Big Changes in Medicare

If you have health care coverage through Medicare, don’t forget that between October 15^th and December 7^th Medicare folks have to decide if we’re going to keep our current plan (different versions of straight Medicare or a Medicare Advantage plan, which operates like an HMO or PPO) or opt for a different one. If you decide to keep your plan, you don’t have to do anything. But if you want to change your plan, it has to be done by December 7th - a day that now lives in infamy for this additional reason (in addition to Pearl Harbor, young people).

This year, it’s worth noting that in many instances, what is covered and to what extent it’s covered, has changed more substantially than in previous years. That’s because very extensive budget cuts were made that we’re really going to feel in 2015 and beyond. I have the Blue Cross/Blue Shield Advantage Plan and my co-pays will increase; it seems that some of the medications I take are no longer covered; and there is now a deductible for medications as well as higher prescription costs. I’ve learned this by just quickly glancing at the phone-book-sized package of information I received from BC/BS. I haven’t even had a chance to look at the government’s phone book, “Medicare and You,” but I’m going to have to review them both very carefully and probably make a few phone calls, too.

However, I did come across two articles that nicely summarize what’s going on and can help us plow through this frustrating process: one from Fiscal Times and one in The New York Times, both of which are more than worth a click, so I urge you to click on these links and help yourself understand what’s new, ‘cause it ain’t good news. Note that both articles suggest you also visit the official Medicare site, which is a good idea, as is contacting your current plan (the stuff they send you includes a phone number). And by the way, if you haven’t yet received your “phone book” (you should have gotten it by September 30^th), call your plan and request it. Ditto for the government tome.

I supported the Affordable Care Act and I still do. It’s apparently doing some good for millions of Americans who had no health coverage or really bad or quite unaffordable coverage. But I haven’t forgotten that it was constructed from a very big, very sloppy law with far too much input from insurance and pharmaceutical companies. And the hateful, dysfunctional GOP forced Medicare cuts to help pay for it. After all, what else could possibly have been cut and the idea of tax reform that forces rich individuals and corporations to pay more is out of the question!

The plain fact is, all health care coverage in America is bad, primarily because health care in this country is a profit-making business. If you’re on Medicare (or anything else) and are sick or get sick or need major surgery, you’re screwed. Even if you have a Medicare Supplement Plan, you’re screwed. If you don’t have plenty of your own money to supplement your health care plan – whatever it is, including Medicare – you’re screwed. Indeed, having enormous medical bills they can’t possibly pay is now the primary reason that people go bankrupt – by the millions – and that situation is only going to get worse.

So, after you spend a cozy night by the fire with your latest Medicare information materials – and try to resist throwing them into the fire – I strongly suggest you phone or email the offices of your Senators and Congressional Representative and let them know that the Medicare budget cuts are doing you harm. I promise you that a deluge of such communications will not go unnoticed by them. You might want to do this both before and after the November election – in which I urgently hope you plan to participate. 

Wake up and smell the calendar. It’s not the 20^th century anymore.

Coming Out of the Pain Closet

I add my voice to the chorus of millions worldwide who mourn the loss of Robin Williams, a bright genius light we loved who, unbeknownst to us, spent much of his private time in an overwhelming darkness, a despair so strong that it trumped fame, fortune, and the true love of family and friends. He suffered – oh, man did he suffer – from severe, chronic, clinical Depression.

So it’s unfair and downright ignorant to think he was insane or selfish because he killed himself. He was neither of those things. He also wasn’t “taking the easy way out” of something we don’t know about. His death is a tragedy – not just because he was who he was: a greatly multi-talented man of only 63 – but because he died of a disease that we as a society don’t understand, don’t talk about, and for which there are a variety of often inadequate treatments and no cure.

Which is why I believe that the best way to honor Robin Williams is not with mourning or tributes or film festivals or posthumous awards. Our greatest tribute would be creating greater awareness and understanding of Depression, in the same way that Rock Hudson’s death set America on a path of greater awareness and understanding of AIDS. 

And that must begin with the millions of Americans who cope with this disease Coming Out of the Pain Closet, risking and fighting the stupid stigma attached to it, and talking about it. So here and now I’m going to walk my talk and Come Out. I have Depression. I’ve had it at least since I was a teenager. I’ve been taking different anti-depressants (with varying degrees of success) for decades.

My mother and my maternal grandfather had it. Other relatives on both sides of my family had it. Some of them, like me, spent some time on the psych wards of general hospitals. Some of them attempted suicide. Others, like me, just thought about it. A lot. It destroyed some of their lives.

It sure has fucked up mine. It led to a nervous breakdown in 2003 and my not functioning very well ( ! ) for the past ten years. I wasn’t functioning very well before the nervous breakdown. I had a thriving business as a freelance writer that I ran into the ground because, increasingly, I couldn’t meet deadlines or make it to meetings.

I became a compulsive TV shopper and was one day short of eviction from my apartment because I was shopping away the rent money. Addictive behavior is a common component of Depression. My privacy and independence were imposed upon by a NYC agency called APS – Adult Protective Services. That was how I avoided eviction.

After my breakdown I became a virtual hermit. I didn’t leave the house for months at a time. I didn’t bathe or dress for months at a time. (These two are also common components of Depression.) Thanks to a legal aid-type lawyer I ended up on permanent Social Security Disability in my early 50s – but I was on Welfare for a couple of months waiting for the Disability to kick in. That in itself was a shameful nightmare. Shame is a big element in Depression.

I had a home health care aide for eight years. I became agoraphobic (fear of going outdoors) and only made it to doctor visits because of the aide. I also developed an anxiety disorder, as well as a condition called “hyper vigilance,” which means I’m unhinged by loud, dangerous noises. To this day, if a fire engine screams down the avenue outside my window and at the same time the phone and the intercom from the lobby ring, I cover my head and duck.

I’m much better now than I used to be. But it’s not “over.” Depression still colors and limits my life. Mine became acute in 1995 when my mother died. I held on for my father’s sake (although I was starting to screw up). When he died in 1999, I really began to fall apart. When my aunt, my last surviving blood relative, died in 2001, my tether shortened and tightened. By the end of 2003 I was gone. I got to a point, pretty soon, where I could sort of function at home, but not a lot and not very well.

For a couple of years, I cooked dinner nearly every night for a frail, very elderly friend/neighbor. It helped her and it helped me. I could put on a good face for the occasional others who came here, largely thanks to my aide, but I couldn’t go down to the lobby to get my mail. I spent most of my time sleeping and watching TV. I became concerned about the state of the nation and started this blog. But I did very little else. The occasional writing assignment, however small, stressed me out. Why did all of this happen?

Because Depression is a brain disease – just as Alzheimer’s, autism, and dyslexia are brain diseases. Depression is also a mental illness. It’s not in the same class as schizophrenia, but it is a mental illness. That’s why people who have it are ashamed, and those who don’t, stigmatize it. And they don’t get it. There are different kinds of Depression and different levels of it. Mine was fairly serious and not everything is detailed in what I’ve just described. But I know it was less than Williams' nightmare because I'm still here. Can you imagine the intensity of what he went through?!

My depression was exacerbated by long-term grief and it stays with me, in part, because I’m pretty broke (financially), in debt, and very lonely. All but one of my local friends relocated, died or dumped me. And even some of those who hung in with me didn’t really get what was wrong with me. They thought I had gone from being an active, well-kempt, successful businesswoman to being a sad, lazy, slob because I was giving in to myself and just not trying.

Well, I’m trying now. And it’s a daily bitch. There are still things I can’t do, in part because I also have physical ailments. I still think about suicide a lot. But I don’t want to die, really, I want to get better, I want treatment for this disease that still impacts my life. Maybe now that sweet, sick Robin Williams has paved the way, my hopes will be realized.

Should you be Coming Out of the Pain Closet? Do you now realize that someone you know is in it? Do you understand a little better that it’s not just self-indulgent “feeling sorry for yourself”?

Do you appreciate that people with Depression who can function at all are brave warriors? Did you know that Depression is at epidemic levels in America? Do you realize that 22 returned US service people commit suicide each day – 22 a day! That’s largely because of PTSD, which is a complex brain disease that includes Depression and a whole lot more.

I sure hope you know more, and better, now – or I’ve just spilled my guts to you and all over the Internet for nothing. But no, not for nothing. For Robin. And for the too many like him. May awareness, understanding, and brain science increase really quickly. There are too many suffering in the closet.