Ave Cassandra Is Back

Back in 2007 or 2008, a marvelous guy running for state representative here in Colorado sat down and talked with me about universal health care. Joe Miklosi is a smart progressive who already knew that the U.S. system is fatally dysfunctional. So I was preaching to the choir.

But at the end of our talk, he did something no one else had. He gently touched my arm and asked me if I was taking care of myself - or if I was reopening a wound every time I shared my brother's story. Hmm. I assured him that working for health care reform was my way of working through my grief - so that no one else would have to lose someone the way we had, etc.

Hmm. In fact, I was pouring salt in the wound on a daily basis. As it turns out, I'm also very bad at organizing and activism. You have to be well organized and optimistic to be good at activism!

So I quit. And now I'm back, but just at Ave Cassandra, not at Health Care for All Colorado, a great group of activists but not for me. I'm not going to post every day, and no more salt, no more activism. I'm just going to pay a bit of attention again. And share the good stuff. And continue to urge my adult children to emigrate to a country with social policies that demonstrate concern for community, including people who are sick. WWJD and all that.

Death as a Rorschach Test

After a post at Slate I realize, once again, that Paul's death is a kind of Rorschach Test.

Usually people who are in favor of healthcare reform get it, immediately - how the U.S. healthcare system failed him in a far bigger way than misdiagnosing his appendicitis.

Physicians almost always get it immediately.

People who are afraid of change, and who don't understand that our health care system is a kind of ever widening net of dysfunction - not so much. For them it's all about misdiagnosis - if they've gotten past the point where it must have been Paul's fault, because the U.S. healthcare system is the best in the world (maybe needs a slight tune-up, but nothing major) - that being the case because we're the best.

And once a group starts thinking it's the best despite all evidence to the contrary, that's the beginning of the end, whether it's a sports team, an automaker, an army or an entire nation.

The United States does a lousy job of protecting what it claims is its most precious asset - its people.

Paulie

Paul does Karaoke

Pablito

Paul on Mt. Whitney

Young invincibles don't need Wellpoint

Infuriating article in New York Magazine on New York's "young invincibles," which is the health insurance industry's term for 20-somethings who make the very rational choice not to buy health insurance to cover themselves and line the pockets of a very profitable industry.

It was a painful article to read, as it opened and closed with the story of Andrew Ondrejcak's bout with appendicitis. He survived.

Paul should have survived too. Would have, if there hadn't been an entire series of screw-ups and wrong judgments at the hospital.

"We trusted them," Sarah told me afterwards. "We trusted them."

Paul had evidently been on some kind of campaign to convince her to be more trusting of people — to assume the best of others. That is the kind of guy he was.

The New York Magazine article is infuriating because it draws absolutely the wrong conclusion about what to do about all the uninsured 20-somethings out there.

The common assumption is that the exorbitant rates are schemed up by the politically influential executives governing the trillion-dollar insurance industry. But if insurers could target cheaper plans at younger New Yorkers, they would: Every business thrives by exploiting untapped markets. State law, however, requires insurers to follow a “community rating” system that throws everyone—young, old, sick, healthy—into one risk pool. “The whole point of insurance is that you’re pooling the risk to spread out the costs for everyone,” explains Cunningham. “If you target healthier groups with favorable policies, you’re likely going to make it more expensive for the older, less-healthy populations who need regular care.” Of course, if the young and healthy don’t buy policies at all, who’s balancing the costs? Recognizing this Catch-22, some states have adopted a more flexible “age banding” system, allowing insurers to customize packages based on age. WellPoint recently created a youth-centric program called Tonik, with plans as low as $67 a month, but it’s currently only available in eight states.

So things are fine in those eight states.

Wrong. In those states there's still a third of U.S. healthcare dollars not going to healthcare, but instead to duplicated administration, obscene CEO salaries, profits, and marketing. People in those states still pay, per capita, twice as much for healthcare as do people in other countries, and there are just as many left uninsured or with crappy insurance packages. I haven't googled "Tonik," but would bet that it's a junk policy, with a high deductible, lots of co-payments, and a fat premium increase if it turns out you have anything wrong with you. In other words, if you might need care.

Elizabeth Edwards on loss

Nice piece on Smirking Chimp about Elizabeth Edwards. Here's the key graph for me:

Not long ago I watched an event on Cspan where Elizabeth Edwards discussed her book, "Saving Graces." Elizabeth gave a detailed account of her recovery from grieving the death of her teenage son, Wade. She shed no tears, but the depth of her pain was palpable. She paid minor attention to despair and major attention to healing. Not as a preacher. Or authority. But as a vessel of resolve and understanding. She freed the audience from fear of discussing her child by explaining how his essence is honored whenever they mention his name. She explained that avoiding discussing him was like erasing him and that he should never be erased. A simple lesson, but profound.

I feel that way about Paul, obviously. Sometimes I cry when I talk about him, but tears don't hurt as much as erasure.

Heartbreaker

What sets off our hearts?

I've been in tears several times over the past couple days, thinking about Paul.

I just now opened iTunes and, in a fit of decision paralysis, scrolled and clicked without looking for the first song.

"Heartbreaker" by Led Zeppelin.

One of Paul's songs, which I've been avoiding for months, because it hurts to hear it.


Tracy Chapman helps:

I've seen and met angels wearing the disguise
Of ordinary people leading ordinary lives
Filled with love, compassion, forgiveness and sacrifice

I have also met angels in disguise, and we all know and/or know of saints. I'm thankful for that.
But it's not enough, is it?
I want us to all be together again.
I want there to be a heaven.

On Mount Whitney

Paul's best friend Robin just sent this along.

As my friend Bob Pfohman would say, "We were happier then."

Except then comes my mother, who would say, "Act happy, dammit!"

And she's right. We do have to act happy. We owe it to each other.

So cheers. Here's to life and the future. As the poem says,


Do not stand at my grave and weep
I am not there; I do not sleep.
I am a thousand winds that blow,
I am the diamond glints on snow,
I am the sun on ripened grain,
I am the gentle autumn rain.
When you awaken in the morning's hush,
I am the swift uplifting rush
Of quiet birds in circled flight.
I am the soft stars that shine at night.
Do not stand at my grave and cry,
I am not there; I did not die.

We're People, Not Statistics

Josef Stalin said that half million people dead in Ukraine was a statistic. But the death of one girl — now that was a tragedy.

Stalin was right. As humans, that's how we think. We can't get our minds around, for instance, 18,000 deaths a year linked to a lack of health insurance in the United States. But we can understand the tragedy of one death, like that of my brother, Paul Hannum.

Paul's friend Pete Holland wrote this song and sang it at Paul's Los Angeles memorial service:

someone's having fun and it seems at our expense
you wish a joke so stupid must make some kind of sense
but it's so funny we can smile
we just sit there for a while
there's no reason, no one knows
i don't get it, are you sure that's how it goes?



the things you don't need, you can always hold and touch
and the ones that disappear are the ones that mean so much
and its so funny we're in tears
and will be for years and years
no lesson learned, no wisdom gained
it's so funny that we're in pain

though every story is a treasure, and every memory gold
we'd trade them all away to watch our friend grow old
so he could laugh once again at the absurdity of life
and be a father and a husband to his daughter and his wife
and it's so funny we can't smile
we sit in silence for a while
the only words that remain
are I don't get it, can someone please explain?



Paul's baby girl was born this October.

The way I am choosing to bring some meaning to Paul's death is to throw myself into the effort to change our country's so-called healthcare system.

This blog, begun on Christmas day — our first without Paul — is part of that.

Welcome to those visitors who have linked here from Crooks & Liars, one of best sites on the web.

In fact, Paul loved C&L too. He'd be glad to know that he continues to be connected with its readers.

A big thanks to SadButTrue over at Les Enragés for editing my guest blog there. Paul's story and that of SadButTrue's best friend in Canada are mirror images of one another; Paul being on the dark side of the mirror, SadButTrue's friend on the bright side. Still alive, still loving, still laughing with his family and friends. Still outraged too.

The Canadian healthcare system was what made the difference. SadButTrue wrote that his friend's first medical crisis was the spontaneous collapse of one of his lungs. "His wife decided not to wait for an ambulance, just bundled him into the car and broke every traffic law getting him to the emergency ward as fast as possible. Which, the doctors told her, saved his life. After reinflating his lung, the docs decided he should stay in the hospital for further observation. The next day his other lung collapsed. The doctors said that, had he not already been in the hospital, this second crisis would have been fatal."

The friend's wife says she suspects she would have hesitated to take her husband in had they lived in the United States. But they live in Canada, and so he immediately received top-notch care, without their having to worry about whether it would bankrupt them.

The fear-mongers who criticize Canadian healthcare from their ideological soapboxes do not want to hear real stories, like that of Paul and SadButTrue's friend. No system is perfect, but the Canadian system so surpasses ours that there is simply no comparison.

Supposedly, when Marie Antoinette said "Let them eat cake," she meant well. You could say the same about Schwarzenegger. But his plan is simply more "Let them eat cake."

Time to storm the Bastille.

Check out Les Enragés.org

Take a look at Les Enragés, where "Sad But True" encouraged me to post the story of Paul's death. He did a great job of editing and hand-holding for this neophyte blogger.

Paul's story ended up there because it paralleled that of Sad But True's best friend — a Canadian man who is still alive gratis the Canadian single-payer system. As I believe Paul would be as well had he lived in Canada rather than California.

The difference being that Sad But True's friend went straight-away to the hospital, without worrying if it would bankrupt him. The difference being that the Canadian hospital didn't send that guy away, but instead cared for him.

The difference being that the Canadian hospital took immediate action when it was clear that there was something wrong, rather than dithering about getting the guy to a charity hospital.

I discovered the Les Enragés site via Crooks & Liars, which also linked to Bob Geiger's story. Geiger writes about his brain surgery for acute subdural hematoma — a bunch of blood in his brain. His surgery went well, but during his recovery a conversation with a nurse stuck with him.

"'Do people still die from a subdural hematoma?' I asked one of the nurses, while still in my ICU bed. 'Yes,' she replied. 'Just not people like you.' When pressed for what she meant by that statement, she said 'People with good health insurance, who can afford a neurosurgeon from Scarsdale don't die from these as much.'

As Geiger looked into it, he found that "a large number of people do indeed still die from the inability to easily obtain a 20-minute surgery, a procedure that has become a simple, routine operation for all neurosurgeons."

He began thinking about it: "I'm inherently worth no more as a person than any other husband, father and friend and yet, in the case of a medical crisis like mine -- and more recently, South Dakota Senator Tim Johnson's condition -- the ready accessibility of an emergency procedure can be the difference between life and death," he wrote.

"In one of the richest countries in the world, death should not be the penalty for having no health insurance. Yet, 47 million Americans still have no basic coverage and too many of those would die for lack of the same short procedure I so easily received."

I believe that most Americans have those same values — good values that should be easy to make reality, because doing the right thing, in this case, is also doing the cost-effective thing that benefits everyone.

Ah. Except for the people who are making really big money from the status quo.

And their dollars are able to create advertising that scares the bejeezus out of people. Rationing! Waiting lists! Socialized medicine!

But the reality is that it could be that enough people understand that what we have right now is what's scary. Not the change to a single-payer system, think of it as Medicare for All, where you choose your doctor; you and your doctor choose your hospital, should that become necessary; and the government picks up the tab. And it costs less than what we have right now.

The crazy thing is that so many people believe that cutting taxes doesn't result in deficits — despite that happening every time — but those same folks don't believe that expanding Medicare to all could save money. Despite the fact that every other developed country in the world has universal health care and pays less per capita than we do.



Who are we going to believe? Our lying eyes or William McGuire and the insurance industry? Our United Healthcare premiums allowed McGuire, former CEO of United Healthcare, to retire last year with $1.8 billion in back-dated stock options.

Paul becomes nothing more than collateral damage for a guy like this.

Baby's first Christmas

Pretty cute.

Christmas without Paul

At my brother Paul's memorial service last summer, a friend said now come the anniversaries. The first Thanksgiving without him. Our first Christmas without him. The first anniversary of his birthday after his death.
This friend knew: she'd lost two brothers herself. Her mother had loved Paul; she told Theresa that in some ways this was her third son lost.
Death being such an intimate stranger. That call comes in the night and your father will never again kiss you, rough cheeked to your smooth. You'll never again laugh in the giddiness of the moment over your brother's ready wit. You relive how it happened, wondering why you're torturing yourself, but it seems necessary -- because otherwise you keep forgetting that he's gone, that he's dead. It seems so unlikely.
There's nothing original to say about death.
Joan Didion wrote about how she kept forgetting that her husband had died. Well, yes — of course. How could he be dead?
Our loved ones are part of our life. Our life, damn it.
I want to say that we have no quarter here in this house for death — but of course we do. All of us have room in our homes for death.
My other brother, his dog, and my husband visited Cherry Creek Reservoir this Christmas morning, after we opened presents. No tree or decorations this year: we sat in the livingroom, a pile of books and dvds on a small stone table, and we opened them one by one. Outside, the remains of Denver's two-foot-plus snowstorm lay under a blue sky.
At the reservoir we took off from a trodden path, through deep snow that forced the dog to jump from one position to the next, just a bit away, breaking through the crust of the snow each time. We sat by the pond where we had scattered my father's ashes, and watched a couple hundred Canada geese plus a couple coots and ducks.
Last year we'd made our Christmas pilgrimage here with Paul.
He was with us for 45 years. And now for the rest of our lives we'll have his memory. And his baby daughter, please.

I recall the marble tombs in Arles.
In the rain.
Roman mothers, wives, brothers
Once cried by those tombs.
During a moment long ago,
Just a moment.

And now here we are.
Consumed, aware that
this moment will never leave us,
but will last forever.