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Personal Stories

“It’s the Economics!” – A clear call for universal health care from a Maine small business

Editor’s note: The following letter appeared November 18, 2016 in the Bangor Daily News, The Ellsworth American and The Weekly Packet detailing the financial plight of a Blue Hill small business, Lucy’s Granola due to sky high health insurance costs. It is a clear cry to make health care accessible and affordable by everyone in Maine. Please join our work – Subscribe and Support Maine AllCare – in helping Maine businesses owners and their employees become more healthy and successful. You may request a health policy expert to speak before your business group by writing to us.

Fix our health care system

Our family of five should be part of the effort to ensure the success of Maine’s economy. We run a small business with six employees, all paid above the minimum wage. We hire Maine-based consultants and suppliers to help us continue and grow our business.

Despite this, we are now looking for full-time jobs that come with health insurance benefits as we can no longer afford private health insurance. In 2016, we have paid Anthem Blue Cross and Blue Shield $24,257.28 for insurance. Our family deductible is $10,000. By the end of this year, we will have paid more than $34,000 for health insurance for our healthy family. Had we enrolled under the Affordable Health Act our costs would have been more as we do not qualify for the subsidy.

In 2017, Anthem has quoted $33,229.68 for our insurance, not including the $14,300 deductible. That comes to over $47,000 for 2017. Under the Affordable Care Act Bronze Plan, we might be able to bring our costs down to between $36,000 and $40,000. That’s hardly “affordable.”

Today’s health insurance costs are the greatest threat to our economy’s growth and success. Clearly, neither private health insurance nor the Affordable Care Act is affordable for our family. With the result of the election, there is an assumption that the Affordable Care Act will be overturned. We need our elected officials to recognize that their failure to develop a truly affordable health insurance system is preventing the success and growth of our state and national economies. It is long past time that the state and federal governments resolve this crisis.

Lucy Benjamin
Clifton Page
East Blue Hill

 

What’s happening to our medical system?

Dear Editor:

A small saga of the elusive eye drops. I went to the drugstore to renew my prescription of my eye drops, which I use for glaucoma. The pharmacy informed me that they weren’t able to be renewed yet. I asked why and they told me that the insurance company refused to fill it until next week. The folks there at Hannaford were as helpful as they could be and called the insurance people to explain that I was out of the drops. I went home and called these people myself and asked who was in charge of these decisions. I was informed that it was one of their pharmacists. I then asked them why he was practicing medicine without a license. Actually, I was really mad as hell and let them know it. A very nice young woman on the other end spent two hours trying to get them to override it and fill the prescription.

After about two hours, she said I had 24 hours to pick it up. By this time it was dark and beginning to snow. At 89 years old, I hesitated to make the trip back into town, 15 miles away. The next day I did get back to the folks at the pharmacy, but they knew nothing of this so-called override. Once more, another nice young technician tried to deal with these crooks. Finally, after many hours they got an override, but by this time I was back home after getting a few samples from my doctor.

What is happening to our medical system? The insurance companies have us all in a stranglehold, as well as the criminal pharmaceutical companies. Family doctors are becoming as scarce as hen’s teeth as they are being told how to practice medicine by these huge profit-making machines, so are opting out of the profession. Who can blame them? They have to pay huge amounts of money to protect themselves from being sued. Oh, yes, we live in a litigious society. Some people make a good living suing organizations and medicine is a mother lode. Years ago, an attorney neighbor back in New Jersey, when told that the state had put in a no-fault program for automobile insurance, said, “Well, I guess I’ll have to go for the medical field to make a living.” So, OK, then we have the lawyers with their claws in the whole mess. Meanwhile, I finally did get my eye drops thanks to some very nice, persistent people, but how many other folks out there have similar stories to tell? And now just today I heard that the insurance companies are starting to plan to insure automobile mechanics. Look, they have got health insurance, veterinary, dental and god knows what else and now the Republican Congress wants to do away with Medicare and Medicaid. What’s to become of the poor, the sick and the elderly? How free is our country anyway? I wonder.

Mary Welsh
Sullivan
Letter to the Editor - Ellsworth American - January 12, 2017

 

Struggling to Serve at the Nation’s Richest University

By Rosa Ines Rivera
October 24, 2016 in The New York Times

Editor’s note: This letter exemplifies why Maine AllCare is fighting for universal, publicly funded health care here in Maine, and nationally. Please join our work by contacting a Chapter near you.

Cambridge, Mass. — I’ve been at Harvard University for 17 years, but I’ve never been in a classroom here. I’m a cook in the dining halls. I work in the cafeteria at the T.H. Chan School of Public Health, where every day I serve amazing students studying medicine, nutrition and child welfare, as well as the doctors and researchers who train them.

While I’ve earned no college credits here, I’ve had a lesson in hypocrisy.

On my way to work each morning, I pass a building with the inscription: “The highest attainable standard of health is one of the fundamental rights of every human being.” If Harvard believes this, why is the administration asking dining hall workers to pay even more for our health care even though some of us pay as much as $4,000 a year in premiums alone?

I serve the people who created Obamacare, people who treat epidemics and devise ways to make the world healthier and more humane. But I can’t afford the health care plan Harvard wants us to accept.

That’s why I have been on strike with 750 co-workers for more than two weeks. That’s why the other day, co-workers and I were arrested after we sat down in Harvard Square, blocking traffic, in an act of civil disobedience. And that’s why the medical school students, in their white coats, have been walking the picket line with us in solidarity.

The co-pays alone can be a problem. When a doctor told me my daughter had failed a hearing test and might need surgery, I thought about what care I could do without. I recently skipped an appointment to have a spot on my lung checked for cancer to save on the co-pays.

Medical students analyzed Harvard’s proposal and found that the cost of premiums alone could eat up almost 10 percent of my income. And Harvard wants to increase our co-pays for every single doctor visit to $25, from $15, for primary care and to $100, from zero, for outpatient hospital care and some tests. Some costs would be reimbursed for lower-income workers, but out-of-pocket expenses would still be hard to meet.

The students say that Harvard’s proposal is unaffordable for nearly all of us according to state government guidelines. If it goes through, I will keep avoiding the doctor to save that money for my kids’ co-pays. Any increase puts me at the breaking point.

Harvard is the richest university in the nation, with a $35 billion endowment. But I can’t live on what Harvard pays me. I take home between $430 and $480 a week, and this August, I fell behind on my $1,150 rent and lost my apartment. Now my two kids and I are staying with my mother in public housing, with all four of us sharing a single bedroom. I grew up in the projects and on welfare. I want my 8-year-old daughter and 2-year-old son to climb out of the cycle of poverty. But for most of my time at Harvard it’s been hard.

The average dining hall worker makes $31,193 a year, higher than other cafeterias in the area, but it still doesn’t go far around Boston. That’s why we’re asking for an annual salary of $35,000 for some financial stability, particularly since most dining halls are open only during the school year. Right now I’m lucky to work in one of the few cafeterias that’s open all year.

I know that health care costs are going up everywhere, and I don’t have all the answers. But there must be some way not to shift costs onto Harvard’s poorest workers.

If good health is truly “one of the fundamental rights of every human being,” then shouldn’t that also apply to the human beings working in Harvard’s cafeterias?

Rosa Ines Rivera, a member of Unite Here Local 26, is a dining hall worker at Harvard University.

 

Maine Attorney General Janet Mills

Remarks by Maine Attorney General Janet Mills to MHMC/MMA Conference in Portland Maine on November 18, 2015

"Stroke Recovery from a Family Perspective"

Originally presented at the 7th Annual Stroke Conference in Portland, Maine on May 21, 2014

I want to talk about your patients, the people in the shadows, out of the light, on the verge of darkness, those in the penumbra of life, a shadow of their former selves, even for a short time. And I want to talk about their families.

When I was a child, the father of one of my friends, a storekeeper and neighbor of my grandparents had a dropsy face. He could not walk fast. He could not smile. Or, if he did, it looked to us like a sneer, an unintentionally evil look. My grandparents spoke of it as if it were a mystery, something he couldn’t help, but something that took Mr. Seeley out of the mainstream of the social life of Ashland, Maine, such as it was. Through the prejudices of an 8-year old girl, I never could warm up to Mr. Seeley, even though he was my best friend’s father. He reminded me of Vincent Price. Of course, I hadn’t known him before his stroke.

Fast forward 57 years.

October 1st, 2013

October 1st last year was an ordinary day. For me, a long one, but par for the course. Good weather prompted me to take a detour before leaving Augusta to go home, and to visit a friend in hospice care at Togus. I later worried that that delay could have cost my husband’s life. I was an hour later than usual arriving home. So, it was not me but my brother Paul who happened to come by the house that evening and find my husband on the floor, unable to regain his balance, to speak intelligibly or to call 9-1-1.

No one could say how long he had lain there. Pangs of guilt. It should have been me. He hadn’t called me in the afternoon as he so often did. He hadn’t answered the phone when I called. I should have known.

At the ER, I learned, of course, that my husband had had a “Cerebrovascular accident” “Accident,” I thought, “what an interesting term. What kind of accident is this?” “Did he fall downstairs?” “Did a car hit his brain?”

Honestly, what other medical condition do we refer to as an “accident,” other than an unplanned pregnancy?

He had had, of course, a stroke. The fourth leading cause of death in Maine. In 2009, there were 640 deaths in Maine and 3,656 hospitalizations due to stroke. Maine has had the highest stroke death rate among all New England states. And stroke is one of the major drivers of health care costs in Maine. I can certainly see that now. Recovery is such a long, slow and unpredictable odyssey. And so many people in Maine are uninsured to boot.

My husband didn’t smoke. He was not overweight. He never drank a lot of alcohol. His diet hasn’t been the best, but he didn’t eat a lot of fatty foods or junk food. His cholesterol was always good. But he has always been hypertensive. And he is male, he is over 70 years old and is less active than in his earlier years when he was an avid tennis player.

On the way to the ER the doctor on duty called my cell: “How many hours ago did he have his stroke?” thinking that if it were an ischemic stroke, she could administer a miracle clot-busting drug and prevent his death. Frantically I called around to people I thought may have seen him during the day, with no luck. There was no way to say he had collapsed either five hours or five minutes before he was found. That could have made all the difference in the world. But, then, a CT scan showed a hemorrhagic bleed. So the miracle drug would not have helped; in fact, just the opposite.

Stan stayed in the hospital for 5 days and they got his blood pressure under control, his hydration, his mobility. The relief was palpable. Then, suddenly, we had to make choices. Rehab -- What’s best? Who do you call? Who do you ask? Is there a Consumers’ Report that tells you which facilities are best? How and where could we, the family, best help him? Quiet due diligence. The decision. And the justification.

There is no book that tells you how to cope, or what to expect, with a stroke, although there are books written about the experience of a stroke&emdash;Kirk Douglas’ “My Stroke of Luck” and Jill Taylor’s “My Stroke of Insight,” for instance.

When dealing with stroke, there is no pill that will make it better. No cup of liquor that will comfort you. No roadmap or clock that tells you where or when things will begin to be okay again. Some days it is like a constant purgatory. The patient is in limbo, and the family is backstage, waiting attentively with flowers and cheers or prayers and long black coats, ready to make changes, unable to know which way to turn, all life’s plans on hold.

When you break a bone, you know the bone will heal. You will have some pain. But you will walk again, write again, dress again, drive again. There is an end date to your recovery.

When you have your appendix out, in a certain period of time you will recover. You will be sore. But you will heal.

When you have a stroke, you must then predict the unpredictable. Your recovery is not measured in days passed or in stitches removed or in hallways walked.

Speech may come and go. Memory may flourish or flounder. Your muscles may work, or not. You may fall without warning. You may feel funny and weak and worried. You may be depressed because you have lost control over your life. And your loved ones may become depressed because they cannot help you except, seemingly, in the most miniscule ways, partly because you are depressed. And depression, it seems, can be contagious.

Everybody asks you how he is. You cannot answer. You become the ‘reassurer in chief’ for the rest of the family and the treasurer in chief for the family finances. You interpret the medical information. You keep everybody informed. You give them guarded hope. Hope you do not always feel yourself. But you are the strong one. The informed one.

Privately, you try to figure out what the insurance is going to pay for and what it won’t. But the papers keep piling up and they are hard to read, to sort out, even for a lawyer. You go through your husband’s papers, try to figure out what he left undone, what is paid or unpaid, what matters can be put off. The disorganization of someone who you later figure has probably had TIAs in recent months is quickly demonstrated. You draft letters and answer phone calls.

This was not my first encounter with strokes.

READ Complete Story

 

Why we need universal health care in Maine

July 30, 2014

As we celebrate the 49th anniversary of MEDICARE – over 49 million Americans are Medicare beneficiaries (2012), including 276,467 here in Maine – let us redouble our efforts in words and deeds in educating our fellow Mainers about the crying need for and common sense benefits of universal access to health care by everyone in our state.

Here are two brief 3-minute videos worth seeing. We are featuring for the first time Delene Perley and Dr. Jim Maier, both of whom testified early this year in support of our universal health care bill, LD 1343, before the Legislature's Insurance and Financial Services Committee. While their stories are personal, the problems of lack of affordable health care, even with the Affordable Care Act in place, are a sad reality faced by many thousands of our fellow Mainers on a daily basis.

The current private, for-profit, insurance-based system cannot, and will not, solve the problem. Only a transformational decision by an informed public can bring about a real solution. Only a publicly funded and privately delivered system – a universal single payer health care system – will improve both the health and prosperity of every Maine family. Only a simple system such as Medicare for All will ensure affordable coverage to each and everyone of us. Please join in our advocacy by subscribing and donating to Maine AllCare.

Best of all, by covering everyone automatically, Maine will save a billion dollars in the first year operation, according to Harvard economist Dr. William Hsiao, a world renown expert in health care financing. Together, we can and will make Maine the healthiest and most productive state in the nation. Thank you on behalf of all of us at Maine AllCare.

 

Sick Inside Our Broken Health System with that Old Familiar Terror in My Gut

by Donna Smith

I stepped up to the appointment check-in desk last Thursday as I prepared to have the CT scans needed to find out what the heck is going on with my body. Many know I have been ill off and on since the day after Christmas, and I spent a week in the hospital after becoming so ill that dehydration was taking a toll on me. Doctors ordered lots of tests while I was in-patient and because the major symptoms have only been masked by meds and have not gone away, there is lingering concern about my cancer status, etc. So I needed to be re-scanned to find out what is going on before we move forward with other care or treatment.

Drinking the barium in preparation for the test was not much fun when I've been taking anti-nausea medication off and on for a month. And I knew they'd also be starting an IV for more contrast dye to see as much of my belly as possible. I was nervous.

The woman at the check-in desk pulled up my record and first asked for my co-pay for the test -- $250, but then also asked if we wanted to make some progress on paying the now more than $2,000 I owe against my 2014 deductible and out-of-pocket costs. I was instantly transported back to the terrified and angry places I have been so many times before when seeking health care has meant choosing between taking care of my health and hurting us financially. My husband stared at me in disbelief and told the woman we would not be making payment on the $2,000. We paid the $250. As we walked back to the radiology area, I felt like leaving in shame. I was ashamed of myself for needing care, ashamed of myself for not knowing how much the co-pay for the one test would be, and mostly ashamed of myself for not being wealthy enough to just take care of myself.

My shame and terror lasted right through the time when I went in for the scan. Then I started to get angrier about the system that does this to me over and over again. We need improved and expanded Medicare for all for life -- a single standard of high quality care without financial barrier -- so no one ever again is more terrified and ashamed of a co-pay than he or she may be of finding cancer or some other serious illness brewing inside. I don't want to see my husband's angry face in a medical waiting room. I want to see him supporting me, comforting me when necessary and maintaining his own calm in the face of medical issues. This is just such an awful system. And the Affordable Care Act/Obamacare, as we all know, did not end these scenes from happening all over the country thousands of times every day.

I had health insurance and they didn't . . .

Editor's Note: Maine State Senator Troy Jackson speaking to the Legislature on May 20, 2013; the crux of the speech is his personal story about a young friend and fellow lumberman who died for lack of health insurance. It is a simple and heartfelt argument for universal access to health care by everyone in Maine, regardless of age, gender, employment or ability to pay.

Please watch this legislator/workingman's story and let us know what you think.

 

Editor's Note: Pay more, get less – stories about the challenges of escalating health insurance costs
Maine people, both individuals and businesses, are struggling to pay for health insurance. As rates continue to escalate and coverage is reduced, more and more of us are coming to the conclusion that the only rational and fair alternative is a state-wide universal, non-profit single payer health care system.

We want to thank Maine AllCare intern, Emily Corinne MacDuffie, for her excellent work in producing these interviews. And special thanks to Charlene Post of Yarmouth and Rachel Reed of Auburn, Maine for sharing their stories. Other stories are in the works.


The Universal Notebook: Nothing healthy about health insurance
By Edgar Allen Beem
Folks on the far-right fringe – tea partiers, libertarians, secessionists, etc. – were in open revolt against Obamacare until the Supreme Court told them what the rest of us already knew: the individual mandate is completely constitutional. While they were complaining that President Obama had gone too far this time, I was thinking he hadn’t gone near far enough. What we really need in this country is universal single-payer health care. Read More.


Poverty Kills by Syndi Holmes


Fighting the Real Enemy: Cancer in America By Donna Smith