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First, the humor -

Recently, unless one was living under a rock, the Republican jihad against "Obamacare" reached both a fever pitch and climbed to ridiculous heights of lunacy and sheer stupidity. This played out on TV and radio and in all forms of American media. The same GOP talking points repeated over and over.

Monday, at my relatively new part-time gig working for a behavioral health service, I was doing a group with my usual clients: all severely mentally ill, poor, and on SSDI. And I mean truly poor. And truly sick.

And they were completely addled about the ongoing talk of 'shutting down the government because Obamacare'.

One lady, who is rather bright, kept repeating this to herself and to me and the group - "If Obama care goes through the government will shut down - does this mean I won't get my check?". All she has is that check so, yeah, she worries about it.

The INCESSANT HAMMERING of the issue on radio and TV drove her to a new level of anxiety and she had voices in her head repeating it and she was continually asking for reassurance.

The group launched in to complaints about the GOP without my initial help and I couldn't resist fanning the flames. I also told them about 'sabre-rattling" and encouraged them to take deep breaths and not burst into flames worrying about this.

But it is very hard for them when it is all they hear on the TV.

After that group and my challenging them to a simple wager ("I'll bet you the government won't shut down") the lady told me she felt some reassurance.

Then Calgary Cruz went into his now much-lampooned "faux-libuster" and had the good judgement to read from Dr. Suess and the Cat in the Hat.

I followed up with that lady Wednesday morning, pulled her aside and explained the filibuster and what Cruz had done with reading Dr. Suess. It took her a moment and she asked a couple questions and a smile crept across her face: "You're kidding!" she exclaimed.

"Nope", I said "I couldn't make that up". She laughed.

"And they call me mental" she cackled.

I followed up with her today and told her about the New York Times article reporting the government won't be getting shut down:

The Senate on Wednesday moved toward approving legislation to keep the government open without gutting the health care law after Senator Ted Cruz’s 21-hour-and-19-minute verbal assault on it ended with a 100-to-0 vote that is likely to lead to an outcome that Mr. Cruz had tried to stop.
She asked again about the "Dr. Suess thing" as if it seemed incredible to her.

It IS incredible. She said "that's so crazy!".

Later at lunch time she talked about it some more and other clients heard about this so I explained the whole mess to them (all 'mentally-ill, remember) to howls of laughter.

And some were reassured because many of them have been addled by the incessant talk of shutdown and a fear they won't get their checks.

If they don't get their check, they can't pay rent, they can't pay for their Medicare premiums, can't get meds or cigarettes. Their tenuous worlds fall apart. A full third of them would likely end up in the hospital. Etc... etc... etc...

Now the serious question:

I talked with a young lady today, diagnosed with schizophrenia, paranoid type, she has a history of homelessness and she has a severe limp that is just painful to watch. I offered to talk to her in an area of the lobby today to circumvent the onerous walk to my office but she insisted it was ok.

In my office I asked about this limp, because it seems loike she has  some painful thing (like a sore) on the bottom of her foot. She explained that 'about 10 years ago' she had surgery on her ankle and 'they put a screw in my ankle to help fix what was wrong and that limits my ability to flex my foot." Long story short, she said she is supposed to have another surgery to remove the screw but has never been remotely able to afford it.

My question is will situations like hers have any increased potential to be addressed after tyranny falls upon us the ACA goes online?

Honestly, I have no clue and wonder what the ACA means for the people I work with.

I also spent nearly an hour and twenty minutes calling around to different charities and providers seeking a 10-day interim prescription for another lady whose Medicare Part whatever seems to have crashed leaving her without prescription coverage, causing her to now be without medication that prevents seizures and helps her major depression.

It's been a goose chase and the only thing we could ferret out was to send her to a local hospital with an indigent program to the the ER thing in hopes of preventing her from being hospitalized. 10 days of meds would cost about $200, 3 days of psych hospitalization probably 10 times that. It seems so needless.

Does anybody have any idea if ACA will make any of this a little better ?

Answers will be relayed to my clients on Monday.


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