Nia Zalamea is a board-certified general surgeon. After five years in a traditional medical practice in rural Virginia, she joined the Church Health Center, an organization in Memphis, Tenn., that seeks to reclaim the biblical commitment to care for our bodies, minds, and spirit. She is one of two general surgeons in the U.S. who does full-time charitable work.
1. Why did you leave traditional medical practice? I went into medicine to serve; it was the one craft and skillset I could offer to an individual in front of me. But after five years, I found out that I wasn’t actually living my mission; I had put five people into bankruptcy. What I saw in rural America was that even one operation could completely derail not just one generation but multiple generations. Not just in terms of economics, but in terms of social capital, education, and everything we know that affects health and medical care.
2. What exactly does the Church Health Center do? The Church Health Center is a medical wellness home for the underserved, the uninsured, and the underinsured of Memphis. We provide surgery on a sliding scale; if someone can’t afford the surgery, it gets written off. The hospital supports the surgery in not charging the hospital fee, which is a huge chunk of the cost. So it’s not free, but the out-of-pocket cost for the patient is extremely low. We just make it affordable.
3. What are some of the barriers that prevent your patients from having access to health care? We have ongoing workshops during open enrollment to get people on to Affordable Care Act plans, but what is deemed “affordable” is not always affordable; the majority of my patients are 150 to 200 percent below the poverty line. Another barrier is access: Just because you have an insurance card doesn’t mean the doctor will see you. And this is where a lot of the injustice lies; many doctors’ offices and businesses have closed their doors to new Medicaid patients. Finally, the Affordable Care Act doesn’t cover everyone; my patients include undocumented immigrants, refugees, and patients from other countries whose children are being treated nearby at St. Jude Children’s Research Hospital.
Of course Obamacare is failing.
Not quite as badly as No-Obamacare was failing, so I'm still glad it exists. It's a necessary stopgap until we find a system that actually works. But you know what? Single-payer healthcare will fail just as badly.
Yes, I know that single-payer healthcare systems succeed in other developed nations. I also know that competitive insurance-based healthcare systems succeed elsewhere. But neither system will succeed in the United States, because the U.S. is the only nation on earth that refuses to keep healthcare spending from spiraling out of control. If the cost remains the same, it doesn't matter who's paying. In the long run, we all are.
California is the facing a new challenge: getting young adults to enroll in the Affordable Care Act. More than 2 million Californians, ages 19 to 34, are uninsured. Getting these individuals enrolled is crucial to balancing the cost of older, sicker patients. The state is developing media strategies to specifically target young adults and encourage to them buy insurance. The Los Angeles Times reports:
The success of the healthcare law "depends on reaching everyone who is uninsured, but particularly young people who may feel like they don't need insurance," said Larry Levitt, a senior vice president at the Kaiser Family Foundation.
Read more here.
This week the company my husband works for unveiled the health-insurance plans available to us beginning July 1. If we chose the plan closest to our current plan, our premium would nearly double and our office visit co-pays would increase 25-50 percent.
I am so glad we are going on Medicare in August.
Medicare isn't perfect by any means. It isn't even cheap. Just the insurance (Medicare medical, Medicare supplement, prescription) is going to cost us more than $500 a month, and that doesn't include the deductible or the prescription co-pays. And that's for this year. Who knows what it will cost 10 years from now?
I was so ready to read a book that would solve America's health-care crisis.
Besides, David Goldhill's title is irresistible: Catastrophic Care: How American Health Care Killed My Father - And How We Can Fix It.
“So what brings you in to the clinic tonight?” I ask, beginning a conversation with a middle-aged woman in typical fashion.
“I need some help with my medication,” she tells me, digging into her purse for the packaging from her last filled prescription.
“It’s for high blood pressure, but… I can’t afford it anymore.”
I take a look at her chart.
“Oh!” I say, pleased with my growing ability to recognize medications without aid from a reference text. “I think that’s on the Wal-Mart list. We should be able to give you a prescription for the generic which will be just four dollars per month at Wal-Mart.”
“I know,” she says. “That’s what I was prescribed. I can’t afford it.”
I don’t talk much about the Affordable Care Act in day-to-day conversation, even with the Supreme Court’s decision last week to uphold its constitutionality. In fact, I try to avoid it. It’s just not a conversation I’m poised to treat as small talk, simply because it’s a conversation that goes way deeper than I think most people realize.
The president's plan meant that religious employers — mainly Catholic universities, hospitals and social service agencies — would not be involved in paying for or administering something they deem sinful: contraception. At the same time, all employees would still have access to the same contraception benefit, no matter whom they work for.
Critics of the president's plan, however, didn't see it that way.
"Dangerous and insulting," a group of leading Catholic bishops wrote to their fellow churchmen. "A cheap accounting trick," Robert P. George, Mary Ann Glendon and several other leading culture warriors complained in an open letter that has generated more than 100 signers.
The "compromise," said New York Times columnist Ross Douthat, "asks the parties involved to compromise their reasoning faculties and play a game of 'let's pretend' instead."
Yet that "game," as Douthat put it, is actually a venerable tradition in Catholic moral theology that for centuries has provided a way for Christians to think about acting virtuously in a fallen world.
The American public is closely divided over the federal rule that would require employers, including most religiously-affiliated institutions, to cover birth control as part of their health care benefits, according to the latest survey by the Pew Forum on Religion & Public Life.
On Feb.10, the Obama administration announced it would modify the mandate in response to criticism that the rule would force religious organizations to violate their religious beliefs in providing contraception coverage. The latest Pew survey shows little difference in opinions among people interviewed before the administration’s proposed modification and those interviewed afterward.
There likely was little Sabbath-ing for politicians and journalists this weekend, as the debate over health policy raged across the campaign trail and in the television studios.
In a fiery comment piece in The Los Angeles Times, David Horsey reported that at CPAC, Mitt Romney pledged that he would “reverse every single Obama regulation that attacks our religious liberty and threatens innocent human life in this country.”
Speaking on Face The Nation, Senate Minority Leader Mitch McConnell stated that the contraception controversy is an issue of religious freedom.
Republican Presidential Candidate Rick Santorum laid out his position on the situation very clearly on Meet The Press.
Despite early indications that an "accommodation" to the mandate on insurance coverage for contraception announced Friday by the Obama Administration might earn their support, the U.S. Conference of Catholic Bishops instead has reiterated its staunch opposition to the measure.
In a statement released late Friday by the USCCB, bishops condemned the Obama compromise (which had been announced earlier Friday), saying in part, “[The] proposal continues to involve needless government intrusion in the internal governance of religious institutions, and to threaten government coercion of religious people and groups to violate their most deeply held convictions.”
President Obama on Friday said that all insurers — not all religious institutions — will be required to offer free contraceptive services to women.
Here's what people are saying about it:
"We’ve been mindful that there’s another principle at stake here –- and that’s the principle of religious liberty, an inalienable right that is enshrined in our Constitution. As a citizen and as a Christian, I cherish this right."
Archbishop Timothy Dolan, president of the U.S. Conference of Catholic Bishops:
“Today’s decision to revise how individuals obtain services that are morally objectionable to religious entities and people of faith is a first step in the right direction. We hope to work with the Administration to guarantee that Americans’ consciences and our religious freedom are not harmed by these regulations.”
Family Research Council:
"Liberals say keep your morals out of the bedroom, yet the President's plan forces everyone to pay the cost for someone else's contraceptive use in the bedroom. That's not freedom, it's a mandate."
This Sunday is an important milestone for me. It's the day I no longer risk losing health insurance.
I left my last job-with-benefits when I was 51 years old. I'd been commuting an hour and a half each day, and I was worn out. My husband had excellent health insurance, and publishing jobs were plentiful.
Six weeks after my job ended, however, the dot-com bubble burst and jobs everywhere started to dry up. In 2003, I discovered I had a great big pre-existing condition — a defective heart valve and an aortic aneurysm that would eventually require surgery. I became uninsurable except through my husband's employer (and mine, should I ever find another job).
And then in 2008, the year I turned 60, the whole economy tanked. I realized I was now entirely dependent on my husband's employer for health insurance, since I would probably never again have a job-with-benefit.
Facing growing furor from religious groups, President Obama on Friday unveiled an "accommodation" in which health insurance companies, rather than religious institutions such as Catholic hospitals and universities, will provide employees with contraception coverage.
Houses of worship remain exempt, and the new approach effectively removes all faith-based organizations from involvement in providing contraceptive coverage or even telling employees how to find such coverage. It also maintains Obama's pledge to ensure that almost all women with health insurance will not have to pay for it.
At issue was a mandate, part of Obama's 2009 health-care overhaul, that employers provide free birth-control coverage. The mandate was announced Jan. 20 by Health & Human Services secretary Kathleen Sebelius. Religious groups, particularly Catholic, fiercly objected, saying the federal government should not force institutions to violate the tenets of their faith. Womens' advocates argued that employees should have access to birth control regardless of where they work.
The Obama Administration announced earlier today a change to its policy regarding conscience exemptions and contraception coverage for faith based organizations.
Sojourners released the following statement:
We applaud the Obama Administration’s decision to respond to the concerns of many in the faith community around respecting religious liberty. This compromise respects the conscience concerns of those persons and institutions opposed to the use of contraception while still allowing greater access to those services for women who seek it. Expanded access to contraception is important for women’s health and is a key part of our country’s efforts to prevent unintended pregnancies and thereby reduce abortions.
A majority of Americans — including Catholics — believe that employers should be required to provide employee health care plans that cover contraception and birth control at no cost, according to a new survey.
But the research by the Public Religion Polling Institute shows that when it comes to providing religious exemptions from free contraceptive coverage – something the White House is sharply criticized for failing to do – the public is much more divided.
The Catholic bishops have slammed the Obama administration in recent weeks, urging priests to read letters from the pulpit blasting a new Health & Human Services rule that will require some Catholic institutions, such as universities, to cover employees' contraceptive costs.
On Monday, the U.S. Conference of Catholic Bishops issued "Six Things Everyone Should Know About the HHS Mandate." Included on the list was, "Catholics of all political persuasions are unified in their opposition to the mandate."
The survey released today, however, paints a more nuanced picture.
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We have come to an impasse in the negotiations to raise the debt ceiling because of several conceptual errors in our public discourse. These errors were most glaring in the remarks recently delivered by Speaker of the House John Boehner in his response to President Obama. The largest conceptual error is the idea that the government of a constitutional representative democracy is different from the people. Boehner said, "You know I've always believed the bigger the government, the smaller the people."
What does this mean? The government is composed of the people, and if people are paying attention and voting according to their own interests, the government ought to work toward the happiness of the people. The problem is that too many Americans have bought into this conceptual error that the government is some kind of leviathan, a monster that exists to take away their liberties. This is nonsense. A correction of another conceptual error in Boehner's presentation makes my point.
Today is my one-year anniversary on vitamin L, and it's finally time to talk about.
I struggle with anxiety and clinical depression, and I take vitamin L -- or Lexapro to be exact -- to treat it. It's been one year since I decided enough was enough. I was tired of being tired. Tired of being sad. Tired of always feeling on edge about almost anything.
Last spring I finally sought out the help I needed all along, and took some concrete steps in overcoming depression and the cultural stigma mental health issues carry within the Asian American, American, and Christian cultures. And that is where I find convergence, because May is Asian Pacific American Heritage Month, and it is also Mental Health Awareness Month. I couldn't have orchestrated it better myself.