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copyright © 2008 Betsy L. Angert.

Teresa Madison forlorn and torn by life's dilemmas contemplates a reality she never considered before.  Death by one's own hand may be the latest and greatest in preventative medicine.  Suicide can be a cure for what ails a person, or at least many have come to believe this is so.  In her age group, more people deliberately take their lives.  Only months ago, Ms Madison perused an article that appeared in The New York Times; Midlife Suicide Rises, Puzzling Researchers. Teresa was not perplexed.

Ms Madison knows to her core society is consumed with ills.  Physical, mental, emotional, financial woes, and a sense of finality overwhelm individuals in the United States.  Teresa feels heaviness in her heart when she opens her mailbox and sees the bills.  Her empty pocketbook cannot ease her pain.  Nor does it alleviate the aches her family feels.

Ms Madison hears people speak of hope for the future.  Countless say change is on the horizon.  Yet, in this election year, this workingwoman does believe the solutions offered are realistic.  She listens to the rhetoric and recognizes the aspirants do not feel the common peoples' pain.

Each of the candidates speaks of the current financial crisis and foreclosures.  Health Care is also an issue.  The Democratic Presidential hopefuls promise Universal Health Care.  Yet, none of the possible nominees propose a Single Payer not for Profit  plan.  Each candidate expects Americans to pay for the insurance they desperately need.  The cost of coverage may be reduced; nonetheless, citizens will be required to pay for the policies.  A Choice Plan may claim to make Health Insurance more accessible; however, those who work and struggle to meet medical expenses understand this strategy will not serve them well.  A Plan for a "Healthy America," provides little comfort for those who are not fit and already feel the pain of being a bit too affluent to qualify for assistance.  "Potabilty" while a wondrous concept is not practical for a person who is uninsured, underinsured, or who can barely benefit from policies that exist.

Perhaps, Americans will not need adequate coverage in the future.  If the country continues to experience an economic downturn, people may just choose to end it all.  Some may sing the song, "Suicide is painless," as they pull the trigger, pop the pills, or inhale toxic fumes.

Historically, research shows, rates of depression and suicide tend to climb during times of economic tumult.

In an article published in 2005 by Cambridge University Press, researchers compared suicide data in Australia from January 1968 through August 2002 with economic problems such as unemployment and mortgage interest rates.  The study found that economic trends are closely associated with suicide risk, with men showing a heightened risk of suicide in the face of economic adversity.

"For some people, suicide is the rational option when they see no future," says Ken Siegel, a psychologist in Beverly Hills.  "One's house is very much a projection of one's self.  To have a home taken away is tantamount to having part of yourself taken away.  There is embarrassment.  For many, it's overwhelmingly unconquerable."

In the most severe cases . . . authorities have linked suicides with the financial stress of foreclosures. . .

"Suicides are very much tied to the economy," says Kathleen Hall, founder and CEO of The Stress Institute in Atlanta.  "It's a public-health issue."

Teresa works as a Realtor; she has for more than three decades.  Ms Madison is well aware of how the housing market affects families.  She read the report, Foreclosures Take an Emotional Toll on Homeowners,  and  thought  how true the words were.  Teresa Madison saw the housing bubble as it floated through the hills of Southern California.  At the time, admittedly, she too was overcome with joy as the ethereal enthusiasm drifted through the air.  Only a few short years ago, Teresa was as most in the Golden State were, elated as the equity in homes rose.  For Ms Madison, the higher prices meant greater income, certain security, and a sense of stability, or at least that was her hope.  When the housing bubble burst so too did Teresa's.  Now, as Teresa Madison skims through the pages of classified advertisements in search of another job, she sees the headlines Foreclosures skyrocket 65% in April, and she thinks of   how this will  further her  dilemma.  How will she  be  able  to  pay  her  medical bills.

Although vibrant, Teresa Madison is aware of the fact that a serious illness could devastate, even destroy her.  The middle age white woman, while successful in her work was never able to save as she had thought she might.  Teresa was not a compulsive shopper as her dear friend Silvia is.  Strapped with debt, Silvia slit her throat and every other part of her body.  Depression or the drugs her physician prescribed almost did Silva in.  While others may think Teresa has reason to resort to drastic measure, Ms Madison never would.  Her faith in the Lord and her love for her family sustains her.  

Teresa has two children that need her.  Her daughters are adults now, and one would presume they could take care of themselves.  However, Tammy needs more than merely emotional support.  She needs someone to take her from doctor's appointment to surgeries.  Trips to the drug store are numerous and while Tammy drives, she is not always able to get into her automobile and travel from home to the pharmacy.  Movement is not easy, although Teresa daughter tries.  Mostly, Miss Madison cries out in pain.  Much of her distress is caused by guilt.  The rest is all too real.

Tammy had tumors as a child; one was in her brain.  Her thyroid was also a concern.  Ultimately, the gland was totally removed.  The younger woman is affected by other illnesses.  None are observable in a casual exchange.  However, health issues are omnipresent in the younger woman's day.  Nights are not better.  Indeed, as the sky grows dark, so too does Tammy's demeanor.

The medication necessary for survival slowly took Tammy's life.  The girl, now near forty still breathes, and mentally, she is extremely active.  However, with each twinge Tammy twists and turns.  Her every moment is as torture.

As a lass, Tammy was told the drugs she needed would add pounds to her posterior.  Her legs and arms would swell.  The small frame she once had would be forced to carry quite a load.  She did not imagine what would actually occur.  

Serious weight gain placed pressure on Tammy's spine.  Today, the vertebrae break easily and often.  Stress fractures fill the severely ill woman's medical files.

Excessive amounts of cortisol have helped Tammy to exist.  Yet, the side effects have lessened her quality of life.  Her teeth deteriorated.  Recently, they were all pulled.  Dentures are in Tammy's near future.  Before her fortieth birth date, she will be fitted with porcelain plates.  Might Tammy or her Mom find a better policy to cover the burgeoning costs?  Is this family underinsured?  Perhaps, but most, if not all insurers consider preexisting conditions.  Pre, post, present . . .

Tammy circumstances have been a constant in Teresa's life.  She works and worries how will she continue too pay the price.  Hospital invoices pour in, just as they did when times were good.  Even when Ms Madison's earnings were greater, she was never able to afford a home.  She helped others buy beautiful abodes and sell these stately properties.  Still Teresa could never save enough to secure a down payment.  Frugal as she is financial stability has escaped Teresa Madison.

Since the subprime mortgage meltdown altered her ability to make money, Teresa has fallen behind in her rent.  A landlord who loved her, and whose house Teresa and Tammy had lived in for more than a decade finally insisted the Madison's must move.  Teresa was grateful; the owner of the property considered all the upgrades Teresa had done and subtracted the cost from the amount owed.

Ms Madison with all her connections was temporarily able to secure another rental apartment; however, the stairs were a problem.  Tammy could not climb these.  A third residence was found.  Still the two women once more were evicted.  No matter how much money Teresa brought in, it never seemed enough.  She was able to stay in a neighborhood that suffered little from the foreclosure catastrophe.  However, Tammy's circumstances and hence the cost worsened.

Days ago, as Teresa pondered what would she do next she read the account . . .

On a brisk day last fall in Prineville, Ore., Raymond and Deanna Donaca faced the unthinkable: They were losing their home to foreclosure and had days to move out.

For more than two decades, the couple had lived in their three-level house, where the elms outside blazed with yellow shades of fall and their four golden retrievers slept in the yard. The town had always been home, with a lazy river and rolling hills dotted by gnarled juniper trees.

Yet just before lunch on Oct. 23, the Donacas closed all their home's doors except the one to the garage and left their 1981 Cadillac Eldorado running. Toxic fumes filled the home. When sheriff's deputies arrived at about 1 p.m., they found the body of Raymond, 71, on the second floor along with three dead dogs. The body of Deanna, 69, was in an upstairs bedroom, close to another dead retriever.

"It is believed that the Donacas committed suicide after attempts to save their home following a foreclosure notice left them believing they had few options," the Crook County Sheriff's Office said in a report.

Teresa Madison reflects on the reality and realizes she cannot cry.  She has shed too many a tear.  Ms Madison is left to ask, how much more can any of us endure.  Foreclosures and health care concerns are only a fraction of what consumes Americans.  Teresa understands her story will not make the nightly news.  Few will ever meet Tammy.  Neither woman can afford to attend fundraisers.  Nor do lobbyists represent Teresa or Tammy.  If either of the Madison women had time or energy to travel to a free rally or a town hall forum the chances that they would be seen or heard are slim.

Teresa and Tammy have heard many platitudes from Pharmaceutical companies, private insurers, and even from politicians.  Each has received pounds of boilerplate letters.  These communiqués explain why Tammy must wait, or why a request for care is denied.  Doctors who have attended to Tammy for decades cannot hasten the process.  Nor are these proficient physicians powerful enough to alter a reality that enslaves them as well.  When talking with many trained professionals in the field of medicine, Teresa hears of their frustration.  

Those who believe in the Hippocratic Oath cannot avoid doing harm, no matter how hard they try to heal the ill and injured that enter their offices.  Current policies preclude a physician from offering authentic and adequate preventative care.  It is just too costly is the conclusion of many.  Others note an investment in prevention ultimately will curtail the initial disbursement.  Moreover, imagine the savings if the sick did not need to continually spend billions of dollars on drugs, diagnosis, and driving from doctor to doctor.  Oh, how Tammy and Teresa would be blissful if they were not led by symptoms and side effects.   The quality of life might have been different if much had been done differently and early on.  At least thoughts of how death might relieve fiscal and physical trauma would have been diminished.

Doctors may not openly speak of how they too suffer when a patient passes or is parallelized by pain,  However, quietly, on occasion, a practitioner may mention how he or she is hurt by the current structure.  Had Tammy been more than a patient, in pain, and only assigned minutes to consult with a specialist, she may have seen the literature.  In 2003, The Journal of the American Medical Association (JAMA) released a Proposal of the Physicians' Working Group for Single-Payer National Health Insurance,  which advocates that American policymakers adopt a truly Universal and not for profit plan.

Some say a Single Payer Not For Profit Health Care system will cause delays, and lessen the quality of treatment.  The Madison's muse how might that be possible.  Each day they wait and wonder, when will the doctor see them.  How many more months will slip away before a surgeon is given permission to perform a necessary operation.

As Teresa and Tammy Madison watch the election coverage, they think of there own.  They too are exposed to much scrutiny.  The Madison must also address the issues.  These two ordinary citizens understand every person has his or her tales to tell.  As Teresa and Tammy sit by the television far from the crowds and the candidates, they ask, 'Will those who aspire to live in the White House ever address what affects the average American?'  

Teresa, who has long trusted in the Lord, continues to "hope" that he will be the agent of "change."  Daughter Tammy, who has also been a person of faith, at times, fears her conviction wanes.  Suicide may not be painless; nonetheless, she trusts she can endure whatever anguish death may bring.  She has withstood life, a broken health care system and an economic structure that causes much distress.  Tammy frequently thinks "yes, she can" live or die.

Scars, Sores, Suicide, and Sources . . .

Originally posted to Bcgntn; BeThink on Wed May 21, 2008 at 10:32 AM PDT.

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Comment Preferences

  •  The sorrow . . . (6+ / 0-)

    . . . of the sick, and the financially strapped affects us all.

    A suicidal system is not painless.

    It is only the giving that makes us what [who] we are. - Ian Anderson. Betsy L. Angert

    by Bcgntn on Wed May 21, 2008 at 10:33:25 AM PDT

    •  really? (2+ / 0-)
      Recommended by:
      DemocracyLover in NYC, mrkvica

      . of the sick, and the financially strapped affects us all.

      I disagree, I think americans have become callous, We step over homeless in the city without blinking, we ignore the Gulf States, we have ignored poor states like WV and so forth for decades.

      Americans are subconsciously taught, if you are poor, you are lazy, unlucky, or brought it on yourself.

      The biggest problem america has had for a while now is lack of empathy.

      •  the effect $40.7 billion and affeect on us all (1+ / 0-)
        Recommended by:
        DemocracyLover in NYC

        Dear dark daze . . .

        Ah, your words while true do not address the more stark affect on those that wish to think only of them$elve$.

        The Cost of Care for the Uninsured:
        What Do We Spend, Who Pays, and What Would Full Coverage Add to Medical Spending?

        Today, there are nearly 44 million Americans without health insurance coverage. A substantial body of research shows that there are serious health and financial consequences associated with being uninsured. Moreover, research shows that leaving a large share of the population without health insurance affects not only those who are uninsured, but also the health and economic wellbeing of the nation. Yet, despite these findings, the number of uninsured Americans continues to grow. Although the national debate over ensuring health coverage for more Americans periodically gains momentum, it then stalls—perhaps in part because not enough is known about both the benefits and the costs of expanding coverage to more, if not all, of the uninsured. . . .

        Uncompensated care is medical care received, but not fully paid for, either out-of-pocket by individuals or by a private or public insurance payer. The cost of unpaid care is estimated by using the benchmark of what would have been paid for the services by private insurance.

        Total medical care expenditures among all of the uninsured in 2004 (including both those without coverage for all or part of the year) are almost $125 billion. Individuals may be without health insurance for long periods of time or for a matter of months. In the survey years (1998-2000) used to project current costs for this analysis, over 60 million were uninsured for either all or part of a year—with just a little over half being uninsured for the full year.

        A third of the medical costs for the uninsured are uncompensated. About a quarter of the total medical care costs are paid directly by the uninsured out-of-pocket, however people who are uninsured for the full year pay for over a third of their care (35%) out-of-pocket—a considerably higher share than paid by either the full-year or part-year insured populations, who paid for just under 20% of their care out-of-pocket.

        In 2004, uncompensated care is estimated to be $40.7 billion. Adults uninsured for the full year receive the
        majority of uncompensated care, $26.3 billion (65% of the total amount).

        Children are less likely to be uninsured and their average health care costs are less than adults as well.

        Uncompensated care represents 2.7% of the projected total personal health care spending for 2004 of $1.5 trillion.

        The primary source of funding for uncompensated care is government dollars. Projected federal, state, and local spending available to pay for the care of the uninsured in 2004 is $34.6 billion—about 85% of the total uncompensated care bill.

        Over two-thirds of government spending for uncompensated care comes from the federal government, most of which goes toward payments to hospitals in the form of disproportionate share hospital (DSH) payments—payments intended to offset losses hospitals incur when large shares of their patients are unable to pay their hospital bills.

        The uninsured who are without coverage for the full year receive about half (55%) of the medical care per person compared to those who have health coverage for the entire year, even after taking uncompensated care into account.

        Per capita medical spending for persons uninsured for the full year in 2004 is $1,629 compared to $2,975 by persons who are insured for the full year. This spending gap holds for both adults ($1,864 compared to $3,653) and children ($802 compared to $1,640).

        Health services research has consistently documented an insurance disparity in access to and use
        of medical services. Compared to persons who have health insurance, the uninsured:
        • receive less preventive care,
        • are diagnosed at more advanced disease states,
        • and once diagnosed, tend to receive less therapeutic care and have higher mortality rates.

        This from Kaiser Commission on Medicaid and the Uninsured
        May 10, 2004

        It is only the giving that makes us what [who] we are. - Ian Anderson. Betsy L. Angert

        by Bcgntn on Wed May 21, 2008 at 11:44:26 AM PDT

        [ Parent ]

  •  Its not easy living in this country. (3+ / 0-)
    Recommended by:
    mrkvica, Bcgntn, dark daze
    •  Amen! (1+ / 0-)
      Recommended by:

      Dearest environmentalist . . .

      Its not easy living in this country.

      Truer words could not have been spoken.  I thank you for the thought.

      It is only the giving that makes us what [who] we are. - Ian Anderson. Betsy L. Angert

      by Bcgntn on Wed May 21, 2008 at 10:53:53 AM PDT

      [ Parent ]

    •  Actually, it is, comparatively speaking. (0+ / 0-)

      All you have to do is turn on the TV news for a few days to see that,  compared to most of the world,  we live like kings in this country.

      Just compare what happened during Katrina to what's happening now in Burma.  The vast majority of Americans had the resources to get out of the way,  and even most of those who didn't were rescued.  The fact that a very small percentage of the potential victims died is considered a national scandal.

      In Burma,  at least 10 times as many people are already dead,  because they didn't have SUVs that they could load up with their most important possessions and drive hundreds of miles away (not that most of them even had enough valuables to fill an SUV,  anyway).  There's no FEMA to bring the survivors trailers (or even tents) to live in while they're rebuilding their mud-floored homes with no electricity or running water.

      There are some people who suffer terrible individual tragedies,  but almost everyone reading this has it pretty damned easy compared to most of the planet.  Maybe you can't afford filet mignon when you go to the supermarket,  but you can be confident that there will be safe-to-eat food there,  and that some part of our elaborate social safety net will make sure that you can get enough of it to survive on.

      •  "terrible individual tragedies" (0+ / 0-)

        Dear Ran Talbott  . . .

        I do not disagree.  Here in America, relatively speaking, we are spoiled.  Each week as I stand in vigil against the war, I watch the cars go by.  Some offer a gesture in accordance with peace.  Others protest my request for love.  All drive by in automobiles, rushing hither and yon.  People drive as though the act is as natural as breathing.

        I contemplate.

        Energy Consumption

        • Though accounting for only 5 percent of the world's population, Americans consume 26 percent of the world's energy. (American Almanac)
        • In 1997, U.S. residents consumed an average of 12,133 kilowatt-hours of electricity each, almost nine times greater than the average for the rest of the world. (Grist Magazine)
        • Worldwide, some 2 billion people are currently without electricity. (U.S. Department of Energy)
        • Total U.S. residential energy consumption is projected to increase 17 percent from 1995 - 2015. (U.S. Energy Information Administration)
        • World energy consumption is expected to increase 40% to 50% by the year 2010, and the global mix of fuels--renewables (18%), nuclear (4%), and fossil (78%) - is projected to remain substantially the same as today; thus global carbon dioxide emissions would also increase 50% to 60%.
        • Among industrialized and developing countries, Canada consumes per capita the most energy in the world, the United Sates ranks second, and Italy consumes the least among industrialized countries.
        • Developing countries use 30% of global energy. Rapid population growth, combined with economic growth, will rapidly increase that percentage in the next 10 years.
        • The World Bank estimates that investments of $1 trillion will be needed in this decade and upwards of $4 trillion during the next 30 years to meet developing countries' electricity needs alone.
        • America uses about 15 times more energy per person than does the typical developing country.
        • Residential appliances, including heating and cooling equipment and water heaters, consume 90% of all energy used in the U.S. residential sector.
        • The United States spends about $440 billion annually for energy. Energy costs U.S. consumers $200 billion and U.S. manufacturers $100 billion annually.

        Perchance, when people fall from higher heights the pain is perceived to be greater.  I do not recall my physics. Does a penny dropped from the top of the Empire State Building hit the ground with greater force than one thrown from the first floor?

        It is only the giving that makes us what [who] we are. - Ian Anderson. Betsy L. Angert

        by Bcgntn on Wed May 21, 2008 at 08:16:41 PM PDT

        [ Parent ]

  •  Economic hardship does not cause depression. (0+ / 0-)

    Economic difficulties may trigger depression, but it is not the underlying cause.

    Any psychologist that says that suicide is a rational response to economic difficulties is one I would avoid.

    Depression is an illness, just like diabetes, cancer.  It is not caused by external things, but how the individual perceives them.  Human thinking can get "sick" just like the rest of the body.  

    •  Causes of Depression (1+ / 0-)
      Recommended by:

      Dear smartcookienyc . . .

      Sorry.  There is no single solitary source. When the brain, body, heart, soul, are involved the source of illness is intertwined.  You cannot separate any aspect.  We are a symbiotic system.  The chicken egg theory applies.  Scientists are uncertain which comes first, the chemical reaction in the brain, body, or the environmental stimulus.  Nonetheless, there seems to be agreement the external does have a substantial effect.

      Causes of Depression

    • Depression has no single cause; often, it results from a combination of things. You may have no idea why depression has struck you.
    • Whatever its cause, depression is not just a state of mind. It is related to physical changes in the brain, and connected to an imbalance of a type of chemical that carries signals in your brain and nerves. These chemicals are called neurotransmitters.
      Some of the more common factors involved in depression are:

    • Family history. Genetics play an important part in depression. It can run in families for generations.
    • Trauma and stress. Things like financial problems, the breakup of a relationship, or the death of a loved one can bring on depression. You can become depressed after changes in your life, like starting a new job, graduating from school, or getting married.
    • Pessimistic personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed. These traits may actually be caused by low-level depression (called dysthymia).
    • Physical conditions. Serious medical conditions like heart disease, cancer, and HIV can contribute to depression, partly because of the physical weakness and stress they bring on. Depression can make medical conditions worse, since it weakens the immune system and can make pain harder to bear. In some cases, depression can be caused by medications used to treat medical conditions.
    • Other psychological disorders. Anxiety disorders, eating disorders, schizophrenia, and (especially) substance abuse often appear along with depression.
    • It is only the giving that makes us what [who] we are. - Ian Anderson. Betsy L. Angert

      by Bcgntn on Wed May 21, 2008 at 12:09:22 PM PDT

      [ Parent ]

    •  I have no psycology schooling, training or (1+ / 0-)
      Recommended by:

      otherwise but can only view this from my own personal experience. Cause or trigger to me is not a big enough distinction. While I don't think a broad brush clear statement can be made, I think it is entirely reasonable to bring this issue up.
      Economic status, most especially in this society is extremely important. Changes in your economic state can dramatically change the perception of yourself and your value as a human being in this society. Your ability to take care of yourself and /or your family... your ability to get help when your self worth begins to slide...those things can make you spiral downward.
      I have wondered how people who were already struggling with their own personal demons (and we all have them) have been coping in a society that values human beings so little. I'm glad to see it at least being discussed.

      ..."For beauty," I replied. "And I for truth,-the two are one; We brethren are"... E. Dickinson

      by peagreen on Wed May 21, 2008 at 12:21:50 PM PDT

      [ Parent ]

      •  Exactly. Perception and interpretation. (1+ / 0-)
        Recommended by:

        "If you are distressed by anything external, the pain is not due to the thing itself but to your own estimate of it; and this you have the power to revoke at any moment."

         --  Marcus Aelius Aurelius

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