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Health care reform must address realities of uninsured

Judy Garland • Sep 30, 2013 at 9:26 AM

I first got involved in health care reform soon after the last big cut to TennCare at an event where folks with diabetes, cancer and other serious illnesses described the shock of being abruptly uninsured and uninsurable. I’d never been an activist, but I became one. I’m amazed to find I can talk up a storm when something matters to me. The more I learn the more compelled I am to speak out.My husband’s eye surgeries with all the preparatory appointments has provided an inordinate amount of waiting, talking and reflecting time for me. Our waiting room companions were mostly seniors, like us. Cataracts are a common ailment in our demographic. It warms me to know that we, 65 and older, can turn to Medicare when clouding of vision begins and set in motion the process for getting help with a straightforwardness that belies the complexity and wonder of it.A couple of documentaries came to mind as I waited. In one, a group of physicians with Doctors Without Borders in some third-world country carried their precious equipment on their backs to a remote prearranged site while blind or nearly blind people, often elderly parents on the backs of their children, arrived from all over to receive an incomparable gift. In the other, a rare concession on the part of North Korea’s last dictator allowed U.S. eye specialists into the country under very strict limits to perform cataract surgeries for a few days. The hundreds who experienced what must have seemed a true miracle wept in sheer joy.Surgeries to remove cataracts have the quality of miracles — done and done, in under 10 minutes. Those documentaries give me a sense of what it might be like for us seniors without Medicare’s gift of uncomplicated access to so important a procedure. The wealthier among us could afford cataract surgery, but for most elderly Americans it would be a hardship, if not an impossibility. Children of elderly parents in America don’t physically carry blind or near-blind parents on their backs but I suspect it might be an apt metaphorical image if we didn’t have Medicare. It’s only one very good reason Congressman Paul Ryan and his ilk (which includes Phil Roe) mustn’t have their way, ever.A recent experience in a hospital emergency room still shakes me. A Life Alert call landed my husband’s 89-year-old uncle in the emergency room. Because of the nature of his arrival, he was in a small room and already briefly seen by a physician when we arrived. The receiving room was overflowing, with people (many of them elderly) standing along the walls. Our loved one was lucky, with a bed and us, but little attention for very good reason. He was one of too many. He’s diabetic and hadn’t eaten since early morning, and just getting someone’s attention to see if it was all right to give him food was a hurdle.Once we finally spoke with a nurse, I asked if that night’s situation was unusual. She said it wasn’t, that most of the patients had no insurance and no other place to go, and they were obliged to take care of them. She said they did the best they could and apologized, though, God knows, she had no cause.It’s a shameful path to health care and a horrific burden on our nurses and doctors who deserve the best we can provide. It’s dangerous for patients, most of whom, unlike our uncle, had no one to intercede for them.If our congressman, Phil Roe, MD, would deign to offer his services to ease the load just once, maybe he‘d stop promoting the emergency room as a legitimate health care option and help it be what its name implies. He obviously doesn’t know or doesn‘t find it politically opportune, but our ER doctors and nurses know the immeasurable difference it would make if everyone had affordable, adequate, dignified, unfettered access to care.We need to abolish the ER as anyone’s primary care. If Roe and his ilk would spend time working on that, instead of wasting millions of taxpayer dollars and valuable legislative time on symbolic votes to repeal the very measure designed to do the job, they’d finally do a worthy thing. It’s become pretty clear they don’t want the Affordable Care Act to go into effect precisely because it will help people and relieve hospital staffs of stressful working conditions that hobble their effectiveness.Republicans are right in understanding that it won’t help them politically when people start to sense that Democrats, just like with Medicare and Social Security, have given them another good thing. I guess only in a more perfect world is “People, Not Politics” supposed to be anything more than a sound bite.Judy Garland of Johnson City is a community activist.

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