The ACA, or How I learned to stop worrying and love Obamacare

“I’m going to regret this.” – C3PO

I’ve deliberately avoided getting into the fray regarding the Affordable Care Act, i.e. Obamacare, as it has a tendency to arouse arguments of a political nature. I deliberately avoided posting my thoughts on Facebook to avoid a flame war between both my conservative and liberal friends, the former seeing the ACA as an intrusion of government, and the the latter as something whose time has come. I can only relate my experience with it, as I am on SSDI and needed health insurance in a big way.

First, having previously been in the healthcare field for 23 years, I had an insight as to both sides of the coin as both a patient and a professional. The insurance industry leaves much to be desired, and certainly reforms were needed. There were – and still are – too many uninsured people here in the U.S., which is the only major country that does not guarantee healthcare as a right. Whether it is specificall a “right” is usually a sticking point. Personally, I think at least basic healthcare coverage should be a right, at least for all citizens.

I was extremely skeptical of the ACA when it was first proposed. There were things about it that I did like (no denial of coverage because of a previous condition), and things I didn’t (penalties for not having coverage, either fines or taxes), but decided to wait and see how things shook out. As it turned out, I wouldn’t have to wait long, as in 2012 I lost my job of seven years and was forced to go on COBRA. Now mind you, I was happy that I had COBRA coverage for three years, but unhappy at the high cost of the premium that went along with it.

COBRA covered all of my medical expenses nicely, via the same local BC/BS entity that my former employer used. As the three year mark approached, I had to start looking at other options, and fortunately that same entity was participating in the NY State of Health exchange. I decided to forego the web application in part, and speak with a human being at BC/BS. This lovely representative found a plan for me that was equal to what I was covered via COBRA, plus a few extra perks. Because my SSDI income was below a certain level, I was able to get a tax credit that wound up lowering my monthly premium by about $400.

“Wow,” I thought, “This really works!” Well come the new year this year, and the tax credit went bye-bye, and while I would  still be paying less for it as compared to COBRA, it was a little disheartening. Fortunately however, BC/BS came up with another plan that was even cheaper ($20 monthly premium), had the same coverage as the previous plan but with a few less perks. I would now need referrals for certain specialists, and the portability factor was not there. Small sacrifices at the end of the day, as I was now saving a ton of money both in premiums, and co-pays.

In short, for me the ACA has been a blessing. It fits in with  my needs perfectly, and while I still have reservations about certain aspects of it, on balance, it is a good thing as far as I’m concerned. I’m not sure what will happen next year as far as this premium is concerned, or if I will need to switch plans again, but for now it’s a good thing. Those who are vilifying the ACA need to take a step back and realize that while it might not be something they would want for themselves, there are many others in my situation for whom it works well.

Bumpitybump…

One of the things that a transplant patient needs to get used to are the bumps in the road on the way to recovery after surgery. Sometimes they’re speed bumps, sometimes potholes. The body has undergone a tremendous shock, adjusting to life with a foreign organ, massive amounts of medication initially, and a host of other things that need getting used  to. Such was the case with me last week.

I go every Thursday (for now) to the transplant clinic at Strong Hospital in Rochester, where I had my surgery. So while there last week, the unexpected happened. Apparently I was a bit dehydrated, and combined with the large amount of immunosuppression I’m on caused a strain on my kidneys. My main anti-rejection medication, Tacrolimus (Prograf), is known to have an effect on the kidneys. Combine that with the two other anti-rejection meds, and things need to be monitored closely, and adjusted down when needed. It was enough however to put me in the hospital for two days to “tweak,” – as my surgeon says – my kidney function.

The last thing that I wanted was to be back in the hospital after making progress at home. I was pretty upset, but I really didn’t have a choice. They didn’t want things to progress to the point where I would have been even worse. the problem was there were no beds on the transplant floor, so I had to spend the night in the ED until one opened up at about 3am. Oh joy. So multiple liters of IV fluid over two days, and a medication change later, I was sent home with orders to drink as much water as I could stand to avoid dehydration.

On the good news front, my appetite, which had been stalled for some time, has come roaring back. I seem to be hungry all the time, which is a good thing since I’m still almost 50 lbs underwweight. It does feel good to have my appetite back to where I was used to it.

So, life goes on, and hopefully, no more bumps.

Coming back after passing through the portals of hell

Just a quick note to mention that I will be blogging again shortly. Not long after the post about acting in The Laramie Project, things went to hell in a handcart. I contracted a near fatal form of viral encephalitis, that left me in a coma for 6 days, and then had a return of my old autoimmune liver disease. It required my having a second liver transplant, 18 years after my first one. I’m home recuperating, and slowly improving. It’s good to be able to concentrate again on writing.

Insanity in Nigeria, and it’s not a person, but a government

“Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof;”

There’s a reason for this being an integral part of the First Amendment to the Constitution, and when I read stories such as this, it drives home that first section even more:

http://www.theguardian.com/world/2014/jul/03/nigerian-man-insane-atheist-bala-islam?CMP=twt_gu

I’ve sometimes wondered if the fundamentalist elements of certain religions in this country would like to see atheists such as myself put into a similar situation as this unfortunate man from Nigeria. The freedom to have no belief or religion is just as important an exercise of the First Amendment as is the right to exercise one’s own religious beliefs. However, exercising a religious belief does not include foisting them on others, especially from one’s own government.

Bed-Stuy, Do or Die…

Today is the 25th anniversary of the premiere of “Do The Right Thing,” the movie that catapulted Spike Lee to prominence. I remember him filming it in the Brooklyn neighborhood of Bedford-Stuyvesant, specifically one scene where a young boy runs down the street, and is almost hit by a car. This mural, painted on the side of one of the buildings in that neighborhood served as a backdrop during several scenes. It stayed on the building for many a year afterwards:

 

Image

“Bed-Stuy,” as it’s more commonly known, was a war zone back in 1989. Crack had gripped the community by the throat. The resulting drug gang wars made mincemeat of so many young lives. The summer nights were a cacophony of music, people talking, or yelling, and the sound of gunfire. Working that year is something that is so seared in my memory, I can still vividly recall it all. Cops were still carrying revolvers (“wheel guns”), out gunned by those wielding 9mm’s, Tec-9’s, Mac 5 and 10’s, and the occasional AK-47. Crack houses were death traps, and no EMS unit – including mine – would ever respond into a known one without a police presence of some kind.

Lee captured a lot of the feeling and desperation of the streets, but he couldn’t encompass it all.

“Da Mayor (Ossie Davis): Doctor…

Mookie (Spike Lee): C’mon, what. What?

Da Mayor: Always do the right thing.

Mookie: That’s it?

Da Mayor: That’s it.

Mookie: I got it, I’m gone.”

It’s a shame so many didn’t listen to Da Mayor’s advice.

A method to my madness

While getting settled here in Syracuse has been something of a challenge regarding getting full-time work, I have gotten cast in a show here that will let me restart my acting again. As I mentioned in one of my early posts, I have been acting on and off since 1984, when I did my first play in college on a dare from a friend. I felt very fortunate in Rochester, as the theatre community is so extensive for a smaller city, and it provided me with so many opportunities not only just to act, but to learn the craft from people who are far better than I am. I know I did improve over time, and it was in no small way due to the many former and current professional actors that I had the pleasure of working with while living there.

I have been cast in a production of “The Laramie Project,” a play I acted in once before, in Rochester back in 2001 when it was still a very new play. I’ll put a link to the production at the end of this post. I started ruminating about how the hell I got the guts to actually step on stage in the first place. It’s not a question I ever really pondered before. It finally hit me that I truly owe it all to my career in EMS.

Why, you ask? In a word; confidence. I never had a lot of it as a kid, and less of it as a teenager, until that moment came when I took the first-aid course at my local volunteer ambulance corps when I was 17, joined the youth squad of the corps, then began riding as crew member at 18. It took time, but it was that experience, and the ones that would follow in the years to come which provided me with the personal confidence (or insanity) to throw caution to the wind, and audition for that first play I was ever in, “One Flew Over The Cuckoo’s Nest,” while in college in 1984.

That first stage experience taught me that I could do anything wanted to if I set my mind to it, even if it terrified me. It also gave me the kind of thrill I had only experienced while riding on the ambulance, and it also had the advantage of providing a getaway from EMS when I needed it. EMS has provided me with a great deal of things over the years, even as I have been removed from it for so long now. Close friendships from that time are still there, and while there has been an inordinate amount of death within our ranks since 9/11, we’ve always been there for each other, through both good times and bad. Those of us that played the game in NYC and beyond understand certain things that the general public never can, and have seen things most people should never see. I carry those things into all the productions I’ve ever been associated with, as they provide a wealth of experiences and emotions to be explored as I explore the characters I am playing at any given time.

With that in mind, should you find yourselves in the Syracuse are this coming September come check out the show. Info is here:

http://cnyplayhouse.com/laramie.htm