The Affordable Care Act. . . What. A. Mess.

First, let me say that I am a HUGE supporter of public healthcare.

By that, I absolutely do not mean socialized medicine.

I mean any program that makes healthcare more accessible to those who need it.

Medicare.

Medicaid.

Allkids.

These are all good things.

And I wanted to see an expansion in those programs because I've seen too many of my patients suffer without insurance over the years.

I firmly believe the wealthiest country in the world can - and must - do better:

However, the Affordable Care Act is a mess.

And I don't even fully understand the confounded thing.

The things I do understand because I have experienced them as a nurse at a non-profit community mental health center since the ACA passed:

- Medicaid is completely restructuring, and, among other cuts, they are paying for fewer medications each month, so the poorest patients are still suffering. As in, "Sir, would you like your anti-depressant or your cholesterol medicine this month? You are at your limit of five meds already."

- Since private insurers costs have skyrocketed, they are cutting mental health benefits, causing a large local mental health practice to have to close its doors abruptly. Patients and staff are suffering as a result.

- Private insurers are also refusing to pay for some medications that they have always covered in the past. When a nurse submits a prior authorization for a medication, the reason "stable therapy > two years" has always been sufficient because they wouldn't want to chance a patient who was doing well becoming suddenly ill again. Well, not anymore. Now, if they have decided they aren't going to cover the medication, they just aren't. End of story.

And those are just a few work examples.

On a personal level, I understand that:

- My husband's monthly cost for our family's insurance has gone up tremendously.

- Our copays for office visits and medications have increased significantly.

- Several medications now require prior authorizations (hoops to jump through) that never have before.

As a patient with chronic illness, these changes add up to substantial additional healthcare burdens for our family.

Finally, though it did not affect us, when we did our taxes this year, our sweet accountant explained to us the penalties for not having insurance and they are insane.

If you can't afford coverage, you are going to pay dearly for not being able to afford it.

Who is this helping?

All that said, I was a bit disappointed that ACA made it through the Supreme Court today.

Because there must be something in place for sure but it needs to be much better than this convoluted hot mess of a healthcare act.

Surely it isn't too late to rethink, rework, do better?

I certainly hope not.

For Clementa, Cynthia, Daniel, DePayne, Ethel, Myra, Sharonda, Susie, and Tywanza

At 6 this morning, I got in the car with my husband, half asleep, to ride with him to work and he quietly told me some horrific news.

"Nine people were killed in a church in Charleston last night."

Honestly, I am still try to process that sentence.

As days go by and more information comes out, there will be conversations about our culture and guns and racial issues and mental health questions.

They started today.

And I'm not saying they aren't important conversations or that they shouldn't be had but right now let's all just stop and think.

Nine innocent people. At church. Praying. Having bible study. Worshiping.

And one evil godless monster murdered them in their church.

I cannot imagine.

When I walk into our church, no matter how bad I feel physically or how stressed I am or what else is going on, it's like a weight is just lifted.

I just walk in and BREATHE.

I love to sing praises and pray and listen to the Word and learn and worship.

I look forward to it all week.

No matter what we are dealing with in life, it gives me such a peace.

Our minister made me laugh so hard a few weeks ago when he said he wants us leave church feeling like we could go "bear hunting with a switch."

When I leave, I do.

I'm ready to take on another week.

I'm sure they felt the same way.

Our church is our safe place to be with God and our faith family.

It's not a place of fear where we look over our shoulder.

We aren't suspicious of strangers there. In fact, we want them to come. Lots of them.

And they welcomed him.

I do not know why he did what he did.

If I'm being honest, I do not care.

I want him to pay fullest extent of the law.

And I will not write his name.

He is not worth it.

I want to remember and honor them.

The victims:

Nine innocent people at church at 9 on a Wednesday night.

I want to send all of our love and support to their devastated families and church and community.

I want them all to know that they are loved and prayed over and they we grieve for them and with them.

I want them to know that we stand beside them in their brokenness tonight.

I do not understand this.

I'm sure I never will. 

But our God is bigger is than the acts of an evil wretched man.

Clementa, Cynthia, Daniel, DePayne, Ethel, Myra, Sharonda, Susie and Tywanza are in His presence now.

And He will hold their loved ones in the palm of His hand.

A new week, a new diagnosis. . .

There is rarely a dull moment with autoimmune patients but this week was particularly interesting.

My rheumatologist received the results of a bunch of really detailed, advanced, highly specific (those are all medical code words for expensive) tests and decided that my primary diagnosis is actually rheumatoid arthritis.

I am not particularly surprised, as I do have a family history, plenty of the symptoms, and the oh-so-attractive RA nodules.

At first, I was quite upset because my great aunt who had it suffered terribly with horrible joint pain and deformities. She was wheelchair bound for many years and also dealt with the awful side effects of long term high dose prednisone therapy which can get really ugly.

I immediately began having visions of not being able to take care of my family or my animals or my patients.

In my mind, briefly, my travel bucket list was also being taken away and replaced with a rocking chair at age 40.

Luckily, this was a short-lived nervous breakdown before the positives of this new primary diagnosis began to emerge:

- There are many more treatments available for RA than for most of the autoimmune diseases

- There are many more treatments for RA than there were thirty years ago when I remember my sweet aunt being so sick (so pipe down, Miranda's brain).

- Now that we know what is causing this insane body pain, we can begin to address it properly.

All of that was on the 10th.

Now that I've had a few more days to process this information, a weekend off work, and some much needed church this morning, I am feeling even better.

This afternoon, I rewatched Christine Caine's sermon at our church earlier this month and here is a link:

https://www.churchofthehighlands.com/media/message/possessing-the-promised-land

Y'all, I know I've mentioned it before. I'm sure I'll be mentioning it again.

Because:

It is one of the best sermons I've EVER heard.

It's one of those that is just right on time when you need it (like when the Lord knows you have some fan-freaking-tastic health news right around the corner) and it is chockful of the real deal good stuff.

Anyway, the central theme in her sermon that the truth of God's word is higher than any fact of this world and that is what we are to build our lives on.

As long as we are still waking up and kicking, God still has stuff for us to do.

It's that simple.

I know this to be true, I believe it with all of my heart, and I share the same thing with loved ones when they are facing illness as well.

It just takes a bit to recover from the tailspin of a new health issue.

Now, though, I have a great doctor who is carefully choosing the best medicine to start with, I have wonderfully supportive husband and family, and I will do all that I need to take good care of myself.

The rest is in God's hands and I believe that He has lots left for me to do and get into - even my travel bucket list. :)

This Bruce Jenner business really has me thinking. . .

But maybe not in the way Vanity Fair seems to want me to.

I get that the cover was meant to - and did - start a national conversation.

My Facebook blew up with posts and articles and debates about Bruce/Caitlyn.

Anyone who knows me knows that is physically impossible for me not to have an opinion on this or any other matter but I'm not going to express it here.

Because, big picture, it doesn't matter.

Earlier this week, before all this took over our newsfeed, I started a post that I hadn't finished.

I was really upset because I read a quote from President Obama, in which he said he doesn't think we are losing the fight against ISIS.

Let me quickly say that I personally like him a lot. This will not be one of those anti-president type rants that I am seeing around the interweb.

However, that statement bothered me terribly.

See, a few weeks ago I read a piece from Ann Voskamp about what is happening to women and children in Iraq when ISIS takes over.

Husbands murdered, young girls raped and brutalized, people starving, mothers having to choose which children to leave behind. . .

I cried when I read it and it has haunted me since then.

I encourage you to as well because I think it's important that we all know the truth about what is happening to these people:

http://www.aholyexperience.com/2015/05/into-iraq-2-what-the-news-isnt-telling-you-why-we-cant-afford-to-pretend-its-not-happening-sozans-impossible-choice-and-our-very-possible-one/

This rips my guts out.

And then came the news that ISIS took another city.

So I wonder how it is that we aren't losing fight against them.

Is it because it isn't happening to Americans? I certainly hope that isn't what was meant but it is what it sounds like.

And all of this horror just * POOF! * leaves our attention because Vanity Fair has a sensational new cover.

I know it's easy to get drawn in to the newest story and I'm not saying paying attention to what's going on around us is a bad thing.

But this:

This is much bigger.

This number includes victims of forced labor and sex trafficking.

If you read the link above, you saw that ISIS is selling nine year old girls for $100 to any man that wants them.

Many churches, including ours, partner with A21 and they do some amazing work.

They posted this yesterday:

15 people were rescued in one week internationally.

That is wonderful but with 27 million enslaved obviously much more help is needed.

So, again, does what Bruce is up to or what Vanity Fair is running this week really matter?

I don't think so.

I wish more than anything to see just a little of that attention and energy directed toward those who desperately need our help, our love, and our prayers.