Recent Newspaper & Online Columns by Kate Scannell MD

States opting out of Medicaid expansion is simply unconscionable

July 22, 2012

Tags: States opting out of Medicaid expansion, Affordable Care Act, MediCal, Health Reform 2012

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 07/21/2012

Last Tuesday, I was eating lunch in a downtown Oakland diner when a 20-something man entered and politely asked the owner for work -- any work at all. The owner apologized profusely, regretting that he had no employment to offer.

Minutes later, a woman and her daughter sat down at a nearby table and carefully counted what coins they carried -- ostensibly assessing whether they could afford a lunch plate. After the daughter asked, "Do we have enough?" the mother replied, "no," and they left the restaurant, declining an offer of help.

On my way out, I told the owner that I had overheard his conversation with the job seeker. "Awfully hard times," I said.

The owner shook his head and said that he had never had so many people seeking work. And that he had never felt so helpless. "Business is down here, everywhere," he said. "We have no jobs to offer. Last week, a young man with an M.A. came in, begging to work in my kitchen."

As we talked, an elderly woman passed by, pushing a shopping cart stuffed with garbage bags. Echoing a commonly heard refrain, the diner's owner charged, "Washington politicians have no idea what it's really like for most of us. To survive -- find work, live in a safe place, get decent health care -- they just have no idea."

At home that evening, I kept thinking about people from the diner. It had been painfully obvious that they were struggling mightily -- for a $3.50 lunch special, a minimum-wage job, a small business establishment on a worn corner of Oakland. Were these people and their struggles really invisible to "Washington politicians?"

You almost want to believe that's true because the alternative -- politicians seeing but doing little to help -- is even more dispiriting. Still, on street corners across America, joblessness and economic insecurity are on hard to ignore.

Perhaps the seeming invisibility of careworn Americans is a byproduct of cognitive dissonance. That is, while our eyes might detect a family rummaging through garbage bins along Main Street, our brain rejects that as possible; it simply couldn't -- and shouldn't -- be happening in the world's wealthiest nation.

Regardless -- whether unseen, or seen but disbelieved -- impoverished Americans exist, and their ranks are growing. Recent U.S. census data reveal that in 2010 our country's poverty rate jumped to 15 percent -- representing more than 48 million Americans.

Of course, it is not only politicians who may have blind spots on this issue. But it is to them that we look for moral leadership and problem-solving when so many millions of us urgently need a helping hand. Serving as our governmental representatives, they are supposed to be of us, for us, and by us. All of us.

That's why it's so disturbing to hear that several states are threatening to boycott Medicaid expansion as proposed by the Affordable Care Act (ACA) -- our nation's new health care reform law. (more…)

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Shedding light on the investigation on mortal loneliness

July 8, 2012

Tags: loneliness, mortality, elderly, UCSF, Breaking out of Bedlam, Leslie Larson, Archives of Inetrnal Medicine, Kate Scannell

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 07/06/2012

Cora Sledge soberly recalled all the useless prayers she had offered up throughout her 80 years of hardscrabble living. Without a hint of self-pity, she recounted: "I used to pray to keep my ma and daddy safe, but that was no use. I prayed for gifts at Christmas and to win the school prize. I prayed to be slim, so no one would make fun of me. That didn't happen, either. I asked Jesus to protect my kids. Look what happened."

Yet somehow, despite all the tragedy that had seeped into her long life through small holes in her big prayers, Cora remained hopeful about her uncertain future. But her hopes now focused more internally, and her prayers reshaped around her longing to escape the assisted-living facility in which her children had abandoned her. She asked for her heart to be healed, all the while it stayed open and "ready to love." She explained, "I pray now like I did when I was a little girl -- not needing to understand. I ask for simple things. Let me not hurt. Let me not be hungry, or cold. Please keep my loneliness at bay."

I finished reading about Cora Sledge in Berkeley novelist Leslie Larson's moving (and comical) novel "Breaking Out of Bedlam" the same day that UC San Francisco researchers reported finding statistical associations between loneliness and an increased risk of dying among elderly people. (more…)

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