health care » Danine N. Spencer

Saturday Link-Love

Happy Halloween! Hope your Saturday is treating you well. Here are a few of the week’s best links:

First, a little horn-tootin’. I am humbled and honored to be included on this list of 50 Eye-Opening Women’s Studies Blogs, along with some of the great feminist blogs on this list. Check it out!

Ashley at the Small Strokes blog has a new project: This is What a Beautiful Bride Looks Like, which features pictures of real brides. Here’s a description of the site, in Ashley’s own words:

As an engaged woman who loves her body, I am sick and tired of seeing ads for “Wedding Weightloss” routines and images of 100% “perfect,” unattainable brides! Here, I hope to collect some pictures of brides with REAL beauty! To submit a photo, e-mail samsanator(at)gmail(dot)com

On Thursday, I participated in a Conference Call with Rep. Cynthis Lummis (R-WY). BlogHer has now posted the full transcript of the event, including my Q&A with the congresswoman.

Finally, here’s a little Halloween fun for ya. The fab team at Bitch Media has put together an awesome list of Feminist Halloween Costumes. I love the idea of going as one of Jem and the Holograms.

Conference Call with Sen Jeff Merkley

This afternoon I had the pleasure of participating in a BlogHer conference call on health care reform with Sen. Jeff Merkley (D-OR). Sen. Merkley gave a brief statement on the goals of health care reform, saying that it will have an exchange to allow individuals and small business to buy health insurance as part of a large pool. In addition, there will be insurance reforms and investments in wellness and prevention.

After that, Sen. Merkley took questions from members of the BlogHer community. I got to ask the first question, which I have to admit was a teensy bit cool. Here’s what I asked, kinda-sorta verbatim to the best of my recollection:

“I had a spinal cord injury in 2005 and was paralyzed from the neck down. I regained my mobility but I still have a lot of health problems. I’ve been on disability and Medicaid since then. I am hoping to work my way to self-employment but I need affordable health insurance in order to do that. My guess is that the public option will be my best bet. We’ve heard Sen. Reid say that they’re talking about talking about the public option. So what is the status of the public option?”

Sen. Merkley told me that my situation is a good example of why we need health care reform. He said I would benefit from insurance reforms, such as not being denied coverage to a pre-existing condition. He explained I would be able to go to the new insurance exchange, where I could choose from a variety of difference insurance plans, including “hopefully a public option.” Sen. Merkley told me he is working very hard for a public option. “I think the odds are very good”, he said, speaking of the likelihood of a public option being in the final bill.

Looking back at my notes now, I wish I would have asked a follow-up question. I wish I would have asked what the public option would actually do. Who would be eligible? How much would co-pays, premiums and deductibles be? Would there be networks of preferred providers?

Oh well. Maybe I’ll get chance to ask another lawmaker that question. I hope so.

On to the next question: Audrey from Maine, asked why tort reform wasn’t a bigger part of the current push for health care reform. Sen. Merkley explained that tort reform, which has already been done in some states, has not substantially reduced the cost to citizens. In fact, it seems to have had about a 1% (yikes!) impact on the cost to citizens. Furthermore, he said tort reform would take away citizens’ fundamental right to sue for gross negligence.

Audrey also asked why there isn’t a bigger emphasis on health care savings accounts in the current debate. Sen. Merkley replied that most working Americans aren’t able to put money into a health care savings account. “It may be a nice addition to reform… It doesn’t get to the heart of the problem,” he said.

Susan, from Madison, WI, noted the lack of bipartisanship in the current debate on health care, particularly on the public option and wondered what issues Democrats and Republicans are able to find some consensus on. Sen. Merkley said there was bipartisan support for investments in wellness and prevention, disease management, growing the health care workforce and providing incentives to employees to stay healthy.

Sen. Merkley said the biggest difference between Democrats and Republicans is over the public option. Republicans believe in a for-profit health care system but “I couldn’t disagree more,” he said. He explained that he wants a system dedicated to healing people not to profits and shareholders.

Susan asked the senator what it would take to bring bipartisanship back to the issue of the public option. Sen. Merkley explained that some of the compromises currently being discussed might help, such as the opt-out idea, where states can opt-out of the public option if their governor or state legislatures decide to do so.

The final question came from Karalee in California (sorry if I got your name wrong, Karalee). Her family is uninsured and her son was just diagnosed with diabetes. Karalee asked if health care reform is passed, what will fill in the gaps for families like hers until the legislation goes into effect in 2013?

In my opinion, this is one of the best questions of the day (besides mine, of course). Sen. Merkley agreed saying, “It’s an excellent question. Unfortunately, I don’t have an excellent answer.” He went on to say that he has been asking these exactly questions on Capitol. He thinks that states should be allowed to set up their public options and insurance exchanges earlier than 2013 if they’re ready. Stay tuned, he said, because debate on this issue is still underway.

With that, the conference call wrapped up. Thank you, BlogHer and Sen. Jeff Merkley!

My Conference Call with Nancy Pelosi

This morning, I was lucky enough to participate in a BlogHer conference call with Speaker of the House Nancy Pelosi. The topic was health care reform and Speaker Pelosi had plenty to say.

In her opening remarks, Ms. Pelosi expressed optimism that health care reform legislation will get passed. “I’m very enthusiastic about where we are on this legislation,” she said. She said women have much to gain from health care reform:

Insurance companies won’t be able to charge women more than men. (Women currently pay as much as 48% more)
It will be illegal to count pregnancy, C-sections and domestic violence as pre-existing conditions.
Insurance companies who participate in the health insurance exchange will be required to have maternity care. (It’s unclear to me if all insurance companies will be required to do so.)
There will be assistance to individuals and families who earn up to 400% of the Federal Poverty Level (FPL) to help buy health insurance.

The first question came from Audrey in Maine, who said her family was facing foreclosure on their home due to huge medical bills. Audrey asked if it was really possible that insurance premiums wouldn’t go up for people in private plans?

Ms. Pelosi explained that there were several provisions in the House bill for Audrey’s situation. There will be no discrimination for pre-existing conditions. Insurance companies couldn’t drop coverage if you get sick. There will be no co-pays for prevention and wellness. There will be yearly and lifetime caps on what you pay out of pocket. If you have a disability or chronic medical condition like Audrey, there will be a cap on what you pay. Ms. Pelosi told Audrey that her case is exactly why the current system needs reform.

The next question came from a woman in Chicago, who happened to be waiting at the DMV. (I didn’t catch her name, sorry DMV lady!) The caller was extremely concerned about the expansion of government into the health care system. “It strikes fear in my heart,” she said, asking Ms. Pelosi to help calm her fears. “We are not doling out health care. We are helping people pay for health insurance,” Ms. Pelosi replied. Ms. Pelosi went on to say that health care reform would be paid for by reducing fraud and waste in the current system. She also insisted the public option has to pay for itself and be “actuarial sound,” which I freely admit is an accounting term that’s way over my head.

Heather from Los Angeles, who has a blood clotting disorder that makes her pregnancies high-risk, asked if there would be any “gray area” on pre-existing conditions. Absolutely not, Ms. Pelosi replied. “There can be no discrimination against people with pre-existing conditions.” She reiterated that all insurance companies who want to participate in the insurance exchange will be required to have maternity care and that insurance companies will want to operate in the exchange because they will have access to millions of new customers.

On the issue of pre-existing conditions, Ms. Pelosi expressed disbelief and disgust at the discrimination women face by insurance companies. “Can you believe that C-sections and domestic violence are pre-existing conditions?” she asked, incredulously.

A caller from St. Louis asked about the proposed cuts to Medicare and Medicaid. Ms. Pelosi said they were going to eliminate the waste, fraud and abuse” in Medicare and Medicaid. She said these efficiencies would extend Medicare solvency by another five years. She quoted the AARP as saying the changes to Medicare would make Medicare more efficient.

Throughout the call, Ms. Pelosi talked about the proposed health insurance exchange. “Reform must take place in the exchange… A public option should be in the exchange.” There will be assistance for individuals (and families, I think) making up to 400% FPL and small businesses to purchase health insurance through the exchange.

After nearly every caller, Ms. Pelosi said, “Keep watching what we’re doing. Hold us accountable.” She said the final House bill she be done within a week or two. It will be posted online at least 72 hours before debate begins on the House floor so look for that.

This was a great opportunity to be a part of this conference call so thank you, BlogHer!

Note: This was written off my notes from the conference call. Actual quotes on the transcript on Blogher.com may be slightly different.

Is Health Care a Privilege or a Right?

I recently watched this intriguing video on health care reform (via CrissWrites.com) which raises the question: Is health care a privilege or a right in this country?

If health care is a right, like the right to free speech or the right to bring a loaded firearm to a presidential town hall, then doesn’t the government have an obligation to help every American get access to quality, affordable health care?

If it is a right, is the government obligated to guarantee quality health care for every citizen?

I think so.

There is no reason why an American should die because she cannot afford quality health care, whether that’s a Pap smear, seizure medication, chemotherapy or prenatal care.

On Friday, First Lady Michelle Obama eloquently made the case that health care is a woman’s issue. She’s right, of course. The health care sob stories always seem to be about women: someone with MS who can no longer work and is about to lose her house because she can’t pay the mortgage; a woman with breast cancer who is facing bankruptcy despite working full-time and having insurance; a woman who works two jobs and simply cannot afford insurance.

Sometimes I wonder whether we would still be debating the need for universal health care at all if these stories were about fifty-year-old (white) men not being able to afford their cholesterol medicine.

Or Viagra.

I Can Live Without a Public Option

I can live without a public option. I can’t live without health care reform. I understand the argument for a strong public option. A government-run insurance plan wouldn’t have the high overhead that private plans do. The American public’s need for quality health insurance that can’t be denied if you have a pre-existing condition or cancelled if you get sick is not being met in our current system and far too many are going without health insurance and indeed, health care.

A public plan, crafted in Congress and based on the needs of consumers, not the bottom line of for-profit insurance companies, has the potential to transform our health care system in ways we probably cannot imagine right now.

But the reality is that change is hard and I don’t want a repeat of the Clinton health care debacle. I am willing to settle for some health care reform, even without a public option, rather than no reform at all. I want as many people to have health insurance as possible. It’s especially important for women.

Seventeen million women have no health insurance at all. Millions more are underinsured. They are not just statistics. In the past three weeks alone, I have learned that two friends of mine are currently without health insurance. One is a young woman in her twenties who changed jobs over the summer. She is currently without health insurance as her old policy ran out and the new policy doesn’t kick in for another month.

My other friend is a married mother of two who owns a small business that employs half a dozen people. Her husband works full-time but doesn’t get insurance through his job and she can’t afford to provide insurance for herself or her employees.

There are also nearly ten million women on Medicaid. As some of you know, I am one of those women. I talk about it a lot because Medicaid is a government-run insurance program (aka Socialized Medicine) and I think it’s important to put a human face on what this Evil Descent Into Fascism really looks like.

Beyond all the rhetoric, what’s really important is this: Without health insurance, you can’t get health care. Going without health care? That’s playing Russian roulette. Just ask Heather Sherba, who was injured in the recent Pittsburgh gym shooting. A recent college graduate, Ms. Sherba thought she was healthy enough to go without health insurance until she found a job.

Um… yeah.

This might be naïve, but I don’t honestly care how we achieve health care reform as long as everyone gets quality, affordable health insurance. If a co-op works, fine. If the Wyden-Bennett plan works, fine. If the public option works, I’ll be thrilled

Progressives, please find a way to do this. It’s a life and death thing for people like me and so many others.

Don’t screw it up.

Thank You, Senator Kennedy

When Sen. Kennedy died and the obituaries and memorials started pouring in, I was shocked to learn about the number of laws he had been responsible for. Many of these have transformed my life personally so it seems appropriate to take a moment to say thank you:

Thank you, Senator Kennedy, for the Americans with Disabilities Act. As a person living with a hearing impairment since birth, I will never know how much this act has improved my life.

Thank you, Senator Kennedy, for the Fair Housing Act Amendments of 1988 (FHA) which extended the Fair Housing Act of 1968 to include people with disabilities and families with children. Looking back, the FHA and the ADA were probably the laws that required the residence hall staff at my alma mater, Minnesota State University, Mankato, to install visual fire alarms in my dorm room. (Because of my hearing impairment, I can’t a fire alarm when I’m asleep with my hearing aids out, therefore I need a visual cue that all hell is breaking loose.)

Thank you, Senator Kennedy, for the Individuals with Disabilities Education Act, which guaranteed a free and appropriate public education to children with disabilities, regardless of their severity, in all states. Even though I had a severe hearing impairment, I went to public schools and got a great education.

Thank you, Senator Kennedy, for supporting Title IX. I have never known a world where it is not normal for there to be a girls’ track, cross-country, swim, gymnastics, volleyball, basketball or soccer team. Without Title IX, we would not have the WNBA. Without Title IX, I probably wouldn’t know my best friend today, who decided to attend MSU, Mankato partly because of its women’s hockey team.

Thank you, Senator Kennedy, for all of your work on behalf of vocational rehabilitation, student loans, food safety, generic drugs, the list goes on and on. I am humbled when I realize how much of your work affects me on a daily basis.

Most of all, thank you, Senator Kennedy, for your work on behalf of universal health care. Yes, “the work still goes on”, even though you’re not here, but don’t worry: We’ll finish the job. There will be quality, affordable health care for every American.

Thank you, Senator Kennedy, for being a great senator, a great liberal, a great Catholic and a great American.

Thank you, Senator Kennedy. May you rest in peace.

Pleasantly Plump or Pathetically Unhealthy?

I was back at the clinic this morning for another experiment in that Evil Demon known as Socialized Medicine. (Cue the Carmina Burana soundtrack.) I was in the dressing room about to change into the ultra-flattery hospital gown for an ultra-fun test when I looked in the mirror and saw this:

Me looking "pleasantly plump" - and liking it! 8/27/2009

I thought, “Wow, I look really cute. I like how I look in this shirt and these jeans. I like my curves. I look, dare I say it… pleasantly plump?”

I was feeling pretty good about myself when I walked out to the small waiting area. Well, that is until I noticed the story on the morning talk show (I think it was the Today Show). The perky, skinny host and guest were talking about how important it is to reduce inches around our middle sections to reduce our risk for heart disease and other fun afflictions.

What the hell, universe? I couldn’t have even one moment of feeling good about myself without being reminded I’m an unhealthy pig?

I guess the larger question is, what is the balance between striving for better health and still maintaining a good self-esteem? How does the media educate the public on prevention and wellness and not make us hate ourselves at the same time?

I don’t have any answers. In fact, after my appointment, I decided to give the cosmos a ginormous “Screw You!” and headed to McDonalds for an Egg McMuffin meal. With a Diet Coke, of course.

The local Mickey D's - 8/27/2009

Socialized Medicine is the Devil's Handiwork

I’m on Medicaid. I have no problems admitting this or talking about it in public. In fact, I’ve done it three times now: in a local TV interview, at an Organizing For America-sponsored health care rally and at Rep. Steve Kagen’s recent town hall on health care.

Medicaid is socialized medicine. A short description from the federal Centers for Medicare and Medicaid Services:

Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers.

Depending on state law, you might also have a co-pay. I don’t know how it is in other states but Medicaid in Wisconsin is excellent. It is there for people who need it, like me. Within a few weeks of becoming paralyzed in 2005, I applied for Medicaid. I was approved within a month. Medicaid retroactively covered my hospital expenses from the date of my application. It paid for two full weeks of inpatient rehab more than United Health Care had authorized. Those two weeks may be the reason I am walking today.

United Health Care had said I could have 20 outpatient physical therapy sessions and 20 outpatient occupational therapy sessions. Medicaid didn’t set a limit. I went to occupation therapy twice a week for five months and have regained all function in my hands. At one time, they were completely paralyzed. I went to physical therapy for eleven months and am walking normally again. At one time, I was a quadriplegic.

That’s not to say Medicaid just writes a blank check. The first year I was home from the hospital was a difficult one. My mom, who was my primary caregiver at the time, and I ran into a lot of problems related to my care we didn’t know how to handle, often late at night or on the weekends. After I ended up in the ER more than 10 times in less than a year, I received a letter from the state Medicaid agency saying I had reached my limit for ER visits. They gave me the names and numbers of my doctors (internist, neurologist, rehab specialist) that I should see instead of going to the ER.

I was thinking about all of this this past Monday. The regular clinic I go to is usually booked weeks (sometimes months) in advance so they have set up an urgent care clinic adjacent to the ER. This is a walk-in clinic; first-come, first-served. It is staffed by physicians’ assistants and doctors and I believe they charge the same as a regular clinic visit.

So Monday – I had been sick for a few days. I knew I’d never get an appointment with my regular doctor so I went to the walk-in clinic. I registered at the desk, where they confirmed my personal data, including my insurance, the “Forward card.” (Wisconsin had so many names for Medicaid it’s ridiculous – Medicaid, Medical Assistance, EDS, Forward Card, Title XIX).

The clerk told me I could have a seat. A few minutes later, a nurse called me into the triage area to take my vitals. After that was done, I went back to the waiting area. About five minutes later, they called me to go back to the exam room. Long story short: the entire exercise in socialized medicine, including the PA pulling up my records online, waiting for the lab work to come and having my prescription filled at the pharmacy (co-pay $1) took about an hour and a half.

Medicaid is socialized medicine. It is not evil. There is a place for it in our society. As for “government takeover of health care”, that’s ridiculous. The government had no role in my health care on Monday, except to pay the bill. They didn’t choose the clinic or physician’s assistant I saw. I could have gone to the other clinic in town. They didn’t tell her which drug to prescribe. She chose the one that was most appropriate for me, although the pharmacy did substitute a generic.

Prior to my enrolling in Medicaid, I had been on Blue Cross/Blue Shield or United Health Care plans for most of my life. The insurance chose which networks of doctors I could see. Medicaid does not do that. Doctors may choose not to participate in Medicaid but there aren’t many who do so. The insurance companies also had lists of drugs they would cover or not cover.

Rationing and government takeover on health care? Please. It’s far more likely to happen with private insurance and we all know it. Is this really about health care or is it about a few hundred Republicans’ job security?

When 14,000 people lose their health insurance every day, that seems incredibly selfish.

Kagen Town Hall: The "Illegals" Are Coming!

Rep. Steve Kagen (D-WI) answering questions at town hall in Minocqua, WI, on August 19, 2009

This morning I attended Congressman Steve Kagen’s health care town hall in Minocqua, WI. If you watch MSNBC, you’ve probably heard about Kagen’s first two town halls this summer, which were a little contentious. Since then, he’s had a few more town halls which seem to have gone better. In any case, I haven’t heard about them on Maddow or Countdown so progress, right?

Speaking of the divine Ms. Rachel, Dick Armey must still be smarting from the smackdown he got on Meet the Press last weekend. From what I could tell, most people attending were local; FreedomWorks had skipped this party. There were a few people from out of town but Minocqua is a popular tourist destination so that makes sense.

The “tone” was pretty subdued, quiet and respectful. I think this is partly due to the location. The event was held at the Campanile Center, which used to be a Catholic Church. It was kind of neat; on the quarter hour, somehow they got the bell-player-music-people to play patriotic music instead of the regular chimes. Coolio. (I can’t pull that off, can I? Shucks.)

The church (once a Catholic church, always a Catholic church) was about 75% full and rough half and half men and women, although probably a few more men than women. 90% were over 60 years old. I think I was the youngest person there. The town hall lasted for about an hour and 45 minutes and old men dominated the conversation. Only four men under 60 and five women (including me) total got to ask questions.

The great majority of the old men, except one or two, were opposed to health care reform. Strangely enough, they seemed to be more worried about the “illegals” getting free health care rather than the rising costs of health care, the millions who are uninsured or even the national debt.

One of my favorite questions/comments came from a gentleman who said “illegals” are 40% of the 47 million people without health insurance. He mistakenly believed the “illegals” would be covered under health care reform. “How can you support that?” he asked the congressman. Kagen replied, “I disagree with your numbers.” He said 2/3 of the uninsured are working families. When the man said health care reform is “going to raise our taxes,” Kagen had a very simple answer for him: “That’s not true.”

Another man said, “The government says we can’t round up all the illegals… When they come [for free care] why can’t they get picked up right then and there?”

A third attributed all the problems in our prisons, schools and health care systems to the “illegals”. A recurring theme was that if we just get rid of the ‘”illegals” problem, America would be hunky-dory. I had to laugh when I heard the guy behind me mutter, “If you deport everybody, you’ll have to pick your own tomatoes.”

Many people were upset about the “government takeover” of health care. As one guy (probably in his 30s) put it, “No matter [what you call it], it’s still socialized medicine.” Kagen tried to make the case for health care, but he wasn’t especially convincing. If I had been against health care reform, I don’t think he would have changed my mind. This may be due to his personality and demeanor. He seems to be quiet, polite and respectful, but I can’t see him doing the big stump speeches, rallying the crowds in a “Yes, we can” style.

Kagen said health care-related debt contributes to 2/3 of bankruptcies in northeastern Wisconsin, his district. A constituent disputed Kagen’s statistics. Instead, the man attributed a significant portion of bankruptcies to predatory lending by mortgage giants like AIG. Kagen’s reply? “I got my numbers from the (local) courthouse.”

(Genius. This is Wisconsin, not New Jersey. Except for Madison and Milwaukee, we all live in relatively smaller communities and most of us probably know someone who works for the state or local government. It’s much harder to say government is corrupt when it has a human face: your family, friends, neighbors, etc. So that knocked the wind out of the bankruptcy argument.)

After a particularly boneheaded rant against socialized medicine, I walked up to the front of the church, introduced myself and said,

“With Governor Doyle not running for re-election, we don’t know who the next governor will be and we don’t know what their priorities will be. We don’t know if they’ll keep funding BadgerCare and Medicaid at the current levels. So my question for you is, do you support the public option?”

And then Kagen hedged. He wouldn’t commit to the public option. Here’s the bottom line on Steve Kagen: He wants health care and health insurance reform. That doesn’t necessarily mean a public option. He repeatedly referred to a plan “whether you call it a public option or a co-op or something else”. He wants more investments in prevention. He wants medical providers to openly disclosure fees for all services.

My sense is that he wants a non-profit insurance plan that would be able to put patients’ needs ahead of profit. I don’t think Kagen really cares if it’s the public option, co-op or something like the Wyden-Bennett bill (if that had the necessary protections for patients).

I left feeling like Steve Kagen is an incredibly decent man. I briefly told my story and his eyes kind of popped out. (I had a spinal cord injury 4 years ago and I’ve recovered for the most part). He repeatedly told people he appreciated their comments or questions, even when they were belligerent or stupid. (Those are my words, not his.) He was assertive enough to correct people when they were wrong. By my count, this was his fifth town hall this month. If today’s event was one of the “good” ones, he must really be committed to communicating with his constituents about health care. In contrast, Dave Obey has yet to schedule a single town hall.

There’s lots more to tell about the town hall but it’ll have to wait for tomorrow when I can think clearly again.

Re: public option – I'm so mad I could spit

I woke up this morning at 5:00 AM, two hours before my alarm was set to go off and couldn’t fall back asleep. Why? I am so furious about the supposed demise of the public option I could spit, or scream or both. I don’t care if it’s not lady-like. It’s true.

Why the hell is the public option even up for negotiation? How many times have we heard President Obama say he wants a “uniquely American solution” to the health care crisis? I understand not wanting to dismantle the health insurance industry, if only because of the hundreds of thousands (millions?) of people it employs. Still, the health insurance industry is currently failing at least 46 million people who don’t have insurance. Those are the ones we know about. Then there are the underinsured. Don’t forget the illegal immigrants who emergency, stabilizing treatment in emergency rooms, which hospitals are required to do and adds to all of our health care bills. (Not mine, obviously. I’m one of those “socialized medicine” Medicaid leeches. Yes, I’m that furious today. The sarcasm meter has been broken it’s so high. It’s either that or just have this entire post be a string of @#%&*(!)

Her’s what Howard Fineman had to say about Obama appearing to back away from the public option last night on Countdown:

“My sense of it is, and it has been for a long time, even going back to the rhetoric on the campaign, that Barack Obama has been much more interested in the idea of universality and in making history that way than in the public option, per se”

Thankfully, the fight doesn’t appear to be over. Speaker of the House Nancy Pelosi and Senators Russ Feingold and Jay Rockefeller all pushed back in a Washington Post article this morning. Rep. Anthony Weiner has been on the offensive over the last 24 hours. Finally, this morning, the White House seems to gotten their act together – sort of. From Thehill.com:

Gibbs reiterated that the president’s preference to create competition and quality in health insurance is through a public option, but Obama is willing to listen to other ideas that would achieve the same outcome.

I’m not asking for a handout. In fact, just the opposite. I’m asking for help in getting off Medicaid, off the government programs. I want to be self-sufficient. I want to buy my own insurance.

Why is this so @#$!@%! difficult?