Platform: Introduction and Health Care

The Peggy Party Platform:

Introduction
I'm writing these as though for a political party platform. Any reader is welcome to revise them, embrace them, excoriate them, share them, etc. Topics in my mind so far include health care, housing, jobs, infrastructure, climate change and minimum wage. If you are particularly keen on any one of these, please feel free to draft something; I'll post it here and give you complete credit. I'm not going to footnote and document these. I'm just going to write them, to start a conversation. All the research and details can come later. Cool? Cool.

Health Care
Overview
The concepts on which this is based are inclusion; simplification for citizens, providers and government; cost savings; comprehensive and complete care; and reduction of over-prescribing (opiods aren't the only over-prescribed drugs, just the most devastating). While it is important to allow choice, it is also important to restrict excessive use of resources. This is socially inflammatory and medically difficult territory. As a general rule, the system should lead with "yes." "No" should require rigorous, medically-based (as opposed to politically-based) defense. Now, to the specifics:

1. Universal
The health care pool must be universal. This concept is based on simple, foundational principles: we are one, for everybody. We are an egalitarian society. We have passed legislation guaranteeing equal access for everyone, and health care should be no exception.

When I say everyone, that's exactly what I mean. Veterans should be included, and have access to health care anywhere; dismantling the VA health care system will result in some savings. The Bureau of Indian Affairs (BIA) manages a health care system for the First Nations; as you may imagine, it is less than excellent. So Indigenous People must be included. Dismantling that system will also result in savings. Medicare patients select a provider for Medicare Part B, the "regular doctor" portion of Medicare, so they should also be included.

This idea should be applied to any specialized, separate health care system, including the care currently provided to members of the armed forces and to Congress.

2. Single Payer
Currently, health care in the US is a siloed system: if you are a member of Group A, you can only go to Group A doctors and must be admitted to Group A hospitals, even if Group B's hospital is just next door, and has a better reputation.

The burden of managing these requirements is shared with physician's offices, who often employ someone just to navigate the complexities of approvals, referrals and payments.

With single payer, this is removed. Hospitals may be chosen, or may be allocated based on facilities and equipment available, or where a particular specialist prefers to practice. The doctor and patient together choose a specialist; the hospital results from where that specialist practices, or equipment needed, or surgical suite available when needed.

3. Women's Health
All decisions regarding a woman's heath are between her and her doctor.

4. Inclusive, Holistic
Since dental and vision care, including dentures and glasses, cannot be separated from the health of a citizen, those items will be included. Mental and social* health care will also be covered completely, by licensed providers. This will further reduce out-of-pocket costs for patients, since these items are seldom completely covered. Prescriptions will also be covered. If requested by the primary care physician (PCP), "alternative" care such as acupuncture, massage, chiropractic, etc. will also be covered. If needed, transportation will be covered.
* Social health may be thought of in terms of questions now asked: do you feel safe in your living situation? how much exercise do you get? It may also be enlarged to include: how often do you visit friends? Do you have regular social activities such as religious meetings, clubs or hobbies? What do you need to help you enjoy these activities?

5. Payment
Nothing will be charged at any time for any services or products prescribed by the citizen's primary care provider.

6. Administration
This system is predicated on everyone having a PCP to monitor prescriptions, manage care and keep track of the citizen's overall well-being. Each citizen will visit their PCP every two years during the month of their birth; after retirement, every year. The visit will include blood work, medication review, vision check, dental check, and such tests as physical ability, EKG, Pap smear, etc., depending on the PCP's recommendation.

Medical records will be digitized and available online to doctor and patient, and for review by local, state-based medical boards, which will oversee the performance of doctors and handle any complaints. These boards should probably be elected bodies of a mandated mix of medical providers, medical administrators and general population.

In order to assure the greatest choice, higher tier services such as elective surgery, private hospitals and "rock star" doctors will of course be available, the cost to be determined by the market.

Comments?
Please comment below. Keep it respectful, please, and be aware that deriding other viewpoints is seldom helpful.

Dreaming New York

In my dreams there are several houses I may visit.* The one I visited this morning is on the banks of the Niagara River, a palatial home with park-like grounds. It has three floors, the third mostly unfinished. It is the house where my Grandfather Peck lived "with his second wife."

I arrived at this house with my sister, by a circuitous route that included a visit to some sort of medical professional (for her) and included a side-excursion to a basement room where the staff was doing some sort of installation which Cheryle insisted on helping with. Contrarily, as dreams can be, I was the nay-sayer, the cautioner, telling her of dire results if she was less than perfect, or even mildly unlucky. As in real life (sigh), she ignored me and did as she would.

The final test of the installation was conducted: a clever device that sped along on magnetic rails, ultimately crashing through to the restaurant next door, where it destroyed 20 tables' worth of china and crystal - and brought us into my grandfather's house.

We dined in the dining room (on left-over pork chops my husband actually did cook last night) and then went outside to sit on what must have been a boat launch into the Niagara River. Our heels were scraping on crusted ice, but the night was warmish (back in reality, the temperature was climbing toward the 80s). Suddenly waves washed over us, and we were drenched.

Back in the dining room, we were wrapped in blankets and clucked over. Two of the diners came toward us: Sr. Mary Sicilia, dead for years, and The Rev. Alice Scannell, still alive, if not kicking, as far as I know. They were very concerned about our getting wet; we were nonchalant. It was a lovely surprise, and we chatted, and I woke up.

For the record:

1. My grandfather never lived (as far as I know) in upstate New York. 
2. My mother, however, is buried in Brewster, NY, on the grounds of the Community of the Holy Spirit, to which The Rev Alice and Sr. Mary Sicilia also belong. Am I being haunted? 
3. While other diners were nonplussed by our bringing our own food (those chops were delicious!), the staff were okay with it, since we were at home. Sort of.
4. No, I didn't wet the bed, but the water was warm.
5. I really wish my readers could see this house. You approach through a rather nice suburb, when you are suddenly in a park, with a variety of deciduous trees, carefully spaced and impeccably groomed and cared for. There are few flowers, until you reach a turn in the path; then the park gives way to flowering shrubs - azaleas, jasmine, roses, and many more - each in its own vast bed, surrounded by graveled paths and lush lawns. Then the house: a brilliant marble facade, with sturdy pillars holding up the main floor. First is the garage/basement entrance, a cavernous space of shadows and cool concrete. Circling past it, you come to the grand staircase and the main entrance. Turning, you realize the house is built on a bluff, and below you is spread the village, the shops, and the shining river. Inside is even better.

*None of them, alas, are Manderley: https://strandmag.com/the-magazine/articles/daphne-du-mauriers-rebecca/

To breakfast

When I went out this morning, the yard was full of fat robins, prospecting for the emoluments of a weather break. I was going to a friend's house, and we were going to breakfast together. Her yard was full of crows, cawking derisively and only reluctantly clearing a path for my car.

This day was for the birds, it seems.

We were contrary, though, and went to Country Cat. We both had eggs Benedict with shaved ham, and coffee. She had a cough, and a Bloody Mary. The drink was lunch: a thin slice of jerky, green beans, an olive - I don't know what all! It was an amazing drink.

But the conversation, the connection, was the best.

Like so many people I know, she's better than she thinks she is, more skilled, more gifted, more aware. She knows herself better than she likes to admit.

I sometimes wish these old eyes could be shared
so you could see yourself as I see you,
your shining intelligence, your passion, your heart.
Maybe then you'd have the courage
to reach for the job, the partner, the life
that would bring fulfillment, peace and joy.

What I did in writing class

The writing class I have begun is called "Writing from the Heart," and I believe it will be a good class for me. I'm an undisciplined writer, and this class creates a sort of "free discipline," if that makes sense. We critique the words, not the writer, and that will be good as well (I'll maybe learn to be less judgy!).

We started with a 2-page guidelines document, followed by a 2-page "inspiration" document, with poetry from Mary Oliver. (If I can, I'll insert them at the end of this.)

These are the two pieces I wrote. I may not post everything I write every time; some of it may be too personal, and some of it may simply be too awful. But here you go:

Writing 1

Death will come for you, I told my husband, my love, in 5 years or 10 years or 15 years. But it will come, and sooner than you expect, because death is like that.

He thought I had called him lazy or incompetent. I had not. I was just frustrated with his idleness when I asked for his help.

I’d had my own telegram from death, you see, a mere six months before. He knocked on the door and delivered the message:

            “All lives are as the grass.”

I retired so I could decide for myself how those weeks? months? years? could be used. I no longer wanted to sell my days for dollars.

I’d rather be hungry and free, because I have been hungry before, and not free.

I’d rather be cold, and free, because I have been chilled before, and not free.

Being a wage slave to a distant master makes for a narrow life, and I want a life that is as wide as prairie, as tall as sky, mobile and graceful and relentless as water.

So when death delivered that telegram I paid attention. I wish I’d done it when I was younger, but I didn’t, so I must do it now, before I’m older.

Here’s a wave at death, here’s a nod to mortality. Here’s a step into the wide prairie.

Writing 2

I remember a house with a hole in the wall. On the other side of the hole was a cousin.

The next house I remember was home – open, airy, wood floors, fine furnishings. It was my mother’s dream, a small suburban dream that turned dark. His tax fraud, her polio, my birth – it’s hard not to think I was the final, third thing that brought the end to all good things.

I try not to think that way. I try not to remember the men inventorying our possessions, taking our home.

The next home: a smaller, darker suburban dream, one with no daddy, except as a sporadic visitor. Almost as soon as we moved in: a hurricane (Donna), the floor tiles floating up, and my personal catastrophe, Raggedy Ann with mildew freckles, lying in the garbage can. How daunting it must have been for my mother, her new beginning flooded and ruined.

She resurrected it though, with new flooring, white, instead of dark brown; new furniture, light instead of dark; and more windows, more sunlight. We never had another disaster in 15 years of living until her health failed.

Then I inventoried our possessions, sold or shipped the goods, and brought Mom to my home. It was an old house, large and dark, but her room always seemed full of light, the children drawn to it like moths to candles. She lived in pain, but always tried to stay in light as well. Sometimes she failed, but she always tried.

I owe her that lesson: the dark can’t win as long as you seek the light. She never taught me how to be married, though – I learned that for myself. Home now is small but light, brimming with love and sunlight.

This "Retirement" thing I'm doing

"So, how's retirement going?" I've had several people ask me, so I thought I'd try a recap.

It started with a truly great party on Saturday, 1/14, thrown by the best boss I've ever had, Jeff. It wasn't as well attended as we thought, because there was a monster ice storm/deep freeze/snowpocalypse in Portland. But a good number of dear friends struggled in, and I felt all the warmth of their friendship. And scotch. Can't forget the scotch!

On Monday, I entered into what may be an endless, ongoing ground war with Medicare. I haven't prevailed, but there appears to be a chance that all will be well. Maybe.

The first week (1/15-21) was housekeeping: a mammogram, a doctor visit, two trips to the dentist. For fun, there was Theology Pub, where we had as a guest a woman who had assisted with the translation of the Bible into the Hawaiian pidgin language. The week was topped by brunch at Salty's with Teddie and Martin, where we drank prodigious amounts of mimosas and enjoyed some wonderful food and conversation.

The second week (1/22-28) began with us hosting coffee hour at church. One of my favorite things is feeding people! More medical followed during the week: the eye doctor, this time. And Steve and I began the delicate negotiations around space, time and chores. (This was also my week of Twitter & Facebook political hysteria.) Then Steve fell ill, so some of my outside activities were constrained; he needed my help. But he was well enough by Friday that I could go host the car campers at our church, St. Anne's in Washougal (stanneswa.wixsite.com/stanneswa). We open the church's fellowship hall every day for 2 hours, so our guests can come in, wash up, cook dinner and socialize. We have 2 or 3 car campers and 3 tiny houses ("homies") on our property. Steve and I will share hosting most Friday evenings.

Now, in the third week (1/29-2/4), I have begun living my true life. I started going to a book group, where we're reading 1984, and I began attending a writing class, "Writing from the Heart." And I've returned to this blog. I've also recognized how important homelessness is to me; it seems to rise to the surface every day, in one way or another. I may have found my "cause."

The book group, the writing class and the car camping program are all connected to my church, but are not "religious" activities. If you are unchurched because church has nothing to offer you, you may want to reconsider. Yes, some of these obligations are a pain in the ass; but many feed my spirit in vital ways, ways I couldn't easily access without the benefit of congregation.

So that's how retirement goes: like any new venture, good days and bad; idle days and busy days; active days and days for introspection.