A few years ago, I wrote about how I didn’t think that traditional organizing wasn’t politically effective anymore, and that coalitions – teaming up with stakeholders to achieve a common goal, even if you weren’t a big fan of your partners – were the way to move forward. Coalition-building makes for some strange bedfellows.
I still believe that, even as the current administration challenges every aspect of healthcare infrastructure, at both private and public levels. Could make for even stranger bedfellows.
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If you watch TV with commercials, it is impossible to avoid the Zocdoc ads, especially during flu season. In theory, Zocdoc is a great idea. I always thought finding a clinician who works for you is sort of like dating. It’s as much about matching with their personality as it is evaluating their skills.
And much like dating it can take a lot of tries to find a good one. Zocdoc has set itself up as the tool to make the process easier.
Except…
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A few months ago, I had planned to do a series of posts talking about how this administration was hurting healthcare, specifically children. But it seemed like every other day – no, every other hour – there was another ridiculous policy or proposal. I had to step away from the news to spare my own sanity.
But there is one thing I can’t afford to step away from. None of us can.
Medicaid.
Every organization I am associated with is talking about how to mitigate planned cuts to Medicaid. It would be catastrophically damaging to implement most of what is in the latest House bill, including some pretty steep impacts to state budgets, since cuts to federal funding will have to be made up as much as possible by the states. But today, I am not going to talk about impacts. Lots of people are doing that, and you can find the whole story with a quick Google or AI search (Just make sure you check that the source of your information is legit).
Instead, I want to talk about the program itself.
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Way back before I was born, as the media and marketing was in their adolescence, Canadian communications theorist Marshall McLuhan coined the phrase, “The medium is the message.” He argued that in communication, the way a message is delivered is just as, if not more, important as the message itself. (Got that from one of my favorite college courses on journalism and politics.)
As with many theories, this one has a broader application beyond the general rules of communication. For our purposes, I would say it is particularly true in healthcare. We already know that trust is a factor in getting messages out and reaching populations that fundamentally don’t trust the healthcare systems. It’s why community health centers are such a good idea and why healthcare professionals often seek to enlist help from religious and community leaders.
But it is bigger than that.
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I knew 2025 was going to be bad. (I feel like that could be my “Once upon a time” line for this year.) We all braced for it, but we couldn’t have known how quickly everything would start to feel like it was unraveling. And that’s just the macro environment – politics, economy, foreign relations.
I did not know that 2025 was going to be bad on a personal level. Since Christmas (close enough to count as 2025), my circle of friends has been hit by the loss of four human loved ones, two and a half beloved pets (the third pet is recovering from a serious stroke), and a near successful suicide-attempt. It has only been three months.
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I don’t have kids, for a lot of reasons. One of the biggest is that, with all my conditions, I just didn’t have the energy a kid would require. It wouldn’t be fair to anyone involved if I brought a child into the world without the capacity to give them the necessary attention.
That doesn’t mean I don’t have incredibly close and rewarding relationships with several kids, especially the ones in my own family. In fact, I just got back from a kid birthday trip. And to come home to the news that a school aged child had died of measles hit hard.
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Guilt, shame, and fear are what I think of as the patient emotional trifecta. Shame is the stigma that often comes with our conditions. Fear is the constant state of wondering when the next shoe will drop and what your future will look like as your condition progresses. But the guilt. The guilt is more complicated.
Back when I was diagnosed, fear was a common motivator applied to patients to keep us on our recommended regimen, whether that regimen fit us or not. But even without using fear as a tool, there is a higher level of awareness of what could happen if we don’t stick closely to the “right” treatment plans. If we step off the prescribed path and we get worse, we tend to tie our worsening symptoms directly to our “misbehavior.”
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Mom always said you can’t help how you feel.
This is true. Our emotions stem from our experiences, both past and present. We can channel them. We can work on how we respond to them. We can subdue them. (I don’t recommend that last one.)
But we can’t make ourselves feel happy when our ex announces their engagement to someone else if that’s not how we feel about it.
The last several days have been emotionally, um, precarious?
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I have a confession to make. It’s been almost a year since I saw most of my doctors. That is the longest I’ve gone since my 1991 diabetes diagnosis.
Why?
Lack of mobility – it was a while between when my car died and I got a new one, and my chronic nausea turns into debilitating motion sickness when I am not driving. Ride shares have to be limited based on how long the trip will be, and even then, I carry saltines, water, and hard candy with me.
OK, that’s only partly true.
I didn’t really want to see any doctors after my surgeries last year, so after I cancelled a few that were scheduled during the short recovery period, I just never bothered to reschedule.
Essentially, I used surgery as an excuse to cancel reasons to leave my apartment.
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I am an all-or-nothing kind of person. A lot of us are. It has its pluses and minuses. I can be very driven about the things I want to achieve. That’s good. But for the things I know are necessary but not what I want to do, I fall into Newton’s first law of motion – I am an object at rest that isn’t going to be anything but at rest. That’s not good.
The reality is that there is very little black and white in the world. Most of it is shades of gray, but I just don’t think like that. Add my tendency to have my feet on the figurative gas pedal and the brake at the same time, and you have the ideal setup for failure.
Of course, this hits the hardest for me with exercise. Because it’s me. I hate it, especially cardio, which works like magic on blood sugars. And maybe food logging, which (to paraphrase 10 Things I Hate About You) I hate with the power of a thousand suns.
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