The GM-UAW Deal--If UAW Workers Can No Longer Count on Employer-Provided Health Care Then Neither Can Harry and Louise

I'm not the first one to suggest the GM-UAW deal to set up a VEBA is a watershed event. Most observers are focusing on the trend it will accelerate in the employee benefits market--and it will.I will suggest another dramatic impact that it will have--on voters.The polls already tell us that health care is by far the top domestic policy issue and second overall only to Iraq.This deal is also going

If the $35 Billion Expansion of SCHIP is About Moving to Government-Run Health Care Why Does the Insurance Industry Support It?

Both the House and Senate have now passed the $35 billion expansion of SCHIP. The House by 265-159 and the Senate by a vote of 67-29. The Senate bill got exactly the two-thirds it needs to override the expected Bush veto and the House fell 25 votes short of the 290 it will need.Opponents of the bipartisan compromise to renew and expand the State Children's Health Insurance Program primarily

"I HAVE CANCER AND I AM PISSED"

That's what someone googled to find my blog today.

I love it.

And whoever you are, I hope you found what you were looking for here.

asymmetrical statement

This is what I wore to chemo today:

i made it out alive

Well, it was really hot and pretty buggy but we survived. The Bill Mason Outdoor Education Centre is a pretty amazing place.

It was quite the day. My son is in a class of children designated as "profoundly gifted." These kids are not only very bright but they tend to be a little quirky (or as the wonderful psychologist who did Sacha's testing said, "just a little bizarre").

There was a time when I thought I would never put a child of mine in a gifted class, since I thought of such programmes as elitist. That was before I learned about the emotional and social challenges that these kids can face. In fact, I have come to realize that the gifted programme is a form of special education that helps equip kids to function in the world. Not all the kids in S.'s class fit this profile, but a significant percentage of them do, simply because these are the kids that most need the gifted programme.

At any rate, all these lovely eccentricities manifested themselves today (like the kid who wore shorts, despite the poison ivy warning, along with a rain coat and winter gloves. Did I mention it was really hot?) along with awesome intelligence ("Actually, it's not air that animals need but the components of air") a keen level of engagement and a wicked sense of humour.

My favourite part of the day's programming? The kids played a game called "Predator and Prey". Each child was assigned the role of herbivore, omnivore or carnivore and had to hunt for food and water, while evading predators. The adults were given soft balls and told we represented bad weather, fire, pollution and other factors that might affect an animal's ability to survive. We got to spend the next half hour throwing balls at the kids in the name of education. It was a blast.

S. was so glad to have me there. He really likes to hang out with his mom. As we were leaving today, he said, "Thanks for agreeing to be a participant today."

And then, when the teacher asked the kids to thank the parent volunteers, he leaned over and kissed me.

I melted.

I'll put up with a lot, even a noisy school bus (and boy, was it loud) for one of those moments.

I am so tired now that I can barely move.

I kept it together enough to bring S. and a friend home from school, give them a snack and make a nice dessert (from What to Eat Now, my new favourite book), take the dog for a walk and read D. a bed time story.

And I only became hysterical three or four times.

Chemo tomorrow. Hopefully this will be an easier round.

give me strength

I am going on a field trip today, with my nine year old son's class.

Twenty-four kids. Twenty of them boys.

That is not a typo.

Wish me luck.

ongoing or neverending?

First conversation:

Nurse, doing my pre-chemo blood-draw: "So are you almost done?"

Me: "No."

Nurse (chirping): "Yup!"

Me: "I have metastatic cancer, so treatment will continue for the forseeable future."

Nurse: "Yup!"

Second conversation:

Nurse setting up my chemo: "You must be almost done."

Me: "No, actually. I have metastatic cancer and will be in treatment for some time."

Nurse: "Well, they usually only give Herceptin for a year."

Me (Too worn out to explain that this is not the case when Herceptin is being used to treat cancer that has spread or metastic): Hmmm.

Am I wrong to hold health care providers to a higher standard?

Don't get me wrong, the nurses are, generally speaking, wonderful. And busy. So I don't expect each one of them to have read my chart.

But shouldn't oncology nurses know enough about differences in treatment protocols to not ask these kinds of questions if they don't really have an interest in the answers?

Just asking.

Who's More Frustrated With Bush Over His SCHIP Veto Threat--Republicans or Democrats?

These days its hard to get Democrats and Republicans to agree on anything. But there is one bipartisan bill that has incredible support in both parties--the $35 billion expansion and renewal of the State Children's Health Insurance Program (SCHIP).By any measure SCHIP has been an incredibly good success--covering 6 million kids. There have been some legitimate questions about it growing beyond

Health Wonk Review is Up!

Joe Paduda is hosting Health Wonk Review over at "Managed Care Matters."Not surprisingly he's got lots of blog entries regarding Senator Clinton's new health plan and lots of other samples of some of the best blog posts from the past couple of weeks.Also making the big time this week was our good friend, Brian Klepper, who had the following letter published in the New York Times regarding Senator

seven things: my first meme

The fabulous Pocketina of DIY not DIE tagged me for my first meme the other day. This strikes me as a great way to try and shake off my habitual post-chemo blues.

The rules:
1. Link to your tagger and post these rules.
2. Share 7 facts about yourself: some random, some weird.
3. Tag 7 people at the end of your post and list their names (linking to them).
4. Let them know they’ve been tagged by leaving a comment at their blogs.

I have been thinking about this for the last couple of days, as there probably aren't many things that regular readers don't already know about me (and many of the things you don't know are things I will never tell!). I have however, managed to come up with a few....

7 Random Facts about me:

1. I had my nose pierced when I was 21. I was in India (on Canada World Youth) and a bunch of us had it done at the same time. The piercing was done with a sharpened piece of copper wire.
That is how I found out that...

2. I am allergic to copper.

3. I am the poster child for the programs of the post Lester Pearson/Pierre Trudeau era in Canada. I participated in the Terry Fox Centre (a week long session on government for 16 year olds from across Canada), attended Lester B. Pearson College of the Pacific (200 students - 50 from Canada, the rest from all over the world - all of us on scholarship, in residence for two years, in Victoria, British Columbia), taught French to children of francophone parents (I worked in Powell River, BC) and participated in the aforementioned Canada World Youth. All great examples of Canadian tax dollars at work (and all but CWY and Pearson College are now defunct). Many of the things I have since achieved have been due to the foundation created by these programmes.

4. I ran a half marathon in October 2000. I trained and ran it with my sister (who willingly slowed herself to my pace). I will never forget her encouraging words as I we climbed up that last hill (University Avenue, for those who know Toronto) and I whimpered that I wasn't going to make it, "You are damn well going to finish this thing!" It is still one of my proudest achievements and I never could have done it without her.

5. I admit this guiltily, but I was relieved to give birth to two boys.

6. I hated being pregnant and suffered from ante-natal depression, that lifted immediately after giving birth.

7. I am a compulsive list maker. I keep lists of just about anything you can imagine.

OK that's me all done. Now it's your turn. I tag Chris (who will hate me for this), my two new post BlogHer friends Mom2Amara (who I challenge to write 7 things that are not part of her 101 things) and Blondie (from Tales from Clark Street), Amanda (because I miss her and want her to start writing again), Scarlett (of Bone Marrow Poptarts), Babz (of LoveBabz: A Life in Transition) and finally, the guy who started a blog called Wayne's Whines but has never really written there. He also happens to be my spouse, I'd love him to start writing and I am really, really curious to know what seven things he will choose.

Medicare Advantage Cuts Still on the Table to Offset the Medicare Physician Fee Fix

The House/Senate deal to renew the State Children's Health Insurance Program (SCHIP) does not include a fix to the January 2008 10% Medicare physician fee cut. It also doesn't include the $51 billion in cuts to the Medicare Advantage (MA) program the House had in their bill to pay for that fix and other Medicare improvements.As I have said many times before, that only means that the Medicare

Hillary Clinton's Health Plan

Here is an excerpt from the Clinton campaign's press release outlining her $110 billion a year health care reform plan:FOR IMMEDIATE RELEASESeptember 17, 2007The American Health Choices Plan:Ensuring Affordable, Quality Health Care for All AmericansHillary Clinton unveiled the third part of her plan today to ensure that all Americans have affordable, quality health insurance. Building on her

sulking

I really don't want to go to chemo tomorrow.

After two weeks off, I feel really good.

And I'm too busy for chemo.

Of course, I will go. But I don't have to be happy about it.

And I'll try to imagine the chemo zapping all the stray cancer cells, tomorrow. And then the Herceptin getting anything the chemo misses.

But tonight, I'm pissed off.

I think I'm going to go pour myself a scotch.

SCHIP Agreement "Near"

There are a number of published reports indicating that the House and Senate have reached an agreement to extend SCHIP along the lines of the earlier bi-partisan Senate agreement.That would mean a $35 billion SCHIP expansion paid for entirely be a new 61 cent tobacco tax.Bush says he would veto such a deal. While the Senate seems veto proof on this one, the House is another matter.If Bush is

Hillary Clinton's Health Plan--the Republicans Better Take it Seriously

Sometimes I think that all the Republican candidates for president think they need do is go into a crowded room and yell, "Hillary Care," and all of the voters will run for the exits in terror.This is not 1993 and this is not the inexperienced Hillary Clinton who tried to drop her drafted-in-secret 1,400 page health care proposal on us all in one "take it or leave it" roll out.She has changed

have i scared you off?

I am only planning on using a handful of comments the blook. And I promise that, if I use yours (and you did not post it anonymously), I will check with you to see if it's OK.

And more people read this blog than will likely ever read the blook anyway.

channelling sisyphus

I have lost count of the number of bags of stuff that have left my house over the last several months. And while we have brought some stuff in, our output has been much higher than our input.

Which leaves me to wonder the following:

Why do we still have as much stuff as we ever did? Why has the clutter not diminished at all? Where does all the junk come from?

SCHIP Negotiations Not Going Well--Medicare Physician Fee Cuts and Medicare Advantage Payments Hang in the Balance

Negotiations between the House and Senate over how to extend the State Children's Health Insurance Program (SCHIP) before its September 30 deadline are not making much progress.The Senate passed a bipartisan extension of the plan that included $35 billion in new spending and paid for it with a hefty 61 cent per pack tobacco tax.The House passed a solely Democratic bill that would spend $60

killing trees

So, I'm printing off every blog post on a separate page, so that I can more easily review and cull the bits that really aren't relevant to the blook.

I am such a linear thinker and having my posts in a neat pile makes me feel much less overwhelmed (not to mention that taking the time to do this is a terrific way of procrastinating).

I am also going through the comments and realizing that there are many of these that I would like to include as well. Who owns the rights to others' comments? Do I need to get permission to use them? Ought I to get permission?

I think pulling this all together is going to be a very emotional process (I can't believe that I did not anticipate this). Re-reading my words puts me right back where I was at diagnosis, during the worst of treatment, the recurrence and the remission. The anguish, the fear and even the joy fairly leap off the page at me. I guess this is a good thing but it sure ain't easy.

I am also fairly taken aback at how much I've written. I'm going to have to find a way to atone, environmentally speaking for the gigantic pile of paper I've amassed.

I just hope there's enough good stuff in here to build a book.

Hillary Clinton to Outline Her Health Plan on Monday--She Will Target Insurers as the Bad Guys

Senator Clinton will unveil her health plan in Des Moines on Monday. The heavy betting is that it will look a lot like the general Democratic health reform template that draws on the recently enacted Massachusetts health reform law.We do know this, she will do what she did in 1993 and 1994 and demonize the insurance industry. On Wednesday she said, "I intend to dramatically rein in the influence

The UAW's Negotiations With the "Big Three" Automakers Over Retiree Health Benefits and Why They are Important to California Health Reform

The health care reform debate in California has come down to whether there should be an individual mandate to purchase health insurance and whether a big chunk of the cost of the program should be put on the employer community in the form of a 7.5% payroll tax for businesses that don't provide their workers with coverage.Organized labor is firmly behind the Democratic legislature's efforts to

badass superhero

Yesterday, the Junky's Wife called me a 'badass' in the comments. This made my day. She also said that I should have my own superhero.

Along with some of my online friends, I have been having fun imagining what she would look like:

super me

a one-breasted warrior
with really great boots
a rhea belle top
and some seriously funky accessories (thanks to Babz for that suggestion)
generous hips (the better to shoot from)
crows feet
and smile lines
honest
smart
strong
and always compassionate
but ready to kick ass
when she needs to.

Health Insurance Premiums Rose Only 6.1% in 2007--But This May Be The Last Year the Trend Rate Will Fall

According to the annual Kaiser Family Foundation survey of employer health benefit plans, the average employer premium rose 6.1% in 2007--the lowest increase in four years of successively falling trend rates.The increase was 13.9% in 2003 (the recent peak), 11.2% in 2004, 9.2% in 2005, and 7.7% in 2006.The average cost of family health insurance also rose to an incredible $12,106 while the

Jane Sarasohn-Kahn Joins the Blog World

A very smart lady who knows a lot about the intersection of health care and technology has joined the health care blog world.Jane has a post up today that puts the new figures on personal health care spending in context with what Americans spend on technology.Her new blog is, "Health Populi."

happy, happy, happy

I saw my oncologist today. He examined me and decided that he does not need to see me for two whole months.

This means that my weeks off will be genuinely 'off' from the cancer centre.

Even better, my lymph nodes all seem normal, my chest sounds clear and he couldn't even feel the edge of my liver.

What a difference a year (or even less) can make.

The nurse was commenting on how heavy my cancer centre file is.

I answered, "That's good. As long as it keeps getting heavier, it means that I'm still around."

Could America Reap International Good Will By Ramping Up its Health Diplomacy Efforts?

Brian Klepper joins us again today with one of his welcome posts:Reasserting Global Health Diplomacyby Brian KlepperA couple weeks ago the Washington Times ran a sensible and honorable article by Susan Blumenthal MD and Elise Schlissel at the Center for the Study of the Presidency (CSP) in DC, arguing that America could reap a huge benefit in good will by significantly ramping up its health

The Cavalcade of Risk Is Up

Dave Williams hosts the latest "Cavalcade of Risk" over at his "Health Business Blog."Check out his picks of the best on insurance risk in the blogosphere.

Schwarzenegger is Right––You Can't Achieve Universal Coverage on the Backs of the Employer Community Alone

The California legislature has passed a major health care reform proposal but Republican Governor Schwarzenegger says it isn't good enough and he will veto it and bring the legislature back to do it over again in a special session.Give the California governor and legislature credit for hitting the problem of health care head-on. If the biggest state can make headway, it could well open up the

spam offends me

Remember the blook? My deadline is fast approaching and I have spent part of this morning reviewing the blog from the beginning.

Boy, my little family has been through some hard stuff.

I have also been deleting spam from my archives, as I go. I really hate spam and take it quite personally (which is dumb, given that spam is, by definition, automatically generated). I mean, how offensive is it to find a link to a commercial weight loss blog at the bottom of a post describing a very recent mastectomy?

it's like the night before xmas

I just found out that I am now seventeeth on the ravelry waiting list.

I don't know if I'll be able to sleep tonight.

update: I got my invite but I can't get in!!! How frustrating is that?

update to the update: turns out that they moved their servers last night and the login is broken! I got a really prompt response to my email, though, so I really do believe it will all be fixed shortly. It's probably just as well, though, as so far, today has been really productive....

The Obesity Epidemic--It's Time to Deal With it the Same Way We Did Smoking

While we debate just how we will change our health care financing system so that more people can be insured at an affordable cost, we are too often overlooking one of the biggest drivers of health care costs--America's obesity epidemic.The latest report on obesity in America by the Trust for America's Health found that the problem is growing at an ever larger rate despite recent "wellness"

just another mom in the schoolyard

My nine year old son told me this week end, as we were heading out for a dog walk, that I look "just like all the other moms."

He sounded so happy when he said it.

And he made me feel very happy. And proud.

He and I both understood what it meant to say that. He went on to say that he's very "relieved" that I don't wear that "fake rubber breast" and that he likes the way I look.

He's a very special kid.

People Who Say Insurance Regulation Creates More Uninsured Are Missing the Forest for the Trees

The health insurance trade association, AHIP, just released a new study on the impact of state health insurance reforms on the market and argues that the "unintended consequences" of these reforms hasn't been good.Here is an excerpt from their release:“This report offers important lessons. It demonstrates that insurance reforms without universal access drives up health care costs for consumers

women like me

Well, since it's unseasonably warm really stinking hot here today, I thought I would post something I started to draft a couple of months ago:

voyeur

Women's breasts emerge in the heat of the summer.
Big ones and small ones.
Perky ones (I could fit them in my hand).
Breasts nursing babies.
Freckled cleavage.
Wrinkled cleavage.
And breasts that can't possibly be real.
I stare at women's breasts now with great fascination.
And not a little envy.
I have never seen a woman with one breast.
Except in the mirror.

As I have written before, I don't wear a prosthesis, mostly because it's really uncomfortable and I am just not willing to put myself through agony in order to blend in.

I do take great comfort in the knowledge that there are other wonderful women out there with similar experiences.

Brys of Big Grrls DO Cry (Field Notes From a Cancer Battle Ground Where Queer Life Meets Precarious Life Head On) wrote "Breastless in Vancouver":

"I spend countless time here and there scanning the crowd for boob-less chests myself, I must now confess. I want to see more people who look like me. I feel lonely in my state of exception. I keep hoping that I will look out into the crowd at the mall and see an obviously breast-less chest like mine, thrust proudly forward into the flow of life. But I don’t — EVER. In the Cancer Journal, Audrey Lorde talks about the politics of visibility of walking in the world, breast-less. Lorde is very passionate about the politics of visibility for the breast-less and excoriates those who would foist prosthetics or reconstruction on mastectomy patients."

Clearly we've been feeling some of the same things but she says it more brilliantly than I ever could.

Jacqueline of Rebel One in Eight, wrote a piece about her perspective on being known as the "woman with one breast." This is a brilliant piece of writing and a great story that has stayed with me and made me proud and happy since I read it back in July. Called peace. and quiet, it's begins with an anecdote about a woman who undergoes reconstruction because she doesn't "want to be known as the woman with one breast. It ends with a story about an altercation with noisy and grossly inconsiderate neighbours and the reflection:

"i'm just wondering which is worse:

being known as the bitch who should move into a retirement community if she wants peace and quiet.
or
being known as a woman with one breast.
.
.
.
honestly. neither reference seems at all bad to me."

inauspicious

A dinner table conversation:

Son: "Instead of making us work quietly on our own, my new teacher likes to have lots of classroom discussions."

Father: "Is this a good thing? Do you like it?"

Son: "Yeah, it's great! As long as I keep an interested expression on my face, I don't even have to pay attention!"

pink eye update

So my doctor says that my pink eye is very likely viral (my eyes are just not goopy enough for a bacterial infection, if you must know). This is both good news and bad news.

Good news: No eye drops.

Bad news: I just have to ride it out, which will likely take about 10 days.

Good news: If the kids get it, I won't have to give them eye drops.

Bad news: If the kids get it, they will have to stay home for 10 DAYS, until it clears up.

This last bit does not bear thinking about.

TEN DAYS!

How Will SCHIP Be Extended and What Will Happen to Medicare Advantage and the Upcoming Medicare Physician Fee Cuts

Health Market Survey publisher Bill Boyles joins us again today. After getting his perspective on the State Children's Health Insurance Program (SCHIP) debate yesterday, I prevailed upon him to put a post together for our readers.Bill has some very important news on just how this debate, which involves three greatly important health care issues--the SCHIP extension, proposed Medicare Advantage

Health Wonk Review is UP

This time Brian Klepper over at "The Doctor Weighs In" has an assortment of provocative posts on a wide range of health care policy and marketplace issues.Check it out.

Romney Wants to Reform State Health Insurance Regulation--Just What Does He Mean by That?

Republican presidential candidate Mitt Romney is calling for the cutting of state health insurance regulations to make policies more affordable. He blames the over-regulation of health insurance at the state level as one of the primary reasons health insurance costs so much.Of course the reason that health insurance costs so much is that health care costs so much, but we’ve discussed that one

it figures

Blue skies,
cool days,
fresh start,
pink eyes.

Both eyes.

Back-to-school means being exposed to a whole host of communicable diseases.

No one else in my family has it. Yet.

They have stronger immune systems than I do but if the kids get it, I have to keep them home from school. For days.

And put drops in their eyes while they scream.

Before I had kids I had never once had conjunctivitis. I have now had it five times.

At least the weather is nice and pink eye won't keep me in bed.

But if you've got something else contagious, love me from afar. OK?

Mitt Romney's Health Plan--A Foot in Each Canoe

Up in Wisconsin's Northwoods, camp counselors play a game with the kids in which they put two canoes together in the lake and have the kids try to stand up with one foot in each canoe. As you can imagine it's an almost impossible balancing act.I was reminded of that last week sitting by our lake reading reports of Mitt Romney’s health plan proposals.Romney has two canoes to deal with:He signed,

"Don't Pit Children Against Seniors"--The AHIP Takes the Medicare Advantage Debate to Another Low

When the health insurance industry trade association, AHIP, tried to employ the NAACP in their battle to protect Medicare Advantage (MA) payments last May by arguing higher payments to the industry are good for poor people, I asked, could they have sunk any lower?From the looks of a letter to the editor in Sunday’s Washington Post, the answer is yes.The title of AHIP CEO Karen Ignagni’s letter is

uneven terrain

Sometimes, my heart is so full of joy that I feel it might burst out of my chest.

Sometimes, my heart is so heavy with sadness for all that I've lost that I can barely move.

And sometimes, I feel both ways. At the same time.