Getting Active - Politically

I hesitate to post this next entry because I know not everyone will be happy to read it. You can either ignore it, or let me know how you feel. But to me, there is no middle ground to be found. As long as people are falling into the fissure that this middle ground has become, there is none.

We see mostly insured people in our practice. They either have Medicare, some form of medical assistance, or commercial insurance. Part of my job is to check each patient's eligibility before their upcoming appointment. Most of the time, everything is fine. I don't even have to bother checking Medicare eligibility, since everyone over 65 is eligible. Once I find a patient, usually using an insurance company's online website, I check them off my list and go on to the next patient. But sometimes there's more to the story.

What if a patient "has" insurance, but has a huge deductible? What if a patient "has" insurance, but no mental health coverage? What if the patient is responsible for supporting a family? And what happens when that patient becomes depressed, through no fault of his/her own? They fall into a crack...

A patient "has" insurance but just barely. What happens when this patient who is trying desperately to get over a drug dependency loses employment? The patient has successfully kicked the habit; the job was lost through company downsizing. The health insurance can be continued through COBRA, but the premiums are becoming too much for the meager unemployment to pay for. The patient doesn't know how much longer they can continue paying. Maybe another job will come through, but it's a toss-up whether the new company's insurance will cover the patient, given the "pre-existing condition."

Those patients "have" insurance. What  happens when a man is found on the street and brought into our practice, found to have a horribly debilitating chronic condition, but has no health insurance at all? What happens when he is taken care of initially, sets out to get the medical assistance that he surely qualifies for, applies for it, but then finds out that it's going to take 4 months to get the card? (Hint: he died. Another hint: Poor people have pride too. They don't want to come if they can't take care of their bill).

These are three typical scenarios that play over and over again in some form at our little family practice office every week. Today our government will try to come to some resolution over the healthcare reform bill. I don't have a lot of confidence that the bill they come up with is going to help our patients. It will require that more people buy insurance. If "having" insurance can yield the results we see, it doesn't seem like such a bargain. 


Think of yourself. You may be covered by a great plan by your employer. Next time you get your paystub, look at how much your employer is paying for your coverage, and add in what you contribute. Try to imagine paying that whole thing yourself, especially if you were to lose your job (God forbid).  What is your biggest health problem? What if you found out your insurance company wouldn't pay for it?


Until we are willing to stand in each other's shoes, and agree that we are here to take care of each other, nothing meaningful is going to happen with healthcare reform. I like to compare the right to healthcare to education. As a nation, we have agreed, more or less, that every single child in our country should be educated through the 12th grade. We test our kids to make sure they're learning at least the minimum required. This is good for the whole country, and we are mostly happy to pay the taxes that make it possible. Imagine if families had to pay tuition? I think we'd be a pretty sorry country. And I think, as far as healthcare is concerned, we are currently a pretty sorry country. Having healthy citizens is good for the whole country, and I personally would be happy to pay the taxes to make sure we were all healthy. Of course, this would be in lieu of the $600 a month I'm currently paying for my family's  health insurance, so I would probably not even notice it. 


Something has got to give.

They're Your Kids Too

We almost all have young people in our lives; whether they are our children, people who wait on us in restaurants, kids sitting in the same movie theater as we are, or working out in the gym with us. They are all around us, and each one of them is precious in their own way whether they know it or not. You may moan as you observe them with their odd piercings, or yell at them when they skateboard on the street. Or you may feel a beam of pride when you pick up the sports section of the paper and see that the team has scored another victory, even though you don't know a single player. They are all our kids. Our kids. We are all responsible for them.

That's why I'm writing today. Some of our kids are getting into things they shouldn't. Back in my day, it was marijuana and LSD. I don't remember anybody dying from either one; I know some lives were messed up, but I can still look on Facebook and see those kids grown up into functional adults. This is something much more dangerous, and from what I'm hearing, all to easy to obtain: I'm talking about prescription painkillers.

The rate of death from prescription painkillers has grown from 11,000 in 1999 to 20,000 in 2004. Researchers believe that the increasing misuse of prescription drugs among those 15-24 years of age accounts for the majority of the statistic. This problem is rooted in rural areas rather than the inner cities: West Virginia has the highest death rate from drug overdoses than any other state and it is now the number one cause of accidental deaths for our young people in West Virginia. 

Why are kids taking these dangerous drugs? Like some of their illegal counterparts, painkillers can create a feeling of euphoria and calm. And if one can make you feel calm, I suppose a young person might think that two or three will make you feel even better. They might not even realize they're doing anything wrong: look at all the commercials and ads for drugs. Most of them feature happy butterflies, sunny skies, smiling people. Nobody ever reads the small print on those ads, or listens to the whispered disclaimer. Maybe their parents take the prescriptions legitimately; maybe they've even seen their parents share their prescription with a friend themselves.  (There are reasons that you should never take someone else's prescription. You might have an adverse reaction to it.)  Unfortunately, some kids are not only taking pills that aren't prescribed for them, they're taking them in combination with others, or intentionally overdosing on them.

I have a very good friend who commited suicide by taking an overdose of prescription drugs. That was sad enough. But when I think about all the young people who will die this year accidentally from a drug, it's beyond sad. I think of their mothers and fathers, sisters and brothers, who will forever have that hole in their lives, always asking whether they could've done something different. There must be so many questions.

What can we do? I have two kids, one of whom is a teenager. We have had all the discussions about drugs that parents should have with their kids, and more. I like to use "teaching moments" so when something comes up, we use it (Heath Ledger, ie.) to drive home a point. We try to set a good example by not over-using pain medication: actually we never take anything stronger than Tylenol.  We take care of ourselves, and we take care of each other.

Kids need to know how important they are. I myself plan on making sure the young people in my life know how precious they are to me. I'll be sure to smile when I see them, and ask them how their day is going. If they look sad, I'll ask them if everything is OK. Sure, they probably won't tell me, but maybe they'll feel better knowing someone cared enough to ask.

What else can we do?

• Set good examples. Don't share your prescription drugs with others if you take them. Don't suggest that pills are the only answer to your problems -- if you have pain, are you also seeking out physical therapy and other solutions? How do you handle your own depression? Do you drink more, or do you try to talk about your problems, or seek professional help when needed? 
• Get involved in your community, especially where there are young people involved. Teenagers are full of ideas and energy! They will keep you young. The schools in Morgan County always need PASS volunteers to mentor young people. 
• If you're a business owner, give those young people a chance. Maybe you could offer one or two the chance to "shadow" your employees for a few weeks in the summer, as an opportunity to discover whether your industry might be a choice for them someday. Sometimes they can earn community service points doing this type of work, if it's required by their school district.
• Know your kids' friends. My daughter has grown up and had the same friends for 10 years. Now she's going to a different school in a city an hour away, so it's hard to get to know who she's hanging out with. But it's important. Always insist upon talking to the adult in charge of group activities, whether it's at their home, or in a public place.
• If it turns out a friend of your child's is having a problem, what do you do? I've had to confront this myself. I'm interested in hearing how other parents have handled it. In my case, I let the parent know that there might be a problem. And in another case, another parent let me know that my child might be having difficulty handling something, and I was very grateful. This can be very touchy, especially living in a small town.

Let me know your thoughts. How can we help our kids avoid making a dangerous mistake with prescription drugs?