that not everyone he knew was as financially solvent as he was, but he had no empathetic ability to recognize times may be hard for others and what small thing could he do to help.

As I was myself in severe financial straits at the time dealing with a serious long term illness in the family, I could immediate understand the technician’s situation, and so, went to bat. We got the department credit card, the technician went on his training trip, and all worked out.   But the message hit home. Some people are so narrow in their view of the world that they have NO ability to recognize anyone may be different. And when that different worldview is thrust upon them, they refuse to learn about it, and so more easily want to brush it under the table. Make it disappear.

Unfortunately, there are a lot of people like that supervisor. Many are in positions of authority as he was, and so exert control with little signs of benevolence. Instead, they are judgmental and their aim to make people causing them problems disappear may not be hidden well.

Years before, sometime in the 1970s I read a book which stayed with me.  Triage by Leonard C. Lewin, published in 1973, was not a best seller and is not a spellbinding page turner but it is a view of a dystopian society where the government and individual corporations make decisions that can and will cause death of “stupid” people, “old” people, “sick” people, “worthless” people.triage-definisiton

triage-bookThe one story I remembered from reading 40+ years ago was about how car manufacturers had come up with a motor that had NO unhealthy emissions and so would eliminate pollution. Sounded great as they they made their presentation to what is clearly recognizable as the EPA until someone finally asked a question they were hoping would go unasked. Simply, the revolutionary motor needed to be started with a proscribed sequence and if not done correctly would blow up. The manufacturers had rejected installing a switch in the car to inhibit imperfect start-up because then they would be accepting responsibility if it failed. The best thing they could offer is that it would only kill the driver who would be showing his lack of intelligence by not following instructions. Passengers would only be injured. The roads would then, they argued, have one less unsafe driver and so driving accident rates could be expected to decrease.

When I went to purchase the book recently to refresh my aging memory the reviews talked about how this is a libertarian viewpoint. Each person is responsible and no paternal oversight should be expected.  I don’t know about that but I do know there is something very much missing in the actions described in the book.

Today we are about three weeks into the new President’s administration and the view from here is one where decisions are being made without much thought about consequences.  It seems like backs are being scratched and the promise to clean up the government by “draining the swamp” is resulting in an exchange of self-interested people with long term experience for people who have paid for their new position and have considerably less experience and a demonstrated predominant display of self interest.triage-decision

I am not inclined to buy into conspiracy theories but it is getting clear even to a Pollyanna like me that something stinks. We The People are not relevant to the people in power.  We WILL be killed off by restricting health insurance, astronomically raising the price of life saving medicine for increased profits,  eliminating environmental protections for water and air, allowing food to have increasing levels of potential carcinogens. Discussions about a new educational policy has not included improving work and life skills nor cognitive reasoning skills. We have been promised that rules restricting businesses will be reduced, thereby helping small business people, but the candidate to run the Labor Department has a long history showing he cares little about wages and work benefits. I fully expect more, not less regulations affecting my own business.

In addition, we are seeing the formation of a shadow administration.   We have a President who has already demonstrated he is unwilling to be informed to make decisions and thereby  relying on his advisers for their input.  In Steven Bannon we have a person who has a history of showing a very narrow definition of who is acceptable.  His advice to the president will ONLY be in their own best interest and those of their cohort.

The rest of us are expendable.  Get ready to play. You’re in the game whether you want to be or not. dice

 

 


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Six Decades of Medical Care

So many changes. Any time you can talk to someone whose life has spanned more decades than your’s, an interesting discussion could result if you asked about big changes they had observed. I thought I’d take you through a small walk about health care as I have experienced it. I suspect this post will be longer than most I write.

doctor-norman-rockwellMy mom trained as a nurse in the 1940s and met a doctor studying to be a pediatrician at the hospital in New York City. When she and my dad moved to New Jersey they were thrilled the doctor had set up practice in the next town and I was told years later that I was his first baby, whatever that implies. Anyway, we would go to his office, located in the first floor of a multi-family house and wait to be called in. I read Highlights magazines and graduated later to Reader Digests. (I guess some things never change.)  I had my first asthma attack at age 5 playing with a hula hoop. I received allergy shots with needles that were sterilized with the glass syringes in the doctor’s office in their autoclave.  When I was too sick to go to his office, he came to our house. The house call that no longer exists.

In college I went to the college infirmary. The health care fee was covered in our overall  tuition which was about $500 a year.  My 19-year-old skiing accident where I banged up my knee was ignored and over a few weeks I healed. I developed arthritis in that knee in my 40s.  (Life lesson…if you get hurt, even if you are young and can heal well, go get help to make sure you are healing correctly.)

My first job after college was for the State of Tennessee in Nashville. I really do not remember the insurance plan provided but it would have been a large group of state employees. I didn’t see the doctor at all except my annual checks for health and I ended up with a minor surgery. I did not take any medication in those days.  I don’t remember the fees but I do remember there was no stress in paying even though I was making about $6,000 a year.

herniated-discI changed jobs and moved to Memphis a few years later and in the course of the move, hurt my back. My new insurance was through my company and even though the injury happened before my first day of work, there was no waiting period.  I saw a chiropractor a few times and then an orthopedic specialist for a year before opting for surgery. There were no MRIs in those days and I was in the hospital for 4 days. My portion of the bill was under $100.  I also started allergy shots again while living there and paid $1 per shot.

I ended up a few years later  in Connecticut. My husband worked and had Blue Cross through his employer. He needed counseling and later a short hospitalization. I started taking blood pressure medication.   We had two babies (one by c-section).  One baby needed a couple of surgeries.  Our copays for medicine were $1. The hospital bills were $500 for the c-section, $300 for the next delivery VBAC, and the other surgeries were about $300 each.

That husband and I split and I was able to pick up coverage for a Kaiser Permanente HMO plan through a small business group. I paid $400 a month for a family plan which included my two kids and me, and later, a new husband.  It had no copays nor prescription costs. I fell and hurt my back again. Again I saw a chiropractor for a while and then he referred me to an orthopedic surgeon. Still no MRI in those days. The hospital stay was 2 days and I think my bill was about $700. I later had a miscarriage and the D&C cost nothing since it was done in the office. My last baby was born in the same hospital as the first, 11 years before but was also a VBAC and cost about $500.

Then I moved back to Nashville and my husband started working for the State of Tennessee and we had HMO plan through Aetna. Prescriptions were $2 or $5 each. Doctor visits to our primary physician were free. Specialists were more and this was when things started getting really interesting since my husband was soon diagnosed with brain cancer.  We were sent for a C-Scan one day and then an MRI the next. The specialist at Vanderbilt Medical Center ran a kazillion tests to determine where the tumor was located and the potential effect removal would have. Surgery was scheduled and became the day my life seriously changed as he had the equivalent of a stroke on the operating table and was not expected to survive. But he made it through the night, improved in fits and starts in 8 weeks in the ICU, another 2 weeks in a regular room and then home. Physical therapy was provided at home for a few sessions and then we went to the clinic for that. I understood the coverage for physical therapy, occupational therapy and speech therapy was for 5 weeks. The clinic suggested visits twice a week. We asked for and went daily every weekday of those 5 weeks.  At that point he had improved enough that they wanted to try the surgery they had had to stop 5 months before. It went well, with 2 weeks in ICU and then home after another week. The bill, when it got to us and I finally figured out the in and out and all around nonsense, was $7500 to us.brain-tumors-fig4ab_large

(Now, we step aside for a minute. Recognizing that $7500 is an amazingly low bill for all the scans and surgeries and special tests and ICU and medicines, it still was something above and beyond what we could afford. He was the wage earner. I was home with the baby, something both of us had wanted to try to do for a couple of years and I was just starting to look for work when his seizures started. So, we had no income, no savings and we had that $7500 bill and of course all our normal living expenses and rent, utilities, food, car expenses and then I needed migraine medications, I’m sure you can understand why.

At that point I did a few things. First, I called our landlord and asked him if he had a smaller, less expensive place for us to live and he listened to the why of the question, was silent and then said “The last thing you need is to move. Pay me when you can as much as you can and don’t worry about it until then. I am in a position to help you.” That man is one of my life angels. I have used this story whenever I hear anyone talk about how people who are homeless are all drug addicts or drunks and basically did it to themselves. There but for the grace of that wonderful man, we would have been homeless.

I also called and talked to someone at the county level to find out if I qualified for any assistance program for the six months until the social security disability payments kicked in. They said no. The problem was we had a VERY few thousand dollars in our IRAs and they wanted us to use that up before any public assistance would kick in. The fact that it was a temporary need and very little set aside for our future did not work into any equation for help.

Finally, I called the credit card companies. We had 3 cards and each had about $2000 on it. I asked for the cards to be frozen. Basically I would not use them but asked for no interest or penalties. I owed the $6000 but did not want to see it go ridiculously higher when we could not make payments. They refused to work with me.)

So, back to the medical care. Cancer is expensive. We had radiation therapy. We had chemotherapy. And then, something unexpected happened. He did not die. I was told to expect him to not live beyond five years and when all was said and done, it was about 10 years. I had gotten a job after the first round of chemo so we would start having more income. I was lucky to get a job at Vanderbilt Medical Center and later the University. In those days the issue of pre-existing conditions meant that he would have had no medical coverage at all and I would not have had coverage for my blood pressure, allergies and stupid migraines for at least 12 months. But the year before the Democratic Congress had passed a law that any employer with more than 100 employees would offer health plans with no pre-existing conditions limitations.

So on we went. The plan each year at Vanderbilt changed. Sometimes it was strongly limited to Vanderbilt with very low fees inside that medical center and higher rates outside. No big deal to us since we were relatively new to town, but it caused messes for people who had relationships with doctors outside the system. One year it was equal inside and outside the medical center. I had sinus surgery that year at a different hospital.  By that time my share of our medical bills were topping $15,000. Still not a ridiculously high price but too high for us.

I went to talk to a debt counselor. After hearing my story he got up and shut the door and said they were not supposed to suggest bankruptcy but our situation was exactly the reason the law was there. I refused. Maybe not my wisest decision but I felt we owed all we owed except for the stupid interest and penalties for the three credit cards. He suggested if I chose bankruptcy my credit would be okay in seven years. I still said no. I felt morally obligated to pay my bills. I just needed help getting them reduced or a time payment plan set up.bankruptcy-causes

hospicemedallionAnd on it went. About eight and a half years into the illness my husband could no longer stay home safely by himself. The option of me quitting working was not feasible, so we needed to find a nursing home for his care. The one that had a bed at the time was my third choice. The top two had a medical director that was our primary care physician so I thought the continuity with the same practitioner would be beneficial. But they had no beds, so he went to #3.  It was fine, as those kind of places go, but week after week he “failed” the test to be able to become a Medicaid patient. He could put the pills in his mouth and swallow them when they were handed to him. He could dress himself in two hours when the clothes were given to him. He could still manage to shuffle to the bathroom. But the time came when he couldn’t do enough of the things on the checklist and so, became eligible. All bills were sent to Medicaid. The nursing home had a fire three days later and 13 patients died. (The story of that night is for another time.)  Ironically, my husband got transferred to one of the places we wanted.   Once Medicaid took over, I had no more additional costs for him. We stopped taking him for MRIs when it needed to be by ambulance and really, why bother after a while. Hospice got involved and visited him three times a week to provide supplemental care issues.

I stayed at Vanderbilt another 18 months after he died.  By that time I had moved to the university side of Vanderbilt and was voted to the Staff Council. My project was to track the amount we shared in our  paychecks to pay for our medical insurance (and parking) each year (the payroll deduction increased about 10% annually) while noting our raises each year (about 5%). While I appreciated the benefits, I wanted people to realize that we were slipping backwards all the time. I quit the Council when I was told to stop; that the administration did not want that kind of information shared with the staff who could not figure it out themselves.  Meanwhile,  Graham, who I had met online in a chat room about 8 years before, asked me to marry him and have my youngest and me join him. He was teaching at a state university in West Virginia, so had a health insurance plan through the state.  He was able to add my son as a dependent pretty quickly but I paid COBRA until we got married.

copayThe new plan was challenging. It was a more standard system with copays and deductibles that had to be met and  with a cap on lifetime use.  Having been exposed to the world of cancer I knew sometimes patients ran into the lifetime limit and care ended, with death soon after. It was horrific to watch knowing a maintenance dose could keep a person alive longer with a decent quality of life.  I started allergy treatments again as my sinuses and lungs were getting horribly affected with the pollution in the Ohio River Valley.  We had no dental care coverage, minimal eye health coverage, and limited options for specialists because West Virginia is one of those places in the nation that just does not have all the choices other places do.

And then the young one left for college. We had to take out an insurance policy of about $1000 a year on top of all his tuition and fees and room and board for him to access the medical care on campus. Then Graham retired and we made our move to Oregon. Graham had enrolled in Medicare and the first problem we had was there were no primary care doctors in our town who were taking new Medicare patients. I paid $500 a month for a COBRA plan from the State of West Virginia when the Supreme Court ruling on the Affordable Care Act allowed implementation. I was pleased because the time limit for COBRA was going to run out before I became old enough for Medicare.

ohpWorking with someone trained in all the offerings, I selected a plan that was good and did not cost “much” It was $550 a month just for me. Since our rate was based on the prior year’s income and we had now retired, we resubmitted about 4 months later with our current income. We wanted to find something in the $350 a month range but instead they enrolled me in the Oregon Health Plan, the expanded Medicaid offering.

I was concerned that I would not get adequate care but was extremely surprised and pleased for the most part. The one issue where the specialist decided not to order an MRI when I injured my arthritic knee (“You have arthritis” he said. “I know,” I answered, ” but it feels different and I can’t walk right.”) and told me to go home. Otherwise, the clinic was friendly, competent and ON TIME.

Last September it was time to re-enroll and our joint income was $200 a month too high to qualify for the same plan, so I had to go back out to the Marketplace and found something for $530.  And OHP dropped me in September but I could not pick up the new plan until January 1. I went three months without my breathing meds ($1000 out of pocket per month) and that set me back to a 20% lung function rating. It will take me about three months to climb back to something better. I have copays and a deductible of $2500. I’m partway there….got that MRI for the knee and that cost me over $700 out of picket because I am working down my deductible.

So, the point here was not to bitch and moan. The point is to show that health insurance has ALWAYS been confusing and ALWAYS has been inaccessible to a large group of the American public.  Prices ALWAYS go up. Benefits ALWAYS go down.

But I sure enjoyed the Medicaid plan. I would be willing to pay an affordable monthly fee for a plan that allowed me to get care without any copays or deductibles or lifetime limits.  THAT was a joy.cost-of-healthcare