This episode celebrates the science fiction drama Orphan Black (BBC America) which ended in the summer of 2017 with their fifth and final season. Alice talks with superfans Maelee Johnson and Rebecca Cokley about eugenics, autonomy, technology, reproductive justice, feminism, and how the show resonates with them as disabled women.
An oppressive winter has finally given way to the happiness of spring. Pretty flowers are in bloom and the bare trees promise to be in leaf again. As I walk into the weekend round, I feel happy for my patients who might be discharged, or simply set foot outdoors.
“You can go home!”, I congratulate my first patient.
“Don’t rush, love”, he replies, and I think after two weeks as an inpatient, he is joking. Who likes hospitals?
Then I remember. He is the widower with the always busy daughter. He talks about her loyally, but also with a finality. “She is not the type to drop by.”
In August, The New York Times published a guest op-ed by a man named David Roberts who suffered from severe chronic pain for many years before finally finding relief. The piece immediately went viral, with distinguished news journalist and personality Dan Rather posting it to his Facebook page with the addendum that it could “offer hope” to some pain patients. However, for many of us in the chronic pain community, particularly women, the piece was regarded with weariness and frustration.
Consider this: women in pain are much more likely than men to receive prescriptions for sedatives, rather than pain medication, for their ailments. One study even showed women who received coronary bypass surgery were only half as likely to be prescribed painkillers, as compared to men who had undergone the same procedure. We wait an average of 65 minutes before receiving an analgesic for acute abdominal pain in the ER in the United States, while men wait only 49 minutes.
These gender biases in our medical system can have serious and sometimes fatal repercussions. For instance, a 2000 study published in The New England Journal of Medicinefound that women are seven times more likely than men to be misdiagnosed and discharged in the middle of having a heart attack. Why? Because the medical concepts of most diseases are based on understandings of male physiology, and women have altogether different symptoms than men when having a heart attack.
Yesterday, the Trump administration dealt a one-two punch to the Affordable Care Act’s health insurance marketplaces and the Americans who buy their health plans through them. The first blow was an executive order to federal agencies to write new regulations that would allow the sale of insurance products that skirt the ACA’s consumer protections. This change could leave millions of people either exposed to high health care costs or much higher premiums, and could lead to significant market instability. The second punch, which goes into effect immediately, is the administration’s decision to end payments to insurers for the ACA’s cost-sharing reductions (CSRs), which lower deductibles and other cost-sharing for lower- and moderate-income families.
The second punch has the power to be a knockout, triggering premium spikes and ultimately a mass exit of insurers from the marketplaces by 2019. Congress could effectively block the punch today by making a formal appropriation for the payments. Since insurers are required by law to offer the CSRs and the federal government is required to reimburse insurers for them, the Congressional Budget Office (CBO) has already assumed the cost of the CSRs in the federal budget baseline. This means that the appropriation is a formality: it would not increase the federal deficit. Senators Lamar Alexander and Patty Murray held hearings on stabilizing the marketplaces in September, with the CSR appropriation being the central policy proposal. Nearly all expert testimony supported making the appropriation.
More than 1 million Americans await a hearing to see whether they qualify for disability benefits from Social Security, with the average wait nearly two years -- longer than some of them will live.
All have been denied benefits at least once, as most applications are initially rejected. But in a system where the outcome of a case often depends on who decides it, most people who complete the appeals process will eventually win benefits. The numbers come from data compiled by the Social Security Administration.
About 10.5 million people get disability benefits from Social Security. An additional 8 million get disability benefits from Supplemental Security Income, the disability program for poor people who don't qualify for Social Security. The disability programs are much smaller than Social Security's giant retirement program. Still, the agency paid out $197 billion in disability payments last year.
Recipients won't get rich as the average benefit is $1,037 a month -- too small to lift a family of two out of poverty.
For some, the benefits come too late.
Chris Hoffman worked as a mason, laying bricks and tile and pouring concrete. He had terrible back pain for much of his life, but he kept working until a series of heart attacks. He applied for Social Security disability benefits in 2014 but was denied. He appealed to an administrative law judge.