Going MIA til August
HealthCare Reform Issue
I. Access
It is well known that there are approximately 47 million Americans uninsured in the United States and of the insured many are underinsured. Currently, the fastest growing segment of the newly uninsured is the group that has been earning in excess of $75,000. These approximately 800,000 individuals lost their health insurance when they lost their jobs or were priced out of the market because of rising cost of health insurance. In addition most Americans "covered" by some form of health insurance still worry about its continuation should they or a close family member become seriously ill and some are "locked" into employment for fear of losing existing coverage.
A further problem is the decrease in employer-sponsored health insurance coverage. Between 1991 and 2003, the proportion of full-time employees participating in employer-sponsored health plans at medium-sized and large firms plummeted from 83% to 65% and in 2006 just over one-half of workers employed in the private sector participated in employment-based health plans. Furthermore, the Institute of Medicine ("IOM") estimates that 18,000 people between the ages of 25 and 64 die each year because they lack health insurance making lack of health insurance the sixth-leading cause of death among people under age 65. This fact alone makes the lack of health insurance shocking and menacing problem.
II. Rationing
For the most part, Americans support universal health coverage with increasing support. In addition, the lack of action on the federal level has lead to increasing action at the state level. Currently there are 3 states which have enacted universal coverage and 12 states which propose universal coverage. However, the biggest argument against universal health care in terms of access is rationing. Rationing occurs when limited resources exist and not everyone will have actual access to the care they need in a timely fashion.
A common myth which exists in the United States is that we do not already ration our health care. The most obvious way in which we ration health care is between those who have insurance versus those who do not have insurance. Even for those who do not have insurance and seek medical attention in emergency rooms, they are more likely to put off seeking medical attention until the problem has become severe and less likely to receive follow-up care.
Using rationing as an argument against universal access also presupposes that rationing of care is unnecessary or immoral. Even opponents to universal health care understand that rationing occurs and is necessary in a system with limited resources. However, the disagreement occurs when deciding who should be responsible for rationing care; the individual or government bureaucrats. Opponents to universal health care argue that the primary way in which it is rationed in the United States is by individual choice and that in an ideal system, rationing would be by patient choice wherever possible. However, an ideal system does not exist and even those with insurance lack the power to make health care decisions because they are limited by their insurance providers. Even more so, those without insurance lack the power choose or even gain access to any health care. The opponent's arguments place a negative emphasis on the health bureaucrats making rationing health care decisions and fail to address the impact of insurance bureaucrats making rationing of health care decisions. Nor do they propose any measure which would help achieve the ideal system allowing patients make these decisions without interference from one source or another (government or health care corporations).
III. Quality of Care
A common view prevalent in the United States is that we have the best health care system in the world; a view that has increasingly come under attack. In our current system, there are between 44,000 and 98,000 deaths from medical errors a year and a 2000 report on the epidemiology of medical error estimated that about 1 million preventable injuries occur to U.S. patients each year; these include transfusion errors, adverse drug events, surgery on the wrong side, and mistaken identity. In addition, our system frequently fails to provide basic services such as immunizations or prenatal, primary and preventative care. The average ranking for the United States on 16 health indicators in a 1998 comparative study of 13 countries was twelfth, second from the bottom and in another study of 11 western countries, the United States was ranked last with respect to its primary care base and its per capita health care expenditures (the highest), while ranking poorly on public satisfaction, health indicators, and use of medication. Furthermore, "[a]lthough American medicine has produced many "miracles," we are not the undisputed leader in medical innovation, only in the costliness and ubiquity of high-technology medicine."
Similar to access, rationing is an argument used against universal health care in terms of quality. The argument posits that because of limited resources, the quality and type of care will be reduced in order to preserve costs. For example, currently in the United States, the elderly and disabled have a privileged position with respect to health care in the form of Medicare. But in other countries, where the entire population is part of the same government-funded health care plan, the elderly are usually pushed to the end of the rationing lines. For example, in Britain, it is extremely difficult for an elderly patient to get kidney dialysis, a kidney transplant, or any other transplant. However, studies have shown that in the United States, when transplants are rationed, income, race and sex play a factor. It is clear when resources are limited rationing is necessary. Furthermore, whenever rationing becomes a factor tough decisions must be made. Is really so bad to approve transplant for a 25 year old versus a 75 year old when the resources are limited? These types of questions are already being faced with limited resources in our current system and will continue to be necessary in any new system.
Furthermore, another argument is that the most up-to-date medical technologies may not be available either because there is not adequate equipment or because there will not be enough money to run the equipment. However, a RAND study found that "for most care that has been studied, there are large gaps between the care that people should receive and the care they do receive. This is true for all three types of care (preventative, acute, and chronic). It is true whether one looks at overuse or underuse. It is true in different types of care facilities and for different types of health insurance. It is true for all groups, from children to the elderly." The current system in the United States fails the majority of the population when they do not have access to the most basic services, let alone the most up-to-date medical technologies, resulting in poor quality of care as a nation.
IV. Cost of Care
Health costs are increasing at an alarming rate, with sixteen percent of our gross domestic product being spent on health, about twice the average for other rich countries. The resulting costs of lack of insurance and underinsurance to individuals and society are high. Uninsured individuals lose between 65 and 130 billion dollars annually in the form of increased morbidity and premature mortality. The IOM estimates that communities nationwide spend 35 billion dollars annually on uncompensated care for the uninsured. In addition, when an uninsured individual cannot pay for expensive health care, society picks up the costs. An IOM report on the effects of uninsurance states, "[t]he unreimbursed costs of caring for uninsured Americans are ultimately paid for by higher taxes and high prices for service and insurance. Local communities tend to bear the main economic burden of subsidizing service delivery, while the costs of public insurance are more broadly spread across state and federal budgets." In addition, about 1.5 million families who file for bankruptcy can be attributed to the result of medical expenses.
Indescribable
It's nights like these that I hate being alone, but it's also nights like these where I am always alone. I want someone to hold me and tell me everything will be ok, but at the same time I hate that I need anyone. I hate feeling disconnected from life and alone in the world. I hate that I always face the pain alone; that I haven't yet been able to quell the tide of emotions; that I have not yet been able to pull myself out of a tailspin of pain, remembering the bad times over and over again.
What I really hate is physically feeling the pain and yet delighting in it. My old friend is still with me. That's just sad, thinking of pain as an old friend who has for too long been with me in my short life. I just want to cry and be cleansed, but I know although this spell will only last for a short time, it will return again and the cycle will continue as it always does. What is the point of continuing?
Hope is a double edged sword. On the one side I need it to keep going, I need to hope things will get better. On the other edge, it's a complete disappointment; to have your hopes raised only to be dashed into tiny fragments of sand and dust; dreams are shattered, hopes dashed, and disappointing reality comes crashing in.
If only wishes were real and dreams came true.
Wounded Heart
Trying to hold back my tears,
As I listen to your heart cry out loud.
My heart wishes I could wipe away the pain of the past;
to help you see loving again is worth it in the end.
But I know I am not the balm your heart needs,
I only wish it could be me,
the one that heals your wounded heart.
Intermission - Goodbye Letter
Dear Mr. D,
You no longer can be a part of my life because you helped facilitate my risky and destructive behavior. Although you may have given me temporary freedom from my mind, that is all you did for me. You added to my depression, lack of self-esteem and sense of self-worth. You stalled my ability to find myself after the rape and rediscover who I really am. You temporarily numbed the pain, but never allowed me to come to terms with the trauma, accept it or move on. I say to you now, I am worth saving, of being me and true to myself. So Goodbye!
Taralynn
Finding Myself Part III
Continuing on the same glorious night, after we finished eating dinner and we were still at the restaurant another friend of ours met up with us, let's just call her Iris (and Flash, if you can figure out why I choose this nickname, you'll have earned a boon!). Anyway, Iris and I met my last year of law school, dolt. She is from here, but worked for a couple of year in NYC, with a very nice job, in a very male dominated field. She's my age, very blunt, forthright and what you see is what you get. She has also been around the block in terms of life experiences and I have to say we clicked very quickly and I am glad for it.
Anyway, she finally made it to the restaurant, we made the introductions to everyone and shortly after a couple of us decided to continue on with the night and head to a bar. I decided to catch a ride with Iris, to catch up & escape another moment in the car with the boys. As we were heading to another bar, I finally broke down and just gab about EVERYTHING. It's just been so hard not having a friend who understands the emotional turmoil I am facing; someone who does not judge, is just supportive and gets it. For once, I have a friend who can actually give me useful advice that I had not thought of already (not that I actually take the advice, but it at least gives me another perspective to ponder).
During the car ride, I explain to her a situation I have been facing recently. I have developed feelings for a certain someone and really do not know what to do with them. He's a great guy, but I can tell I've already been placed in the "friend" zone with him. Plus, these feelings are really inconvenient and as my dad says, feelings rarely are convenient. You see I am trying to sort out my baggage, my issues and my life, having the focus on me. I really can't afford to take on anyone else's baggage or issues. So my intellect tells me to, STOP TURN AROUND AND RUN! But, my heart keeps hoping for a different result.
Of course I have not acted on these feelings, and my other girlfriends had no clue about them as they really don't know that much about my relationship with this guy (so good job on hiding those feelings to the outside world, woohoo). Iris is telling me they are what they are and just accept them. Be the friend for this guy and maybe someday he'll realize what's in front of his face. My reaction to that, is no way jose. My typically response to these kind of situations is to shut those feelings down and put distance, time and space between me and the guy to let the feelings dissipate. I mean, I don't want to wait around for him to "realize" or whatever, especially when all that type of thinking leads to is hoping for something that is not and may never be.
Coming full circle to Part I, the reason why the conversation with the guys, in the car annoyed me so much is I'm tired of being every guys "friend." When will I be seen as a women, not a friend, not a sex object, not a girl, but a women. I realize though, guys will not stop seeing me this way until I stop acting this way and demanding more. I have to admit I like being one of the "guys" sometimes, but really I'm not a guy, and I have different needs, likes, desires and expectations. Although I view myself is a strong independent women, I really do want some traditional roles to be filled, for a change I would like to be treated with respect, kindness and some social grace.
Well I definitely did not see where this piece was moving, but there it is ... only 3 more parts to write, then I'll be done with that one night and can gab about my adventure at The Beach.
Till next time...
Peace, love and all that jazz.
Intermission - Frozen Safety
Why does it seem my mood, my feelings change with the tide? One night I am feeling strong with my new found respect for myself. I see things that night which hurt and anger me, and I refuse to put myself through the torture of watching the train wreck that is you.
I leave, and drown my pain, my sorrow and hurt in dancing. I escape into a world of movement, cadence, and physical connection with myself. My pulse raises, my body sways, I lose myself in the rhythm, the beat, the music and for a short while my soul transcends.
Suddenly, my soul slams back into my body as real life intrudes upon my moment of peace. My chest tightens and feelings bleed from my heart. The dance temporary stemmed the flood of emotions, while I still search for a permanent fix. I head to the restroom, my friends have all forgotten me, I am only a thought, a memory, in the back of their mind.
I can no longer stem the tide; tears stream down my face. Once again I find myself alone, to face the onslaught of emotions. As the wave crests, I wonder why would anyone want to be around for this moment, I can barely stomach it myself. As I rock myself back in forth trying to give comfort, all that runs through my head is “It will pass, it will pass, I just need to survive it.”
As the tides recedes a new found numbness settles over my heart. Inside my soul cries again, as the walls have been built back up stronger, thicker and taller and it is trapped once again in the safe, cold, alone cocoon I have built for it.
Finding Myself Part II
When we finally arrived at the restaurant, my girl friends had not yet arrived. We put our name in for a table outside, on the patio, with a view and waited for everyone to meet up. As everyone is drinking around me (I am at a time in my life where I am choosing to not drink when I go out, can't handle the hangovers and can't afford the lost time while studying for the bar), I am admiring the ambience and drinking in the atmosphere. The couples around us are dressed to the nines and seem more in line with my age bracket. I look over the couples with an envious eye; thinking it would be so nice to have a romantic date.
I have to admit that throughout most of the night I was listening but not really participating in the conversation. My friends were quoting lines from movies and songs, which I have no aptitude at. So instead of trying insert myself into the conversation or steer it towards some other topic, I preferred to let it continue around. One of my many faults, however, is that I am easily bored. So to stay off my boredom, I played solitaire on my cell phone while listening to the conversation around me. I know it appeared to everyone else I was having a conversation via txt. Why do you ask? Because every so often I would break out in laughter. What my friends around me didn't realize, or don't realize, is I am a great multi-tasker, so while I appear not to be listening I am, and am adding my own two cents about what's being said, how it's being said, and by whom. It would be rather embarrassing for me if I did not have a filter between my head and mouth. Luckily for me, I do and most of my smart ass comments, or snide remarks stay in check.
The comments are not meant to be mean, but sometimes to put certain people in their place, so as not to allow their heads to swell too big with their own self-importance. Granted, I know this is all an act, hence the reason I keep my comments to myself. Plus, I have to admit, sometimes people would not get some of my references. While they quote movies & lyrics, I quote books, philosophers or just use euphemisms.
Anyway, the point to this portion of the story is, I no longer feel the need to fit in to every conversation or situation in which I find myself landing in. Normally, conversations such as these would make me uncomfortable, feel inadequate and left out; got to love our little insecurities. But that night, I was perfectly content to allow those around me have the spotlight on themselves and talk about things which hold no interest for me, while I observed and reflected on the dynamics of the group and amused myself in my own way.
I am very happy I no longer feel the need to fit in anymore, because, quite frankly, I have never "fit in" in big groups of people. I've always felt more comfortable and more successful in small groups or with one on one interactions.
So epiphany number 2: I do not need to force myself into a conversation to "fit in" or even feel a part of a group. I can be very content just watching and listening to those around me. It's nice to feel more comfortable in my own skin and no longer playing societal games.
Intermission - Wishful Thinking
I know I should continue on with my story from the other night, but I am having such an overflow of emotion right now I just need to free write for a little bit.
Wishful Thinking
I feel as though there is a whole burning in my chest; as though I am the walking wounded. I watch you from across the way and begin to dream of what could be if only you could see me. I am surrounded by mother nature's beauty yet my eyes keep straying to you; your flaws, quirks and annoying actions, increase your perfection in my minds eye.
But, I know the inconvenient truth; you don't see me and never will. You will never see the stars in my eyes when you are near, the joy or comfort I feel when you are near me. These feelings are a blessing and a curse. You have awakened me to feeling again, I don't know quite yet what to do with them. Intellectually, I know I am feeling too much because of the novelty and newness of it all, and hopefully, with time the heart wrenching hurt and disappointment will dissipate. Yet I am feeling feeling something again; a gift you have given me that you will never know.
Along with these feelings you have awakened in me, I am beginning to dream, to have hope again. For so long I have shut these emotions off, protected myself from feeling, so I do not hurt again. Now I fear my heart has suddenly been exposed, left in the open, to be loved or to be hurt? Either way I hope that when the time comes I am ready for what life throws at me. But, please I pray it is not hurt. I'm not sure I can survive another disappointment, another heart break.
If only wishes were real & dreams came true.
Finding Myself Part I
So, let me just start by saying I went to bed with a smile on my face and woke up with one as well. Talk about the start of a new beginning. What has caused all this spontaneous smiling? I can't really pin point an answer, so I would say it's a combination of events which merged together to form one great evening out. Here is Part I of my story:
I began the evening studying for the bar exam learning about secured transactions & commercial paper. As I was studying, i received a text message from my friend "Emo" asking if I wanted to go out to the SR, this restaurant on the lake and watch the sun go down. Willing to jump at any excuse to get away from learning about purchase money security interests, drafts & promissory notes, I of course responded with a resounding YES. About an hour and half later I was headed out to the Lake with my friends Emo & "Flash." As we were driving down, I learned that a case Emo has been working on was granted an appeal; explaining his celebratory mood. And for Flash, to give you a taste, when you go out with him, it's a free night at the Improv staring Flash Gordon. This night he was particularly hyper. Being in a good mood, I don't know I just wasn't feeling the comments, especially when the conversation turned toward a discussion of their conquests. So here is important event #1:
So, I was raised by my dad & brother, played sports and have always had many guys as friends. I'm used to hearing the "talk" about girls, but I guess it never really bothered me until last night. Do I really want to hear about your conquests? No. Do I really want to hear something that's supposed to be beautiful be brought to its lowest level & assigned a number? No. I have to admit the other reason I was uncomfortable in the car was that I am a woman & was there. I wanted to say "How dare you talk about other females this way in front of me! Have you no respect?" But, I bit my tongue, txted my girl friends asking them to shoot me and save me from the guys.
So, I don't know if my reaction stems from the recent new found respect I have gained for myself, or if it's a result of important event which was later admitted too at the end of the night ...
To Be Continued ...
Warning: although this story is mostly true, I have taken a little poetic licenses to exaggerate some events to correspond with my new found reactions & feelings.
The Anniversary
You see I have had plenty stressors in my life recently; got in a some trouble, my dad left for China again, and I am currently trying to study for the bar exam. But, thinking last year went ok, this year should be better right? So, I had a group of friends over for a BBQ, games & then we went to the fireworks. I got home around 11:30 and really couldn't face the night alone. My brain was working overtime. So, I decided to head out with 2 of my friends. Low and behold, 4 drinks later we are heading back to my place & I have a complete meltdown, IN FRONT OF THEM.
I have to admit, if I hadn't had those 4 drinks, I would never have asked them to stay or have broken down so completely in front of them. And I have to admit I'm a little embarrassed by the whole thing. But, it was the first time I didn't have to spend that night by myself; the first time I had someone hold me as a mourned over my loss.
So, as much as I can be hung up on the fact that I let someone actually see me vulnerable, I'd rather focus on the fact I finally was not alone to face it. What a nice relief.
The other really good thing that came out of the whole incident was that I finally faced / realized a type of emotional abandonment which stemmed out of the rape. I remember telling my mom about the rape, and her response was to ask whether I was drinking. My response was yes. I don't remember exactly what her response was, but in essence I got it was my fault for putting myself in that situation by drinking. So not only did I have the physical, mental, & emotional trauma from the rape itself, but I had an emotional trauma resulting from my mom's response to the rape.
I have to admit, I really felt abandoned and now I finally get why for years I have been wondering what's wrong with me. I mean if my own mom can't love me, or can abandon me, why would anyone else want me. Don't get me wrong, I'm a pretty intelligent person and know this is bunk, but emotionally this is how I have felt for years. After discovering this is really where it stems from, helped me to move on. For the first time in a long while I feel as though a burden has been lifted from my shoulders, I am excited about facing the next day (hence the reason I am still awake this late at night, can't seem to sleep but for the excitement). The most important realization for me is that I deserve so much better than what I settle for when it comes to men.
No more settling for second best, or overlooking some serious defects just because they give me attention or treat me nice upon occasion. I deserve, no I DEMAND better. Guess I'll be single for a while more then ;-)
So here's a shout out to all my fellow women; do not settle for anything less than what you deserve. Don't settle b/c there's nothing better at the moment, or it's too hard to end something or start something new. It's not worth it in the long run and it will only make you more miserable and lessen your feelings of self worth.
Peace, love and all that jazz ...
Another Late Night Ramble
I guess you could say I recognize I am not perfect so I do not expect my friends to be perfect. However, is it too much to ask when things go bad, that their is just some information that is completely off limits to no matter what. No matter how mad I am at someone, and no matter how many times they might have done this to me, I never even think to use that kind of information against them. To me it's, I don't know, it reflects worse on the person who takes these actions than the person being blind sided by them. I guess to me it's just hitting below the belt & is a cheap shot, cowardly, dishonorable.
I have to admit, I am so tired of being hurt or let down by my so called "friends." It really makes it hard to totally put myself out there. I may talk about my problems, but I have to be in a really bad position for someone to witness emotional outbursts from me. To actually see how vulnerable and soft hearted I really am. From learned experience, it makes me incredibly uncomfortable to think about it, I just picture my heart being exposed to be torn out, spit on, and stomped into oblivion.
In essence, I have created a very safe life for myself; which is not living. A part of me recognizes this and acts out in various ways to combat the restraints I have put in place, but I always seem to come back to the safety. I have to admit it's an incredibly lonely place to be, but on the flip side I'm protected. So damned if I do, damned if I don't.
Any thoughts?
I'm Back
So what you ask? I am going to finish up my Master's in Public Health & apply for Ph.D. programs. I don't really know what else to do.
On a personal note, I had a recent discovery that gives me hope for the future. You know all those romance novels I just love to gobble up; well, I always believed those kind of stories have to have some basis in real life, someone had to experience those feelings or something close to it. And I have been waiting, and waiting and waiting for some example to prove my theory is correct. Well folks I may have just gotten a small sample of what can exist.
I wonder if it's not necessarily the perfection of the moments, but the perception of perfection which leads to the rampant of feelings combined with the bodies' chemical response. I know one thing is for sure, have a guy treat me nice and boom I fall. The one thing I've learned is that it's not love, at least the lasting kind that the emotions represent, but its fall into feelings; and for a short period of time I feel special to someone other than my family, life stands still, and only we exist in that moment, in that time & in that place. I don't know if I can completely classify it, but all I do know is i will always cherish that moment.
I have been given a memory to combat the mother of all bad memories and for that I will always cherish and be thankful for it. And hope for the future the same type of moment can be continuously recreated with the person I am searching for.
It just makes me sad that I have all this love, passion, caring bound up inside of me with no one to share it with and I fear that I may never find that one person who wants to share that with me.
If only, if only, the wolf cried at the moon.