Tag: healthcare

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Living in Society

The Health Care Abomination that is America

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Dec. 15 is the deadline to sign up on the ACA marketplace for health insurance effective Jan 1, 2025.

When I left the company and career of 25 years, securing health insurance was an issue. That was July 2009. There were no easy options, so I stayed on COBRA coverage.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan. (U.S. Department of Labor website).

COBRA was expensive, so I looked around. I found the Iowa Farm Bureau offered a health insurance plan which was less expensive with reasonable coverage. More than farmers bought their plan, and so did my spouse and I. It wasn’t the best policy, yet it was good enough and met our needs.

The Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010. When the ACA marketplaces were organized, I completed an online form and found that with subsidies, I was eligible at a lower cost than we were paying the Farm Bureau. I signed up for a plan and stayed with the ACA until I was eligible for Medicare.

Today, with Medicare supplemental insurance costs, our health insurance bill for two people is about $935 per month, not including dental or vision coverage. I looked at buying a plan for dental, yet the cost of paying regular care out of pocket was less expensive. The same with vision. Eye treatment related to a health condition was covered under the health plan. The cost for this is slightly less than what I was paying for COBRA in 2009.

The poverty guideline for a household of two is $21,150, according to the U.S. Department of Health and Human Services. Our income is more than that, yet many struggle to bring that much home. Health insurance on such income? Without government help people can’t afford it.

All of this serves as a long build up to the significance of today.

I previously wrote the following about deadlines to sign up for health insurance on the ACA marketplace:

To be covered Jan. 1 you have to be enrolled by Dec. 15 and have paid your first premium. At this late date, I doubt Congress is going to act on the subsidies. In fact, last week, the U.S. Senate rejected extension of ACA subsidies proposed by both Democrats and President Trump. Here is from the website:

December 15: Last day to enroll in or change plans for coverage to start January 1. January 1: Coverage starts for those who enroll in or change plans by December 15 and pay their first premium. Open enrollment continues until Jan. 15 but there would be a lapse in coverage if you wait until then.

For people who don’t have health insurance now, the Dec. 15 deadline is meaningless. Even the Jan. 15 deadline can be difficult without the means to pay for a policy. There is a lot more to say on this topic, yet Tick! Tock! Life is going by at the speed of an eighteen wheeler with the hammer down.

I agree with U.S. Senator Bernie Sanders it is time to guarantee healthcare for all in the United States.

According to the most recent data, the United States spends $14,570 per person on healthcare compared with just $5,640 in Japan, $6,023 in the United Kingdom, $6,931 in Australia, $7,013 in Canada and $7,136 in France. And yet, despite our huge expenditures, we remain the only major country on Earth not to guarantee healthcare to all people as a human right. (It’s time for the US to guarantee healthcare for all, U.S. Senator Bernie Sanders, The Guardian, April 29, 2025).

President Obama was handicapped by the influence of insurance companies while he negotiated the ACA. It is remarkable any healthcare bill at all was enacted into law. Step-by-step, Republicans are stripping away the meat of the ACA, and will continue until all that is left is its bones, which they will grind up for fertilizer. Eliminating the ACA subsidies is just one part of a long plan to remove all the good things the ACA accomplishes.

If you look at my personal journey on retirement health insurance, it was only with Medicare that my worries about how I would pay a medical claim were addressed. Before that, my privileged status as a white male who was able to find a job with health insurance enabled me to find care. The care was never what I wanted, but I didn’t go broke because we had bills after our child was born in a hospital, or a major surgery.

It is easy to say there should be, as Senator Sanders says, Medicare for all. Getting that done in the United States is nearly impossible with the influence of special interests and their money in Washington, D.C. This is what makes healthcare an abomination in America. I know we can be better than this.

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Living in Society

Change with Flowers

Daylilies

Before dawn it was 78 degrees Fahrenheit. I went for a hike before the sun came up and beat the daytime heat. It will be the kind of heat they were talking about in the Bible… namely, Hell. A couple groups of joggers were out with me, one running by flashlight. We locals often have the same ideas if there are different interpretations of illumination.

I went to the clinic for a blood test this morning. A technician was working on the entryway. Looked like he was installing a new security system. He asked, “How are you?” I responded, “That depends upon what the doctor says.” Well… he left himself open to that old-time joke.

The university remodeled the waiting room. They removed almost everything except the seats, replaced those and increased the capacity to 13. They included two double-wides, not that anyone in our area needs one of those. They must have high hopes. That or standard practices that make no sense out in the country. I noted they made me wear a wrist band. Not like I would get mixed up with anyone else at my early morning appointment. They did use it to scan me after the blood was drawn.

When I was checking out, the person at the window said my current physician is moving to Coralville. Did I want to follow him, they asked? I said I wanted to continue to visit the local clinic, where I have been going since 1993. They changed my appointment to be with the new practitioner. I should have asked whether it was a physician or some other type. Guess it doesn’t matter for my kind of common maladies.

I made a list of outdoors work for after the clinic, but the only thing I did was spray the cruciferous vegetable patch with DiPel which is made of bacillus thuringiensis, a common pesticide used by organic growers. Everything else will have to wait until the heat wave moves on. According to our post-DOGE weather report, it looks like it is heading east and we may break loose by tomorrow. Who knows, though.

Importantly, I have returned to writing. I wrote a chapter with a career update, then turned to my real interest: remembering our time as a family when we moved from Indiana to Big Grove Township. I can tell it will be a good summer for writing.

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Living in Society

Taking Treatment

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Like many people, I am self-sufficient, reasonably healthy, and don’t like going to the doctor or clinic. I go often enough to catch things before they get bad and mostly take their preventive medical advice. On Tuesday I had the third colon screening of my life and the results were favorable. The practitioners were helpful and congenial. I knew one of them from in real life, although surgical spaces with structured hierarchies and apparel are real life too.

My previous colonoscopy was on Feb. 20, 2015. The visit became a horror show when the physician asked me whether I wanted to add an extra procedure just as I took sedation. This seemed a bit of hucksterism. The treatment plan had been laid out for weeks. While I still had consciousness, I told them no thank you, I came for a colonoscopy, so let’s stick with that.

When I presented for the procedure on Tuesday, there was a protocol whereby I stated my name, date of birth, and why I was there. Then the practitioners repeated “colonoscopy” then they each said “I agree.” Things went much better because of this protocol. In both cases, no polyps or biopsies. On Tuesday, doctor said I was good for ten more years. I thought of the Social Security life expectancy table and said to myself, may I live so long.

Neighbors were involved in both procedures. In the earlier case, the neighbor hooked me up to the saline drip which had the apparatus for administering sedation. The night before, we had a discussion on the telephone about another matter. They had the professionalism to not bring that up while I was getting my IV. The procedure was well done. Tuesday, a different neighbor was called in because there was a shortage of nurses to do all the work. This nurse had been a member of the board of directors of a group I was in. In those days, I did not know they were a nurse. We used the time between tasks to catch up.

The community of practitioners is not very big in Iowa. It seems inevitable there is a relationship between the patient and one or more of the folks in blue scrubs and hair netting. One should be on best behavior… always.

The other thing I would mention about my 2015 procedure is getting a colonoscopy was a communal event. After check in, the morning’s patients were assigned space in a large room with flimsy curtains partitioning off one patient from another. We could hear each other talk and we knew what was going on right next to us. That curtain made for little privacy. In 2025, I had a room of my own as a base where the person accompanying me could wait and I could leave my clothing until needed. I felt the care was more personal in the new setting.

Other than the procedure, Tuesday was a lost day. I used the afternoon to sleep off the sedative. One day in the life in Big Grove. Let’s hope there will be others.

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Living in Society

Reading the Shifting Sands of a Life

Flowers in the driveway.

Afternoon plans changed after the optometrist dilated my pupils. It was part of my annual eye exam, in which I seek to monitor whether or not diabetes is showing in my retina. I got an all clear diagnosis but the dilation persisted well into the afternoon. I could not bear working outdoors on a sunny day. That evening it rained for several hours.

Thursday morning I wheeled the recycling bin to the curb for pickup. It has been warm enough I dispensed with wearing a sweatshirt. A light breeze felt good on my skin as I contemplated the dark sky while walking back to the house. Simple things in a simple life.

Also on Thursday I began a five-day prep for a colonoscopy. The hospital would have me reduce the amount of fibrous food eaten, which is a chore since almost everything I eat by design has plenty of fiber. I asked them about it, yet they had no guidance about what I should eat, saying, “Do the best you can.” It will be a change during which I expect to drop a couple of pounds of weight. After the procedure I expect to gain it back.

Four paragraphs in and I’m not sure where this post is going. I don’t want to write about the political-media-government generated chaos available in my email and social media news feeds. I rely on email, newspapers, substack and BlueSky for most of my information in this category. Thing is, everyone has the capacity to access the same kind of information, so repeating it wouldn’t be adding much new to the fray. I guess I’ll write about my changing relationship with the public library.

My writing space has thousands of shelved books. Organizing them is a work in progress. There are thousands more stored in boxes. I don’t need to add many more to my collection, so this year I started using the public library more. It started with a simple request.

I asked the library to order Chris Hayes’ new book The Siren’s Call and they did. Part of this process is the person who suggests a new book gets the ability to read it first. I read it and reviewed it. I am glad others in the community will be able to check it out and read it too. Then I asked the librarian to order Bill Gates new book, Source Code: My Beginnings. They have a process to make book suggestions online, which I love. They did order it, I read it, and wrote a brief review on Goodreads. After reading it, I have no interest in finding a spot on my shelves for it. Better the library keep the copy, as this book should be popular. By this time I was enjoying the public library again.

I began exploring the website, the hosting of which is currently paid by a grant from the federal government. They have a feature called “What’s New” which is a query form that calls up the titles added to the library shelves in the last week. I’m checking it out daily. Already I found several new books to read, books I might have missed in other places. In addition, my home page has this banner at the top: “In 2025, you have saved $434.00 by borrowing from the library rather than buying!” Now I was really hooked.

My philosophy of reading is pretty simple. Read some pages in a book every day. This habit is part of developing a way to live a good life. Some books demand more daily pages than my typical 25 per day. Once I get going on a good book, it is hard to stop reading.

If you haven’t been to the public library in a while, I recommend you check them out. Maybe you will find a way, like I did, to reinvigorate your reading. Plus, there is usually no cost to check out a book! Other advice: figure out your topic before writing an essay. It may keep your readers more engaged.

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Reviews

Book Review: The Hidden History of American Healthcare

In The Hidden History of American Healthcare: Why Sickness Bankrupts You and Makes Others Insanely Rich, author Thom Hartmann returns to familiar themes of greed, racism and oligarchic corruption. He applies them to a system of healthcare that profits the wealthy and provides marginal healthcare to Americans. A proponent of Medicare for all, Hartmann dives into what’s wrong with American for-profit healthcare and how changing it to a single payer system would be better for citizens.

Describing the overall theme of the series of Hidden History books, Hartmann lays out the challenge:

Americans must now prepare politically for 2024, and that starts by picking candidates and promoting policies that will beat oligarchy at both the presidential and congressional levels.

But most urgently, the entire country must laser-focus on stripping the oligarchic and fascistic elements that have crept into our republic since the Powell Memo, multiple Supreme Court interventions, and the Patriot Act with the war crimes and torture it has already facilitated.

Preface, The Hidden History of American Healthcare by Thom Hartmann

Anyone who bought health insurance through an employer or privately knows the issues with the American system: health insurance premiums are expensive and subject to high annual increases; there are co-pays that vary depending upon what type of coverage is purchased; preexisting conditions affect premium amount and can exclude people from some types of coverage; rather than visit a clinic close to home, an insured must visit medical professionals within the network of the insurance company or face higher costs. This system led to health care costs representing 24 percent of GDP. Countries like Taiwan have a healthcare cost of six percent of GDP, according to Hartmann.

Thom Hartmann

There is a better, less expensive way of providing healthcare. The trouble is, Hartmann said, “(it) would cut off the hundred of millions of dollars that health care industry executives take home every month.”

Hartmann seeks to put healthcare into historical context. He recounts the first single-payer healthcare system in 1884 Germany. He takes us through the creation of Medicare from John F. Kennedy’s initial proposal to passage into law under LBJ, and through the Republican dissent over the program. Hartmann describes Republican efforts to privatize Medicare through what is called Medicare Advantage implemented by President George W. Bush. That section of the book alone makes it worth the reading.

Like previous books in the series, Hartmann’s book is readable and familiar. It is divided into four sections: How bad things are in America regarding healthcare; the origins of America’s sickness-for-profit system; the modern fight for a human right to healthcare; and saving lives with a real healthcare system. The last section proposes solutions to our healthcare system problems.

The Hidden History of Healthcare in America takes us through the history to make the critical point: “It is time for America to join every industrialized country in the world and make health a right, not a privilege.”

Because the subject of the book is so familiar, it renders a complicated process to bare essentials with concrete proposals for action to fix the healthcare system. I highly recommend the book, which is scheduled to be released Sept. 7, 2021.

~ Written for and first published at Blog for Iowa.