Friday, November 20, 2009

CIGNA -- can you hear me now?

This comes from Badtux the Snarky Penguin (via Skippy the Bush Kangaroo), a blog that's new to me. Then again, lots of things are new to me. Oh brave new world that has such blogs in't! And I'm always partial to prog-blogs with animal names.

CIGNA denies hearing implant to child who will never be able to hear if she doesn't get it within the next few months [link to think progress].

Isn’t it wonderful that in the right wing's wonderful free market world this child doesn’t have to worry about the evil government getting between her doctors and her health care? And the magical Free Market Fairy smiles because that's $20,000 higher bonus that CIGNA's CEO can get next year. Why do you want to make the Free Market Fairy frown by, well, saying that this girl should be receiving the health care that her parents paid insurance money for? Heresy!

So why are we bothering with protecting these bastards, again?


Good question, Badtux. Cigna is my health insurer, mysteriously taking over from Great West Life about a year ago. The State of Wyoming pays the majority -- but not all -- of my health insurance premium which goes to a company that denies health coverage to six-year-olds whose families pay health insurance premiums. All those premiums get bundled together to pay a bonus to the CIGNA CEO who gets rich denying health care to little girls.

It's again time to share the new CIGNA logo



New revised logo by Ryan O'Connell and featured on Sick for Profit.

Thursday, November 19, 2009

Dear Rep. Lummis: You'll be known by the company you keep

Rep. Cynthia Lummis toes the Republican National Committee line on most issues. She's consistently voted against health care reform, health insurance coverage for children, climate legislation and equal rights for gays. She loves the Department of Defense yet despises the gubment's role in almost all other things. So odd how Repubs hate gubment but have never met a defense appropriations bill they didn't like. "For the troops," they will say. What they really mean is, "For the lobbyists."

Rep. Lummis is fearful that Khalid Sheik Mohammed is scheduled for a jury trial in New York City. Most Republicans won't give New Yorkers (except the rich mayor) the time of day. Now they're all worked up, afraid that a raggedy band of Islamic extremists are so powerful that their very presence will instill terror in cops and firefighters and cab drivers and the other 9 million or so battle-hardened city dwellers.

Here's Lummis's statement today:

“The decision by the Obama Administration to allow the murderers of more than 3,000 Americans access to the federal court system will have serious negative implications for national security and the justice system. The terrorist attack orchestrated by KSM and his gang of brutal killers was an act of war against the United States and should be prosecuted by a military commission, not a common criminal court.

“It is unconscionable to think that these terrorists will enjoy the same legal rights and benefits guaranteed to U.S. citizens under the Constitution. That is why I joined Rep. Louie Gohmert in introducing legislation to amend the Military Commissions Act of 2009 to make it mandatory to try terrorists, like KSM, through military commissions.”


Obviously Rep. Lummis is not picky about the company she keeps in D.C. Rep. Louie Gohmert is a right-wing Texas fundamentalist. Lee Fang at Think Progress wrote about Rep. Gohmert's bizarre speech during the October House debate over the Matthew Shepard Hate Crimes Bill. He said that the bill

would lead to a legalization of necrophilia, pedophilia, and bestiality. Later in the speech, after reading lengthy passages from the Bible against homosexuality, Gohmert said that taking away “moral teaching in America” would create a situation similar to that of Germany in the “1920’s and 1930’s” when a “little guy with a mustache” took over:

GOHMERT: If you’re oriented toward animals, bestiality, then, you know, that’s not something that can be used, held against you or any bias be held against you for that. Which means you’d have to strike any laws against bestiality, if you’re oriented toward corpses, toward children, you know, there are all kinds of perversions, [...] pedophiles or necrophiliacs or what most would say is perverse sexual orientations but the trouble is, we made amendments to eliminate pedophiles from being included in the definition. [...] But people have always been willing to give up their liberties, their freedoms in order to gain economic stability. It happened in 1920 and 1930’s. Germany gave up their liberties to gain economic stability and they got a little guy with a mustache, who was the ultimate hate monger. And this is scary stuff we’re doing here when we take away what has traditionally been an important aspect of moral teaching in America.

Several times in the speech, Gohmert credited the conservative Christian “C Street” leader Chuck Colson for inspiration. Oddly, Gohmert also meandered into a self-defensive monologue about how he is not racist because he once voted for Alan Keyes, the birther leader who has said that President Obama is “a radical Communist” who “is going to destroy this country, and we are either going to stop him or the United States of America is going to cease to exist.”


That's odd. Don't those "C Street" Republicans revere old-line dictators such as the little guy with a mustache? Isn't it cute how a former judge, U.S. Army veteran and East Texas tough guy such as Gohmert can't even utter the name "Hitler?" Maybe it hits too close to home.

Rep. Lummis better watch out who she teams up with. Wyomingites, as a rule, don't care for extremists, whether they be from the right or the left. Hatred and fear don't seem to be family values in Cheyenne, at least not in my middle-class neighborhood. Maybe it's a different story for Lummis, who grew up in Cheyenne. Maybe she knows something I don't.

But I doubt it.

Wednesday, November 18, 2009

Sen. Mike Enzi tours Wyoming to probe brains of voters

Brianna Jones at the WyoDems sends this:

This is a heads up that Senator Enzi’s staff will be holding sessions in the following communities over the next few weeks and starting tomorrow. Please share this information!

Buffalo – Thursday, Dec. 10 – Town Hall – 11 a.m.-12 p.m.
Cowley – Tuesday, Nov. 24 – Town Hall – 10:30-11:30 a.m.
Kaycee – Thursday, Dec. 10 – Town Hall – 9-10 a.m.
Torrington – Thursday, Nov. 19 – Platte Valley Bank – 11 a.m.-12 p.m.
Wheatland – Thursday, Nov. 19 – Platte Valley Bank – 2:30-3:30 p.m.

This is a great opportunity to encourage community members to speak to Enzi’s staff, ask him about some of his recent votes and impart the urgent need for robust health reform.


These are all solidly Republican outposts. I expect lots of softball questions for Enzi. But it's a small victory if even a few Dems show up and ask a real question without getting beat up. I expect a few Dems showing up in Wheatland due to the fact that the Platte County Dems are feisty. Check out their blog at http://plattedems.blogspot.com/.

A few questions for Enzi:

Why did you vote against the Matthew Shepard Hate Crimes Act?
Why are you a health care reform obstructionist?
How can you continue to use my first name? Have you no shame?

What would you like to ask Sen. Enzi? I'm happy to pass any and all questions on to the senator via e-mail.

Learning something new from "WWII in HD"

B-17 Stratofortress, B-24 Liberator, M-1 rifle, dogface, Tarawa, D-Day, Kasserine Pass, Patton, Mt. Suribachi, panzer, blitz...

And so it goes.

Watching "WWII in HD" on the History Channel, I realized that all these terms -- and many more -- are etched permanently into my brain. Chris and I have been transfixed on the couch for the past three nights watching the personal WWII stories unfold in HD. Both of our fathers were WWII veterans. Chris's father was an Army lifer and also a veteran of Korea and Vietnam. It's not so much the HD but the new color footage that makes the difference. And I'm learning some new things in the process.

Baby Boomer boys devoured war stories. Those stories usually came from magazines and books and black-and-white TV and other boys. Fathers often didn't share the real stories about war. Maybe they thought it would damage our fragile sensibilities. Maybe they just wanted to forget.

I turned to books. In the fourth grade, I pulled Richard Tregaskis' "Guadalcanal Diary" from my dad's packed shelves and read it over the course of a couple days. It was more exciting than "Ivanhoe" and "Treasure Island," other books on my father's shelves. But Tragaskis' book was about recent history. It was also about my father and our neighbors and my Little League coach. I was pleased to see that the character of Tragaskis, the war correspondent, is being featured on the History Channel series.

After "Guadalcanal Diary," I turned to Bill Mauldin and Willie and Joe. I tried some of the war's "big books," such as "Berlin Diary" by William Shirer and Churchill's six-book series. Just couldn't get into it. Boring. Too much about politics. Too little action.

Not sure what makes "WWII in HD" so vivid. The only true HD is the film shot of living veterans. The old footage has been high-def'd, which may make it a bit more vivid. But most of the footage was shot from cockpit cameras or G.I. photographers dodging bullets. I credit story and editing. The twelve featured witnesses to that era have distinctive voices. Pilot Bert Stiles was obviously a talented writer and left behind some samples for the series. He was killed in action. There's an Army nurse and a Nisei soldier who wonders at the irony of being held behind barbed wire in a German prison camp while his family was being held behind barbed wire in an Idaho internment camp.

For me, it always comes down to story.

Tuesday, November 17, 2009

Cheyenne Zonta Club announces "16 Days of Activism Against Gender Violence"

Mona Pearl at the Zonta Club of Cheyenne sent out this announcement today:

The Zonta Club of Cheyenne is again participating in 16 Days of Activism Against Gender Violence. The campaign formally kicks off on Nov. 25. Proclamation signings by Governor Dave Freudenthal and Cheyenne Mayor Rick Kaysen will take place on Nov. 20 and Nov. 18, respectively. The Wyoming Division of Victim Services' “Silent Witness” display in the Laramie County Public Library will open on Nov. 30.

The Cheyenne Zonta Club has invited other organizations to join the campaign, including Safehouse, Cheyenne Community Clinic, United Way of Laramie County Women’s Leadership Council and Prevent Child Abuse-Wyoming.

Since 1991, the 16 Days Campaign has helped to raise awareness about gender violence and has highlighted its effects on women globally. Each year, thousands of activists from all over the world utilize the campaign to further their work to end violence against women. The campaign has celebrated victories gained by women’s rights movements, it has challenged policies and practices that allow women to be targeted for acts of violence, it has called for the protection of people who defend women’s human rights and it has demanded accountability from states, including a commitment to recognize and act upon all forms of violence against women as human rights abuses.

Contact Mona Pearl at 307-772-9001; 307-421-3788; pearl@wslc.com


Nobody would be surprised to hear that violence against women is a problem in Wyoming. In a Sept. 23 article in the Wyoming Tribune-Eagle,

Cary Heck, a professor of criminal justice at the University of Wyoming, believes domestic violence is a problem in the state. “I think that is linked a little to socio-economic status, and we sort of have a frontier mentality,” he said. “Wyoming is a drinking state -- and I think those things are linked.”

The professor said domestic violence is hard to prevent from a public policy perspective and that past domestic violence can be linked with future domestic violence. “Generally it’s an explosion that occurs,” he said. “It’s hard to make public policy that will keep those explosions from happening because they’re really not rational events.”

Eileen Gavagan, victim/witness coordinator for the Laramie County District Attorney’s Office, said the state needs tougher domestic violence laws, more counseling for offenders and education for family members.


In the article, the Violence Policy Center in D.C. ranked Wyoming third in the number of domestic violence murders. Wyoming usually places in the top ten in this category.

Not a pretty picture.

But it's not only murder. Most cases of violence against women end up in broken broken bones and broken homes. A woman and her children fleeing to a battered women's shelter. Traumatized kids, and the possibility that they may repeat the behavior as adults -- as either batterer or victim.

Take some time to go see the "Silent Witness" display when it opens Nov. 30 at the library.

If you still need to be pursuaded that gender violence is a problem, go to the Wyoming Coalition Against Domestic Violence web site at http://www.wyomingdvsa.org/domestic/facts.htm

And if you're curious about how this subject fits into the current health care debate, go to my Sept. 15 post at http://hummingbirdminds.blogspot.com/2009/09/sen-enzi-please-explain-why-getting.html

Sunday, November 15, 2009

An issue of morality -- "Healthcare For All Americans"

Cheney/Palin in 2012? How about Palin/Cheney?

The talking heads were having fun this morning over at Fixed News Sunday. Did I watch it? No. I was working on my own fiction in the form of a new book of short stories. I prefer fiction that comes out of my head (and heart) to that manufactured by Fixed News.

But Crooks & Liars reports that Liz Cheney was pumping up the volume for a return of her pops to the political scene.

Appearing on Fox News Sunday, Liz Cheney dropped the former vice president's name as the panel was discussing President Barack Obama's decision to respect the Japanese Emperor by bowing during a formal greeting.

Fox News felt compelled to cover Obama bow to Japanese Emperor Akihito and Empress Michiko after conservative blogs attacked the president. "Sarah Palin would not have bowed to the Emperor of Japan. She wouldn't have even curtsied to him," said Bill Kristol.

But for Liz Cheney, Palin wasn't the only answer to replacing a president that would dare to pay respect to a foreign leader. "You can look at the comparison and think Cheney 2012," teased Cheney. It wasn't clear if Dick Cheney's daughter was joking but the Fox panel seemed warm to the idea.

"That's all I'm going to say," she said.

Kristol, who has long been an advocate for Sarah Palin, had an even better idea. Cheney/Palin," he suggested.

"Or Palin/Cheney. Don't be sexist," replied Chris Wallace.


Ha ha! A Fixed News reporter trying to be politically correct. That's a news item in itself.

But ponder the reality of a presidential ticket featuring the Wyoming-bred Lord of Darkness and the Idaho-bred and Alaska-trained Rouge Rogue. Yes, the mind reels. It would be a wonderful gift to us Democrats, and it might even help us elect some Wyoming Dems. Oh boy, I keep cracking myself up. Elect Wyoming Dems to national office? I suppose it could happen. But if a smart and savvy Dem entrepreneur such as Gary Trauner can't even beat the likes of the GOP's Cynthia Lummis in 2008, what chance do other candidates have?

I keep wondering if Dick Cheney can do more damage as president than he did as Veep. What do you think?

A president with ties to Casper and Jackson could bring some much-needed economic development to Wyoming. In the last year of the Bush Administration, Cheney and his oily cohorts spent a lot of time approving energy leases in the western half of the state. It doesn't seem like such a wise move now that natural gas prices are tanking, but if he could do a similar thing as president, we would no longer have to worry about wildlife and wilderness because every square inch of the state would be filled with roads and wells and poisoned prairie.

If any wild animals do survive, Sarah Palin can shoot them from helicopters. That will cut down on any excess population.

I don't know about you, but I'm going to shout it from the roof tops: "Cheney/Palin in 2012!"

Saturday, November 14, 2009

Montana progressive org hiring director

This comes from the always-alert jhwygirl at 4&20 blackbirds

Forward Montana (FMT), a homegrown organization dedicated to training, mobilizing, and electing a new generation of progressive leaders based in Missoula, Montana, and Forward Montana Foundation, dedicated to engaging young Montanans in civic life, seek an energetic Managing Director to manage and grow the organizations. The Managing Director will work closely with the boards of directors as well as staff to achieve the organizations' financial and programmatic goals. The Managing Director will report to the Chief Executive Officer and work closely with the Board of Directors.


Deadline is Dec. 7. Go to http://www.forwardmontana.org/index.php?option=com_content&task=view&id=277&Itemid=10

Wyoming progressives, feeling lonely and forlorn, have been known to migrate north to Missoula for various forms of liberal-minded employment and/or education (just ask jhwygirl and Left in the West's Matt Singer). We hate to lose you, WyoProgs, but duty calls. Don't forget to write (or blog or twitter or FB)!

Friday, November 13, 2009

Got wood? A modest proposal from Digby

Digby is the Jonathan Swift for our times:

I have a moral objection to paying for any kind of erectile dysfunction medicine in the new health reform bill and I think men who want to use it should just pay for it out of pocket. After all, I won't ever need such a pill. And anyway, it's no biggie. Just because most of them can get it under their insurance today doesn't mean they shouldn't have it stripped from their coverage in the future because of my moral objections. (I don't think there's even been a Supreme Court ruling making wood a constitutional right. I might be wrong about that.)

Many of the men who are prescribed this medication are on Medicare, so I think it should be stripped out of that coverage as well. And unlike the payments for abortion, which actually lower overall medical costs (pregnancy obviously costs much, much more) banning tax dollars from covering any kind of Viagra would result in a substantial savings.

For more, go to http://digbysblog.blogspot.com/

Wednesday, November 11, 2009

Rep. Millin and WyoDems thank veterans

Representative Lori Millin, Democrat of Cheyenne, is my rep in the Wyoming House. She issued the following statement to mark Veterans Day:

“On Veterans Day, the Wyoming Democratic Party would like to take a moment to thank the past and present service members who have selflessly devoted their lives to the service of our country.

“To Wyoming’s 58,000 veterans and the thousands of men and women currently serving in the armed forces and the Wyoming National Guard, thank you. We are extremely grateful for your dedication and the sacrifices you and your families have made.

“To all active Wyoming troops, including the 800 currently deployed men and women of the Wyoming National Guard, we hope and pray for your safe return.”


Millin's district is in the northwestern part of Cheyenne, including the Wyoming Air and Army National Guard Bases. Also my neighborhood, which butts up against the Air Guard base. The Guard is a good neighbor. Some of the people at the base are my neighbors. They also come from all over Wyoming, Colorado and Nebraska. I hear them fly their choppers and C-130s overhead and I thank them for their service, especially on this Veterans Day.

You can chat with Lori on Facebook. See her web site at http://www.lorimillin.com/

And happy trails to Wyoming Gov. Dave Freudenthal, visiting the state's National Guard troops in Kuwait and Iraq.

Monday, November 09, 2009

Instead of imagining "Medicaid cheats," Wyoming legislators should ensure mental health coverage

More on the Wyoming Medicaid situation by Wyoming Tribune-Eagle reporter Bill McCarthy:


Bob Peck, Wyoming Department of Health chief financial officer, met with the Wyoming Legislature's Joint Appropriations Interim Committee last week.

Without federal money from the American Recovery and Reinvestment Act of 2009, he said, the state's general fund would face about a $66 million deficit for Medicaid spending.

Medicaid is the health program for low-income people that is funded by the states, as well as the federal government. It is managed by the states.

"I want everybody to understand the stimulus funds are a temporary relief from the general fund obligation," Peck said.

The "biggest drivers," he said, are increased enrollment and use of the program.

Expenditures jumped from $466.7 million in fiscal year 2008 to $512.1 million in fiscal year 2009. Enrollment fluctuates month to month, he said, but this year it is up about 6,000 or 7,000 people. Not all enrollees access services, but the number of
people using services also is on the rise. Since fiscal year 2007, he said, enrollment is up 2.3 percent, but the number of people receiving services jumped 9.8 percent.

"We do think there are things that we can do to control costs," Peck said, but the state may potentially face future deficits.

But Appropriations Committee co-Chairman Sen. Phil Nicholas, R-Laramie, said there are some balances that have to be weighed. If the state lowers payments to providers, for example, a family practice doctor might decide not to see Medicaid recipients. Those patients could then end up in the emergency room instead. Peck said his department is trying to be analytical about cost savings and to gather more data on the trends in the claims data to find cost-effective ways of delivering care.

Committee member Sen. Ray Peterson, R-Cowley, said he sees people who seem
to be living quite well, yet their children are using Medicaid. Peterson said he would like to see the requirements tightened.

"We're aware there's abuse out there," Peck said, but often the state is prevented by federal regulation from acting. For example, Peck said at times single mothers live with boyfriends who make plenty of money, but the mother's children are not legally his dependents. The children's income status is reliant on the mother's income solely.


Remember the "welfare cheats" of the Reagan era? Newspapers and airwaves were filled with stories of men and women (mostly black) driving their Cadillacs up to the local grocery and using food stamps to buy steaks and desserts and other high-end edibles. There were stories about food stamps being traded like money, even used to buy drugs.

Did it happen? Probably. Did it happen often? Who knows. The stories caught on like wildfire and before long, every black person on food stamps and school-lunch programs and unemployment was a "welfare cheat" and not to be trusted with our hard-earned taxpayer dollars. Various remedies were attempted, but the Clinton administration brought us workfare programs. Most states (including Wyoming) had success with getting people off the welfare rolls. Single moms in Cheyenne found themselves working two or three jobs to make ends meet off welfare. Kids were often left to fend for themselves. Not a rarity among any working person in Wyoming. During most of our time in this state, my wife and I have worked at least two jobs each. There was a span of two years when my wife worked three jobs. There's a joke that goes something like this: Q: "What do you call a Wyomingite with two jobs?" A: "Underemployed." I have a tendency to mangle jokes, but you get the point.

I hope we're not getting to a point where we have a plague of "Medicaid cheats." Are there people who game the system? Yes. Is there an instance of a Cheyenne resident driving a Hummer to the Health Dept. to sign up for Medicaid? Maybe. But more than likely these are apocryphal stories that we just might want to believe if they are repeated often enough.

Is that what Sen. Nicholas and Sen. Peterson and Dept. of Health CFO Bob Peck have in mind? Wyoming is a conservative state, to be sure, but most its people are fair-minded. But we live in combative times. Media and the Internet Tubes are filled with all kids of opinions and rants and even lies. People says lots of things when they're under stress.

If the presiding phrase becomes "Medicaid cheats," we can look forward to lots of yelling and screaming on all sides of the issue. And families around the state will be left without much-needed medical and mental health care. It's hard enough to come by already, but shrinking budgets and narrow minds can turn it into tragedy.

The Wyoming Dept. of Health, especially the Mental Health Division, is staffed with caring, helpful people. The department's Children's Mental Health Waiver, complete with its strategy for family "wraparound care," is visionary. Because this is a Medicaid-funded program, it's also being stressed during hard times. It's undergone some changes since our daughter was enrolled in the program from March 2008 through Sept. 2009. Let's hope the misguided words of a few conservative politicians don't sink it.

If you've been a part of Medicaid or are concerned about this issue, call or write to your state representative or senator. Find contact info at http://legisweb.state.wy.us/. Do it before they get to Cheyenne for the next legislative session.

Increased demand stresses Wyoming Medicaid funding

A story in Monday's Wyoming Tribune-Eagle addressed the state's Medicaid and CHIP programs.

The number of children on Wyoming Kid Care CHIP is declining, but the number of children on Medicaid is going up.

Bob Peck, chief financial officer for the Wyoming Department of Health, said one explanation could be that parents are losing their jobs.

Formerly working parents who had their children on the Kid Care program for child health insurance may be having to enroll their families directly into Medicaid, he said.

Medicaid is the health program for lower-income people that is funded by the states, as well as the federal government. Kid Care CHIP offers health insurance coverage for Wyoming's children and teens through age 18 that are uninsured and meet income and eligibility guidelines.

Peck said the number of Kid Care children dropped from 6,200 to 5,400 over the past year. The number of children enrolled in Medicaid in fiscal year 2008 was 49,719, while in fiscal 2009 it was 52,185.

The number of children receiving Medicaid services in fiscal 2008 was 44,114, while in fiscal 2009 it was 45,746. Medicaid expenditures for children jumped from $126.4 million to $143.8 million, according to information Peck provided to the Wyoming Legislature's Joint Appropriations Interim Committee last week.


My daughter Annie was one of the 44,114 on the Medicaid rolls in FY 2008 and one of the 45,746 children receiving Medicaid services in FY 2009.

As I've said in earlier posts, Annie qualified for Medicaid coverage under the Children's Mental Health Waiver. In that program, teens can qualify for Medicaid coverage because the Wyoming Health Department factors in their income and not their parents. If the incomes of my wife and I were factored in, Annie would not have qualified. She would not have received intensive inpatient mental health services and we don't know where she would be now. Still dealing with her mental illness, and untreated. Still suicidal and still cutting her arms and her legs.

But she did get the appropriate care, thanks to federal health care programs, and she is now back in school and taking mainstream classes instead of special ed courses. I have nothing against accommodations made for K-12 students. In fact, I'm all for it. My tax dollars -- and yours -- at work. Those taxes being spent on special ed and mental health care come mainly from the feds, as Wyoming has ridiculously low tax rates -- and no state income tax.

But educational services such as I.E.P.s and special classes don't have to last forever. They exist to give young people a helping hand and when that helping hand is no longer needed, it is released and can be used for another deserving student. There always are more deserving students.

All told, Annie spent 11 months in mental health rehabilitation centers, both in Colorado and Wyoming. The Wyoming Mental Health Waiver kicked in when our insurance ran out after 45 days. Medicaid paid for 225 more days on treatment by nurses and psychiatrists and other mental health professionals. Total bill for her care was in six figures.

As parents, we did the paperwork and wrangled with insurance companies. We visited every weekend and went to family therapy sessions once or twice a week. We checked out Annie for short shopping excursions and spent the weekend with friends in Casper so we could see Annie another day before driving the 180 miles back to Cheyenne to our jobs and other responsibilities.

Chris and I have means. I work for the state and Chris works for the YMCA. We don't have big salaries. We do own a house and have two used cars. We eat on a regular basis, and occasionally take a vacation. We don't own any solid gold umbrella stands, unlike the Wall Street rip-off artists who ran this country into the ground. We aren't war profiteers like Dick Cheney. He may not own a solid gold umbrella stand, as umbrellas are as rare in Wyoming as humidity. But I hear tell that Cheney has a gilded shotgun.

Wyoming is notoriously cheap. I worked for ten years without a raise. When Annie was born in 1993, my wife was unemployed and we enrolled in the WIC program so we could get milk and juice and cereal for our family. My wife's workplace offers health insurance but at a price so steep that she and my daughter are on my state plan. If the House health care bill passes the Senate (not likely) and its provisions enacted immediately, my 24-year-old son could be covered for three years under my insurance plan. Alas, even if the Senate concurred with the House bill, most of its provisions won't be enacted until 2013. My son will be a year too old for the 27-year-old coverage stipulation.

That's the problem. As we dither over health care reform, real people are getting sick and dying. Rep. Grayson had it right when he described the Repubs' health care plan: "Don't get sick. If you get sick, die quickly."

But my subject is mental health. The Medicaid plan is crucial for those families faced with a bipolar or depressed or suicidal teen -- and no idea what to do or where to go for help. Help is hard to find in this state. When you do, it has a cost.

Much more on this subject in the coming weeks...

Sunday, November 08, 2009

Mental health issues, in war and in peace

I am not a military veteran, and only know about war second-hand.

But I do know depression first-hand. I know how DNA and bad juju can combine to make a potent cocktail of melancholia. It can lead to extensive funks or something worse. Suicide, even murderous rampages.

Vietnam veteran and former Georgia congressman Max Cleland wrote a stirring op-ed Saturday in the New York Times. He was severely wounded in Vietnam in 1968, and treated at Walter Reed Medical center for his injuries. His post-traumatic stress disorder (PTSD) didn't rear its ugly head until the breakout of the Iraq War caused him to relive his own experiences. He sought help by returning to Walter Reed.

I never saw it coming. Forty years after I had left the battlefield, my memories of death and wounding were suddenly as fresh and present as they had been in 1968. I thought I was past that. I learned that none of us are ever past it. Were it not for the surgeons and nurses at Walter Reed, I never would have survived those first months back from Vietnam. Were it not for the counselors there today, I do not think I would have survived what I’ve come to call my second Vietnam, the one that played out entirely in my mind.

When I was wounded, post-traumatic stress disorder did not officially exist. It was recognized as a legitimate illness only in 1978, during my tenure as head of the Veterans Administration under President Jimmy Carter. Today, it is not only recognized, but the Army and the V.A. know how to treat it. I can offer no better testament than my own recovery.


Cleland documents all of this in his new book (co-authored with Ben Raines), "Heart of a Patriot: How I Found the Courage to Survive Vietnam, Walter Reed and Karl Rove." I plan to read it. It will make a good companion piece to a book I read last summer, "A War of Nerves: Soldiers and psychiatrists 1914-1994" by Ben Shephard. In it, the author documents "shell shock," "battle fatigue," "neurasthenia," "gas poisoning" and all of the terms used in other 20th century wars to describe PTSD. A fascinating look at the inner workings of the machinery of war, especially the ongoing conflict between the needs of the soldiers for psychiatric treatment and the needs of the generals to wage war.

In the early wars of the century, the generals usually got their way. Mental health professionals on all sides struggled to address soldiers with shell shock from their time in the trenches. British doctors sent soldiers home at an alarming rate. The generals objected and the soldiers spent time in recovery near the front. It was discovered that proximity to the war zone actually worked better than sending them home to fester in a hospital or to be looked upon with pity by people with absolutely no idea of what really happened at Ypres and Paschendale and the Somme. Newspapers operated under wartime restrictions. The people at home could only guess at the scope of the horror.

Some writers and poets documented the slaughter. Wilfred Owen said it best in the preface he wrote for the book that he'd never see:

Cleland continues in his op-ed:

There are estimates that 35 percent of the soldiers who fought in Iraq will suffer post-traumatic stress disorder. I’m sure the numbers for Afghanistan are similar. Researchers have found that nearly half of those returning with the disorder have suicidal thoughts. Suicide among active-duty soldiers is on pace to hit a record total this year. More than 1.7 million soldiers have served in Iraq and Afghanistan. Imagine that some 600,000 of them will have crippling memories, trapped in a vivid and horrible past from which they can’t seem to escape.

We need to make sure that returning soldiers and sailors and marines get the mental health care they need. It's crucial for them. Very important for the rest of us. Don't let those stereotypes get cranked up again. During the 1970s and 1980s, we heard a lot about "crazed Vietnam vets." An exaggeration, to be sure, as most Viet vets were working and having families and buying houses. Maybe they got help for PSTD or never experienced its effects. But there were some who went off the deep end and got all the attention.

Let's not let this bad image get started. Take care of our veterans NOW. And do it right.

Saturday, November 07, 2009

Shame on CIGNA, my health insurer

This comes from Buzzflash:

On the same day Cigna posted a 92 percent increase in 3rd quarter profits, Rep. Jan Schakowsky (D-IL) released the following statement condemning Cigna for its opposition to health care reform.

"Cigna opposes urgently needed health care reform, and today we know why. Millions of Americans are struggling to provide health care for their families, while Cigna today reported its third quarter profits had soared, nearly doubling. For Cigna, maintaining the status is a good thing – for America, it would be a disaster."

"Our health care reform bill helps the families and businesses that need affordable health care and want to stop price-gouging by insurers."

The Affordable Health Care for America Act, H.R. 3962, includes a number of provisions to prevent price-gouging and ensure premiums are reasonable. It requires publicly-disclosed justification of all premium increases before they go into effect and includes provisions, authored by Rep. Schakowsky, that require rate review of premiums so that excessive increases are denied.

It limits the amount of premium dollars to 15 percent that insurance companies can spend on things other than providing health care: profits, marketing, and bureaucracy. It makes health insurers subject to federal antitrust laws for the first time since 1945. And it provides funds for states to beef up their regulatory oversight. All these provisions would take effect next year in 2010.

Health care reform bill passes U.S. House

And as if you didn't know -- Wyoming lone Rep., Cynthia Lummis of Cheyenne, continued her role as a Republican Know-Nothing and voted against the bill. She did vote for an earlier amendment that would limit women's right to choose. Busy day for Rep. Lummis.

FMI: http://www.nytimes.com/2009/11/08/health/policy/08health.html?_r=1&hp

Follow health care reform as it happens

This info comes to hummingbirdminds from Mike Kruger, online outreach specialist, U.S. HOuse Committee on Education and Labor:

Dear Michael:

As I’m sure you’ve heard the House plans to vote on the Affordable Health Care for America Act - H.R. 3962 this weekend. I thought you and the folks at Hummingbirdminds blog would be interested in how this bill would benefit them specifically.

We have an interactive graphic to find out exactly how health insurance reform will affect individuals -- http://majorityleader.house.gov/links_and_resources/health_care/index.cfm -- with nice embeddable code so you can keep your readers from straying.

Impacts of Health Insurance Reform by Individual Congressional Districts --
http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1802:hr-3962-the-affordable-health-care-for-america-act-district-by-district-impact&catid=169:legislation&Itemid=55 -- so you can grab the ones for Wyoming.

We have a clearinghouse page with all kinds of information --
http://edlabor.house.gov/blog/2009/10/affordable-health-care.shtml -- for
virtually all other questions about the legislation.

Let me know if you have any additional questions.

Cheers,

Mike Kruger
http://edlabor.house.gov
http://www.twitter.com/edlabordems
http://www.facebook.com/EdLaborCommittee

Friday, November 06, 2009

Mental health care for Wyoming teens is usually far from home

Let's say that your 16-year-old daughter announces in the dead of night that she wants to commit suicide. It's nothing to trifle with. You rush her off to the local hospital emergency room. The staff psychiatrist, psychologist and social worker assess her and decide that she needs to be evaluated at the nearest residential treatment center. She's a threat to herself and can't go home. Everyone agrees, including the parents.

Their choices are limited. The adolescent unit of the Cheyenne Regional Medical Center's behavioral health center was closed last year. The nearest in-patient centers are in Fort Collins, Colo., and Laramie, Wyo. -- each about 50 miles from Cheyenne. Easy drives for six months of the year. Not so easy the other six months, especially the jaunt over the mountains to Laramie's Ivinson Hospital. Next closest choice is in Denver. Next closest Wyoming choice is Casper, 180 miles away on I-25. This is a bit less than the driving distance between our nation's capital and New York City. Traffic is lighter, though.

These only are options if you have insurance. As we know from recent statistics, more than 70,000 residents are uninsured, including 13,000 children. The Wyoming Department of Health has what it calls the Children's Mental Health Waiver. This allows parents of modest income to receive treatment for their mentally ill teen using Medicaid dollars. The waiver plan considers only the teen's income -- and not the parents' -- to qualify. Once you qualify, the plan kicks in where your insurance coverage leaves off. It covers both inpatient and outpatients treatment. If you're in a residential center, the waiver also pays for educational costs provided through the local school district. These are teens, after all, and they have a lot of classes to keep up with.

The waiver program recently changed. Now psychiatric care is considered separately from educational costs. Not sure why that happened. Maybe because Medicaid dollars are running short. Maybe it's due to governmental infighting. Who knows? I do know that our daughter received more than $150,000 dollars of residential center care in 2008 and thousands of dollars more in aftercare expenses in 2009. We're on our own as of Sept. 30. That was about 18 months of our government picking up the tab for a disturbed teen. We had to fill out paperwork and put together a wraparound care team and check in with therapists. But we didn't have to worry every day that our insurance coverage will reach its 45-day limit (which it did) and our bipolar daughter would be booted out into the street. That brought some peace of mind as we drove 360 round-trip miles each weekend to visit Annie and participate in therapy sessions.

Most Wyoming parents with troubled teens don't know about the waiver. I only knew about it because I'm on the board of UPLIFT, the Wyoming affiliate of the Federation of Families For Children's Mental Health. I've told other parents about it. Some have checked it out but only a few have actually gone through the process of using it. They may think of it as a government handout. They may be intimidated by the process. Some parents have their own mental health issues. Others are just busy trying to make a living.

It would be very helpful if we could take our teens to a local residential treatment center rather than shipping them all over creation. These are kids, after all, and they need to be close to their support system which is family in its many forms. It is difficult in this state of few people and wide open spaces. But there must be a way to do it. Act locally, think globally. That's a good slogan for our times. Local treatment for our kids would be good for our community. But where to start?

The scenario at the start of this piece was real. What choice did those parents make? They decided to keep their daughter at home. They will keep up with therapy appointments and make sure that her daughter gets the right medications and takes them regularly. They are doing all they can. They also harbor fears that they may not be doing enough of the right things for their child. They also wonder if it wouldn't be better to leave this state of many natural wonders for life in a place with better health care facilities that are closer to home.

Sunday, November 01, 2009

In Cheyenne, the uninsured are up the creek

Great series of health care articles by Michelle Dynes in the Wyoming Tribune-Eagle. The headline for the front-page article was "Resources shrink for uninsured." The main resource that is shrinking for the local uninsured is the Cheyenne Community Clinic, which will close on Dec. 31 for lack of funding. Laramie County United Way did not approve the clinic's latest funding request -- it gets more than half of its $190,00 budget from LCUW.

Other local entities feeling the pinch are the Cheyenne Regional Medical Center's emergency room, the Cheyenne Community Clinic, University of Wyoming's Family Medicine Residency program and Access Health Care.

Access Health Care's Dr. Jason Bloomberg "said he wishes that Wyoming congressional delegates would take the time to volunteer at one of the clinics that serve the uninsured."

That would be a learning experience. Especially for Dr. John Barrasso (R-WY), who consistently votes against health care reform. You'd think a doctor would know better.

Here are some facts and figures from the article which may or may not astound you

CRMC emergency room saw 37,000 patients this year; 24,000 four years ago.

Fifteen percent of Laramie County's population are totally uninsured, without even Medicare and Medicaid; that's 12,320 people.

The Robert Wood Johnson Foundation: 49,988 working Wyomingites went without health insurance coverage between 2006-2007; 42,433 working Wyomingites went without coverage between 1994-1995.

The UW Program recorded 32,000 patients visits in 2008, 9,800 in 2004.

The Henry J. Kaiser Foundation: Uninsured cancer patients are more likely to be diagnosed later and to die earlier than those with insurance.

These are sobering statistics. It appears that we all have someone in our neighborhood without health insurance. And that neighbor is probably working.

What are we going to do about this?

Names of the Dead on the Day of the Dead


Wyoming Democrats support public option

The Wyoming Democratic Party is asking state residents to support the public option in health care reform. You can go to the WyoDems' web site and print out a petition calling for the public option. Get ten supporters to sign on and send it back to the WyoDems so they can send it to D.C. along with hundreds (we hope) of other signed petitions. Find the printable petition at http://www.wyomingdemocrats.com/ht/d/Blogger/pid/273375

This is especially important for Wyoming because we have one U.S. senator (Enzi) who was one of the "Gang of Six" on the Senate Finance Committee who spent most of the past year obstructing real reform. No surprise that Sen. Enzi has received a total of $781,419 during his career from the health insurance and pharmaceutical industries (source: American Spectator).

Let's put that in perspective. The Cheyenne Community Clinic just announced that it will close by the end of the year. The Clinic, referred to by director Murray Lou Rex as "the safety net to the safety net," receives its $190,000 budget from United Way, Cheyenne Regional Medical Center, the City of Cheyenne and Laramie County. The United Way has decided to end its support. This is a crushing blow, as it supplies half the clinic's budget.

Imagine that Sen. Enzi used his ill-gotten gains from Big Insurers and Big Pharma to fill the gap left by United Way. That would keep the clinic running eight more years, allowing its volunteer docs, pharmacists and nurses to rack up another 16,000 "patient encounters."

Our other U.S. senator, John Barrasso, is a newbie so we cut him a bit of slack. However, he's one of the handful of physicians in the U.S. Congress, so we do have expect a little more empathy and sensitivity from him. Alas, we haven't seen it when it comes to health care votes. He voted against the Children's Health Insurance Program, commonly known as CHIP or SCHIP. Wyoming has 6,314 children enrolled in CHIP, according to Nov. 2008 statistics released by the Children's Defense Fund. Imagine voting to cut off funding for 6,314 children? I can't.

And what about freshman U.S. Rep. Cynthia Lummis? She tows the Republican Party line and votes against anything promoted by Pres. Obama. She also is the 15th-wealthiest member of Congress. We pay for her health insurance. We also pay for Sen. Enzi's Medicare coverage.

So Wyoming Democrats are urging their senators and lone rep to dig deep for some thoughtfulness and empathy when it comes time to vote for real health care reform.

Here's the wording from the WyoDems' petition:

The heath care system of the United States is in crisis. Almost fifty million Americans completely lack health insurance, including more than 70,000 people in Wyoming. Tens of millions more lack adequate coverage, and the millions who do have private coverage are paying increasingly unaffordable premiums, resulting in inadequate access to care and premature death, illness, or financial ruin for millions of Americans.

Nationwide, public polls show that a majority of Americans want health care reform to offer the choice of a robust public option similar to Medicare in order to, in the words of President Obama, “keep the insurance companies honest.” At the same time, co-ops or so-called “triggers” are inadequate in and of themselves to address the health care crisis. We need a public option to create significant competition for the medical insurance industry and give insurance companies an incentive to control costs.

Republicans and their allies in the health insurance industry have organized and funded groups of extremists to disrupt efforts on the part of the Democratic majority and administration to reasonably discuss the issue with the American people. These supporters of the status quo have demonstrated an utter unwillingness to compromise in any way to pass meaningful health care reform.

For these reasons, we the undersigned strongly support health care reform that includes a robust public option. We hereby call on Sen. Mike Enzi, Sen. John Barrasso, and Rep. Cynthia Lummis to vote for only such health care reform proposals as contain a robust public option at all stages of the legislative process, including conference and reconciliation.