Tag Archives: Affordable Care Act

It’s obscene

I didn't draw this, Martin Shkreli

Whomever drew this is a minor diety…

I know this is old news, but whenever I trip over the fact that in America pharmaceutical companies are legally allowed to jack up prices on medications that keep people alive by over 5,500 percent without warning… It kinda torques me off a bit.

Martin Shkreli is still an immoral, unethical, pathetic excuse for an American in my opinion.


A Conversation


“Yeah, Little?”

“I think I’m old enough to start to figure this stuff out now.”

I stared at the embers for a moment. The warmth of a rare fifty-degree day in northern Iowa in November had lost it’s battle with the evening chill, but I was loathe to give up the day just yet. I pulled my coat a little tighter, wishing I could pull the picnic table a little closer to the fire pit.

“What stuff, Honey?” I took a sip of my beer, wondering if we’d reached the point where the cooler was keeping the last can cold or if it was by now keeping it from freezing.

There was a pause from the other side of the table, then, “I’ve seen this happen before. I know I don’t have the best attention span, but I have a good memory. This happens every year, doesn’t it?”

“What happens, Little?”

“The trees. They look dead. But they’re not, are they – they’re just sleeping. They’ll come back again, won’t they, Papa.”

“Yep, the trees will come back in the spring,” I answered. Bonfires give a person a sense of calmness and patience that is increasingly rare in today’s world. “They always do.”

We sat together for a few moments, listening to the sound of nothing, the darkness gathering its strength from the shadows. We’re normally content with a comfortably silent companionship, but after a few minutes Little stirred again. “Papa?”


Slowly, “When the trees come back in the spring… Do you think we’ll all be here to see them?” She stared at the fire.

Another sip of beer. “What do you mean, Honey?”

“I’m old enough, Papa. I think I get it, sometimes. Things die in the winter.” She glanced at me, then back at the fire. “The trees, they come back, but some don’t. The plants, they come back, but some don’t.” She paused. “Every year it’s different.” A longer pause, then, “Will we all be here? In the spring?”

I took my gaze off the fire and looked at Little Buttercup. “Pretty deep questions for a five-year-old.”

She looked back at me, brown eyes wide in the firelight, “Some would say I’m almost 35.”

Papa and Buttercup

Papa and Buttercup

We stared at each other for a moment. I blinked first. “Am I really talking about mortality with a Golden Retriever?” Little Buttercup looked back at the fire, her silence an answer.

Bonfires, even in the chill of late November, bring a contemplative calm to conversations. We enjoyed a moment or two of quiet, thinking our thoughts. Then, from the puddle of fur at my feet, “I’m serious, Papa. I see what happens. I’m not as silly as you think. I need to know, will we all be here in the spring when the trees come back?”

“Oh, of course.” The words were uneasy.

“What about Nitty-Kitty,” she asked, lifting her head from her paws. “I worry about her.”

“So do I, Honey,” I said, “but she’s a tough little kitty.”

“She is,” agreed Buttercup, putting her head back on her paws, staring at the crackling logs. “I try to play chase with her sometimes but she never wants to play.” The fire crackled. “She’s so very small, but she doesn’t know it. Every night she’s out in the woods hunting. I worry sometimes she’ll try to fight that raccoon that lives up in Butterfly Corner and she won’t come back.”

“Me too.” We picked up little Nitty from a shelter years ago knowing she was a barn cat. Her silky black fur is stranded with silver now, but the fierceness of youth is undiminished. “But what can we do? Nitty lives to prowl in the woods – it’s what she loves. If she’s not here in the spring we’ll be sad, but we have to know that she’s doing what she wants to do.”

“Nitty’s tough.” A pause. “I hope she’s here when the trees wake up.”

We stared at the fire, my Golden Retriever and me, letting time slip through us. Then…


“Yeah, Little?”

Little Buttercup never looked away from the fire. “Papa, why doesn’t Mama ever come outside?”

“What do you think?”

The pup was quiet for a moment. “I don’t know. I remember her coming outside once. You were working by the garage and Mama came outside with her walker to talk to you, but she fell in the driveway on the rocks and hurt herself. I tried to help her, but she cried and you ran over and were all upset.” She sat for a moment. “The only time Mama comes outside is when you push her out in her chair and she gets in the car and you take her away. Then when you come home she gets out of the car and goes straight inside again in her chair. She never stays outside to play.” Two big brown eyes looked up at me. “I think maybe being outside hurts Mama? But how can that be?”

“You’re pretty smart for a dog,” I said. I picked up my beer. Empty. I reached into the cooler for the last can, hoping it wasn’t frozen. A sip, then, “You’re right, sort of. Mama gets sick real easy and she always hurts, so it’s not easy for her to come outside. She can’t walk much because it hurts and sometimes standing is hard for her. She wants to come outside and play with you, but it hurts her too much and sometimes the air makes her sick.”

“How can air make someone sick? I breathe it all the time.”

Mama's Last Outing

Mama’s Last Outing

“Oh, she has some allergies,” I answered. A glance at the Goldie Treever was enough to realize she didn’t understand. “There are invisible things in the air that make her sick.” My mind ran ahead, trying to get the words right. “And she has a disease that makes her so gets sick real easy from other people. You and me can come outside any time, and we can play with other people if we want, but Mama can’t. If she is around other people the germs – more invisible things that everyone has – will make her very, very sick. Everyone has germs and they don’t bother most people, but they make Mama really sick every time.” I picked up my frozen beer and took a sip.

Buttercup picked herself up and moved closer, still not quite looking at me. “I worry about Mama.”

“I do too, Little Buttercup.”

She leaned her head on my knee so I could scritch her ears. “When you take me in the car we only go for a little ride,” she said. “But when you take Mama in the car you’re gone a long time and I get lonely in my kennel. If Mama gets sick being outside and she can’t be around people, where do you go?”

“She has to go to her doctors every once in a while,” I answered, pulling my coat a bit tighter.

“What’s a ‘doctors?'”

“Oh, I’m sorry, Cupsy. I forget sometimes… Doctors are people who try to make Mama so she’s not sick all the time.”

“They must not be very good. She’s always sick.”

“Well, they try,” I said. “They’re really very smart people, and they want to help her. But it’s complicated.” I stared at the fire as I continued, “They don’t really know why she’s so sick all the time, and they only have a few minutes to see her so they don’t have time to really think about it much. But they do the best they can.”

“I wish they could do better. I wish Mama wasn’t sick. I wish Mama could throw the ball for me like you do sometimes when you’re not busy.”

Nothing hurts quite like honesty from an innocent you love. She continued, after a pause, “I wish you weren’t so busy all the time. You’re like those doctors – you only have a few minutes to see me.”

She let that hang in the air while she scratched her ear and I sipped my beer as time whirled inkily about us.

“Yeah, I’m sorry, Honey,” I said. “I wish I could spend more time with you, but I’m just busy.”


“Why what?”

“Why are you too busy to play with me?”

“Well, someone has to pay the bills,” I snapped. “Those damned doctors aren’t cheap. I have to keep working to pay for this you know.”

She sat up sharply. “Wait. You mean to tell me that there are people who can help Mama, but they’re too busy – and you have to pay them? So you’re too busy to play with me?” She paused. “WAIT A MINUTE!”

I waited whilst my pup cogitated.



“Okay, Papa. Explain this. Mama’s sick. People can help her, but they won’t unless you give them money?”


“So you have to ignore me – and Mama too! – to work to make money to pay these people?”


“If they want to help her why do they need money? Why don’t they just help her?”

“I wish it were that way, Honey,” I said. “But they need equipment and tools to help her, and they had to go to school for a long time to learn how to help people and that’s expensive.”

She flopped down on the ground. “But you said they don’t have time to help her much.”

“They don’t – they only have a few minutes to see her. They have to help a lot of people every day to make enough money to keep helping people, so they can only see people for a few minutes. Mama’s illness is something they can’t really help, but they try.”

“Monkeys are confusing,” said the canine. “These ‘doctors’ must be really poor and live in tiny shacks if they have to work that hard. Why don’t people just give them more money?”

“Oh no,” I replied. “Doctors are usually very rich. They have much, much more money than we do and usually live in really big houses.”

“I don’t get it. If they have a lot of money, why don’t they help people like Mama so she can be healthy and play with me?”

“I know, Honey. It’s confusing.” I sipped the last bit of my frozen beer. “The doctors want to help, but they can’t. Mama’s illness isn’t something anyone really understands. It’s expensive, but we have to keep seeing the doctors because insurance makes us.”

At this point the Golden Retriever named Little Buttercup stood up and stared me right in the eye. “Okay, monkey, what’s an ‘insurance’ and why won’t THEY help Mama?”

This is going to be difficult… “Okay, Honey. Insurance is something people buy to help when they’re sick. You pay in a little bit every month even when you’re healthy, then when you’re sick they give the money back so you can pay the doctors. It’s like a savings account in a way.”

She stared at me with a steadiness that was unnerving. “So this ‘Insurance’ thing make you take Mama to the doctors even though the doctors are expensive and can’t help Mama?”

“It gets worse, Cupsy.” I replied. “When I take Mama to the doctors she’s around other people. Remember how I said being around other people makes Mama sick? So when I take her to the doctors, they don’t help her much AND it makes her sicker every time.” I shivered as the fire waned. “But the insurance people won’t give Mama her money if she doesn’t go to the doctors because if she doesn’t they think she must not really be sick. So she has to go to the doctors and get sick and I have to work to pay their fees so insurance will believe she’s sick and will give her her money.”

She blinked at me. “Who in the world made up this system?”

“Beats me.”

“But wait! You said these insurance people give Mama the money she paid them when she’s sick.”


“So why do you have to work so hard that you don’t have any time to spend with me or Mama?”

“Because the insurance people took Mama’s money and decided to keep it. They say she’s not really sick so they shouldn’t have to give her money back. So we have a lawyer to fight the insurance people for us, but we have to pay the lawyer. So I have to work to pay the lawyer to get the money from the insurance people to take Mama to the doctors that can’t help her.”



“My head hurts and I’m sad now. Can we go inside?”

I shook my empty beer can. “Yeah.” I put my hand on her head and scritched her ears. “I hate to say it, Little, but there’s more. Tomorrow we’ll talk about how people around us elected a government that wants to take a different kind of insurance away from us altogether so Mama can’t have any medicine.”

“I hate to say it, Papa, but I think you monkey-folk are really weird.” She stood up with a yawn, picked up her tennis ball, and headed for the house. “At least wolves look after their own and care for their sick.” A pause as she trotted up the stairs and stood by the door, waiting for someone with thumbs to let her in.


“Yeah, Little?”

“Do you think Mama will see the trees? Will Mama be here in the spring?”

“Yeah, of course she’ll be here.”


“Yeah, Little?”

“Why are you crying?”

“Let’s just go inside, shall we?”

A reaction

…Hmmm… Sometimes you don’t get what you work for. Congress has defunded Social Security Disability to the point where we can’t get any help for my disabled wife even though we’ve paid into it for decades. And to make matters worse, the private long-term disability insurance company we’d been paying in to for years has used Congress’ deregulation to change the rules and has now stopped paying her monthly benefits as well. I’ve had to let my people go and sell off most of my business in order to stay home and care for her… We’ve given plenty of effort – we’re both college educated, we were both highly regarded professionals in our fields, I started my own company – then she gets ill and *poof* it’s all gone. We’ve worked. I’m still working 18 hour days. We’ve already lost so much, now we’re in danger of losing our home… We don’t want anything free, we just want to get what we’ve paid for.

And trust me, she WANTS to work! She’s trained her whole life to do her job, to be a professional. But she’s in so much pain, is so very ill there’s no way she could even get down the steps to the driveway let alone actually work.

If Americans don’t have government protection, if we don’t regulate the insurance industry, if Congress doesn’t fund Social Security, it’s people like Wifey and myself who get caught in the machinery and lose everything. The people on Social Security Disability, Medicare, Medicaid, etc. aren’t scamming the system – they’re people who need help, who have paid into the system, who are depending on those programs to survive.

Dollar Sign

A Fine Mess…

Health care costs are a very real concern for us. At one point last year I was paying 48% of my income directly to private health care insurance. Thankfully the Affordable Care Act was passed – I’m saving about $900 a month on my insurance alone now. BUT, the insurance isn’t as good as what I had before in many ways – I have to pay more in deductibles, and office visits cost more as well. I’m still coming out way ahead on the deal, but it’s frustrating and nerve-wracking.

The problem is, the system isn’t working for everyone the way it did for me. Here’s an NPR story that looks at the issue in a bit more depth:

I’m very tempted to write a detailed essay on my views on the matter, but I’ll restrain. I’ll settle by saying I’m very, very concerned about the views the leading conservative presidential candidates have on the issue. If we deregulate the health care insurance industry we leave ourselves open to more corporate greed demanding, in essence, “your money or your life.” Pharma BroRemember Pharma Bro Martin Shkreli? The young man who bought rights to a pharmaceutical and immediately (and quite legally) raised the price from around $13 a pill to over $750? The drug in question is a common, and very effective, treatment for an illness often suffered by people with compromised immune systems – people like my wife, for example, and those who are on chemotherapy treatments. Without the medication a person only has a 15% chance of survival. So it’s quite literally a question of your money or your life. Without government regulation, health care insurance companies could very easily follow Shkreli’s example.

And that scares me.

Is there anything we can do?

Man, just let me know if there’s anything we can do…

You know, if I had a nickel for every time I heard that phrase I’d probably be a thousandaire by now. People wanting to help, or at least saying they want to help… And I understand that! I bet I say that phrase to friends three times a week myself.

My wife is ill. She’s been very ill for a number of years now. There’s no cure, she’s going to die (just like the rest of us, only a bit quicker). She has a number of problems, notably CVID, Sjogren’s Syndrome, and uncontrolled asthma. The three are related, and each one of the three illnesses also brings along a host of other secondary illnesses along with it.

Push comes to shove, my Beloved  Wifey is disabled, and there’s a good chance she may pass away before her time. We struggle to keep her working – her HR department keeps threatening to fire her. If she doesn’t go to work, she loses her job, we both lose our insurance. If she goes on disability it will take two years before they pick up her insurance again.

We’ve refinanced our mortgage, we’re paying ahead at the funeral home… She can’t get life insurance, so we’re trying to make things as comfortable as possible for her over the next few years and at the same time find a way I can live here on our acreage once she’s gone.

Beloved Wifey can go to work sometimes. Other times she has to stay here at home for days or weeks on end. We never know. Day to day. Hour to hour. She misses work, I need to make up her income somehow on my own. I’ve grown used to 18 hour working days over the years.

So, as my wife’s primary caretaker, when friends say, “just let us know if there’s anything to do,” it makes me flinch a little. “Oh, we’ll let you know if we need anything,” we always say. Then we put it out of our mind.

People often say things they don’t mean. And we know it.

“Is there anything we can do to help?” Yes, can you clean the upstairs bathroom? We haven’t had time. The tub up there, the drain doesn’t close right. And we live in the country, so there are always dead flies on the windowsills no matter what we do. I’d get it myself, but I need to be tending to my customers – we need all the money we can get.

“Just let us know if there’s anything we can do.” Sure, it’s no secret we’ve been working on the basement for the last four years – we still need help getting the lights up, the ceiling done, some carpet down on the floor, some sheetrock needs to be hung… My brother-in-law is helping, but his time is limited. We can’t enhance our income by doing studio photo shoots until the studio is finished, and we can’t stop paying high utility bills until we can get a couple doors up to stop the draft… The basement is a liability right now, but it could be making me money – if I can find a way to get it finished. But I’ll never ask.

“If you ever need anything, just let us know!” I need to be working, to be sitting in front of the computer, to be learning a new technique with my camera… I need to be making money. But I don’t have time to take care of Beloved Wifey, tend to the dogs, AND get my ten hours of work done today. I could sure use some help – just someone to take the garbage out and feed the dogs, maybe throw the frisbee for SuperPup Buttercup.

“I really wish we could do more.” Well, I have twelve hours of work to do, and I also have four hours of laundry to get through, two dogs to tend to, and a sick wife to help – it’d sure help if you could just fold the laundry for me… Or straighten our prop room so I can find stuff when I need it in the spring. Anything. Any help is appreciated. Any little thing.

But those things are difficult to say. How does a person admit that he can’t care for his family without help? “Nah, we’re doing fine.” I have a grove full of deadwood that I can’t find time to deal with. I’ve offered to hire people to come and take the firewood away if they’d just cut it and take it… But that never works – I’ll be out in the woods for a good ten hours this weekend trying to clear the winter deadwood away, and another ten hours trimming the trees outside my grove so the neighboring farmer can get through with this equipment this spring. Those are twenty hours I could use working, or spending time with Beloved Wifey. But how do I say this?

How do I say that I really could use a load of groceries from town? It’s easier for me, somehow, to take three hours off work to go to the store myself then admit I don’t have time – then make up those three hours by working between two and five in the morning. (Five is when I normally get up so I can get a few hours work done before Wifey and pups wake up and demand attention.)

If you really do wish to help, we’d be VERY happy to accept – but it’s difficult for us to ask.

Do you have a few hours to help pull deadwood out of the grove? I’d be more than happy to let you! That gives me that much more time to catch up on work… Please don’t ask, I’ll say I can do it on my own. Just come and do it. I have a chain sharpener. Are you coming from town? If you ask, we’ll say we don’t need anything. In truth I’d be happy to pay for someone to grab some staples from the store… We’re always out of dog food, we can always use “real” food (we live on English muffins and frozen Totinos pizzas – everything else takes too long to cook. Every minute I spend away from my computer is a minute I’m not making money to help Wifey. Or spending time WITH Wifey.

If Beloved Wifey should need to go on disability, we’ll need to find means to pay for both our insurance coverages for a minimum of two years before Medicaid kicks in. Refinancing, paying bills ahead – we’re doing what we can to be ready for the time. But we sure could use some advice, someone to come over and explain how this all works. To me the words of finance are may as well be ancient Latin.

“Is there anything you need?” Yeah, I need a friend to stop over with a six-pack and some funny stories before I go crazy. We need someone to figure out if we need to insulate our basement (who has time to research that sort of thing?), we need people to stop over and play with the dogs… But if you ask, we’ll be too polite, too embarrassed, to “Iowan” to accept.

So, please, just DO it. We’d appreciate it more than you could know.