If She Would Just Become a Drug Addict….

Sweet Stephanie

This is my fourth grandchild, Stephanie.  She is a very sweet and loving child.  She loves to read to her Nanny, still fits on my lap for relaxation in a rocking chair, and her eyes are either blue, turquoise, or gray – depending on what she is wearing.  She is shy and occasionally stubborn, but she comes by that pretty naturally. 

Stephanie has missed school again this week.  She has another sore throat and fever.  She has a lot of sore throats, and strep throat more than any little being should endure – because Stephanie has huge tonsils.  I’ve seen her tonsils and they nearly close off her throat.  Sometimes she must sleep nearly sitting up, and she snores like an old drunken man.  Because she has huge tonsils. 

Stephanie still has those monster tonsils because she is not covered by insurance.  Her parents are both working, and although they are not destitute by any means, they are struggling to make ends meet.  Neither has employer provided insurance for dependents.  Her mother COULD cover her children (she has another daughter from a previous relationship) through coverage offered by her employer, but the premium is exorbitant would eat up approximately 3/4 of her paycheck.  That is not an exaggeration.  The insurance, while very pricey, is really not a great policy – it has a high deductible, big co-pays, and additional charges that are euphemistically described as “co-insurance” charges.  These costs would easily consume the rest of Mama’s paycheck. 

Stephanie also does not qualify for state-sponsored insurance programs designed to provide children with affordable access to health care.  One program is not available to anyone who has access to insurance (regardless of cost).  The other program has income guidelines – and Stephanie’s parents make just more (and I do mean JUST more) than the guidelines allow.  Because they are working adults who do not receive government assistance, Stephanie’s parents are expected to pay cash for any health care services they seek. 

Stephanie’s situation is not all that unusual, given the economy and rising costs of health insurance premiums – both for employers and employees. I get that.  There is resistance to “socialized” medicine (the physician and insurance industry PACs are well funded, very organized, and persistent and have the most to lose).  I get that, as well.  Our legislators are mostly wealthy, and have access to great medical care.  I get that, too. 

As a nurse, I have seen much waste, fraud, and stupidity in the provision (or not) of health care services.  But I am trained to provide care to everyone entrusted to me, and I believe everyone should have access to affordable health care. 

Then I read this post by amostlyseriousnurse.  In this post, she discusses a heroin addict’s abuse of hospital services in which he received free medical care, via uncompensated hospital admissions, FOURTEEN TIMES in one year to have wounds cared for – self-inflicted wounds resulting from injecting heroin directly into his buttocks because his veins are shot.  I am sickened by stories like this. 

There has to be a better way…there are the haves (insured) and the have-nots (uninsured but eligible for assistance) and a very large portion of the population (the working poor) who could be bankrupted by medical costs.  Parents should not have to choose between groceries or insurance premiums for lousy coverage.  They should not have to watch their child struggle with yet another bout of strep, or administer yet another antibiotic (thankfully – free due to pharmacy sponsored programs).  A child should not have to suffer repeatedly in this, a country with exceptional health care facilities and services because her parents are neither rich enough to pay cash, nor poor enough to qualify for services. 

I think I’ll either have to spring for some insurance coverage, pay for a surgical intervention, or introduce Stephanie to heroin…


Filed under General Mumblings, Uncategorized

68 responses to “If She Would Just Become a Drug Addict….

  1. Gosh, this is such a HUGE issue–and one I well-appreciate. As someone with bipolar disorder, I have to deal with a lack of insurance equity for mental health care–which is grossly wrong in my mind.

    Oh well–so glad to hear you take up this issue. Our system is clearly broken–and, by the way, Stephanie is such a cutie!


    • You are right, lack of insurance equity for mental health care is wrong. If I could choose how my tax dollars are spent, I would ensure that every person has full spectrum health care first – all other programs could come after that.

      Thanks for reading, and your compliment of my Steph. She is a precious child.

  2. It is truly an outrage. What sort of society are we?

  3. I’m sorry to hear that you’re going through this; it’s unfortunate and I hope you obtain the coverage:)) I look forward to sharing more with you:))

    • If only I could put Stephanie on my insurance, all would be taken care of, I guess. Her parents have not asked for my help, but I just feel so helpless minding my own business from the sidelines…

      • At one point when my daughter and son-in-law were minus insurance I offered to take a temporary guardianship of the grandkids (on paper only) and put them on my health insurance. I did not have to do it as they were able to get on Mass Health. I did, however, help pay for dental exams as no dentists were taking Mass health.

      • I suppose that would be an option…

  4. –This makes me sooooooooooo angry.

    Poor Sweet Stephanie.

    I see the abuse on this end, too. People I know– getting every single thing for free…. & it’s just so darn wrong on several levels.

    I guess, parents who work their butts … need to work a bit harder and harder and harder….

    What the hell is going on here?


    • Public policy is heavily influenced by corporations and PACs. Corporations claim they cannot continue to provide health care benefits and shift more and more expense to their employees – yet are allowed to pay CEOs millions (billions?) and claim billions in profit. In addition, many corporations pay ZERO taxes, or receive humongous “rebates” from the government. Yet the government cannot provide health care to its citizens. It is sickening. And there will always be those who abuse or learn to defraud the system on – both sides of the equation. The doctors who defraud Medicare or insurance companies are the lowest of reptiles (no offense to the reptiles of this world).

  5. It is so hard to reply to this situation because it makes me so angry I can’t see straight. I am sorry your granddaughter is suffering because of it. I’m certain there are millions more out there facing the same issues and I know we’ve been there in the past.

    • Yes, there are millions of people without health care coverage or the means to pay for needed care. I’ve been very fortunate to have had coverage for most of my life. We all pay in the end for abuse of the system – and we will all pay for the millions who can’t have at the very least preventative care provided in terms of higher rates of illness…

  6. Luckily for me when my kids were growing up I was working at a job that offered decent health care, as my then-husband did not. When I had to assume care of my grand daughter I had to quit my job. She has insurance (she is disabled) but I didn’t for 18 years. This year I finally turned 65 and got Medicare. In my research to find the best supplemental I found that one of the things that is covered is male erectile dysfunction! Someone needs to tell these old farts to give it up. At that age if it doesn’t work who cares?
    P.S. I blogged about my first time with my insurance card- http://tempisfugit.wordpress.com/2012/03/14/sixteen-candles-and-counting-bust-out-the-fire-extinguisher-granma/
    P.P.S. My Sarah also had huge tonsils but the doctors felt they should stay in and now she is fine. Hope your situation gets better, answers are hard to come by.

    • Thanks for stopping by. I think nearly every insurance (public and private) will cover medications for erectile dysfunction. So those religious fanatics who screamed about providing birth-control don’t say anything about providing erectile dysfunction medications to unmarried men, do they? (I am assuming that they approve of sex within a marital relationship.)

      I think having huge tonsils is not an issue if a child’s health is okay – tonsils serve a purpose (they are actually lymph tissue that help fight infections). But they can also contribute to illness and I think that is what Stephanie’s doctors have decided, along with her sleep apnea issues associated with the restricted airway caused by the blockage of her throat while sleeping. (An expensive test her mother is still paying for).

      I remember reading about your insurance card escapade, and in a little bit I’ll go back a read it again.

      • Yes, that birth control issue is what had me wondering at the ED meds…and that is why I am spiritual but not religious.
        Hope Stephs issues get resolved with good results. Maybe she could sit on the sidewalk with a sign; charging to see her freakishly huge tonsils and make some money that way (just teasing poor Steph).

      • Yes, we may have to have a bake sale, as well to raise money for her surgery…

  7. Wow, very sorry to read this…

  8. I tussle with my extended family constantly about this issue. I am fortunate enough to be a “have” as I’ve got insurance for life through my former employer (State of Alaska). I kept my daughter on as long as I could. I had my ex-husband on my insurance because it was better than anything he got through work. We are penny wise and pound foolish. We need to invest in our own population, our own children, our own workers. Situations like this should never happen. This is a sickening problem, just as is the issue with diabetics not getting sufficient testing strips and people with various illnesses not getting adequate treatment and medication.

    • Yes, I am a “have” as well. Well, at least as long as I stay married – my husband carries me on his insurance (also state-employer provided). It is excellent coverage and I am very grateful for it. I think you are right – we need to invest in health and prevention – and we could save a lot of dollars in the long run.

  9. It’s a shame that health care is a mess. It is NEVER okay for a child to have to endure suffering because insurance companies have these insane policies. Oh … my anger is more than I can write about. So sorry for her constant discomfort.
    P.S. My grandkids call me Nanny, too. LOLOL

    • Thanks for stopping by, Nanny. Our health care system is a mess and a shame for a country that prides itself on being progressive. Thanks for caring.

  10. It is almost as if you need an Occupy-type movement to give a voice or forum to the many Americans who support change in this issue.

  11. This breaks my heart. I know many Americans are livid with Canada about us having universal healthcare, but here is exactly the case for easy access. My child would have had a tonsillectomy by now and it hurts me to know a child must suffer because of not being covered. I hope a solution is found soon because it isn’t fair that there are have and have nots. So sorry for you.

    And I had my tonsils out when I was 8 years old, on my birthday, 50 years ago and we didn’t have to pay a cent. And today, I am not overtaxed like some believe. I live a pretty good life and never have to worry about not getting healthcare.

    • Sandy, as a neighbor of Canada most of my life, I am not livid at all, perhaps a bit envious. I am sure your system has its issues, but at least everyone has access, and no one has to decide between groceries, or heat, or rent and health care.

    • You would not believe how my Southern relatives like to rail against Canada as if Canadians are dying left and right because of the health care there. I have more than a few Canadian friends and they are just fine with their health care system. In fact, having lived in Idaho and Alaska I pretty much rubbed elbows with Canadians all the time, plus I have family there, and I had a friend who could not move his mother to Alaska lest she die from lack of health care, whereas she was cared for in Canada. I wish we had a health care system as robust as the Canadian one.

  12. It is very sad that a country has wealthy as ours has so many people going without basic heathcare and food. Maybe one day, we’ll fix the system or replace it with something that works.

  13. this is so fucked. the republican house shredded Obama’s original health plan which would have meant Medicare for All – which is what he should have sold it as in the first place to get more public approval…and which the house still would have probably voted down…merely because he proposed it. anyone in who isn’t part of the 1% and who votes for these GOP criminals is crazy. meanwhile, i can only hope Stephanie gets treatment…somehow. continue…

    • We’ll figure something out (for Stephanie, that is). As for the country…we are screwed as long as we let the rich, powerful corporations and lobbyists influence public policy decisions. Bastards.

  14. Stories like this fill me with such anger I can barely breathe. At the system, at the people who manipulate the public to support the system, and to the people who let themselves be duped into defended “the best health care in the world” that, chances are, they themselves barely have access to.

    • It is an outrage. For millions of Americans – who pay taxes and struggle. It sickens me, not just because someone I love suffers and is not provided care, but because so many find themselves in similar situations. I think a lot of families are just one medical emergency away from financial ruin – and some are already there. We should all be angry, and we should let our voices be heard.

  15. Jackie Cangro

    I mean this really burns my britches. Not just for poor Stephanie, but for the thousands and thousands of people she represents. Basic healthcare should not be a privilege; it should be a right. I believe that healthcare coverage should not be tied to your job.
    Maybe if we remove the words “socialized medicine” from our vocabulary, people will get past the semantics and be moved to action. I know that no healthcare system is perfect but there has to be something better than this.

    • Yes, landing a job with benefits is like winning the lottery these days, and like I mentioned above, more and more employers are shifting the costs to the employees. I don’t have coverage where I work (I opted out as I already have coverage) but to cover family members would cost about 500 dollars a month for a spouse, and about 800 dollars a month for family coverage. If you are a parent who must also pay day care expenses, you wouldn’t even break even if you tried to cover your children.
      I am amazed at people who object to “socialized medicine” but eagerly sign up for Medicare…

  16. I’m so sorry about your grandaughter’s health. Do any companies offer an individual, child’s policy in her state?

    • The companies they’ve checked either require coverage of at least one parent or exclude pre-existing conditions (or both). And they are prohibitively expensive for struggling parents.

      We’ll figure something out, we always do. But we need reform of some kind.

  17. I hope that you can find an immediate solution to your granddaughter’s health problem. We need a long-term solution to healthcare in this country. One of my grown children has an auto-immune disease and the cost of treatments and medicine is outrageous. Thankfully she has medical coverage. We would all be bankrupt if she didn’t.

  18. We are grateful that the grandchildren do not have more serious medical conditions. We do need some sort of long-term solution, for everyone.

  19. This should not even be an issue. I feel so helpless that I can’t change it. But perhaps we can do something to help one child. If you set up a fund for Stephanie (my mother’s name by the way, so I love Stephanie already) – to treat her issues, and post it here, I will contribute. If we all contribute a little bit, maybe she can sleep through the night and not miss school. Is that too much to ask?

    • I was also going to suggest establishing a pay pal account I could contribute to. Thanks notquiteold.

    • I am so touched…I am crying. If it comes to that, I will certainly keep your offer in mind. I am hopeful that we can find affordable coverage for Stephanie so that any of her medical needs can be addressed. Financially I could pay for her surgery myself (and will make that offer), but that won’t solve the long term issue or address any complications that might arise.

      When I tell people that I have met the most amazing people in the world through a blog – they scoff. Thanks for your concern and offer to help.

  20. As an old social worker I know that I can’t change the world unless I change it one person at a time. Years ago I established a rotating fund to help some very poor people. We never had more than a couple of hundred dollars in it which came in a few dollars at a time. It was enough to get people in to get a tooth pulled or whatever the need was. In time it seemed to fill up again as the person who got the help got a few bucks or others tossed a few bucks in. When the fund was dissolved we distributed the money back equally to everyone who donated. The odd part is that none of us had much. I certainly don’t even today, but there is always a little bit that we can do for each other. {{{{{ }}}}} It is amazing what happens if people of good will gather together.

    • You are so right – we each can do a little and it helps a lot. My intention in writing this post was not to solicit funds – but to put a face and a story with the issue. Stephanie’s mother has exhausted every avenue to obtain affordable coverage – and her parents have not asked me for help. They may be poor, but they still have their pride. I think the time has come to acknowledge we can’t fix the system but we can take care of the problem. We will get her immediate needs met. I hope to be able to take some time to help care for her in her recovery.

  21. EXCELLENT post. I love the way you expressed the issue here simply by pointing out a situation that no one could accept as ‘okay.’ It sickens me (no pun intended!) that people who are hard-working, tax-paying citizens can’t afford to take their kids to the doctor. Something is wrong with this picture!!

  22. What a beautiful granddaughter you have. This is so sad to read.. I have two little boys and could not imagine them having to go through this if I did not have insurance offered by the company that I work for. It is these things we take for granted that i am thankful for.. I really and truly hope you and your family can find a way to help her. No Child should suffer. And thank you for taking a stand and posting this for others to be made aware.

  23. Deborah the Closet Monster

    A few weeks back, I read about someone who intentionally lost his job because that was the only way he’d be able to afford health care. How can this be sane, or right?

    I’m troubled by how much we lose as a society when our society’s citizens must spend so much money–and fear so much the loss of it–to get basic care that they don’t get it. I wish I had solutions, but so far . . . I have only endless frustration.

    • Me, too. And I know her parents are beyond frustrated, they are hardworking, loving people who are struggling financially. Some people are better off not working at all, and that is a sad commentary.

    • I know many people on SSI who desperately want to work but cannot or they will not only lose their income but their insurance and without insurance they would die. There is something terribly wrong with this picture.

  24. Poor, sweet girl. When I was a kid, they yanked our tonsils out as a matter of course. Prevention, I guess. All I remember is the promise of ice cream. Those were the days when my grandmother would check herself into the hospital for a little R&R. My goodness, times have changed (and by “changed” I mean worsened to the point of disaster).

    • Ah, yes…the good old days. When you could buy Sudafed over the counter without signing your life away…back before a patient with legitimate pain and a doctor’s prescription can only get 15 pain pills, but a criminal with a truckload of cash can get 1500 pills in a week from pseudo “pain clinics” …and addicts weren’t the only ones getting taken care of.

  25. The sad thing is that the people who oppose helping her dont point at her, they point at that addict who is clearly the minority. We’re better than this. I hope.

    • Those who object and point at the addict don’t understand that they are paying for him regardless of whether Stephanie gets care…

      • Very definitely. Caring for one another is not a matter that should be called into question for anyone.

      • People who point and judge have real issues anyway… My daughter just lost a good friend to an OD. He was a wonderful and talented young man. He struggled to stay clean, going to NA meetings daily. You never know who the addict is since they are our sons and daughter, brothers and sisters, friends and co-workers and are often fully insured even after they end up noticeably addicted. And the reality is that if we had universal health care including addiction treatment we would be better off – and it would take nothing from Stephanie. As it is, we harm our entire society by denying health care.

  26. Margie

    My country, Canada, has universal health care. But there are many things this doesn’t cover, so many patients need financial assistance to cover costs not covered by medicare. My community often has fund raising drives to help these folks out. When my child had cancer, we didn’t need financial help, but I know that if we had of, all the relatives would have offered to help. And I certainly appreciated the advice and help I got from my friend who was a nurse!

  27. #1 Son

    Lucky for Steph I JUST became a heroin addict. I was bored with sobriety (Come on now, that was funny)

Talk to me.

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