Category Archives: Health

Life is a Pre-Existing Condition

Afford me a moment to ramble about health insurance and pre-existing conditions.

My mother died from terminal lung cancer almost eight years ago.  She fought her disease with a fierceness and dignity that I find almost unimaginable.  The greatest insult during her entire ordeal was with her health insurance.

After more than two years of purchasing a health care policy on the individual market in pre-Obamacare days she was denied coverage when she was diagnosed with lung cancer.  The functionary on the phone told my father that her cancer was a pre-existing condition.  It was as if they were telling him that she waited to get diagnosed with cancer after more than two years of paying premiums.  As if she waited to deal with her cancer because…reasons?

My mother probably started her path toward lung cancer taking her first drag of a cigarette as a sixteen year old in East Moline Illinois in the 1960s.  Based on health insurance company logic she had a pre-existing condition going back almost forty years.

In truth, we all have a pre-existing condition.  We are alive and we will die.  This might be a little bit of hyperbole, but after dealing with health insurance companies I do not feel that anything is beyond the pale.  When you are at your lowest these people will step on your throat.  When you have lost family members these people will drop a letter detailing their refusal to honor the policy you dutifully paid upon for two years.  These are the people that Republicans in the House of Representatives have sided with instead of actual human beings.

If you think that things will be fine you need to wake the fuck up.  Health insurance companies will drop your ass from your policy for any of the following reasons:

 

  • Breast cancer
  • Uterine cancer
  • Pregnancy or expectant parent
  • A Cesarean delivery
  • Being a survivor of domestic violence
  • Medical treatment for sexual assault
  • Mental disorders (severe, e.g., bipolar, eating disorder)
  • AIDS/HIV
  • Lupus
  • Alcohol abuse/drug abuse with recent treatment
  • Alzheimer’s/dementia
  • Multiple sclerosis
  • Arthritis (rheumatoid), fibromyalgia, other inflammatory joint disease
  • Muscular dystrophy
  • Any cancer within some period of time (e.g., 10 years, often other than basal skin cancer)
  • Obesity, severe
  • Cerebral palsy
  • Organ transplant
  • Congestive heart failure
  • Paraplegia
  • Coronary artery/heart disease, bypass surgery
  • Paralysis
  • Crohn’s disease/ ulcerative colitis
  • Parkinson’s disease
  • Chronic obstructive pulmonary disease (COPD)/emphysema
  • Pending surgery or hospitalization
  • Diabetes mellitus
  • Pneumocystic pneumonia
  • Epilepsy
  • Hemophilia
  • Sleep apnea
  • Hepatitis (hep C)
  • Stroke
  • Kidney disease, renal failure
  • Transsexualism

That’s right, if you survived an abusive domestic situation you have a pre-existing condition for which a health insurance company could deny you coverage.  Born with cerebal palsy?  Hell, that is almost the definition of pre-existing condition in the eyes of a health insurance company.  Paul Ryan came for your health care and he succeeded.

So, basically Republicans want to punish us for having the gall to live and to expect more than a Hobbesian existence.   The ethos in Republican circles is “Fuck you if you are not rich and powerful.”

Paul Ryan came for your health care.  Paul Ryan is coming for your retirement.

The Right Wing Health Care Shell Game

Republicans in Congress, with the House leading the charge under the guidance of Paul Ryan, are conducting a great game of three card Monte with the American public.

The proposed American Health Care Act is a joke.  It’s like Diet Obamacare and everyone with half a brain understands that fact.  It is also the type of bill that is so neutered yet destructive enough that it is finding strange bedfellows in opposition like the entirety of the Democrats in Congress and Rand Paul.  If you ever thought Rand Paul would be a dissenting vote on Republicans’ attempts to repeal the Affordable Care Act raise your hand?

Now the spin begins.  Republicans and Donald Trump are trying to sell the idea that the goal is cheaper health insurance.  This is a farce because cheaper health insurance generally does not cover any health care.  If something is cheaper it usually means one of two things: someone else is picking up the tab or you are getting less coverage.  It is a zero sum game.

Under the Affordable Care Act the federal government was subsidizing your health insurance if you were so qualified to receive subsidies on the individual market.  Under the American Health Care Act you will just receive less coverage.  “But it is cheaper!” Paul Ryan will scream with Ayn Rand-esque shrillness.  Yes, just like a regular cab rear wheel drive F-150 is less expensive than a crew cab four wheel drive F-150.  Both trucks are F-150s, but one is cheaper because it has less content.  Everyone understands why those two trucks are priced differently and people will understand why health insurance is cheaper under Paul Ryan’s plan when they discover it covers no actual health care.

Thankfully, after seven years of claiming to work on a replacement for Obamacare and despite Donald Trump’s promise of amazing coverage for everyone Republicans have shown their utter lack of vision and leadership on the issue by producing a piece of crap bill.  Furthermore, provisions in the bill that would be windfalls to multi-millionaire CEOs and other rich people just show who the paymaster of the Republican Party really is in 2017.

Paul Ryan is Coming for Your Health Care

Paul Ryan, the wunderkind of the right wing, finally saw fit to release his proposed “replacement” for the Affordable Care Act.  Let me sum it up for you:

  1. If you relied on the individual market or Medicaid for health coverage you will get less. According to Paul Ryan you will like it because the free market will warm your insides with the fiery glow of Ayn Rand’s ridiculous ideology.
  2. If you relied on Planned Parenthood for any health services you are screwed because Paul Ryan hates Planned Parenthood. This is red meat thrown to a conservative base that might have a hard time supporting the bill, but can now hide behind the fact that it defunds Planned Parenthood.  Imagine the member of Congress going back to angry constituents, “I realize you are getting less health care, paying more, and even being denied coverage but we defunded evil Planned Parenthood.”  Look for this to be Ted Cruz’s defense when the human blobfish eventually goes along with passage.
  3. If you are wealthy you like this bill. Why?  You will pay less in taxes.  It is the right wing salve for the soul.  Got an HAS?  You will get to sock away more money under this plan.  The problem with this part of the plan is that poor people are living paycheck to paycheck and cannot afford to fund an HAS for future health obligations.
  4. The bill keeps the popular provisions of the Affordable Care Act that deal with keeping your children on your insurance until age 26 among others, but I suspect that these provisions will be weakened or removed entirely as the bill works its way through committee and reconciliation assuming it gets that far in the process.

Republicans do not understand how people actually live.  Asshats like Jason Chaffetz subscribe to the old Ronald Reagan “Cadillac driving welfare queen” when saying bullshit like this:

Americans have choices. And they’ve got to make a choice. And so maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest in their own health care. They’ve got to make those decisions themselves.

This is the first shot in a war that Paul Ryan intends to fight over the government providing any sort of assistance to anyone other than the rich and corporations.  Remember, Paul Ryan only has eyes for…

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Having “Access” to Health Insurance is the Latest Right Wing Bait and Switch

Over the next few weeks you are going to hear a lot of right wing talking heads spout off about ensuring “access to health insurance” in whatever plan they happen to be promoting at the time.  However, access to health insurance is not the same thing as being able to obtain health insurance.

Bear with a thought exercise for a moment.  Everyone in the United States has access to a Chevrolet Corvette.  However, only a small percentage of the population of the United States can actually afford a Chevrolet Corvette.  Access does not equal the ability to obtain.

The example is facetious and it does not go far enough.  No one needs a Chevrolet Corvette for transportation when a Chevrolet Sonic will do just fine in most cases.  Yes, it is a completely different car but it provides basic transportation.  Again, a large segment of the population cannot obtain a Chevrolet Sonic even though they have access.

Prior to the passage of the Affordable Care Act millions of Americans were denied access to health care based on pre-existing conditions.  Now, Republicans are likely to not totally scrap the prohibition of denial based on pre-existing conditions but it is likely to be modified in a way that benefits health insurance companies in denying you coverage.  Therefore, Republicans will have preserved “access to health insurance.”  See, they are looking out for the little guy.  Aren’t you relieved?

Beyond accessibility is the issue of affordability.  Under the current system, which again is defined by the Affordable Care Act, health insurance for lower income individuals is subsidized.  Makes less money and you qualify for a larger subsidy.  According to Republican logic this is evil.

Under Republican plans the current menu of subsidies would disappear and be replaced with…you got it, tax credits.  These tax credits are not based on income, but age so even if you are rich you get the same tax credit as someone who is poor.  Furthermore, these tax credits will do nothing for the segment of the population that cannot afford health insurance and does not pay taxes because they make too little income.

Make no mistake that the right wing of the right wing, known to most in Washington D.C. as the so-called “Freedom Caucus,” will probably support none of this tax credit nonsense.  The reasoning will be a word salad including the terms “socialism, communism, fascism, Obama, market based solutions, capitalism, Ronald Reagan, America, freedom, and Jesus.”  You can feel free to rearrange the words to match whatever particular politician from the Republican Party happens to be speaking.

In practice this means that whatever mechanism to ensure affordability that survives the gauntlet of Ted Cruz and Rand Paul will likely be so meaningless as to make health insurance as unaffordable as it was prior to the Affordable Care Act.  Therefore, “access to health insurance” has been limited because affordability is central to accessibility.  Do not fall for this madness.

Under Republican plans prices for plans will go up, the ability of health insurance companies to screw you over will increase, and the ability of people to actually afford health insurance will erode considerably.  However, you will have “access to health insurance” and that should make you feel all warm inside as you read that dog eared copy of Atlas Shrugged.

Taking Stock of Goals – First Day of Summer Edition

The longest day of the year has come and gone.  It seemed like an appropriate time to take stock of my goals for the warm weather months now that we are officially in summer here in the northern hemisphere.

My stated goals way back in April are available here.

How am I stacking up right now:

  • 2,500 miles on my bike – Currently at ~806 miles or 32% of the way to the goal. I was really racking up the miles for a few weeks but work and life has really cut into the ability to get away for 90 minutes or more.  On the flip side I have been spending a lot of time doing HIT workouts.  With a less constrained schedule the next couple of weeks I should be over 1,000 miles by the July 4th
  • 2 sets of 25 kettlebell swings and squats with a 45 pound kettlebell – Currently doing 2 sets of 25 swings and squats with a 25 pound kettlebell, but I am ready to move up to a 35 pound kettlebell in the next week or so. I will reduce the reps for a period of time.
  • 2 sets of 15 bicep curl, overhead press, and triceps extension with two 45 pound dumbbells – Currently doing 2 sets of 8 reps with two 35 pound dumbbells. For whatever reason it seems like I am not really getting stronger when it comes to these exercises.  It is like I have really hit a wall when it comes to progress.
  • 4 sets of 15 ab rollouts – Done!
  • 5 1,000 meter rows at a sub-2:01 500 meter split – I have been dogging it on my rows with 500 meter splits in the mid-2:03 range. On the plus side, I am going to add a sixth 1,000 meter row to the end of my workout to increase the aerobic activity.

This seems like good progress with ~6 months left until ski season really picks up.

2016 Summer Goals

When you take on a hobby or activity where your skill level and experience do not match your desire you run into a wall. This impact into that wall is what makes us know that we are still alive and not just going through the motions.

Skiing is the activity that makes me know that I am still alive. Furthermore, skiing also reminds me just how much I suck every time I slide off the lift and peer down the slope. My first trip down an intermediate slope was an exercise in trying to let go and not think about ligament damage. 1,700 vertical feet later I knew that I had to get better.

Getting better last year meant losing weight. I ended the winter a hair over 220 pounds. A lot of time in the saddle on my bike and a lot less snacking at night, plus cutting back my beer drinking, led me to a weight loss of over 20 pounds. I clocked in at 197 pounds during my first day of skiing this year in Winter Park over the Thanksgiving holiday.

Getting better this year means fitness. The bike is an important part of my summer fitness program. A bad day on gravel beats any day inside. Without the zen like quality of chewing up mile after mile I might go insane. Here is what I worked up as my fitness goals to be achieved by the time snow starts falling and skis need to be waxed:

  • 2,500 miles on my bike
  • 2 sets of 25 kettlebell swings and squats with a 45 pound kettlebell
  • 2 sets of 15 bicep curl, overhead press, and triceps extension with two 45 pound dumbbells
  • 4 sets of 15 ab rollouts
  • 5 1,000 meter rows at a sub-2:01 500 meter split

Do you notice what is not on my list of goals this year? Any mention of weight. Last summer I got too focused on losing weight at the expense of overall fitness, but particularly strength. I was an aerobic superstar by Thanksgiving and I paid the price skiing in some early season powder when my legs started to quiver like sand during an earthquake.

My contention is that if I hit the relatively limited set of fitness goals listed above that some measure of weight loss will follow, but it is not going to be my guiding principal this season. Everything is pointed toward an epic 2016/17 ski season.

Oat Bran versus Wheat Bran

In the pursuit of the perfect morning muffin recipe—a post on the ever evolving recipe is forthcoming, I promise—I have reached a conundrum when it comes to bran. Should it contain wheat bran or oat bran?

The non-bran aficionados out there might say, “Bran is bran, right? Just use whatever you have on hand.” I would have counted myself among this cohort had I not stopped one day at the co-op and looked at the nutritional information on the back of the bran packages.

What got me going down this path was not the nutritional information, per se, but the price difference between the two types of bran. A package of wheat bran compared to a package of similar sized oat bran was less than half the cost. Now, neither was expensive by any means since these are two relatively basic baking commodities and, in some cases, are actually the byproducts of other food production.

The price difference got me looking at the nutritional differences. I was somewhat surprised since I viewed all bran as interchangeable up until this point. Wheat bran has ~125 calories per cup versus oat bran’s ~230 calories for the equivalent measure. Wheat bran has ~25 grams of fiber per cup versus oat bran’s ~15 grams for the equivalent measure. Advantage wheat bran, right?

Not so fast. As one bran is not like the other bran, one fiber is not like the other fiber. Wheat bran contains insoluble fiber while oat bran contains soluble fiber. Insoluble fiber is good for keeping you regular and that is about the extent of things. It is that “roughage” your grandma always told you to eat in order to be healthy. Soluble fiber is a little more complex story. When combined with the liquid in your digestive tract soluble fiber creates a sticky, gel like substance that binds to various compounds and expels them from the body in the same manner that insoluble fiber leaves our bodies. Yes, it helps you spray paint the toilet so to speak.

One of the compounds that this gel like substance binds to is cholesterol. This is why Cheerios get to make heart healthy claims. While it is probably not a healthy silver bullet for your heart it is part of the solution. And hey, is less cholesterol ever a bad thing?

In my recipes I am more likely to add oat bran over wheat bran for the simple reason that I include a lot of wheat bran via whole wheat flour. This way I am taking care of both sides of the bran equation. However, in my most recent muffin recipes I have been splitting the bran 50-50 between oat bran and wheat bran to see if it effects the flavor and/or my bowels. So far so good.

What is your take on bran?