Of Two Minds

I stumbled on this documentary about bipolar disorder last night on Amazon Prime, and it is so well done that I didn't even pick up my phone as I watched it. Which says A LOT.

The film follows the lives of four people living with bipolar disorder for over a year and veers off once in a while to profile a handful of others, which I think leaves viewers with a robust understanding of the commonalities bipolar people all deal with but really underscores the fact that no two people's experiences are the same. Some people (like me) have hallucinations, some cut themselves, some find manic episodes to be thrilling, some (like me) find them scary and exhausting, some experience functional depression, some (like me) fall into depression so deep that it's past the point of functioning and therefore safely past the point of being capable of self-harm, some attempt and eventually succeed at suicide, some hate taking meds and even refuse to fill their prescriptions, and some (like me) can never forget how awful it is to be off our meds and therefore take them religiously.

The people profiled are straight, gay and bisexual. Some are religious and some are atheists. Some have money and some are struggling so much that they can't afford their meds and rent and seriously consider leaving the United States for a country that can offer them healthcare. They live in cities all over North America. The documentary really does a deep dive into the environments and experiences that shape the way people manage their mental health—though my only criticism is that there are only three people of color, all of whom are just one-off side interviews, which I think really misses an opportunity to paint a more robust picture of experiences and contexts and cultures and personal decisions.

It's edited deftly to be thorough and intimately informational but not overwhelming. I was left feeling emotionally connected to everyone—to the point that I rooted for all of them but ended up angry at one person and genuinely disliking another.

If you or someone you love is living (or struggling) with bipolar disorder, I highly recommend watching this. It's quite beautiful.

I have a preexisting condition. Rick Santorum doesn't care.

Scamming?

I'm bipolar depressive, and I've been bipolar depressive since long before I was finally diagnosed as such seven years ago. So I definitely, unquestionably have a preexisting condition. And when I learned years ago that because of this I was de facto uninsurable if I lost my job, it terrified me.

And then I lost my job.

Scamming? Thanks to the Affordable Care Act, I can get insurance despite my preexisting condition. My insurance is not subsidized through the ACA marketplace; I pay the hundreds and hundreds of dollars in monthly premiums, the thousand-plus-dollar deductible and the chokingly high co-pays entirely with my own money. I'm on four medications that cost over $1,000 a month. I see a psychiatrist once a month to regulate my meds. I see a kidney specialist every few months to monitor the potentially fatal side effects of my meds.

Scamming? Despite your 9-months-of-payments accusations, Rick, I am faithfully making a full 12 months of payments for a full 12 months of coverage. I SPEND ALMOST HALF MY SALARY FOR COVERAGE ON THE COMBINED ELEMENTS OF MY MEDICAL CARE, WHICH WOULD PROMPTLY BANKRUPT ME AND THEN FORCE TAXPAYERS TO PAY FOR MY EXORBITANT MEDICAL EXPENSES IF YOUR CONGRESSIONAL ILK REPEALED THE AFFORDABLE CARE ACT FOR NO QUANTIFIABLE-AS-OF-YET REASON BEYOND YOUR PARTISAN GRANDSTANDING.

And YOU accuse ME of scamming the system—without a shred of evidence to support your lies, no less. You have a staggering amount of nerve, Rick. A staggering amount of repulsive, hypocritical, selfish, hateful, lying nerve.

YOU are the one who is scamming. You're scamming the religious community with your "faith-based" campaigns to destroy the families of gay people, immigrants and now sick people with preexisting conditions. You're scamming your vast low-information base that looks to you for moral and political guidance on matters regarding public policy, the common good, witnessing for Christ and basic human decency. You're scamming Trump's all-caps FAKE NEWS with your insistence that you bring value to the public dialogue on anything beyond your self-righteous narcissism.

You are a catastrophic moral and intellectual failure as a human being. And that fact is compounded by your desperate attempt to distract the country from your ethical bankruptcy by condemning me and every other taxpaying citizen who is dutifully and faithfully and responsibly managing preexisting conditions through the financially essential and morally right Affordable Care Act, which you—again, without even hinting that you have or are willing to supply a shred of supporting evidence—dismiss in blanket-statement Trump style as "a failure."

There is a reason you have been publicly vilified for well over a decade, Rick. And no feigned persecution complex can exonerate you. You are beyond contempt. You are beyond pillory. You are beyond malice.

And you'd better pray you're never beyond uninsurable.

Pre-existing conditions and the ACA

Before the Affordable Care Act, I was completely uninsurable—no special considerations, no gray areas—if I was unemployed, which I was for over a year before the ACA was enacted ... though I did qualify for relatively expensive COBRA coverage through my former employer that very fortunately filled that time gap.

But COBRA eligibility expires after a fixed time, and without the ACA—and until I could get stabilized enough to hold a job—my expanding schedule of doctor visits and my compounding and perpetually evolving psychotropic prescriptions and my surprise hospital visits would rapidly drain me to bankruptcy and eventually relegate me to living on expensive federal disability coverage.

I now have a job but I'm staying with my ACA-sanctioned plan because it specifically covers the entire network of doctors and specialists and pharmacies and hospitals I've managed to assemble and sign release forms for and ensure are thoroughly and reciprocally sharing my complete medical history. Plus I'm not 100% stable and I'm still—and definitely not without precedent—spooked about becoming unemployed again, and my ACA-sanctioned plan gives me tremendous peace of mind about maintaining a reliable continuation of coverage.

Let me clarify for the sake of precluding any tedious welfare-state arguments that might arise that I am paying the full premiums and co-pays and deductibles for my coverage and am receiving no federal subsidies. U.S. households with incomes between 100% and 400% of the federal poverty level are eligible to receive federal subsidies for policies purchased through the Affordable Care Act exchanges, as they should be. For me, the ACA simply allows me to purchase coverage through a broker or directly from an insurer just like anyone else, with no restrictions or refusals for having a pre-existing condition.

Four weeks ago, I started taking a powerful psychotropic that within a day caused me to black out, slam my head into a tile floor, shred my face with my shattered glasses, bite deep into my upper lip, suffer a concussion and not fully come to until I was holding the side of my face together with a bloody cloth in my sister's car on the way to the emergency room.

We just got the bill for that little adventure, which if I'd still been uninsurable would have struck an immense financial blow. And it doesn't even include the cost of an ambulance since my sister drove me to the hospital. But as this photo shows, my ACA-sanctioned insurance helped save my face, my brain and my finances.

The Affordable Care Act is a vital, grossly overdue federal program that provides medical care and financial protection for millions of citizens in a spectrum of medically and economically challenging situations. Our new president and our newly Republican-controlled congress continue to work noisily and patronizingly and almost belligerently to repeal or dismantle or destroy—or whatever the spin-certified verb du jour is—the Affordable Care Act without providing a consistent or sometimes even plausible justification for their efforts and after months and years of chain-rattling still failing to provide even a shadow of a shred of a consensus—much less a foundational set of proposals over which to negotiate—on what to enact or not to enact in its absence.

The whole exercise stinks of political theater and desperate partisan grandstanding and manipulative demagoguery that cruelly continues to waste time and resources and patience while the health and solvency and even dignity of millions of sometimes desperate citizens and their families and dependents hang in the balance.

And I can personally attest that it's costing our country immeasurably more than just money.