Let Obamacare fail on its own Merits.

Heal the sickAs October 1st and the possibility to sign up for Obamacare gets closer, the world has had the dubious pleasure of watching American politicians fight over the best way to care for the those who can’t afford medical care.

The great thing about America is our federal system: As a federal program, Obamacare depends heavily on each state’s implementation of it. States whose legislatures and governors are politically sympathetic to the program (i.e. mostly Democrats) are doing everything they can to help it succeed. They’ve accepted increased Medicaid funding, set up state-run exchanges, and hired navigators to get things done.

But legislatures and governors who aren’t so politically sympathetic to Obamacare (i.e. mostly Republicans) aren’t content to let the program fail on its own — though many are convinced that it would. Instead, they are trying to block implementation at every step.

They often use the argument that the federal government can’t do anything right, but then, when Obamacare offers states the more Medicaid funding and the chance to run their own insurance exchange — after all, something run by the states is better than if it is run by the feds — they balk and leave their citizens to rely on the Federal implementation.

Obamacare recognizes that people will need help figuring out the new system, so part of it is the implementation of navigators in each state. In Florida, though, the state has passed legislation saying that navigators do not have access to their county health facilities.

I understand that some people don’t want Obamacare to succeed. Heck, they don’t even want people to get any benefit, because “when people get an entitlement, they never give it up, so let it burn.” I get that.

But trying to create failure by blocking access to Obamacare creates “bad optics” at the very least. Thankfully, some counties in Florida have found a way around the state’s ban on helping people enroll in Obamacare, but this only adds to the drama. It may even, indirectly, make the point that those closer to the individual are better able to serve than “those bureaucrats in Tallahassee”.

(Photo credit: Tabitha Kaylee Hawk)

In which I sound like a cranky ingrate

Scenes from Matanda, Malawi
This girl is going to have to walk 1km home. Photo from kym54 on Flickr.

This week, if you’ve seen any of my action on Twitter or Facebook, you probably know that I was admitted to the hospital on Monday for blood clots in my lungs. Three years ago I had a pulmonary embolism while I was in the hospital. To avoid the out on my third strike, I’m going to have to live the rest of my life regularizing my leafy green intake and taking Coumadin.

So, fine. I had a blood clot (again!) and I could have been one of the 100,000 Americans that die every year (one every 5 minutes) from a blood clot.

But I’m not. I survived. I’m very happy to be alive. I don’t really know how I would feel if I hadn’t survived this, but I know that my wife and children were quite upset when they came to see me in the hospital — their lives would be completely different had I not survived. And so, I’m happy for them that I’m sitting here in my back yard listening to the cicadas while my daughters play with the bugs they’ve caught today.

If the blood clot didn’t result in brain damage (i.e. a stroke), then the inconvenience of Coumadin is probably the most debilitating long term effect that most people suffer. There are even (very expensive) drugs available that take care of thinning the blood without being affected by diet. I’m on one now because the Heparin I was in the hospital for wasn’t getting my INR up quickly enough. But it costs $40 per dose. Paying $280 per week for preventative medicine doesn’t really work for my budget when there is a cheaper alternative (Coumadin) that has been working for 60 years.

But now when I tell people I’ve had two blood clots, they tend to freak out. “That sounds scary!” Or “I‘m praying for you.”

I understand this. When a friend of mine showed me a clot that he had in his leg, I was pretty surprised that he was up and about and not falling over in front of me. “Shouldn’t he be more worried?” I thought.

But now I think I understand his point of view a little better. People die from blood clots. Like I said, an American dies once every five minutes from one.

Maybe it is just that those of us who have had one (or two!) of them and survived realize that we are past the deadly part — we’re alive and life keeps happening.

I appreciate that the possibility of death looms every second that I’m alive. I appreciate the prayers of others for my health and my family’s well-being. Really, I’m grateful!

But I’m also grateful for drinkable running water. Water is essential for living, but most Westerner’s don’t spend time thinking about how blessed they are that they don’t have to walk to a communal well every day to get their water. And I don’t spend time telling them how lucky they are to have running water.

Death looms, but I’m alive.

It takes a lot of infrastructure and work that we don’t usually see to get plenty of fresh water, but I can take a nice long shower.

I’m lucky to be alive. There, I’ve acknowledged it. Can I just get on with living?