8/30/2009

Family Values in Health Care

It has struck me as odd lately to see so many "Christian" groups and "Family" groups jumping on the Teabagger Nutjob crazy train. Of course, it shouldn't, because as any LGBT person in America can tell you these people resemble Christians in name only. Surely, were Jesus to return today and start in with all that "It is easier for a camel to go through the eye of a needle than for a rich man to enter heaven" or "love your neighbor" crap he'd be labeled a Socialist and some guy with an AK-14 from the local church would start stalking him.

But, the reality of our health care system is that is does break up families and it wrecks lives. Take the case of M. related by Nicholas Kirstoff at the New York Times:

The disease [early onset dimentia] is degenerative, and he will become steadily less able to care for himself. At some point, as his medical needs multiply, he will probably need to be institutionalized.

The hospital arranged a conference call with a social worker, who outlined how the dementia and its financial toll on the family would progress, and then added, out of the blue: “Maybe you should divorce.”

“I was blown away,” M. told me. But, she said, the hospital staff members explained that they had seen it all before, many times. If M.’s husband required long-term care, the costs would be catastrophic even for a middle-class family with savings.

Eventually, after the expenses whittled away their combined assets, her husband could go on Medicaid — but by then their children’s nest egg would be gone, along with her 401(k) plan. She would face a bleak retirement with neither her husband nor her savings.

A complicating factor was that this was a second marriage. M.’s first husband had died, leaving an inheritance that he had intended for their children. She and her second husband had a prenuptial agreement, but that would not protect her assets from his medical expenses.

The hospital told M. not to waste time in dissolving the marriage. For five years after any divorce, her assets could be seized — precisely because the government knows that people sometimes divorce husbands or wives to escape their medical bills.

“How could I divorce him? I loved him,” she told me.

“I explored a lot of options with an attorney here in town,” she added. “The attorney said, ‘I don’t see any other options for you.’ It took about a year for me to do the divorce, it was so hard.”

So M. divorced the man she loves.
I can relate to that story. When my grandmother was diagnosed with Alzheimer's we tried to allow her to stay at home. I lived with her while working at our local hospital up the street. Yet, it became apparent that she would be unable to stay at home. While I was at work she would wander the streets thinking that she was a young mother and someone had taken her baby. The delusions got worse and worse and when she began to go into rages and become violent there was nothing that could be done.

By that time, I was spending more time at my mother's house to just get a break from it all. It was taking a toll on my sanity and health as well. She was finally hospitalized in a nursing home that another of her grandchildren worked at over 50 miles from home because no local home had a bed available - despite the fact that there was one across the street from her house and she and her late husband had sold them the property to build it at a substantial discount over 40 years before!

Interesting side note about that: She eventually ended up in that nursing home after being refused repeatedly on the grounds there was "no bed available." It became clear that there were several beds available but they were being held for people with private insurance or self-pay rich people because the nursing home administrator was shifting funds from that home to a swank "retirement community" he and his friends were building nearby. She got her bed when Strom Thurmond (yep, that Strom Thurmond) called the nursing home and hinted that he'd ask for a full review of their reimbursements over the past 20 or 30 years if she didn't get a place to say. Within hours a bed suddenly "opened up." BTW: My elderly mother and aunt were driving 100 miles round trip daily to see their mother in the other facility.

By this time she had few assets other than her home. She had willed that home to my mother as a life estate and eventually to be mine free and clear. Unfortunately, her going into a nursing home complicated matters. Eventually, my mother moved into her house and out of her tiny apartment. Meanwhile, I had met Michael and we were living just across town in a rented home next to my brother who was ill with HIV.

When my grandmother died the house went into limbo. We were told the state could not evict my mother but that it was not clear whether it could pass to her because my grandmother had been put on Medicaid to help pay for what Medicare did not during her long decline. So, for another two years my mother lived in the house until she had a stroke. At that point her own health rapidly declined and she eventually died in a hospital.

At this point the house was again in limbo. No one was living there and my grandmother's will had not been probated because of my mother's own illness at the time of my grandmother's death. She had recently had a fractured hip that did not heal properly and a heart attack just after the surgery. She had also developed Hepatitis C from a blood transfusion during the surgery.

Michael and I had purchased a house about two blocks away by this time. However, having a house free and clear of payments could have helped us immensely either as a rental property or to move into and sell our house with its high interest rate loans. I decided to probate the will.

Not surprisingly, the probate attorney I hired told me that it was almost certain I would lose the house. The reason was that the state wanted its money back for my Grandmother's care. The Republicans in our state didn't like the idea of poor people inheriting, only rich people. But, we decided to try it anyway and see if I could possibly keep the house.

By that time my grandmother's will had disappeared either during her early dementia or when my mother cleaned after she moved in. All I had was a copy entrusted to my brother by her that he'd kept in his safety deposit box. By this time he had passed away as well. So, in order to probate it, the will would have to be proved meaning that all potential heirs would have to agree it was the correct will.

Up until that time I'd had a wonderful relationship with my mother's side of the family. In fact, I considered myself more related to them than my father's side. Unfortunately, it wouldn't last. My aunts and uncles and cousins didn't understand what was being done. They refused to sign a simple letter saying that the will was final, I should be named executor since my mother had died and they agreed for it to be probated. The reason for this, I found out, was they were all afraid if the will were probated the state would come after them for the costs of my grandmother's care for several years.

So, I had to hire a process server and have them served as though I were suing them (which I was not). One of my aunts tried to push the server off her porch thinking I was trying to make them pay for my grandmother's care.

Even when we finally assembled them all at the Probate office and the judge explained to them what was happening they were not happy they still thought they were being sued. None of them would speak to me and the only one who seemed to get it was my one surviving uncle who spoke up for me and hoped that the state wouldn't take the house my grandmother had left me.

So, in the end, the Probate judge ruled that the house would have to be sold and the proceeds given to the state to pay for my grandmother's care. If anything were left over it would be mine (not a chance) and I would be reimbursed for my attorney fees for opening and closing the estate.

After several months the appointed executor who makes a living doing this, sold the house for less than $20,000. I got about $400 that went directly to my attorney to pay her fees. The resulting sale did not pay for reimbursing the state for even a month of my grandmother's long illness.

Since that day in the probate office when my aunts and uncles were terrified of the state seizing their property to pay for my grandmother's care I have not heard from them. One of my aunts contributed a little bit to helping with expenses before my transplant and I saw her in Wal-Mart just before moving to Arizona and we exchanged a few words and a hug, although it was clear her eldest daughter prefers we do not speak at all. I speak to one of my cousins infrequently online because she is the black sheep of her family and seems to hold me no ill will. One of my cousins told me after my transplant that she thought it was a waste that they saved a "homosexual" with a liver when they should have saved a good Christian. One of my aunts and her husband died without me every being able to see them or speak to them again.

So, the state, because of the horrific health care system we have, broke up the family I was closest to my entire childhood and life until that point. Beyond that, because I could not inherit the house as my grandmother wished, we remained in our house paying high interest rates. A few years later when I, myself became sick and needed a liver transplant and Michael was diagnosed with cancer, we would be unable to balance the medical bills and lost wages to keep our house. We eventually ended up all but homeless and would have been without the kindness of a friend who rented us her guest house for almost nothing. Had we been able to sell our house and move into my grandmother's we would have been spared a horribly disruptive episode in our lives as we both tried to recover from serious and life threatening illnesses.

Why is it that an illness like dementia in the case of Mrs. M or Alzheimer's in the case of my grandmother is allowed in our society to destroy families? Why is it that "family groups" who profess to want to "protect the family" cheer on the system with its patchwork of laws, insurance, and greed that seem designed to destroy families? Does anyone else not find it disingenuous that churches can possibly take the position that reform of our health care system is bad? Why is evil allowed to masquerade as good in the guise of "Christianity" in our country?




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