My risk of death or bankruptcy just went up: “House Republicans pass bill in first step toward replacing Obamacare” https://www.theguardian.com/us-news/2017/may/04/republican-healthcare-bill-passes-house-vote-obamacare-repeal?CMP=Share_AndroidApp_WordPress
Congressman Rodney Davis has a questionnaire asking for constituent input on questions of the day.
I filled it out some weeks ago (in mid-December) and found some of the questions to be . . . . Well, here. This is what I sent to his office after I posted my questionnaire response:
Several of the questions on your recent survey were hard to answer, because an accurate answer might be taken as supporting a position that is the opposite from what I intend. These two in particular:
“Do you believe we need to shore up Medicare so it’s available to future generations?”
Of course I support preserving Medicare. However, I would oppose any changes in the basic design of how Medicare makes healthcare available to seniors. In particular, I would strongly oppose turning it into some kind of voucher program.
My understanding is that, together with the cost savings provided by Obamacare, Medicare is very close to being fully funded. It seems quite possible that no changes are needed going forward. Depending on the details of health care costs and payrolls in the future, it may be that some additional funding will be required, but that is the question for the future.
“Do you believe Congress must provide proper oversight of the VA to ensure our veterans are receiving the care they deserve?”
Again, providing oversight is exactly what Congress should do. However, I would oppose giving the VA additional mandates—either in terms of the care they are to provide, or in terms of the reporting they are required to provide—unless those mandates are fully funded.
I have no sense that the VA is doing anything other than providing the best care they can with the resources provided. Congress’s deeper obligation, beyond oversight, is to provide the resources necessary to care for our veterans.
I expect to go on pestering Congressman Rodney Davis on a near-monthly basis for the next two years.
You know this, right? Age-related diseases—at least, those of middle age—mostly aren’t. Rather, they’re lifestyle diseases that seem age-related because it takes years or decades for the harm done by the lifestyle to start showing up as symptoms.
I’m prompted to write this by something Charles Stross wrote over a year ago, where he talks about the symptoms of aging. I almost didn’t link to that post, because he’s really talking about something else—his post is about the political effects of reasonably foreseeable improvements in medicine—but along the way, he describes his current circumstance:
. . . chronic low-grade pain of the middle-aged body: joints that creak and pop, muscles that need an extra stretch, sore feet.
And goes on to compare it to his hypothetical world with science-fictional medicine:
Unlike today’s senior citizens, you don’t ache whenever you get out of bed, you’re physically fit, you don’t have cancer or heart disease or diabetes or Alzheimer’s, you aren’t deaf or blind or suffering from anosmia or peripheral neuropathy or other sensory impairments, and you’re physically able to enjoy your sex life.
Of course there are age-related diseases—Alzheimer’s and anosmia probably are. But especially the ones in the first quote—the age-related difficulties of the middle-aged body—aren’t age-related at all. To imagine that they are is to make a category mistake—and a serious one, because the error makes it much more difficult to recover your health.
I’ve hesitated to write this post, because I realize that I’m speaking from a position of privilege—I’m healthy. This is partially a matter of luck, partially a matter of good genes, partially a matter of a lifetime history of good health care, access to adequate nutrition, and so on.
Even so, I’ve got real first-hand experience with exactly the list of middle-aged body problems that Stross lists.
Eight or ten years ago, I was feeling old. Tasks that required strength were more daunting than they had been—especially ones, such as carrying things up or down steps, that added additional weight to my already excessive body weight. My balance wasn’t as good, making slippery tubs and icy sidewalks seem like serious threats. My plantar fasciitis was kept at bay only by being scrupulous about wearing supportive shoes and by limiting the amount of standing I did. I could still get down on the floor and get up again, but it was hard enough that I didn’t do it when I didn’t have to. I had trouble getting a good night’s sleep, because my back would ache when I lay still too long, and when I did sleep through the night I’d need considerable stretching before I could move normally the next morning.
I viewed all this as normal aging. Partially, I think that was because I was actually in pretty good shape. I could walk 5 or 6 miles. I routinely bicycled to work when the weather was nice. I went to the fitness center two or three times a week to use the weight machines and do some stretching. Despite all that, my physical capabilities were declining, and I didn’t see anything I could do about it, except perhaps spend even more time exercising, which didn’t seem practical for someone with a day job.
It wasn’t true, though. Over the past six or seven years, I have felt better each year. It is not a strain to carry things of ordinary weight, even going up and down stairs. My static balance is excellent—I no longer fear slippery tubs, although I do still try to be careful on ice. My feet don’t hurt when I stand a lot, even when I’m barefoot. I make a point of sitting on the floor, just to add some variety to the day. I sleep well, and I wake up able to move.
What did I do? Nothing extraordinary.
Starting to do tai chi was probably the key shift, because it changed so many things at once about my movement practice. Somewhere along the line I ran across parkour, and then even before I had done more than play with that I discovered natural movement as a thing—and that was what gave me a framework for thinking about movement the same way I’d come to think about food.
Trying to figure out the best diet is a waste of time. It’s computationally infeasible, and anyway unnecessary—just eat a wide variety of foods (and limit your consumption of industrially produced food-like substances) and your body takes care of the rest. (See Michael Pollan’s In Defense of Food for details.)
Similarly, trying to figure out the best exercise regime is a waste of time. You are far better off to get a wide variety of movement (and limit the time spent doing things like sitting in chairs and wearing shoes). Once again, your body will take care of the rest.
What struck me—what prompted me to write this post—was that Stross’s description of what his science-fictional medicine feels like is what I’ve felt like. It’s not exactly aging backwards, but it is a recovery of a feeling of ease and comfort that had slipped away under cover of “normal” aging.
My life feels kind of like a science fiction story, with the science-fictional medicine being just recovering normal patterns of movement.
It makes me want to advocate these lifestyle changes, perhaps more strongly than is advisable. As I say, I recognize that I’m writing from a position of health that isn’t available to just everyone. I can’t say that if you’ll just start walking and running and bicycling and lifting weights and doing taiji and experimenting with parkour and natural movement, you will reverse the aging process and feel young again. There are kinds of impairments that cannot be completely recovered from, and perhaps some that cannot even be improved.
And yet, I do advocate these lifestyle changes. Move better. Move more. Eat food. I bet you’ll feel better—especially if you’re starting to suffer from the symptoms of “normal” aging.
I was one of the first people to try to sign up for insurance on healthcare.gov. That turns out to have been a mistake. At least, that’s my theory.
With considerable effort, over a period of a couple of days right at the beginning of October, I’d gotten through the first part (where you verify facts about yourself to confirm that you’re you). Then I’d done the part where they ask about your income, etc.
At that point—when I’d entered all the info about my and Jackie’s contact info, race, ethnicity, income, and so on—I clicked the last “submit” button. . . and waited.
After a long time, the submission timed out.
Not wanting to have to go through all that entering again, I just backed up a screen and clicked submit again. . . and waited again. And it timed out again.
I did that over and over again, hoping that eventually I’d get a successful submission. And at some point I did get one. In fact, I got a bunch—many of those failed submissions had apparently gone through before they failed. But (I now believe), something about them had gotten corrupted at some point.
On the first visit after that, I’d gotten through to the point of seeing what policies were available to me and how much they’d cost. I printed the list and reviewed it with Jackie and investigated the networks offered by a few plans and picked a policy (sticking with Health Alliance, but going for one of their new Silver plans). But when I returned, there was a glitch: I could no longer sign up for insurance for Jackie and myself; it offered me a policy only for myself, with no sign as to whether I’d be able to get Jackie signed up after.
Yesterday, I finally gave up on making my way through the signup process, and called the telephone interface.
Turns out, the people on the other end of the phone go through the exact same interface. So, of course, they ran into the exact same problem I did.
After escalating to the senior tech guys, the proposed solution was to reset my account and have me start over. (Something I would have done a long time before, if that interface were available.)
Sadly, I couldn’t make that work either.
Finally, I started over completely. I created a new account (with a new login name, using a new email address), re-verified my identity, and re-entered all the info about me. This time, having already selected a policy, I pressed straight ahead and enrolled.
So, I have successfully signed up for insurance through Obamacare. It took about an hour, once I started over from scratch. I suspect it would have worked pretty smoothly, if I hadn’t tried so persistently to sign up in those first few busy days.
Despite the aggravations of getting signed up, I’m pretty pleased. Obamacare is going to save me hundreds of dollars a month. Our insurance bill had been our largest bill—quite a bit higher than our rent. Now it will be just another monthly expense—bigger than our phone bill, but less than rent or groceries.
And yet, the cost savings is far from the most important thing. Before, I worried constantly that any major medical problem would ruin us—make it impossible to get affordable insurance; trap us in a policy that all the healthy people had fled, with premiums spirally inexorably higher until they consumed all our money. Now, at last, we have some security on that front. Cheap or expensive, at least our insurance is actually insurance. A major medical problem would still be a big deal—one of us would no longer be healthy. But at least it would just be that, and not that and a financial catastrophe too.