Back Away From The Stuff

[kyburg]

 

I've gotten a few swift kicks to the head lately, courtesy of folks I only interact with via Twitter and LJ - kambriel  remarked on Twitter the other day how passing strange it is to attend an estate sale (and it is), and almost on top of that I heard that a dear creature named Melissa Mia Hall had died alone in her home, too concerned about the cost of seeking care for pain, lest she lose everything she held dear.  Pain from a heart attack that killed her.

Pain like that, they give you morphine for - if you're hospitalized.  Which you should be, all things considered.  You've paid your taxes to fund research into preventing and treating these things, after all.  I could go on - I'm sure you've heard it from more legitimate voices than mine.

I wish I'd known.  I would have demanded she be seen.  Yes, hang it all and risk everything - you better believe it.

This is not a demand that anything you have is forfeit or should be, in the case of basic medical care - far from it.  In a country as rich as ours, as developed and smart and accessible as our medical skills are - keeping anyone who has paid their due from it is criminal.  And gee, that's everyone.

I can remember when hospitals grew their own food.  I remember hospitals before Medicare...and after.  Before Roe v. Wade - and after.  Before paramedic programs - and after.  We can do amazing things today, and talking with my mother who graduated from nurses' training in the mid 40's during WWII only confirms that.

We all deserve the benefit of those years.  Now, put that to the side.

I am here to talk about The Things.

If you are truly concerned about losing everything in case you get Something Expensive - take a look around for a moment and tally the worth you think your Things are worth.  Then cut it by 2/3'rds.  I've had three house fires, I know how this works - what you have is not worth what it cost you to get it.  Always insure for replacement value, not actual - for that reason.

If what you have won't even see you through an ER visit, put losing The Things as a worry out of your head.  Because you won't.  Losing your things won't even put a drop in the bucket, so don't even go there.  You couldn't possibly sell everything anyway.  Some things can help and some assistance programs require you to go to poverty to qualify for them - if you're concerned about needing them, read up on just what that would look like in your world and think about how you would accommodate those standards.  You can't qualify for help if you don't have a place - so assuming you would be getting assistance only by living on the streets isn't realistic.

So you aren't going to lose your home.  You are going to pay your home costs first.  Those dollars don't have any assistance available to them, so they get the money first.  Ditto the food, the lights and anything that will allow you to keep working.  You will negotiate your medical expenses, because at the very bottom?  There is always assistance available  You wouldn't believe it on this side of the Styx, but I tell you from experience.  I once had a heart-to-heart with a social worker when Cliff was in long-term acute care in 1997 - his Medicare lifetime benefits were almost all used up and the hospital accounting department had charged her with informing me that his care was soon to begin being 'uncovered' - so to speak.  After giving her the list of things I had available to take the place of Medicare (at the age of 34, ESRD qualifies you and nobody else will cover you), which included the MRM California has, and the workmans comp case he was part of (with two companies as his employer had been sold twice since he had been terminated disabled).  The two of us talked.  Suddenly, Medicare stopped being an issue - and I walked over to the county offices and applied for Medi-Cal/Medicaid.  With that onboard, the concerns eased.  I paid the rent, the utilities, the insurance policies, bought food and kept working.

You don't want to get into debt, I can completely understand that.  Don't  then - if anyone wanted me to get a workup done that wasn't covered by my insurance plan and I couldn't come up with out of pocket?  I go back to them and tell them to find a way.  You think it's medically necessary?  Fine.  You make it happen.  If you can't?  Well, guess you weren't serious about that then, were you?  If there is a risk of something Bad happening to you because they couldn't get the knowledge they needed about your condition?  The responsibility is now on them - you didn't go AMA on something because you didn't want to lose everything.  I can't guarantee the results on this - but it certainly has shifted the blame away from the patient who is the perfect innocent in these cases.  It also tends to reduce unnecessary medical tests.

Did it work for me?  Hell, yeah.  It's not my fault and I have no compunctions about negotiating a way, even if means shifting the liability responsibility back onto the provider.  They carry malpractice insurance, after all - something you don't have and can't get.  I'm not interested in being a very good girl when the deck is that stacked against me.

I'm not going to tell you it isn't terrifying.  It is.  I know.

Not saying you won't feel like dirt and worse.  I know.

You will be hounded by collection agents - I fear none of them.  BRING IT.

Hope you can eat a lot of ramen and pasta, because you will.  My favorite save-the-money-for-the-drugs diet is still a box of pancake mix, a dozen eggs and a pound of bacon, maybe with syrup.  That at least has some fat in it.  I used to make sourdough bread in the breadmaker.

But you will not lose everything.

It will SUCK.  Harder and longer than anything you ever knew.  

But I tell you to do this.  Why?

Let me go back to The Things.

I grew up in a town where most of the residents had gone there to die.  Seriously - everyone has a grandparent or two in Hemet, or had one, as the case may be.  They shipped them in from the midwest, from Oklahoma and Texas and other points outside of California.  Moved them in, with their Things to keep them company (and little old people tend to hoard, I might add) and left them there.

I grew up surrounded by the Things they left behind.  Estate sales and yard sales and 'antique' stores by the buttload.  'Junking' wasn't something you avoided - it was a national pastime.  I remember the stacks of 78's I used to listen to, right alongside my Beatles 45's.  We used to do crafts with doilies and old linens, costume jewelry and empty jars.  Every drama department had closets full of period clothing from the 30's on up - so full, you couldn't put anything else in there.  Things were donated all the time.  We put them in boxes and stacked them to the ceiling.  I love Depression Glass.  All of us have considerable collections, and only Mom's pieces are younger than she is.  I have rehomed more books than I own and that's saying something.  You should read some of the pieces I kept as touchstones - the racy 'The Maiden Widow' is amazing, something like 1921 or so as the copyright.  Racy in the terms of 'how DOES one become a widow and remain a virgin?  HMMM. CHICKEN OR THE EGG!'

You touch these things and you can almost feel how much they were loved and treasured by someone who just isn't here anymore.  Over and over again.

I would much rather have them, than their Things.

You want to know what happens to your Things, if you aren't here?  Check the video on top.  It's ghoulish.  And yeah, I grew up with that.  Passing strange, indeed.

So - lose The Things.  If it costs you your life if you don't risk that - you lose everything.  I've had three house fires, and if we count the two burglaries?  Guys - you can replace Things.  You can even get the chance to get them back, worst case - if you die trying to preserve your ownership of Things, what have you done?

And like it or not, none of us are going to get out of here with our Things.  Not a single one of us.  Now or later.

Not many faith systems fail to touch upon this, the Buddhist tradition hitting it harder than most of them.  When in doubt, divest.  Dump it, get rid of it, do without it.  No Thing is worth your life.

Keep your outrage about your fears of paying for medical care - they are valid and you aren't smoking crack about it.  Stay angry when you hear about some patient discharged from a hospital bed to a street outside a homeless shelter - it's wrong.  Be as fair and up front as you possibly can when dealing with your health care providers.  Work as hard as you can to cover the costs, that's only meet.

Always do your best.  Your life has an impact on others.

But know this.  Nobody gets my life - or my Things - without one hell of a fight.  I will NOT go quietly, and that's a promise.

Comments

[sekl.livejournal.com]

Psst. Your tags are showing.

[kyburg.livejournal.com]

I've been trying to get them to behave, but.

Will try again.

[thatwordgrrl.livejournal.com]

See, the acute stuff? Suck it up and deal, cupcake.

But have a chronic thing? Yeah, that's another matter entirely.

Because you get through it this time. But there's always another time. And another. And another after that.

[kyburg.livejournal.com]

Understood, but yanno?

There aren't many things more chronic than asthma and type I diabetes. And they STILL don't get my stuff.

But damn if it isn't work. And it's not fair, but there you go too. I guess my reluctance to be a good girl kind of stems from that.

[moropus.livejournal.com]

The medical system can wear down a chronically ill person long before the disease would if he had insurance and money. Poor people must surely die sooner because of that.

That sign in the emergency room that says if you have no insurance you are leaving the minute you can walk under your own power? What is that sign for if there is always something somebody can do? You know how long a cancer patient can walk without any actual treatment? Up until its too late to treat him. I've seen people die like this because nobody knew what to do.

[moropus.livejournal.com]

I would not even care if they took people's stuff if they would just treat everyone exactly the same and get rid of that ghoulish policy.

[kyburg.livejournal.com]

It has to be a sign of the times - I can remember signs saying 'nobody will be turned away due to lack of funds.'

If there is such a sign, I want a picture of it. And I want to know whose facility it resides in. Oh very yes.

[moropus.livejournal.com]

It is all over the emergency room of Toumey Healthcare System in Sumter SC where I lived for 11 years. In every cubical of the emergency room, in the bathrooms of the emergency room, in the hall ways of the emergency room. I can only assume they were tired of poor people using it for a free clinic because they could not afford to go to a doctor and were trying to put an end to it if these signs aren't standard. I can't send you a picture because I moved away 15 months ago. Its 600 miles.

They made me sign a form saying this which they did not give me a copy of when I was admitted there, regardless of the fact that I presented them with insurance cards, along with forms informing me of the penalties of insurance fraud, etc, to include using somebody else's card or an expired card.

[kyburg.livejournal.com]

Boy, they sure aren't in my experience. I'd forward that stuff to JCAHO - that's harassment.

[dame-of-dames.livejournal.com]

Thank you. Your words are very inspiring.

[pagawne.livejournal.com]

Buy it, use it, break it, fix it, or do without. Yeah, I remember those times. We do not go the before R.v W. time, I tend to go overboard and get nasty. I saw the results.

[foogod.livejournal.com]

I agree completely with almost all of this.

The one thing I would point out, though, is yeah, you have more experience than anybody else I know with all of this stuff, but most of your experience is with being the one supporting the chronically-sick person, not being the sick person yourself.

Being sick, really sick, takes a lot out of you in ways that people who haven't been there never even imagine. I know you must know this, but it doesn't seem to be really being acknowledged in some of the advice above. It's easy to say "just go fight with them to give you what you deserve", but when you're having a hard time just fighting hard enough to stay alive, sometimes that's not an option. You may have somebody by your side bull-headed and savvy enough to do it for you, but an awful lot of people just aren't that lucky. I've never been one, but I've met people who have.

Those are the people who lose their homes and everything else they own, because they don't have the strength left to defend it and they don't have anybody else to fight for them, and it is a real concern.

But the real point, in my opinion, is that even that concern shouldn't stop you from getting the care you need. People get screwed up perspectives on the importance of Things, but all Things can be replaced, or can be lived without, if you're still alive and reasonably healthy. If you lose that, though, all the things in the world become pretty much irrelevant.

[kyburg.livejournal.com]

It's an incredible privilege to be this experienced. At the same time, it's a commodity nobody wants.

I swear by the power of one phone call - it's been the fulcrum by which amazing things have happened, time and again. And just about every time, it has been to call the powers that be and simply say 'can't do it from here, now what?'

If I can change the learned response to 'make the call' from 'no, I'd better not' - my job here is done.

As I told Bet - it's a lot of work (day in AND out), and it's not fair. I just don't have it in me to be quiet about it.

[dsmoen.livejournal.com]

I know someone who would preserve The Things instead of his life. He's been doing that for decades. Probably should be on Hoarders.

I knew it was bad when he couldn't sleep in his bedroom any longer because he had so much stuff that he would, he said, never part with stored there.

I just looked the house (which he owns) up on Google maps. Totally derelict. If it were sold, it'd probably be a teardown.

Anyhow, don't be That Guy.

[kyburg.livejournal.com]

Pathologies come in all shapes and sizes and kinds. As I said, those little old people I mentioned tended to hoard as a general rule.

I've seen way too much of that, too. It's horrifying, amazing and pervasive. Everyone knows at least one person 'like that.'

[dsmoen.livejournal.com]

In his case, I saw it go from the bad side of normal into the obsessive area -- it started happening when he lost his job and started clinging to his past and who he'd been rather than re-making who he was. In software engineering, skills are obsolete so quickly that if you don't pick yourself up when you fall off the bus, you may have fallen off for good.

Sigh.