Identify what is most important )0( Eliminate everything else
The idea that some lives matter less is the root of all that is wrong with the world. Dr. Paul Farmer
The suffering of others is not alleviated when no one knows about it.
There is no one right way to live. Daniel Quinn Ishmael
The only thing that you need to start an asylum is an empty room and the right sort of people.
We are what we pretend to be, so we must be careful about what we pretend to be. Kurt Vonnegut

Monday, February 29, 2016


I received a call from the cardiac rehab department at the hospital.  They were reminding me to be there and advised me on what to wear and to allow plenty of time for the evaluation.

Then, she told me that they had checked my insurance coverage and my co-pay would be $35.00/US.
Each time.
Three times each week.
Twelve weeks.  Minimum.

When I checked with my insurance company last week I was told that rehab was completely covered.  I guess not.

The conservative total for this will be more than $1200.00.  It depends on how quickly my heart heals.  I told her that I could not afford any of that and was feeling just plain crappy when we finished.

I called the health club at which I can have a free, although limited, membership.  That membership is provided by my insurance company.  They are happy to have me, even so recently after a major heart event.  So, my plan is to go there and sign up after my first and, likely, last rehab appointment.

So, anyway, I was feeling better because they help heart patients there all the time and I will have the information from my rehab evaluation session and I was offered a free session with a personal trainer to help me set up an exercise plan.  I was feeling even better.

Then I received another call from the hospital cardiac rehab department, and the woman who called told me it was pointless for me to use the evaluation appointment if I was not planning on continuing for the whole term.  I explained that it was not that I wanted to avoid those, but that I could not afford to continue.  She was not very nice and I had the feeling that I would become a lost cash-flow patient.  I began to feel terrible.

She went on and on and I kept apologizing for not having enough money and finally she said that I would need at least four sessions and that I would be inadequately prepared for a decent recovery.  By this time I was crying and trying to not let her hear me.  I told her that I would take good notes during those sessions and take whatever brochures they might have.  Still scolding me (at least it felt like that to me) she agreed to let me come to the first one, although she stressed that what I could afford would be inadequate.  I promised her I would do my best and she told me that rehab was not supposed to cause stress and that I needed to take a deep breath.  I am feeling a little weepy just writing this.

So, anyway, I will go this week and take the sessions I can afford and figure out how to get the rest of the money so that I can take the entire course, as I do not want to die right now.  The survival rate for heart patients who take full advantage of cardiac rehabilitation is over five years.  Those who do not take the therapy usually die within three years.

I have a small investment that I was holding dear for the years to come, especially if our Social Security system fails, but I have two choices.  I can sell that investment, pay for the rehab and hopefully get a few more years.  Or, I can not sell it and die without being able to eventually use it.

There really is only one choice.  And, I guess what bothers me the most about this whole freaking mess is that it is simply another aspect of the Haves, those who have enough disposable funds to afford better insurance as well as the added costs of rehab or anything else health-wise they need, and those who do not have. 

I used to be one of Haves.  I had to go through hell to be one of those folk, but I was one until I could no longer be in that other life, where I would have died and, interestingly enough, avoided this heart problem.  I am not complaining.  Really.  I have the means to sacrifice and get the health care I need.  I am not happy about it, but as I said, I would so much like to live more than a couple of years longer.

I was still stressing about this whilst watching my grandsons so that their parents could celebrate their anniversary.  It is only their second because they married on leap year day, today, February 29th.  And, I was thinking, what do people without insurance do, and I already know the answer.  I lived it when I was homeless and going through the divorce and it is a disgusting factor of life for most of the people I have worked with during the past decade.  More.

Many of my clients, and others with whom I have worked, have never had any kind of health insurance.  They, their spouses, their children and their parents share a legacy of need that includes so many of the things that we take for granted.  We may be socially conscious, be volunteers, make donations of money or time to worthy organizations or we may not.  And, you know, it really does not matter beyond the moment of giving or helping because those problems are not going anywhere; they are simply and dishearteningly waiting until that moment of help passes.  There are not any long term solutions to anything connected with poverty.

Except that I believe there are solutions.

Education for everyone, even those students and families that are challenging.

Job training for those who slip through the cracks of our educational system and can turn their lives around at any age.

No one has to throw money at anything poverty related.  People just need the extra help they need.  Not one single person is beyond help and learning, no matter what crappy choices they have made in their lives.

It is interesting that my daughter and I had a similar conversation when I was in the hospital.  It centered on how difficult of a time I was having choosing a candidate for whom I could vote this fall.  She is a staunch Republican (where did I go and I am a tree hugging, Berk wearing, granola eating pacifist and as Independent as it is possible to be and still be able to live among other people.  Really.

It delved into health care and other social constructs and at one point she said that she does not enjoy talking about politics but she loves talking with me.  Sweet girl.

And, there we are.  I am no long a Have, but because of some resources and an amazing family I am managing to avoid be a Have-Not.  I am not going to let the loss of that cushion bother me, because I believe that I will always have what I need when I need it, and I guess that is why I have that small investment and why I have it right now.

I am hoping that that I will not feel unwarranted sensitivity and and a poor-me feeling when I meet that woman at the cardiac rehab place.  I will pull up my BGP before I get off the elevator at the hospital, although I will have to hope that it does not contain a camera. 

There are times when it is difficult to remember how blessed I am, and those time slide right in so easily that I barely notice until my panic subsides.  I cannot let fear or loss or need or anything that helps me feel deprived, because I am not.  I have a life worth fighting for and worth sacrificing for over and over again.  I deserve this now new life, no matter how long it lasts.

And, I am absolutely not going to waste a moment on anything but happiness and safety and love and family and all that I can cram into every single moment.


  1. I've just had a moment where I could have smacked that bitch in the gob for ya!! What a fuckwad! Someone said to me the other day, to see a persons true colours, just give them some power! I think we've worked out what fuckwad is! Bitch that's wot! Okay....*calm thoughts* Glad you have the means to get the treatment you need. I don't think I'll knock NZ's health system from now on though. Be well, live long and prosper! xx

    1. Ohh, I flubbed my reply...

      So, anyway, I am trying to think that she is just focused on her job, which is helping cardiac patients no matter what the barriers, that she can see only the benefits of doing everything in the program. Where this breaks down is that she seems to be unable to see this whole thing from the patient's viewpoint, and that only creates greater stress and fear in a person who is already feeling vulnerable and worried about making the effort to do the right thing. We, us cardiac patients, all want to keep on living.

      I actually find this a bit amazing as not living was something I was willing to consider in that other life. Crazy, but nice to be where I am now.

    2. She's still a bitch, doing her job or not......Unnnnless it's just a ploy to get people so stressed they kark it and that's one more off the list! Note to self, calm thoughts....don't kick the cat ;) xxx

  2. We have a different system here in Australia from yours in the US. My husband and I no longer have private health insurance so have to go through the public system. He is currently having treatment for a leaking heart valve and while it sometimes takes a while to get in to see a specialist at the hospital it does happen eventually. If there was an emergency he would be treated in the emergency ward. I am so pleased you have a little money tucked away that you can use for your rehab.

    1. That is very interesting. Even though a person might have trouble wrestling the money part, is is pretty easy to get an appointment here. Critical health concerns get priority for appointments, and waiting to see someone for an easier and less critical issue, well, the waiting time is not overly stressful.

      I guess no health system is perfect, although that would be wonderful. Can dream.

  3. I'm with Sue W - want to wack that woman upside the head with a hockey puck -( think that was actually one of your sayings)
    what a (expletive) bitch!!!