Keeping the homefront maintained


This has been the year for DOING all that we have put off for lack of funds in years past.  We finally got the house releveled, only to find that we have foundation damage and will need to spend about $1000 to get that repaired…but since it’s not an emergency type thing it is waiting til next year.  We got the eaves painted, that’s needed to be done for years, and got gutters put up — it was a good excuse for me to make ready for a rainwater harvesting system also to be put in; I have two barrels of an eventual 8 barrel system already set up.  It also prevents any further damage to the foundation which was caused from NOT having gutters.  I bought the paint to paint the house but it of course started BLOWING as soon as I got it, so that may have to wait for an unseasonably warm day when I am off for me to work on, or may even have to wait until spring.  Today, the neighbor/contractor took down our front steps, as he is pouring the footers for our new deck.  This truly was an emergency — our old steps wobbled BADLY when you went up or down them, and several of the flats on the stairs would simply flip up without notice when you were walking up or down.  The last thing I need is for somebody to fall when the stairs collapse as they’re coming in the front door!

The price for the deck is $2200 which makes me wince, but we are paying cash for this as we have for everything we’ve done this year.  So far we’re at nearly $5000 in maintenance/repair costs, and that doesn’t include my garden beds/soil/etc which can come under the heading of ‘landscaping’ (such as it is, my little redneck garden) or the chickens and coop. All of this I am happy to say we have paid cash for.  It has meant not paying off credit cards and student loans as soon as I would have liked but it DOES mean that the work is done and paid for come hell or high water.  That makes me very satisfied.

One of the first projects for the new year is making a patio of stone and sand/flagstone in the back, and putting latex roof protectant on.  Our roof is 10 years old and while it doesn’t leak, mobile homes don’t exactly have the highest quality shingles on them.  Plus, with the latex roof coating, I get less of the asphalt contaminants in my rainwater.

If TSHTF we are at least moderately prepared with all the big maintenance stuff completed now.

The moral and economic need to ration healthcare.


http://www.lvrj.com/news/34137724.html

This folks is what is coming for the rest of the US.

Remember in my last post about wait times in the ER when I said that the emergency room is the arterial hemorrhage of funds in a hospital?  Well, thanks to COBRA (a federal mandate that all patients must receive a medical evaluation and stabilization regardless of their ability to pay) we can’t shut down services (and a good thing or I’d be out of a job) but tough times are a comin’…

A hospital group I don’t work for but am familiar with from working as a paramedic & transporting patients to has a novel way of putting a tourniquet on their bleeding ER:  they have a doctor working in triage.  Thus, patients get a medical evaluation by a licensed professional, and if they don’t meet ’emergency’ status (urgent but not emergent) they must pay their full copay.  Up front. Before being seen.  You know, they don’t have very many drug seekers at their emergency room doors any more.

Now on to the reason for the title of my post.  Above are some of the economic reasons, partially.  Below will be some of the moral reasons.

I am a paramedic in addition to being a nurse.  I have 15 years of experience in emergency medicine, in everything from extreme rural situations to urban, along with critical care flight experience.  So I think that I have the empirical experience to make some value judgements about how we ration healthcare in this country.

Why do we work trauma codes?  This is when someone is so gravely injured at the scene of an accident that they die.  These people sometimes have an electrical rhythm on the ECG monitor but they almost never live, even with the best care and best most dedicated surgeons.  I can think of only one in 15 years that lived, he was 22 and still had some brain damage; what saved him was being 6 blocks from a trauma center and only having bled out from being stabbed in a bad spot, not having serious injuries.

(DISCLAIMER: ALL BELOW ACCOUNTS HAVE BEEN DISGUISED TO PROTECT PRIVATE INFORMATION. )

There was a patient, two really, from a motorcycle crash recently.  The first patient died on scene but the crew worked him and sent him by helicopter to the hospital.  He ‘lived’ for another several hours including 4 hours in surgery; the other patient had injuries but will live.  The pt who was worked used in the teens of units of blood, forced the closing of a trauma center due to all resources centered on him, and incurred in the hundreds of thousands of dollars of medical treatment, essentially to give false hope to his family.  Why?  Why do we do this?  Even if he made it through surgery he wasn’t going to make it out of the hospital; his age and extent of injuries made that pretty well impossible.  Why do we expend such huge resources on patients who are not going to live??

The second patient was from a long term care facility.  This patient was essentially a vegetable, who coded when the trach got bent and the patient was deprived of oxygen.  So, the patient was worked, gotten back…for what?  Why did we expend such large amounts of resources on someone who had ZERO quality of life to begin with…and still has ZERO when we are done?  This person will still be on a ventilator, will still never wake up, and will live out their days in a bed in a long term care facility.

Third patient was an infant.  Baby was being held in mom’s lap, because parents are illegals and don’t know about car seat laws.  Dad got in an accident, got Tboned, car got spun around and baby was flung from mom’s arms out the window.  Kid had an open skull fracture with brain matter hanging out, also was dead on scene.  This baby got worked anyway, got transported into the trauma facility, and of course died anyway.  Why?  Why did we expend resources on this baby?  Why did we give false hope to the parents that their baby would live?

I know I sound cold and heartless when I write about ‘expending resources’ as though it’s all about money.  Well, realistically, it IS all about money.  Even if we had universal healthcare, there would still need to be a discussion about rationing healthcare.  Who pays for the people who are vegetables living in nursing homes?  You and I, the working taxpayers do.  Who pays for the 97 year old stroke patient who will never get better, who lands in ICU for a month before he dies?  You and I, the working taxpayers do. I personally would rather invest my tax dollars into preventative healthcare for all the uninsured community members I live among.  I personally would rather invest my tax dollars into dental care for those same community members.  I would much rather invest into comprehensive healthcare — universal healthcare if you will — for ALL the children in my neighborhood.  I have seen too many tragedies resulting from the lack of access to basic health and dental care; one of my neighbors died last year from an abcessed tooth.  By the time she was sick enough that her husband insisted on taking her to the emergency room, she was already dying from the abcess.  It had eaten through the skull bone and gotten to her brain.  She left a husband and three kids without her.  Why?  Because she was working, as was her husband, but couldn’t afford health/dental insurance.

I respect peoples’ religious choices even when I don’t agree with them.  However.  There needs to be a realistic discussion about who is going to pay for this stuff when it is unreasonable medically, ethically, morally, and financially to expend the resources needed to keep them ‘alive’ at the expense of the rest of us and our ability to seek and get affordable healthcare.  Not to mention the emotional costs to everyone involved – family, friends, AND staff caring for them.  I personally think that if families want to keep their loved one alive at all costs then it should be on them to shoulder the cost.  People would make much smarter choices about keeping loved ones ‘alive’ if it was a choice between their house or the long term care facility.  Cold hearted?  Yes.  Realistic?  Also yes.  Have I made that choice myself?  You bet.  My mom died at our house.  I refused to allow them to transport her and work her.  They would have, time down and other factors made it an ‘allowable’ choice but I would not submit her to that indignity.  She was never going to come back.  Her long term health condition made that impossible, not to mention her age.  It was awful.  But it was the right choice.

In future years, the high energy ways of extending life and using resources profligately will simply not be possible any more. Thus, our failing economy, and the realities of peaking oil and a lower energy future make this an urgent discussion topic.  We MUST ration healthcare, this is reality.  The questions are:

how do we divide up the ever shrinking pie? I vote for preventative maintenance.

who is more important? I vote for children and otherwise healthy adults, who will continue to contribute if they get timely healthcare.

how do we shift the paradigm?  I suspect that economic realities will do it for us, but personally I would much rather see proactive discussion on this topic.

Edited to add this blog post I came across; he says basically what I do but has lots of links and stats to back up what we’re both saying.  http://bornagainredneck.blogspot.com/2008/02/health-care-rationing-or-worsening.html

Ladies: What are YOU taking with you to Camp TEOTWAWKI?


OK, this post isn’t exactly what many of you were thinking I was going to be writing about.

Yes, I think we all should be stockpiling guns, ammo, water, food, seeds, etc.  But this post is about something near and dear to my heart:  makeup.

I really really really don’t want to give up makeup.  The Egyptians were using cosmetics that while kinda toxic were both practical and beautiful…I want the same for myself–although for me, practical means hiding the GINORMOUS dark circles I inherited from the French/Jewish side of the family, and beautiful is kinda self explanatory.

What do you all do for makeup?  Have you given it up?  Have you turned to ‘ecofriendly’ makeups?  Which ones?  How do they compare?

Yep.  I know.  TEOTWAWKI is coming, and sooner than expected, and I’m worried about MAKEUP.  Go Figure.

It’s a new era in the US.


Barak HUSSEIN Obama is President-elect of the United States.

Hussein is an honorable name.  That’s why it’s capitalized.  I speak a little Arabic, it’s a beautiful language, very poetic in how it phrases things.

Wow.  I’m relieved it’s not McCain, after all these years of having him as our senator, I was MORE than a little worried about how he would perform as president…not to mention his age.  Or his Miss Pissy Pants Wackadoodle running mate.

Is now a good time to start writing to the president-elect about pressing forward with the hard things we will have to do together as a nation to avoid energy related disaster?

Well we all knew the NAIS wasn’t really ever a ‘voluntary’ program, now it’s official.


http://www.libertyark.net/APHIS-PIN-Mandate-080922.pdf  This is the link to the full text of the USDA’s latest memo to veterinarians regarding the enforcement, against the wills of farmers, of a ‘voluntary’ program.  If you want your livestock treated or checked, you will have your farm registered, your animals placed in a database, and be assigned a PIN whether you want one or not.

Now, since the USDA hasn’t really made provisions for enforcement of this ‘voluntary’ program, it’s unclear how exactly it will be enforced…particularly in the states (mine being one of them thankfully) where it’s against the law to enforce it.  The point is, however, that this law was pushed by the CAFO organizations — they only need to get ONE PIN for their entire herd, while a small farmer has to get a number for EVERY animal he owns.  The CAFO’s already have the money and personnel to manage the databases, while the farmer will be required to purchase it and anyone who even gardens on more than the container scale will be at least slightly aware of how much time just the business of running a farm/managing crops entails.  Where will they get the time for this?  How will they afford the costs involved?  It’s not like you make a good living from farming on the sustainable scale.  Most of the farmers and ranchers I know also have side businesses.  They have to, or have a spouse who works outside the home.

Here is a letter from one of our home state senators to the Arizona Dept. of Agriculture regarding this memo:

KAREN JOHNSON
DISTRICT 18

State Senator
FortyEightth Legislature
1700 West Washington
Phoenix, Arizona 85007-2890

PHONE (602) 926-3160
TOLL FREE 1-800-352-8404
FAX (602) 926-3429
E-MAIL kjohnson@azleg.state.az.us

COMMITTEES:
Education Chairman
Appropriations
Judiciary
Natural Resources

October 31, 2008

Mr. Donald Butler, Director
Arizona State Dept. of Agriculture
1688 West Adams Street
Phoenix, Arizona 85007

Dear Director Butler:

During the 2007 legislative session, I sponsored a bill (SB1428) that
prohibits forced participation in the National Animal ID System (NAIS)
in Arizona. Governor Napolitano signed that bill and it has been the
law now for more than a year. (See ARS 3-1207 and ARS 3-1214).

I recently received a copy of a Memorandum (attached) issued by the U.S.
Dept. of Agriculture which indicates that veterinarians who visit a
property are to collect the defined data fields in order to assign
a PIN, as defined in the National Animal Identification System
Program Standards.This pin is to be the location identifier for all
Veterinary Services disease program activities and according to the
memo must be assigned, with or without the consent of the property
owner.

Im sending a letter to Attorney General Terry Goddard asking him to
intervene with the U.S. Dept. of Agriculture in this matter. I expect
the law to be enforced in the spirit intended when it was drafted.

I would like to know how you intend to deal with this, since we have a
law in place that prohibits forced participation in NAIS? I should tell
you that I have been contacted by various Arizona residents telling me
that they are being forced into premise registration, especially the
cattlemen. I am calling on you to do everything in your power to see
that this law is respected and that animal owners in Arizona are not
compelled to register their property in a government data base.
Please advise me on how you plan to handle this.

I look forward to hearing from you in a timely manner.

Best regards,

Senator Karen S. Johnson

cc: Attorney General Terry Goddard

Attachments

KSJ:kw

I applaud her courage in both sponsoring and upholding the law regarding this.

The National Animal Identification System was sponsored by factory farm corporations, designed to put small farmers out of business, to force the consumer to purchase from them, the big corporations.  It is being pushed by people who have financial ties to big business and do NOT have our best interests in mind.  A federal judge in California actually put a cease and desist order on the USDA regarding NAIS until they could address the multiple lawsuits’ concerns brought by outraged citizens.  In spite of that, it is obvious the USDA intends to push forth with this anyway.

PLEASE CONTACT YOUR STATE LEGISLATORS TO EXPRESS YOUR OUTRAGE ABOUT THIS PROGRAM!

It’s a multipurpose post this time.


DH, Mr. Vice President, on Halloween.  I don’t know why the caption doesn’t show up!  Is he a scotsman dressed as a gorilla, or a gorilla dressed as a scotsman??

More on socks:  I made the kilt hose DH is wearing in the photo.  They were fairly quick to make, the pattern can be found in the archives of Knitty.com.  But — because they use a large size of needle and worsted weight yarn DH tells me they’re not very comfy to wear if one is standing/dancing for a long period of time due to the knobbies of the purl stitches inside the sock.  My friend suggests wearing hiking liners inside the socks, but that seems to me to defeat the purpose of handknit socks — custom fit comfort.  I have found this to be so on the socks I just made for myself as well, they are comfy as bed socks but I’m not sure I would want to wear them out on one of my going to town expeditions…too lumpy even with two layers of yarn as a buffer.

Anniversary:  Halloween was our 7 year wedding anniversary (no, we didn’t plan a Halloween wedding.  A hurricane made that choice for us), and 11 years of being together.  Wow.  Numerologically and psychologically speaking we’re in a whole new era of our married life now.

Birthdays:  Oldest son turned 25 the same day his wife left him and went back to her parents’ house.  Ouch.  He tells me he is doing ok, cleaning and organizing and working many hours to keep busy.  I worry.  It’s my job, I’m the mom.  Middle son turned 23 the same week, he is working two jobs just to stay afloat.  He has bald spots from being so stressed he pulls his hair out.  I worry.  It’s my job, I’m the mom.  Youngest son turned 21 also the same week (they’re two years apart, within 6 days of the same day).  He still isn’t speaking to me; I’m assuming he’s doing alright since my sister hasn’t called me to ask for bail money or anything (he lives with her).  I worry.  It’s my job, I’m still the mom even to the kid who won’t speak to me.

Children related worries are directly related to the economy, which are indirectly and directly related to peak oil.  I’ve told them it’s OK if they come home, if they need to come home, it’s not their fault.  They can’t control the economy.  They can’t control the prices of things.  Plus, frankly, I’m not going to be spry enough to paint the house and do the roof myself forever.  They nod and agree that it doesn’t mean failure, but they hope it doesn’t come to that.  I am not sure they’ve figured out that, all things considered, even if they need to drive more to get to a part time job if that’s all they can afford, it still means less income outflow for basic needs in the long run.  Ah well.  We’ll celebrate Thanksgiving together, we can talk about it then I hope.  And I pray they won’t think of me as their crazy mom when we do.

Planted one bed with winter crops:  winter lettuce, broccoli, carrots, and cabbage.  The weather has been kind of freaky, and although we had one week of fall like weather, it’s been back to the 90’s during the day so I am still getting tomato and eggplant blossoms…although I’m not holding my breath that the fruit on the eggplants will actually mature.  Damned javelina rampaged through my yard and got the last crop.  DH is on board for electrified poultry/goat netting, thank the Gods.  It’s pricey but it’s effective and we can take it down in favor of real fence in a couple of years.

Two days until the election.  I don’t like either candidate.  We need a candidate who will say we need to shore up our infrastructure and look after ourselves first!  Somehow I don’t think either will make more than a passing show of an attempt at that.  It’s a sad thing when choosing a candidate has come down to ‘which candidate do I hate less…which candidate will do less harm’ as a way of voting.  I don’t think either will pay attention to the implications of the Financial Times’ article just published and reviewed at Casaubon’s Book by the brilliant Sharon Astyk.  If I actually knew how to link directly to the post I would, but you can read it by looking through this past week’s archives — I have a link to her site here.

Still waiting for Lehman’s to get their Best Grain Mill back in stock!!!

I’ve been putting off getting a Berkey water filtration system but it’s time.  We have piped water, but the quality is WAY down lately and it tastes like rotting plant matter.  It may not kill me but I really don’t want to drink it — and if it tastes that bad, what’s in it that I can’t taste???

So.  Who else is feeling like they are not NEARLY prepared enough for the continued crises coming our way???