Category Archives: Seniors

Five star health care inequality

As the Senate barrels forward with an attempt to cut our health care so rich people can get a tax cut, a new health care issue got my blood boiling this weekend: uber concierge medicine. This article, on the cover of the Sunday business section, enlightened me on a new inequality fronteir.  The story profiles the rising prevalence of private health care managers in the Bay Area.  These health firms for the ultra-wealthy command $40-80,000 a year in fees and ensure their clients have five-star health care experiences (i.e. shorter wait times for specialists, better referrals, coordinated services).

Can’t help but wonder when this story originated, but reading it at a time when Congress wants to take away health care from 23 million Americans (or, if they’re lucky, just increase their premiums by 800%), was extremely unsettling.

While I’ve always been concerned about wealth and income inequality, the move to Stockton makes me hyper-aware of the growing disconnect between the wealthy and poor.  (I can’t include the middle class in that sentence, because sadly, it seems as though the middle class disappearing. It terrifies me to say that, but living in the Central Valley and working in the Bay Area, I primarily observe examples of poverty and wealth–no real signs of a growing middle class in Northern California).  Anyway, one area of hope for equity, thanks to the Affordable Care Act, was health care.

With the ACA, in states that expanded Medicaid, the health benefits protection helped many more people get access to essential coverage.  As a Kaiser member, observing patients of all socio-economic levels accessing health services always gave me a bit of hope for the future.  In the last two years, between David’s pneumonia hospitalization, my miscarriage, pregnancy and delivery, I’ve spent time in Kaiser health centers in Oakland, Modesto, Walnut Creek and Stockton. These cities vary significantly in economic, education and health outcomes.  And yet, while economic disparity grows stronger between the coastal and inland cities, the ACA’s massive coverage improvements provided hope for a narrowing health outcome gap.  In my purely anecdotal experience, the quality of care and dignity of service in Walnut Creek was the same as Stockton, or any of the other cities. I can find few other public services examples where that is the case, and I attribute that to the ACA’s role in lifting standards and quality for all.

Apparently, feeling hopeful after observing waiting rooms of diverse patients is not a universal reaction.  From the article:

“Whenever I bump into a bleeding-heart liberal, which I am, I mention that schools, housing and food are all tiered systems,” he said. “But health care is an island of socialism in a system of tiered capitalism? Tell me how that works.”

Dr. Howard Maron, who founded MD Squared, is similarly candid about the new reality of ultra-elite medical care.

“In my old waiting room in Seattle, the C.E.O. of a company might be sitting next to a custodian from that company,” he recalled. “While I admired that egalitarian aspect of medicine, it started to appear somewhat odd.”

As we “bleeding-heart liberals” lament growing political and ideological polarization, we have to acknowledge it will only get worse if health care becomes even more tiered. (Should clarify, for all the ACA’s promise and potential, we are still far, far from an equitable health system. But the law was a step in the right direction).  The tiered system in public schools, neighborhoods, parks, transit, and more ensure the company CEO never brushes up against the company custodian.  And when that CEO never interacts with the custodian, what does she know of his experience? How will she ever favor policies that help him if she never sees him? It’s the classic Crash opening quote conundrum.

I recognize that viewing a hospital waiting room as a de facto town square, a public center where people of all backgrounds interact, is a deeply depressing statement. But in reality, what else is left? And if wealthy liberals want to take that away (to be clear, the article profiled wealthy Northern Californians; it’s not Texas oil tycoons normalizing this type of income separation, but our “liberal” neighbors) how can we possibly be surprised when Congress wants to barter away health care protections to gain tax cuts?

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A small, beautiful, hurting world 

Thinking about Turkey and Nice. My understanding of foreign policy is much weaker than my grasp on domestic issues, but it is all horrifying. Following my new favorite  thinker, Anne-Marie Slaughter, to try and understand. Vox’s reports are also super helpful.

Without anything to contribute to the conversation, other than sadness, trying to think of the beauty of Istanbul. Four years ago, David and I spent Thanksgiving in Istanbul. It was a dizzingly incredible city.

I remember boarding the Turkish Airlines flight, giddy with excitement. It was the first time David and I were flying across the Atlantic together, and I was SO excited to take such a big trip. 

When we arrived at the Osmanhan, our hotel in Sultanahmet, Fatih, the manager, greeted us warmly and welcomed us to the city. I don’t generally remember hotel managers, but he was so kind and helpful throughout the trip.

We started each morning with an incredible breakfast on the hotel’s roof deck, looking out at the Bosphorus. The view, the perfect tomatoes and cheese, the cool morning air-it’s one of those scenes that you tuck away to remember when stressed or wanting a vacation. 

Although it was November, the city was packed. It truly felt like a crossroads for the world-so many different languages and cultures, everywhere we went.

I remember actually feeling a little overwhelmed at Taxsim Square. So many people out, enjoying a Friday night. It was crowded! We ended up finding a rooftop bar, and I remember feeling fancy as we drank Pilsners and ate popcorn, looking out at the city (isn’t it random the memories that stick? I really remember the popcorn. And a lively birthday dinner at the table next to us).

The Hagia Sophia and the Blue Mosque and all of Sultanahmet…all incredible. Thinking about all the history and turmoil they’ve witnessed. They’re still standing, incredibly magnificent. 

Hoping for a peaceful end to this current chaos and praying for those who are hurting.

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Virginia McLaurin + Advocacy

Like millions of others, the video of gleeful 106 year-old Virginia McLaurin dancing during her meeting with the Obamas in the White House made my Monday.  I watched it multiple times and could not stop smiling with joy. LOVED when the President looks at Mrs. Obama with a look of, “you are painfully awkward and I love you so much,” as she dances and chats with Ms. McLaurin.

Of course, I wondered, who is this sweet centenarian? Is she really 106? What has she experienced in her life?
A quick search brought up a video where she’s tells the interviewer how she does not want to leave her home during a snowstorm, how she just needs a few things, but she can generally take care of herself.  She’s adamant she wants to stay in her own home and hopes she’ll always have control of her mind.  A sentiment shared by almost all seniors, thoughtfully expressed by Ms. McLaurin. Another video of her on the local news, sharing her story of volunteering 40 hours a week at a school for children with developmental disabilities in DC.  She’s glowing with pride and love for her students.

But then, a sad, surprising post on her Facebook page.  Just two years ago, in an apartment blocks from the White House, Ms. McLaurin was sleeping on an air mattress.  Her apartment was infested with bed bugs, the building neglected by its property manager. She could not sleep in her bed.

At 103 years old, her property management company had the nerve to leave her sleeping on the floor, in an apartment overtaken by pests.  This amazing, vivacious woman, who lived through more tumultuous moments in our country’s history than most people alive today, was ignored by the company responsible for maintaining her home. How many seniors, who push through adversity their whole lives, find themselves abandoned, and forgotten by the very people and systems entrusted to care for them?

As I scrolled further, my heart rose as I saw Ms. McLaurin is now back home, her home restored.  A tenants’ rights advocacy group got involved and shared her story with the DC media.  A local fumigation company donated their services to wipe out the infestation, and the tenant rights’ advocate stayed on top of the case to make sure Ms. McLaurin was safe and comfortable during the whole process.

It made me think of President Obama’s start as a community organizer and the power of community and advocates to look out for and lift up those who are neglected.

By the way, it was that same tenants’ rights advocate who pushed to make sure Ms. McLaurin had an opportunity to meet the first black, community organizing president, in the White House this weekend.  Pretty cool.

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The experts 

Currently reading Karl Pillmer’s 30 Lessons for Loving. The gerontologist (swoon!) interviews hundreds of older adults about their relationships. In his intro, he answers the age-old question: what do we call seniors? We struggle with this all.the.time. at work. “Senior citizens” is too dated, “older adults” too clinical. I love his conclusion: they’re the experts.

It got me thinking about last Thursday, sharing the day with some incredible experts. Papa turned 90 on October 8 and thanks to Mom and Dad’s generosity, I got to fly to LA to celebrate his birthday. It was a wonderful lunch celebration at a delicious deli in the valley with Papa and Betty’s friends and family.

Some of my favorite lessons from the experts:

1) No matter how old you are, it is always exciting to have a birthday. Papa could not believe he was 90 years old, no matter how many times he excitedly asked about his age. Even at 90, he was thrilled to have a birthday.

2) When you’re over 90, you eat what you want. Papa’s friend Mimi, a deli connoisseur, kept imploring me to get a pastrami sandwich. She’s a classy, svelte older lady, so you can imagine my surprise when a GIANT plate of piping hot pastrami arrived for her. And she ordered bread for more sandwiches. Go Mimi!

3) Always, always, always tilt the glass when you pour champagne! Papa’s friend Jay, 93, sweetly scolded after my failed champagne pour.

4) Always, always, always drink all the champagne! It was an absolute treat watching Dorothy, 100(!!), delight in her mimosas and bubbly all afternoon.

5) If someone is going to take your photo, PUT SOME LIPSTICK ON. Dorothy was totally prepared for photo time. I never wear anything on my lips (borrrrringgg) starting to think that should change.

 With Dorothy, looking vibrant in her bold lip, and Jay 
6) Be a good friend. Stay close to your friends. Papa’s best friend Ben, 90, celebrated with us and regaled us with fun stories of their seven decades of friendship.

7) Just be nice. After the party, we were hanging out with Papa, and totally unprovoked he said, “People are always nice to me. I’ve always been nice to people and always liked people, and they just like me.” Papa is a total role model for kindness, sweetness and generosity toward others. For 90 years, the world has been all the better for it.

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Filed under Family, Observations, Seniors

36 Hours in DC

“We’ve expanded the options for home- and community-based services offered by Medicaid, which means that more older Americans are able to make the same choice that my grandmother did and live independently.”

I can’t tell you how exciting it was to hear this sentence.  On Monday morning, President Obama addressed the White House Conference on Aging in the East Room.

And, unexpectedly, I got to be there to hear it all! It was pretty surreal.  Working in aging policy, it’s easy to get bogged down in the wonky details of long term care and Medicaid.  So it’s hard to express how thrilling it was to hear the President jump into those details. I never thought I would hear the President even say the phrase “home and community based services.” Hearing him elevate its importance gives me hope it will become part of our lexicon and maybe…maybe…people will finally start talking about aging and solutions to long term care.

The WHCOA happens every ten years and the whole day was a whirlwind. Seeing many aging advocates I admire, listening to the Secretary of Labor’s inspiring words about poverty advocacy, and just knowing that for one day aging issues were on the Administrations radar-it was awesome.

In the foyer in front of the East Room.

So grateful for the opportunity to be a part of it all.  And so grateful for a quick trip to see my amazing sister!

Shannon and I got drinks at Woodward Table and Katie was awesome and drove me to the airport. I wish I had more time to catch up with these three, but feeling very thankful for the brief time to catch up in that beautiful city. DC always gives me a shot of energy and the excitement at WHCOA reinvigorated my dedication to this field.  Quite a day and a half!

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