from another blog, I figure I'd share it on the lj blog audience. enjoy.

Over the last few days I've been providing care for a young woman with Crohn's Disease. This is a type of inflammatory bowel disease that gradually erodes the small intestine, large intestine, mouth, rectum and any other part of the GI system. Unmanaged, it's a terrible thing to live with - constant diarrhea, abdominal pain, weight loss and more weight loss - and a condition with many potentially surgical complications leading eventually to early death in many. When it's managed with proper medications and close follow up, complications can often be minimized and quality of life can usually be maintained for most people.

In short - managed or not - it's no fun at all.

This young lady, being intermittently homeless and unemployed, is eligible for Medicaid, and indeed she has medical insurance through one of the private HMO's that administer Medicaid in NYS (fyi - all Medicaid beneficiaries in NYS must be enrolled in an HMO, with a few exceptions).

Does this mean that she has good healthcare? Does "access" to hospitals and medications through insurance assure this woman of her basic civil right to quality healthcare? If you're reading this, the answer is probably already obvious to you.

Despite having insurance this woman does not "have" a doctor, instead, she bounces in and out of hospitals and ER's every 2-3 months when the medications prescribed during her last hospital stay run out, or when she has a C.D. flare.

Now let's assume for argument's sake that she only comes in for flares - as happened this time around - and not for lack of care. Following a hospital stay of several days during which she had multiple rounds of powerful IV antibiotics and several diagnostic imaging and lab test done, she is discharged from the hospital in "stable" condition; her acute symptoms have mostly resolved, and she only needs to follow up in order to make sure her symptoms do not recur, and that her medication levels (CD is a fickle disease) stay optimal.

Follow up? Really?!

Besides prescriptions (of which the hospital can only give a limited supply), she needed two things:
1) Appointment for gastroenterology (in-house)
2) Appointment for CAT scan (in-house)

GI Appt: Due to the type of insurance she has, the GI clinic would only accept the patient if she has a referral in hand from her primary care doctor (PMD). Say what? (that's almost exactly what the patient said). She has never met her PMD, nor did she even know that she had one. Her insurance card has the name of some guy she had never heard of, without contact information - and even we weren't able to contact him. So despite wanting to set her up with good follow up, and her interest in continued care, there's a good chance she won't get it. We tried a little rouse - setting her up with a primary care clinic appointment at the hospital, having her PMD changed in the hospital, and then referring her to GI. We have yet to see if this will work.

CAT scan: So, the CT office won't make an appointment for the patient without a referral from the GI doctors. Oh, but wait, the GI doctors won't see the patient without a referral from the PMD. Hang on? But who is that again? Some doc she was assigned to when she got her insurance card (in a packet with tons of other LONG documents in legaleze that no person in their right mind would sit down and read, even if they had a medical degree! How many of you read all your credit card, loan and health insurance benefits descriptions???).

Long story...

Now, how many layers of complexity can you identify in the story? What do you think this does to a person's ability, and even desire, to seek medical care for a condition they seem to be able to "live with". Now add to that financial difficulty that many Americans see, an average 7th or 8th grade education, frequently also mental illness (even if "just" depression) and what do you get?

A de-facto violation of civil rights. Yes, insurance gives you access to medical care, on paper. But this convoluted non-system (and I call it a non-system b/c nobody in their right mind could in any way plot the flow of resources, care, or people through this mess) essentially obliterates individuals' right to care by dropping insurmountable obstructions in their laps.

Why else is this a problem? Take a guess at how much time I had to spend today working out these fine points? 2 hours. And the other student that works with me? 1 hour. And the clerk on the floor? 1 hour. The Social Worker? 30 minutes. The nurse? 30 minutes.

TOTAL: 5 "man"-hours spent on logical problems and bureaucracy that should have been spent on providing medical care to someone else.

Another problem? The incalculable costs of her frequent hospitalizations. Many of which could be prevented with early interventions and regular follow-up.

Anyway, the list goes on. But the conclusion remains - we cannot continue relying on private health insurance for medical care. The insurance industry's interest conflict with ours. They want to make money (legitimate desire) by cutting the amount of money they spend on us. We want to stay healthy by seeing the doctor in the hopes of preventing, or minimizing, future illness. You see the problem?

Once we get private insurance out of healthcare, we may be able to actually get decent care, but until then, waste, expense, and sub-standard care will continue to prevail for the a majority of people in the US.

so lets see....
how long has it been since I've posted on here?
What.. about half a year? oh dear! That's a bit too long I fear! 
Ok, enough rhyming, I figure I'll slowly get back into the blogging scene, although how people do it weekly/daily whatever is beyond me. So who knows it might be another couple of months before I do another one.

Anyways, I suppose whats on my mind right now... I've been seeing a lot of movies lately. Most of them were enjoyable, so far (knock on wood). I still have yet to see a really bad movie or one where I thought "here I've just wasted two hours (or however long the movie was) of my life." But rarely is the case, since I see so many in the comfort of my desk on a decent sized screen! 
So here's a quick list of the movies I've seen, that I would recommend to anyone else who looks at these... 

Hotel Chevalier/Darjeeling Limited - A movie you have to watch more than once (for most) in order to get it all. Still, I liked it.
Charlie Wilson's War - Well made, very entertaining. The ending was quick. It tended to focus more on
The Kingdom - a bit slow to get going, but once it does, (about at the start of the second act) its pretty captivating. I like how it shows both sides of battle.
The Brave One - actually that's a meh...a movie to watch while you're doing something else
No Country for Old Men - you really have to be in the mood for this type of movie, but I thought it was pretty suspenseful, more about the bad guy than anything else
Juno - Yeah, if you haven't heard of it, I'm ashamed of you. I thought it was pretty good, but not great. It didn't really hit me like it did others who thought it was amazing. However, its still quite entertaining
Once - An amazing movie. I highly recommend it. Great movie, even better music
Intermission - just a fun movie in general, a background movie
Underground  - A 1995 bohemian movie, a bit long, but overlooking that, very well made. I like it more and more the more I think about it.  Recommend this
La Doublure (The Valet) - A French romantic-ish comedy. Entertaining, and good to see if you want to stay in. 
Paris Je T'Aime (Paris, I Love You) - A collection of short love stories in Paris that explore love on many different levels. Cameos Galore! Off the top of my head...Willem Dafoe, Natalie Portman, Steve Buschemi, Nick Nolte, Maggie Gyllenhal
Dan in Real Life - A "finding yourself" type of movie. I usually like these types of movies. This was pretty good. Not great, but not bad either it had its moments.
Bourne Ultimatum - Awesome. 'Nuff Said
The 11th Hour - A much more biased version of inconvenient truth by Leo Decapuccino. It was all about scaring the audience into environmentalism. Not the right way to go. But, it had some interesting facts
Vier Minuten  (Four Minutes) - Great German movie about passiona, love/lesbianism, and more importantly music. This is up there.
Les Chansons D'Amor (Love songs) - A very fun French Musical. I liked the music. The story was kind of fun, not very deep. But I think it was more  about the songs and singing. 
Across the Universe  - Usually covering beatles songs are a big no-no. But in this case, its a big yes-yes.  Cameos by Selma Hayek and Eddie Izzard (which was a total surprise)
Rendition - About torturing suspected citizens to get information. It was OK. 
The Lives of Others - Great German Movie. Another Recommend. Takes place in the time Germans spied on each other post world war II. You might need to brush up on history to get the context, but you can manage without it. Very very well done, and great acting. 
4 luni 3 saptamani si 2 zile - A very powerful russian (or is it romanian) movie about abortion. Brutal but excellent film making

Sorry about the random order of the movies, but it all just came out in that order, and I'm not about to spend much time (maybe that's why I suck at blogging) on reordering.. meh. 

Movies I want to see:
La Vie en Rose [French]
Mongol [Mongolian]
Falscher Die [German]
2 Days in Paris [French-ish]
The Savages
Love in the Time of Cholera
Wristcutters: a love story
There Will Be Blood
Lust Caution [Chinese]
Le Scaphandre et le papillon [French]
Naissance des pieuvres  [French]
Assassination of Jesse James
Mon meilleur ami [French]

wow. its been a while since I've posted on this one. hahaha. :)
anyways, its the middle of the summer, and i'm still waiting. and still sending stuff in. oh well. there will be other things to happen and to look forward to, there are always other opportunities. You know, I was listening on NPR and I heard that the average 30 yr old (or somewheres around there) person nowadays holds about 6 different jobs before that age? Apparently they were doing an article on how america's twenty-something crowd takes more time to figure things out about themselves mostly due to the fact that society no longer puts pressure on the younger crowd to get their life in order so quickly. In our parents' era, they were expected to at least have their life in order by around 18. So that's either hold a job that they could get promoted in or go to college/professional school to get a better job or something like that. No it isn't like that. The self-styled "boomerang generation" no longer has the expectation to have their life set by such a young age. There is a growing population in this age group that are "wanderers." Which is by no means a bad thing. They're spending more time to discover new opportunities for themselves instead of thrusting their lives into something they might or might not enjoy. Maybe this will lead to a happier generation because they'll have the experiences at their youth that will give way to an occupation they're sure they'll enjoy. Maybe not. Who knows. Either way, actively waiting (sounds like an oxymoron) for your future isn't a bad thing. It isn't "putting it off" (which has such a negative connotation). It isn't being lazy. It just is. Society evolves. Rather, it changes. I think that word has to be somewhere in the description of what a society is.

OK. here's something that probably annoys the hell outta anyone that's experienced this - those damn flash ads. Especially those on the top of these myspace pages that you mouse just happens to flow through when going up to the address bar or whatever. and then outta no where 'SAY SOMETHING. WAAAT??' or "OMIGOSH. NO WAAYY!!" it literally screws up the train of thought and surprises the heck outta me. not to mention its so annoying anyways. and if your laptop is in a public place and you forget to turn the vol. down all the way and it happens? yeah, bloody annoying to everyone.

and then theres the ones you don't even have to mouse-over. Page just loads and a female voice just says: CONGRATULATIONS, YOU'VE JUST WON AN XBOX 360. or whatever. stupid bitch. shut the hell up. if she were here, she'd win a free invitation to my fist. arrrgh. so you have to find the small little square to click on to stop it from playing. but some of them don't even have the mute button! like the one where it says SWAT THE FLY TO WIN XX BUCKS!! and there's this annoying fly sound that just goes on and on and on while you're listening to music.

i don't even know what they're selling, so they don't even serve their purpose. terrible marketing is all i have to say. it just serves to make me angrier. and you wouldn't like me when i'm angry..

remember the days of yesteryear?