BELOW THE LINE – a regular column for those living below the poverty line or on a drastically reduced budget

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One of the biggest challenges of unemployment is not having medical coverage.  This can be quite a challenge when you have health problems – I have Type 2 diabetes and high blood pressure.  Both had worsened during my period of unemployment, requiring an additional two medications.

Aware that our insurance would expire at the end of February, I started looking at medical expenses much more carefully.

I worked out an arrangement with my primary doctor whereby he will charge me $57 a visit.   I was also told I could get my quarterly A1C check for only $14.    My podiatrist said he would charge $80 per visit.

In an emergency, ER cannot turn you away, even if you have no money, so we’re covered there.

When it came to prescriptions, I called three pharmacies to get a price for each of the five prescriptions I have been on.   Without insurance, they would cost me about $350 a month.

Believe it or not, I have managed to get that figure down to $13.33!!!

One drug for diabetes is priced at $283.75 for a month’s supply.   In consultation with my doctor about our changed insurance situation, he said I could switch to a less powerful drug called Metformin, which is free at Meijer’s.

Meijer offers a second one free.  Both are loss leaders.  The idea of offering them free is to get you to purchase all your prescriptions there, which would then give them a nice profit as drugs can be very expensive (and very profitable).  But you don’t have to get all your prescriptions at one place.   We often shop at Meijer anyway so these two loss leaders still bring us into the store to buy food and other things.

Target is cheaper for two of the other prescriptions.  I can get a three-month supply of Glimepride (a drug for diabetics) for $20; and a three-month supply of Metoprolol (for high blood pressure) for $10.  By buying them quarterly I saved an extra $6 on the two.

Both are generics.  Always choose generics when they are available.

Wal-Mart is the cheapest place for Lisinopril, a drug for high blood pressure I did not even need before unemployment.    It will also cost me $10 for three months.

So my total expenditure on prescriptions comes to $13.33 each month; with four visits a year to each doctor my total medical costs over twelve months should work out at $764.    If we had chosen private insurance we would have been paying more than that each month with a high deductible.

It clearly pays to shop around.   There’s always a cheaper option.

PUTTING MY FOOT IN IT

Foot 2

Mentioned in the article were outpatients, those who go to the hospital in the morning for quick surgeries and are home in time for dinner.   I’ve had three such surgeries in the last eighteen months, all on my feet.

The first surgery, on September 1st, 2011, was for a bunionectomy.   The surgery itself lasted about an hour, but the repercussions caused me to have serious medical problems for almost one full year.

During surgery I got infected with one of those new bacterial infections London is warning about.

It was clear within a few days of surgery that something had gone wrong.   The wound in my left foot was just not healing.  The podiatrist tried all the usual things, then took a blood sample from the infected area and sent it to the lab.

I still remember his face when it came back.

We had gone to his office.  He had the results in an envelope, which was un-opened.  When he opened it, his face literally changed color.  From pink, it changed to white and there was a look of horror in his expression.  He mumbled something about how he could not handle this and was sending me to the hospital immediately for treatment.

When he finally passed me the lab report, I saw that I had contracted VRE.  This meant nothing to me.   But I’m now very familiar with it.   My foot was infected with the bacterial infection for almost a year – it’s even possible that it’s still in there.  I have to check my foot every day and at the first sign of the area turning red I have to go back for more treatment.

What is VRE?

The simple answer is this —-

MRSA is a bacterial infection that thousands of people get every single day.  It’s normally treated with a strong antibiotic called Vancomycin.   VRE is Vancomycin Resistant Enterococci.   IOW, there is no sure treatment for VRE!   No antibiotics work.

This did not stop them from putting me on a serious regimen of antibiotics, taken both orally and infused through a PICC-line in my right arm.  A nurse came twice a day to administer the infusion.  As my youngest daughter is a qualified nurse they let her do it on weekends.

The strong antibiotics were not only expensive  (one pill was $132 and a week’s infusions was roughly $5000), they also led to some uncomfortable side effects, which required further medications.

It was suggested on at least three occasions, by three different doctors, that the best thing would be to have my foot amputated, though they use a different word that makes it all sound better.   I said I would only agree if the infection was spreading beyond the foot, which I’m thankful to say it never did.   If it spread it would kill, just like MRSA does.

After a few months of this we were not getting anywhere.   We did have lots of people suggest various treatments, all of which I gratefully tried.  People were absolutely wonderful.  Two people even sent me moonshine assuring me it would work wonders.  I wasn’t sure if I was supposed to soak the foot in it or drink it!  I had a wound vac (which was great fun!), and even hyperbaric treatments (which were horrible).  It was a nine-month-long nightmare.

It was then that a wound care professional in our church contacted me to see if she could be of any help.  My wife started consulting with her and from then on, we got results!  She was amazing.  Basically, everything I had been told to do had been wrong.  Moist healing is the best.  (I had been told to let it air out between dressings.)  In moist healing, where the wound is kept moist and semi-airtight, the skin cells can migrate across the wound bed and fill in the wound.  She recommended silver based dressings that not only killed the bacteria but also debrided the wound (got the mucky stuff out of it).  It was just amazing to watch it heal – if I had had her instructions at the beginning, this nonsense wouldn’t have lasted a whole year – maybe only a couple of months.

A lesson I learned from this is that antibiotic resistant bacterial infections may be solvable with simple treatments.  After all, people did live before antibiotics, some of them even to a ripe old age.   We have become very dependent on them since World War II.   Sadly, their overuse may have weakened us all, so that we are more vulnerable to infection.

If that’s the case, then the catastrophe the British government warned of will likely come true!

REFLECTIONS ON THE CHANGE IN ROME

Pope Francis l

240 years later, the country has clearly changed its attitude toward the Catholic Church and, in particular, the papacy.

Whereas the colonists burned an effigy of the pope and kicked a football (soccer ball) made to look like his head every November 5th, the anniversary of a Catholic attempt to blow up the English parliament and its new king in 1605, today’s Americans have been glued to their television sets watching the election and presentation of a new pope with as much interest as in a US presidential election.

Unbelievably, there is no questioning Rome’s claims of its special status in the myriad world of Christianity, with its thousands of sects and denominations.   A Catholic friend called me the day after the new pope was chosen and told me that his understanding has always been that the Catholic Church was the church founded by Jesus Christ and the reason why some people left the church in the sixteenth century was due to corruption within the church.   Take away the corruption, therefore, and you have the pristine church that Jesus founded.

On February 28th, CBS, to its credit the only non-cable station carrying live coverage of the previous pope leaving the Vatican, had the following commentary as Benedict XVI’s helicopter took flight:

“Just as Jesus’ disciples watched Him ascend into the heavens, so his personal representative on earth ascends watched by his disciples today”  (paraphrased).

Really, somebody should educate these journalists – none of them seem to know any history.

As I told my friend on the phone, the church Jesus Christ founded was very different from the Catholic Church.   The early apostles went to church on Saturday and observed the annual holy days given to the Israelites at the time of Moses.   They avoided the same meats the Jews avoided following the Old Testament instruction they had known since early childhood.

After the Jewish revolt in 66-70 AD anti-semitism throughout the empire led to persecution of the early Christians.  When the church emerged from that dark period it was a very different church.

Two hundred years can make a very big difference.   The dominant church two centuries after the Jewish revolt was totally different from the early church; just as American attitudes to the papacy today are the opposite of colonial attitudes in the eighteenth century.

PAPAL NUNCIO – FIRST CLASS AMBASSADOR

vatican-city_1

In the evenings, we would regularly take our children for a walk around the neighborhood.   As fuel was severely rationed, there was little danger from traffic – though the occasional goat could get too close!

One of the homes we frequently passed was the residence of the papal nuncio – the “Embassy of the Holy See”.

The papal nuncio at the time was described in the national newspaper as “the doyen of the diplomatic corps”.  In other words, the senior ambassador.   It was his job to organize the diplomats of the various nations represented in Ghana, whenever the Ghana government had something special going on and wanted to invite ambassadors to be in attendance.

Arguably, this made the papal nuncio very influential.

It struck me at the time that the Vatican had the world’s best diplomatic corps – far better than the United States.

In 1979 when the Shah of Iran was overthrown, we were in Ghana.  It was a tumultuous year for both countries.   The US Ambassador to Ghana was informing the State Department in Washington DC that the pro-US military government of Ghana was stable and that the people were loyal to it.   Many of us were better informed – we knew the people were greatly suffering contending with serious food shortages and an inflation rate of over 600%.   Non-diplomats were expecting trouble!

We were not surprised to learn that the US Ambassador to Iran was informing Washington that the pro-American Shah of Iran was stable and popular.    Early in 1979 the Shah was overthrown and replaced by the Islamic theocracy that still rules the country.   Some say this event was the start of World War III, which is still going on – the never-ending conflict between the West and Islamic militancy.   The then Ambassador’s ignorance cost the US dearly.

In Ghana, the government was overthrown on June 4th and a radical, revolutionary government took over, backed by Libya’s madman, Colonel Gaddafi.  Other Gaddafi sponsored coups followed in other west African countries.   Once again, a serious failure of US intelligence.

The doyen of the diplomatic corps was always better informed.

NARROWING THE GAP

Pope bus

In 1978, sensing the failure of communism in Eastern Europe, they chose a man from Poland as pope, the first non-Italian in five centuries.  Pope John Paul II contributed to the fall of communism, along with Lech Walesa, Margaret Thatcher and Ronald Reagan.

Four decades earlier, cardinals voted in Eugenio Pacelli as Pope Pius XII.  Pacelli had strong German connections in a year when the likelihood of a European war was growing.  Germany seemed the most likely victor so the church was simply taking advantage of an opportunity.

Another opportunity presents itself now.

Arguably, the biggest issue confronting most countries is the growing gap between rich and poor.   The economic Rule of Inequality is a reliable way of predicting revolution or domestic strife.   The bigger the gap the more likely a revolution!

According to the Economist magazine some time ago, China is very concerned about this gap and the prospect of instability, so this has become a major focus of concern.  There has been a clampdown on corrupt officials in an effort to resolve the problem.

According to the same magazine, the only industrialized country with a greater gap is the United States.  What saves the US right now is food stamps, unemployment benefits and Medicaid – take these three away and there would be serious rioting across the land.  The gap may be great, but the issue was not even mentioned in the last election.

The situation is a cause for concern in many countries right now – what will it be like if there is a double dip, if the global economy goes down again like it did in 2008?   It’s quite possible this could happen.   If it does, and life becomes harder for what are sometimes referred to as the “99%”, the “1%” can expect trouble.   (These terms were made popular by the Occupy Wall Street movement.)

So, the Vatican’s choice of Pope Francis I is astute, showing an awareness of the greatest need in the world at this time – the need for a new economic system that replaces the evils of our present failed  system with something more equitable.

"Once in a while you will stumble upon the truth but most of us manage to pick ourselves up and hurry along as if nothing had happened." — Sir Winston Churchill