Healthcare Does Not Have a Problem With Silos

August 3, 2017

Healthcare does not have a problem with silos.

In fact, there are no silos in healthcare; there are only boundaries.

If we truly want to change healthcare, we need to break boundaries.

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Housing is a Human Right

July 30, 2017

A year ago, through the kindness of a friend, I finally got a home.  I moved into a one-bedroom apartment with my cats in a quiet neighborhood after a year of homelessness.  And in this year, I have been able to heal and find myself again.

We talk about social determinants of health, but I think few people really understand how impactful they truly are, particularly housing.

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The Problem with Medicare QMB Administration

March 29, 2017

I find it ironic that before I became disabled, one of my last jobs was teaching social workers and doing outreach to the public about Medicare Savings Programs (MSPs) and now I rely on them.  If the government hadn’t funded a grant for me to do this outreach, I might never have known this program exists.  Problem is, most doctors, hospitals, politicians, and even the Medicaid offices that administer them don’t understand them at all which limits my access to care at times.  Not to mention, most don’t know that their low-income Medicare patients could qualify for them.

The Medicare Savings Programs are a great resource for those who are poor and need medical assistance.  The problem is, they shouldn’t be administered by the states through the state eligibility offices with Medicaid.  This current set up confuses providers, creates huge burdens on patients, and adds stress to an already broken system with subpar tools and resources.  But because it is administered along with Medicaid, as if it’s Medicaid, I’m subjected to this system, one that already already makes me feel like a burden, one that takes away my dignity as I try to simply get by.  And unfortunately, it’s never going to get better.

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Narrative

March 19, 2017

This week, the current president released his budget plan which included deep cuts in many of the programs that make our country great and that keep people alive.  Programs from meals on wheels to the Environmental Protection Agency to the National Institutes for Health among many others are threatened under this budget proposal in a way and to an extent they haven’t been before.  In some ways this move is not surprising to me as it continues a deep narrative about a person’s value and worth, particularly when they have very little – or rather a person’s lack of worth.  A narrative that blames and shames individuals based on stigmatizing assumptions about who people are – particularly the assumption that when someone has little, when they are poor it is a character flaw, they are merely lazy or uneducated.

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Who Is Included?

December 5, 2016

I can’t count the number of times the topic of who is and should be included in policy discussions and conferences comes up.  Just this week I encountered two examples where patients though ostensibly “included” were not included really at all.  Considering how long this has been an issue and how often it is discussed in patient communities, I am still disappointed that the discussion continues and inclusivity has not really expanded to mean all patients included.

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The Real Access Issues

May 6, 2016

Recently, the diabetes online community has been in a bit of an uproar over United Healthcare’s decision to name the Medtronic insulin pump as the preferred pump for all on its plan.  #MyPumpMyChoice and #DiabetesAccessMatters are added to every tweet on the issue as people debate choice in health care, health care costs, and access to healthcare in general (though mostly around tech – i.e. insulin pumps).

For some time now I have been rather frustrated with the larger issues of access, the ones that don’t get talked about as much and don’t have popular hashtags, the ones that aren’t sexy but are often more critical.  And those include basics like access to dental care and eye care and mental health care – (and I know this will piss many off) but what I think are the real access issues.

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I Believe in Change

February 1, 2016

I believe in the power of reaching out to the politicians who represent me.  Having worked for a state legislature, I know that when constituents call or write in about specific issues, they are noted.  Politicians do listen and often your voice can bolster their ability to make change.

Unfortunately, my experiences in the last few years have served to show me how far removed my representatives are from understanding the plight of those with disabilities – including mental and physical illness, in poverty, and homeless.

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