Rationed Health Care Will Kill Me

Dear Reader, let us just wade right in here. Recently you may have heard a term new to most: rationed health care (RHC). What is it? It is the medical community's response to running out of doctors, equipment, or even human organs. It is fascism and bigotry that most USians can either ignore or give their tacit approval. I know that the title above may seem to be overly ripe click bait, but the truth is more murky than your local lab coat may be willing to admit.

Nissi, a black pittie, looking sadly at the camera. 

Here in the early spring of 2020, the spread of a novel corona virus is infecting people with Covid19. While less ambitious than the Black Plague, it is currently associated with a 2-5% fatality rate, with that rate increasing dramatically for those that have managed to kick around on this dirtball longer than most, those making the best of life with other conditions like diabetes, cancer, or other chronic conditions. The best data on US standards prior to Covid19 can be found in the Uniform Anatomical Gift Act, a non binding document adopted state by state (sometimes with changes.)

The argument goes that first come first serve is UNFAIR in a medical crisis. I watched a nurse, in real time, talk as though saying that some jaggoff with young kids is more deserving of medical supplies and effort than a grandma with a poor pancreas. His youth and status as someone that could mash their meat against someone else's meat enough to make yet more meat makes him more worthy of LIFE ITSELF. Is that how you want your Granny to leave this Earth?  Do you think that would be fair to her and her family?

This problem is not a surprise. We knew we had too few ventilators, too few beds, too few caregivers. The Obama Administration knew, and told this clown car known as the Trump Administration. The WHO knew, Bill Gates knew, all credible sources that looked at the problem knew. They knew that we would need to ration care during a health emergency like this one and our powers that be DO NOTHING. DID NOTHING. And as soon as the public looks away, they will go right back to it unless something changes. 

At the center of this disaster is negligence at both the corporate and governmental level. Profit making hospitals have to ration their money into the features of a hospital that can generate profit. That profit comes from you, the patient, the taxpayer and goes to the very top of their corporate chain. It does not go to new buildings to provide more health care to the less privileged making them also under-served. It does not go to buying equipment that may only get used in an emergency. And the US government allowed it.

I am not knocking an individual person here. Nor do I have a chance in this fight - if infected, I am likely to die at home long before I would give consent to be taken to a hospital in this pandemic. My crippled immune system would make me more likely to get sick from the germs in an ER, and the stress would cause a flare that would go unattended by most staff even in the best of times. Even if I were to go to an ER for something else, Covid19, germs, worn out & stressed staff not able to pay attention to special needs cases, and my body's stress response means I would die of one or the other. So I have made the decision to stay home, to die at home if it comes to that: surrounded by those that can care for me, that care about me, in however much peace and comfort we can muster. 

Individuals run from the responsibility of their own decisions by hiding as a cog in a machine, just a representative for a corporation they barely understand, let along control. Modern doctors do not stand up for the poor like they should. As of yesterday, apparently this country realized that black and brown folk are 70% of Covid19 deaths. This is the result of a chain of inequity of which the hospitals were the last link of the chain. THIS IS ALSO THE RESULT OF RATIONED CARE. You can disagree with my earlier statement about bigotry in RHC, but the truth is in thousands of dead black and brown bodies.

There is no fairness in a plague. There is no fairness in a hospital where infection floats from room to room on garb that has not been changed or  sterilized. There is no fairness in death. None. First come first served has the benefit of being something that we do see as fair in other circumstances. It also has the benefit of rewarding those that took action early. We can do better. We can make sure that we need to ration less the next time, and the time after that. 

You are welcome to do your own research, (find out how much your own life is worth, you may be surprised.) I did before I ranted above. Much love to health care workers in general and ALL those workers that make sure we can live though this: from green grocers to ER nurses to delivery drivers to electricians. You are seen, needed, and awesome. 

SmartAss ProTips: Your Med Backstory

I want to have some resources here for you to use if you want or need them. While writing a piece on Go Bags, I realized that I had not talked to you about putting together a basic medical summary. This is the first thing you want in a hospital/medical BugOut/BugIn bag, or any travel bag for that matter.

Nissi (a black pitt) and Lucky (a tawny Chiwowow) keeping the neighborhood safe by sniffing a suspicious tree.

We will get into what Go/BugOut/BugIn Bags are, why you may need one, and a guideline of things to consider when making one. But before that, and Go Bag or not, you should have a MedStory!

MedStory is my own term for a unofficial medical history. Anything written my you will be considered unofficial - remember, patient reporting is considered the least reliable source of information around by docs, etc - but that was before "fake news." 

Even if you are not doing the whole Go Bag thing, you should do this. Even if you are healthy, you should do this. Keep a copy in your bag, in your car... You know your life best, so keep it where you know it can easily be found in an emergency. Since this will be too big to fit in the typical wallet, a note near your ID that indicates where your history is stored could save your life or the life of someone else if you are a organ donor.

I am going to give you what I think would be useful, and you can use or change it as you see fit for you and your family. We are going to cover information personal, medical, and medicinal. If you have a suggestion to add, please comment below and we will all benefit!

When you write your medical summary, imagine the conversations you normally have with medical professionals, only this time they need to know and you are unconscious with no family or friends present. There is a lot of information to think about here. You do not need to let yourself be overwhelmed by it. Take each suggestion one at a time. 

Ideally, you will have a summary for each family member. Even if you are around for your spouse, kid, or parent experiencing medical distress, this stuff is stuff you want to just hand off and not worry about - you will have enough worries.

Start with the basics: your name, address, phone numbers should be at the top. Another very important piece of information is your emergency contacts: their names, addresses, phone numbers. Who is your next of kin? Who is authorized to receive and act on your medical information? Do you have Advanced Directives (also called DNR orders). Do you have a medical power of attorney? You should have a copy of that in here, along with a notation of the location of the original, should it be necessary. Are you an organ/blood/marrow donor or on a registery?

While the rest of your medical information is covered below, next you should list your allergies, whether you think they would be an issue or not. Example: an egg allergy could really mess you up if you are given certain vaccines. So list them all is my advice! Make a note of each allergy & severity. Iodine makes me itchy, but penicillin will kill me.

You also need to mention any conditions, illnesses, or whatnot. Some people will list psychological diagnosis, and they can be important, but others are not willing to disclose them without establishing, personally, that it is pertinent and that they feel safe doing so. Sometimes an illness can be figured out by the meds you take, but do you really want people guessing at that moment?

You also want the names, addresses, and phone numbers of any health care practitioners you are currently seeing or have seen recently (last couple of years). If you have seen a specialist, you will always get asked why you saw them, so list that too (example: saw a pediatric gastroenterologist for stomach pain that resolved on its own or a physical therapist for SI joint dysfunction that improved with a completed course of PT). 

Now you need to detail what you are normally putting into your body. List any over the counter (OTC) or prescription medications you take, no matter how innocuous it may seem to you. If you take ibuprofen for occasional headaches, they say so. Please keep in mind that many prescription medications are used for more than one application, so list the reason you are taking it. Also list any herbal or homeopathic intake. 

I want to say if you are taking anything illegal, you should put it here because sometimes your docs really do need to know, but you have to make that call for yourself. 

So that is a good start. I will update this article as experiences or conversations make me wiser. If you have a tip, let us know below! I am considering making a Google form or something, what do you think?

BadCripple: The ACA and You

Dear Folks,

First: take a deep breath. We have some things to talk about. You may have to Google some stuff, you may have to visit some sites more than once. But you are going to be okay.

Since I am chronically ill and both sick and flaring, you will have to find most links on your own. Let me break down this part of my life for you: my phone thinks the damn hospital is my place of employment, okay? There is no setting to say I am just disabled. Heh.

Thanks to the ACA, you are going to be far more okay than you have ever been, if you were not independently wealthy. If you are independently wealthy: shut your damn dirty mouth about the ACA. Your fucking crocodile tears are part of the problem. Go polish your Bentley, the grown-ups have the floor. 

I am looking at you, Marco Rubio - quit fucking up your people in favor of some more money, you jackass. You were never going to be President anyway. Go write some useless memoir. I will read it when it gets to used book store bargain bundles.

Well, most of you are going to be okay. If you are poor but working in a state that did not accept the federal money to expand Medicaid you may still be fucked for a while. As I understand it, though, the Administration is going to try to find other ways to get you covered (you know, when they quit putting out the flaming Tea Party doggie bags on the White House lawn). That is the fault of your state, though, you got it? Good, because you have enough flaming shitballs to juggle just to get through the day. All I ask is that you vote, and remember this when you vote.

Okay, the rest of you: did you take a breath? Good, good. Take another one. For the first time ever, you are going to have reliable access to affordable healthcare. Yeah, really! You will have it no matter what happens to your job, even if you move, even if you or a family member comes down with a multi-million-dollar illness. No shit! Even if you get poor, unless you were in a red state that turned away the money to help you then. Think about that when you vote.

I know, I know, the web site is hard to use right now. But it is not just about the web site, and the web site is going to get fixed. You have until, like, January to get situated. That information is everywhere. You are going to be okay.

About the goddamn web page: this is not a simple thing. This is not some script kiddie's About.me page. This is a complicated thing, connecting to state and federal government, the IRS, dozens of health care insurers... You know how hard it is just to get some suits to decide where to go for lunch, let alone coordinate that kind of cooperation. Although other countries have universal coverage: this has never been done before. 

So make up your own mind, but educate yourself first, please. We have enough business people, "elected" leaders, and party dunces hollering straight out of their asses. You take care of yourself, and if you still cannot get things going for you and your family, take a deep, deep breath. You have a while.

SmartAss Politics, I Have Them: Fathood

As I was writing about my politics as one piece, I noticed that it grew pretty big very quickly. I am breaking it down into parts, which will hopefully be less irritating, and allow me to explore each piece a little more coherently. I started writing about the politics of fathood a while ago, in response to someone being Wrong on the Internet. The timing of that incident has long past, but my views are still the same. So, come, and share them with me!

Wall of Text version: I am a big liberal, you may want to get used to it. I hold the lofty belief that the world would be a better place if we could all be the people we want to be (without causing harm to another, or hindering their ability to do the same), as determined by our own ideals. I also believe that a representative government has a duty to make sure that we all have the opportunity – an equal opportunity – to do so. While I am talking about my beliefs, I want to include that government should maintain a social safety net for those neglected, ignored, and/or abused by that society.

I believe in the use of the word “fat” as a value-neutral term.That is easy for me to say because I am not considered fat. I have been fat - or at least reacted to in a manner that suggested the other person thought I was fat. I have considered myself fat (hello there, body image issues, how have you been?). I have never been called fat by anyone since I left my parents home. As an adult, I have weighted from 105 to 175 pounds at different points in my life. I am personally uncomfortable using the term fat because I do not believe that the use of it as a value-neutral term is wide-spread enough for me to assume that it is being heard in a value-neutral way. Do you find yourself asking WTF is this “value-neutral?!?”  I say this: fat is a descriptor, like brunette, tall, or tan; rather than a judgment indicating lazy, gluttonous, jolly, etc… And while that is what I mean when I say “fat” I shy away from using the term at all for fear it read as a judgment even though such is not my intent.

Here is an interesting article: New York Time: Body Mass Index Can Be Misleading.

I believe that the BMI can tell you that you are obese, and yet your cholesterol, blood pressure, and heart health may indeed be fine. I mean that you can be heavy and healthy at the same time. I know for a fact that your BMI can be “ideal” and you can be an internal mess – that is where I find myself lately. So my “The BMI does not indicate health” stance does go both ways. Any meaningful use of the BMI must take into consideration the origins and original purpose of it, along with its inherent flaws.

I know I am going to fuck up being a good ally on occasion. I hope it is a rare one. Not only is it the right thing to do, but this issue challenges a lot of people that I care about deeply.

Now, articles agitate folks every so often, and I do not want to get into that one way or the other but I am glad that the discussions happen. I lay clam to being fat accepting, but there are people you should be reading if you want to really get to know what that means.  The Fat Nutritionist is a good start.

First, Do No Harm is a place where people can go to talk about fat-phobia they are subject to from medical professionals. I have seen this in action. I have watched my husband’s knee and back concerns blown off by tying them to his weight (he had bulging disks, and a torn meniscus/missing cartilage in a knee).

Now, of course there are intersections between disability and size-acceptance, and s.e. smith talks about that really well here.I love s.e. smith, as you all will probably figure out sooner or later.


I am sure this topic will come up again in the future, but this looks like a good start.

Do you have a Health at Every Size or fat acceptance link or story? Share it below!

MSNBC and NAFC: Ed Picks Up the MSNBC/Free Clinic Mantle

Connecting people with life saving health care should not be a political issue.

Ed Shultz made me very happy last night. Although he did not mention Keith Olbermann’s early involvement with MSNBC and FreeClinics.US, he did pick up the mantle last night. He announced a new fund raising drive for a free health clinic in New Orleans, organized by NAFC (the National Organization of Free Clinics). To be fair, Ed was actively involved while Olbermann was at the helm of the effort – I had simply feared it would be either forgotten, or deemed to inconveniently reference the ex-MSNBC host.

If you are not familiar with the work of National Association of Free Clinics, you should definitely check them out – if you can donate, have access to a venue, can volunteer or if you need services. They have added a new way to donate $10, just text HEALTH to 50555.

The announcement is a must watch, and the interview that follows both stresses the importance of the work of the National Association of Free Clinics and lets you know what you can do to help, or to get help. I was only a little surprised to hear talk about the suicides they prevented. Besides helping people with neurological and biochemical issues;  just getting someone the help they have lacked for a chronic condition, or putting them on the path to a diagnosis which can make a huge emotional and mental difference in a person’s life. Life is pretty bleak when you know something is wrong with you but you have nothing but your word to back that up. Things can spiral wildly, until the only power you may feel you have is to decide when and how to end it all.

NAFC does great work, and deserves support. People depend on their clinics. It is sometimes a literal life and death issue. Help them out if you can. Go to them for help if you need.