Friday, April 3, 2015

Medical Care in 2015


Our story goes back several years, maybe 9 years. Approaching retirement, self employed, and deeply involved in the community (chamber of commerce, city council, church, charities, et.al.), Hank was cruising forward to a long life of business, financial comfort – not wealth – travel, and a meaningful volunteer life. All of his family commitments were covered – ex-wife financially independent, kids doing well on their own and college bills all paid, and retirement funded.

Hank was in a solid relationship with his life partner of 6 years; yes a gay partnership as akin to marriage as possible. Even a commitment ceremony was held in a local church with close friends and family in attendance. That was a year before. The two men were building a good life on solid ground and in full witness of the community.

Then things went haywire. At first the drinking got heavier and consistent. A daily pattern developed. Functionality in career, business and elected duties appeared fine. But they were not. And they grew more so.

Hank didn't like this feeling. Things were getting out of control so he talked with friends who suggested a psychologist. Appointments were made with Doctor Bob and 18 months later Hank knew he was chemically dependent on alcohol. Also on cigarettes, a long time addiction of 44 years at 4 packs a day.

So that New Years Day Hank quit smoking and used the patch as an assist. He awoke the next day knowing he really had quit smoking. It was almost a spiritual event! Cigarettes were in his past and he felt a great weight lifted from his life. Now to see where this would take him.

Hank knew he had to quit booze, too. He just knew doing that would be very difficult if he remained a smoker. So with nicotine out of his life he waited for the patch to work before setting a date for dumping his beloved scotch.

One month into patch therapy and he began forgetting to apply the patch. He knew then and there he was free of cigarettes. Hank gave it another month and by March 1 he realized the time was near to take action on the alcohol front.

On March 21st of that year (2006) Hank walked into the detox center at the local hospital. He signed himself in. His partner accompanied him on the otherwise lonely walk. Then he walked away.

One week in hospital, two weeks of half-day outpatient care, then seven months of weekly group therapy sessions, Hank graduated to an alcohol-free life.

Meanwhile, Hank had normal health issues surrounding aging and smoking. COPD was the first diagnosis (chronic obstructive pulmonary disease) which could lead, and did, to emphysema. Because Hank had lost half of his lung capacity due to disease, he was placed on drugs and oxygen to battle the emphysema and sleep apnea that were co-health issues. Later that fall, Hank was enrolled in a pulmonary rehab program to better deal with his breathing issues. During that rehab Hank encountered a cardiac problem – atrial fibrillation, where the heart goes into a spasm of high count pulsing. Hank was taken by ambulance to the hospital where he was placed on heavy drugs to regulate the heart’s rhythm and referred to a cardiologist.

The cardiologist conducted a lot of tests and pinpointed the problem. A-Fib for Hank was a prelude to a stroke. Both the pulmonary and cardiac conditions were now related and both doctors took charge.

In winter of 2007 a bout of flu and severe bronchitis settled into the lungs and Hank was in trouble. A huge lung infection and low functionality in the first place, meant Hank was on drugs and oxygen 24/7. It was a scary time for Hank. He realized that his future might not unfold as he had imagined.

That was the turning point for Hank. He began to assess his future, his financial responsibilities and his hopes and dreams. The latter came under strict assessment. Here’s what Hank came to understand:

  1. Business life would need to be curtailed
  2. Elected public office would have to ease up or eliminated
  3. Volunteer life would need to focus on church, AA (Alcoholics Anonymous) and community
  4. Family matters needed to be better defined and solidified
  5. Financial obligations would have to be paid down or eliminated
As it turned out all of the above focused on using retirement investments to eliminate debt as much as possible, pay medical bills to current status, and learn to live on lower income and reduced expectations.

It took six months to a year to do all of the above. At the end Hank was living on Social Security and Medicare benefits, all of his debts were paid but a tax issue with the IRS and the mortgage. The IRS and the mortgage became impossible a year later and so the house went into foreclosure and seizure. Bankruptcy kept a roof over their heads for a time, but Hank and partner were facing a dim future. Tim, his partner, had lost his job when his employer declared bankruptcy in the recession that swamped the real estate industry. Tim’s employer was a marketing firm serving real estate agents and brokers. Few homes were selling so no marketing business. The shop was doomed and closed after 30 successful years.

Now both Hank and Tim were living on Social Security and Medicare. Tim had Type-1 Diabetes. Hank had his emphysema, A-Fib and severe sleep apnea. Medical costs built in spite of bankruptcy.

Jettisoning one car and downsizing the Mercedes to a used Ford Fusion, the two men leased a small apartment and downsized their life after shutting and locking the doors to their previous home now fully owned by the bank. A sheriff’s auction was scheduled to sell the home.

The journey from quitting cigarettes to moving to an apartment had taken seven and a half years. During that time Hank had left the city council, been elected a commissioner of the local park district, co-founded the local paper, served as a volunteer managing editor, columnist and city hall beat reporter for the paper. Seven years of writing, news gathering, community building and what not. A lot of what not.

AA and church work continued unabated. This became a key focus of Hank’s to discover his inner strengths and weaknesses. He worked on them a lot. He helped others gain sobriety and keep sober. Along the way he did as well.

Now nine years later things seemed stable. Simple but stable. No travel. No luxuries. Just lots of good friends and local connections. The can-do spirit soared and life was good.

Then the state legislature cheapened retiree benefits in an attempt to fix their budget problems. Medical benefits for state retirees (Hank had been a career employee of the state university) were reduced. Now large annual deductibles were required for each drug and prescribed medical procedure. Co-pays were added as well. The premiums gyrated for a while – both up and down – but finally came down. The new costs imposed, however, soared and thwarted the reduced premiums.

So Hank could do nothing more than refuse some procedures and some drugs. First to go was the oxygen service. Second to go was the heavy duty lung inhaler drug. Now the emphysema and sleep apnea were going it without their prior major supports. The insurance company could do nothing. The service providers could do nothing. And the doctors were powerless to overcome the bureaucratic complexities.

No. The State of Illinois had taken its stand. Retirees had had their due. Now they were on their own. After years of service the state refused to take responsibility for its own mismanagement and folly. It had wasted time and resources on other follies. It decided to leave its people, staff and retirees unprotected and under-served.

There’s more to the state’s story but I won’t bore you with that now. Let’s just say that public policy and public ethics are two different things in Illinois. And just maybe that is true for the nation as well. We all say the right things from time to time, but when action is needed, all is silence.

It is up to the individual in every case to move forward on their own, ready or not. Willing or not. Able or not. The latter is mostly the plight of the retiree. We don’t want public employees to get rich while working for the government. So we underpay them. We reward them with good, solid benefit programs to make up for that. But then, much later, when it is too late, the state reneges on their obligation and guts the benefit programs.

This is what it is like living in a state with a poor future. Having squandered their promise and innate treasure, the legislature has sealed the fate of generations of good people who gave their time, effort and talent to it when they could. Now they can’t. But no matter; time will soon take care of that little detail.

Illinois is joining the hopeless future of West Virginia, Mississippi, Alabama, Tennessee, Arkansas and Oklahoma. Failed states with a proud past. Just no future. Hallelujah?


April 3, 2015

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