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After her father has a stroke, Carmen Morales is summoned back to the Kern County home she was kicked out of twelve years before, by the Grandmother – “Abuela” – who refused to intervene. Over the course of the weekend, as Carmen attempts without success to determine whether her father — Padre — has insurance, she reconnects with several members of her extended family. Carmen stays with Kelsey, the only family member who had known she was trans, but the situation is complicated by Kelsey’s boyfriend Dace. Dace treats Kelsey poorly; he also reminds Carmen of his younger brother Diego, Carmen’s first crush.
At the end of the weekend, Kelsey tries to make a nice Sunday night dinner for Carmen and Dace, but Dace stands them up. She invites their cousin Inés (“Innie”) to join them instead. Innie is hostile at first, holding long-term grudges against both Carmen and Kelsey. But after a tequila-filled evening, the three of them manage to come to terms and rekindle their old friendship.
Chapter 9: Resolutions
I wrapped my arms around my knees, hugging legs to chest, trying to be small and inconspicuous. Trying to keep them from hearing my sobs. Padre’s clenched fists were pounding the heavy table so hard I thought it might crack, and he shouted to be heard over Momma’s tirade.
I wasn’t processing the words. I never did; they didn’t matter.
I only need . . . .
I desperately needed to pee, but was too terrified to make any move that might direct their anger at me. A dinner plate, still dripping with suds, flew across the room like a frisbee, missing Padre by a country mile but slamming into the wall with more than enough force to shatter, sending shards ripping across the room. As he rose, his face flushed, I couldn’t suppress a whimper.
I startled awake, pulling out of a dream that might or might not have been a memory, only to find that my need to pee was all too real. As was, unfortunately, the sound of intense argument coming from the master bedroom. To make the morning still more perfect, the smell of weed was back with a vengeance.
Unlike the argument in my dream, the one down the hall did not appear to be violent; Kelsey’s voice was low and venomous, Dace’s slurred and deep, but neither were shouting or throwing things. As long as it stayed that way, I intended to mind my own business – starting with a few minutes sitting on some porcelain.
Primary business accomplished, I took a look in the mirror and decided I’d better have another shower. Three nights of less-than-great sleep left me looking, and feeling, washed out. I might be able to get by without washing my hair again, if I could tame the tangles with a brush.
Bueno. I went back to the living room to get what I would need for the day, tuning out the argument that was happening on the other side of an uninsulated interior wall. That was muscle memory, first learned at home, then strongly reinforced on the street. I don’t need to know what they’re saying.
I only need to know . . . .
I’d forgotten to zip my bag, which wasn’t like me. Thinking about the day, I pulled out black pants in some wrinkle-free poly blend and paired them with a conservative top. I would probably need to go to Padre’s workplace in person, and I would definitely need to go back to the hospital. So, a reasonably professional look. Something I would wear to work.
The thought made me chuckle. I might be the only analyst getting up on Monday morning and wishing she could be going into work.
But the chuckle caught in my throat as I noticed something I’d missed when I rolled off the couch to make my bathroom door dash: The ash-tray by the chair facing the couch had been used, and I knew for a fact it had been clean when I went to sleep. Drunk or sober, I would never have gone to sleep with that smell around.
He’d been sitting there, just a few feet away, smoking pot and watching me?
My skin crawled, just thinking about it. God, I can’t let myself drink like that! I should have woken up!
My need for a shower now felt almost as urgent as my earlier need to pee. I made my way to the bathroom, even more determined to ignore the spat that was increasing in intensity if not volume. I can’t hear what you’re saying. I don’t need to know why you’re angry. I only need to know . . . . Am I safe? Can I hide, quietly? Can I walk away?
Or, do I need to run?
The hot water and soap somehow didn’t leave me feeling any cleaner, and even the faint smell of weed on the towels made it worse. Pinche pendejo!!!
At least the argument wasn’t still active when I left the bathroom. Kelsey was in the kitchen, in far more practical sleepwear than I had seen her a few hours earlier — just a light-weight pair of cotton shorts and a sleeveless, racerback top that proudly displayed both muscles and her tats.
One look told me I needed to tread softly. “Hey . . . you okay?”
“Oh, I’m fucking perfect.”
I sat across from her at the small table. “Is there anything I —“
“No.”
“Do you want to —“
“No.” A bit more forceful, this time.
We sat in silence for a few moments. She drank her coffee and I tried to come up with something to say. Nothing came to me, though.
Finally I reached over and put a hand on top of hers. “Kels . . . I’ve gotta go, and if I get everything done today I’ll head back home. But I’m only a phone call away, okay?”
She nodded, but didn’t say anything.
I gave her hand a squeeze, got up, collected my bag, and walked out, feeling hollow. But I hadn’t gotten half way to my car when she stomped out of the house and said, “Hey.”
I turned around and she caught me in a death grip of a hug. After a second’s surprise, I managed to return it.
“Call me before you leave this time, okay?”
“Kels —”
“Not now,” she directed, interrupting again. “I can’t deal right now. Just . . . call me later?”
I had no better option than saying “of course,” so I did. Then she let me go — abruptly — and marched back into the house.
I wasn’t surprised that Kern Cotton’s telephone was still running its horrid automated telephone system. Lots of businesses found it easier to deal with the public that way, and chances were good that the owner and his sons gave their private numbers to their important customers. I couldn’t blame them, since anyone hired to answer the telephone would mostly just be dealing with computerized spam calls. Better to let the recorded voices babble at each other. AI foreplay.
The upshot, though, is that I needed to drive out in person. Kern Cotton was up near Wasco, just twenty minutes away over two of the long, ruler-straight roads that make up much of the San Joaquin’s infrastructure.
Unfortunately, Wasco was also the home of Central Valley High School. With only a couple hundred households, Buttonwillow was nowhere near large enough to have its own high school, so we all got bussed to CVHS. Padre usually dropped me off in the mornings since it was on his way to work, but I got out hours before his shift ended and would take the bus home.
I didn’t need more memories banging on my skull, but every sight, smell and sound seemed like a trigger. Here was the roadside stand that had great produce; there was the place the bus went off the road when tule fog caused an early morning collision between a pick-up and one of the big dump trucks headed for the Shaftner landfill. There was the Catholic Church that looked like an overgrown Taco Bell.
And there they were — the low, mustard-brown buildings with the dark brown trim. In front of the buildings, seemingly larger, stretched the football field where so many of my childhood friendships were tested, and failed. Where the chavos I had known since grade school, the boys I had played baseball with, turned on me. Tomás, Santi, all the rest. I’d maybe hoped for better, but I’d always known their friendship was soft. Provisional. They only tolerated me because Diego did.
I had thought so much more of Diego. He’d treated Innie with respect, but I was barely worth his contempt.
“Chill, girl!” His laugh was patronizing, but he needed both hands to keep Innie at arm’s length. “You want the puto? You can have him.”
She didn’t stop swinging, and her voice was a battlecry. “You’re gonna eat that shit, cochino!”
“What do you want it for, anyway?” Tomás sneered. “Puto’s not into your kind.”
She spun out of Diego’s grip to clip Tomás on the side of the head, hard enough to make his ears ring. “You don’t fuck with a Morales – ANY Morales! – or we will Fuck! You! Up! Got it???”
“Leave it, Compas.” Diego looked down at me, as I struggled to get back to my feet. “Just stay away from us, Puto,” he spat. “Far away.”
It was not so easy to stay away, when you see the same people every day. Wherever I went, the whispers followed. I would be tripped in the halls; my locker would be defaced. My books dumped in trash cans.
I thought I deserved it, back then.
It would be easy to say that I have no idea how I survived, but that wouldn’t be true. I know exactly how. My secret “girl time” with Kelsey. Abuela’s uncompromising demand that I excel in school. And one extraordinary teacher who saw something in me when no-one else did.
He was half-sitting, half-leaning on his big, squat, metal and formica desk, his long legs stretched out before him, crossed at the ankles. Despite the setting, he somehow managed to look like a Seventeenth Century grandee in a Velázquez painting. The same impossibly high forehead and cheekbones; the long, narrow face; the dark, intense eyes over the eagle’s beak of a nose.
“My name is Alfonso Filipe Olivares y Cortez. It is my duty and privilege to try to get all of you to learn something about the past. And you will tell me – if you find the courage! – that you don’t care.” His knowing smile and the lift of a thin, aristocratic eyebrow challenged the room to contradict him, but of course no-one did. “You will tell me that the past does not matter.”
All traces of amusement vanished in an instant, replaced by intensity and conviction. “I will respond with the words of a wise man, that you would do well to remember: ‘The past is never dead. It's not even past. All of us labor in webs spun long before we were born, webs of heredity and environment, of desire and consequence, of history and eternity.’”
He lit a spark that morning, that first day of my sophomore year. He spoke with passion and poetry about an idea as abstract as the relevance of history, and I found myself, for the first time in my life, wanting to be educated. Wanting, with all my heart, to imagine a world beyond Buttonwillow, beyond Kern County, beyond farming. To see it, experience it. Live it. From that day forward, I didn’t just study to keep Abuela off my back.
One good teacher. That’s all it took.
I realized with a start that I’d been stopped by the football field, oblivious to the passage of traffic or time. I shook my head and got the car back on the road.
The past is not even past.
The last few days demonstrated the wisdom of Faulkner’s words, which Señor Cortez worked so hard to hammer into our thick, adolescent skulls. I was a twisted lump of metal caught between the hammer of Abuela’s relentless, immigrant ambitions and the anvil of my parents’ broken dreams. I had no power to outrun my dark memories, nor any way to keep them buried. They were part of me.
But that idealistic, inspirational teacher was a part of my past, too. I needed to remember that.
Like Buttonwillow itself, Kern Cotton seemed unchanged, even as the people I associated with both places aged — sometimes radically. The squat, low building that housed the office remained near the entrance. Someone had installed a ramp to the front door by the side of the stairs. At a guess, this had nothing to do with complying with disabilities law. Old man Cavallaro probably needed it, these days.
I recognized the woman who was in the process of making coffee in the front office area, though I doubted I’d ever known her name. Anglo, mid-fifties. Running a little plump. She looked over as I walked in. “Be right with you, Hon.”
“No problem,” I replied, stopping at the counter that separated the working area from visitors. Not, “no hay bronca;” not here. Everyone out in the fields would speak Spanish as a first or second language . . . maybe as their only language. But here, in the office, things would be different. They would understand the casual Spanish expression, but using it would send other signals as well. Ones I did not want to send.
She quickly finished getting the coffee machine going and came over, wiping her hands on her jeans. “Sorry about that — nothing moves around here until the coffee’s flowing! What can I do for you?”
“I need to speak with someone about my father, Juan Morales.”
Her expression immediately transformed. “We were so worried about him! Will he be alright?”
“It’s too soon to tell,” I said cautiously. “He’s still in the hospital, and he isn’t conscious yet. They can’t figure out his insurance coverage, and I was hoping someone here could help.”
“Oh, my goodness! I’m so sorry! Let me see if Mr. Cavallaro is available.”
“Thank you. I really appreciate it.”
“Sure thing, Hon. Just have a seat and I’ll be right back. Can I get you a coffee while you wait?”
I assured her that I was fine, and took one of the vinyl-covered chairs as she hustled to the back of the building.
She looked a bit distracted when she got back. “He’ll be a couple minutes. Are you sure you wouldn’t like some coffee?”
“No, really, I’m fine.”
She went back to her desk and started working on something that apparently took all of her concentration.
After ten minutes had passed, I was having trouble controlling my impatience – and my uneasiness. I returned to the counter to ask if there was a problem.
“No, no. Mr. Cavallaro was just in the middle of something. I’m sure he’ll be right with you.”
“Okay, but . . . .” I decided to play the only card I was holding. “I really do need to be getting back to the hospital.”
“Oh! Yes, of course. I’ll . . . I’ll just go check, okay?” And off she went again.
I stayed at the counter and waited.
After another five minutes she came out again, and this time she looked uncomfortable. “I’m sorry. Mr. Cavallaro says that he has no recollection of Mr. Morales having any daughters. He can’t discuss personnel information with just anyone.”
Much as I wanted to be angry, it should have occurred to me that Padre never told anyone. However, there were conversations I didn’t want to have out in the open with a secretary. “I understand. Listen, I’ve been gone for twelve years, but I have met Mr. Cavallaro on several occasions. If he could spare five minutes of his time?”
She looked dubious and sounded even more so. “Well . . . I’ll ask him.” Back she went. Two minutes later she returned, followed by a large man with jet-black hair who looked more than a bit annoyed.
I’d never met him in my life.
He walked to the counter briskly. “I’m very busy this morning. Mrs. Ivers said you know me or something?”
I shook my head, a bit confused. “I’m sorry; she said she was getting Mr. Cavallaro. I thought she meant the owner?”
“I am the owner. And I don’t recall ever meeting you.”
My brain was working slowly, but it caught up. “It’s my mistake; I must have met your father. I was here a few times when I was in high school, but that was thirteen, fourteen years ago.”
He nodded, not unkindly. “He passed three years ago, rest his soul. Now, like I told Mrs. Ivers, I can’t release personnel information. I’m sorry you drove all the way out here, but I can’t help you.”
I opened my purse, pulled out my wallet, and showed my ID. “My name is Carmen Morales, as you see, and Juan Morales is my father. My grandmother called me on Friday and asked me to come back and help with the insurance issues.”
He looked at the ID and shrugged. “‘Morales’ isn’t an uncommon name, especially around here.”
“My Uncle Augustin can vouch for me. I’d call him, but he is stubborn about getting a cell phone. Still, he should be here by now.”
“Ah.” He looked uncomfortable and uncertain – expressions that did not seem natural to his face. But he appeared to reach a decision and turned to Mrs. Ivers. “See if you can get someone to track down Augustin and ask him about Ms. Morales. I’ll be in my office.” He left.
Mrs. Ivers made a call.
I didn’t move from the counter. Too bad if I make you all uncomfortable.
Another ten minutes passed before a call came in that Mrs. Ivers forwarded to the owner. And then, finally, he emerged from his office and waved me in, looking distinctly unhappy. “Please have a seat. I’m sorry to hear about your father.”
I nodded, not saying anything, and perched on the end of the offered seat, my back straight.
He glanced down at a file on his desk. “You were asking about insurance?”
“Yes. He didn’t have an insurance card in his wallet, and I haven’t found one in his papers. I’m pretty sure we were on Kaiser when I was living here, but the hospital said you’ve switched to an employee choice plan?”
He nodded. “That’s right. I checked our records, and it looks like your father took the option to go off the Kaiser plan back in 2018.”
Something felt wrong, but I decided I’d play dumb. “Okay, that’s helpful. Was he required to inform you of the name of the plan he selected?” You’d better say “yes” to that one!
An unhappy nod. “Yes. We have his election form.”
“Great,” I said brightly. “Can I get a copy? That should have everything the hospital needs.”
“Ummm . . . look. I’m not a lawyer. I don’t know what we’re allowed to give you, and what we aren’t. All this privacy stuff is a headache. I’m really not comfortable handing over personnel documents.” He again looked down at the manilla folder on his desk and rather deliberately rested his clasped hands on top of it. “I just don’t think I can do that.”
“Okay,” I said, drawing out the word while I thought about his response. “Can you at least tell me the name of the provider? And maybe the group and member numbers? I don’t need the actual document.”
He squirmed in his seat. “I think I’m allowed to tell you he selected an Anthem Plan. But I’m not comfortable providing any other information. I hope that helps.” Rising, he held out his hand. “Again, I’m sorry about your father.”
I smiled, shook his hand and thanked him for his assistance and well-wishes before departing. He was Padre’s boss and Uncle Augustin’s as well; I couldn’t afford to piss in their sand box. But once I was outside I felt an overwhelming desire to wash my hands.
Something’s not right.
I got in the car and headed South and east. Back to Bakersfield, and the hospital. When I got there I spoke with the folks in billing and told them what I knew, but when they ran it through their systems they didn’t get confirmation of coverage.
“I’m really sorry,” the woman said sympathetically. “It doesn’t necessarily mean your father isn’t on the Anthem Plan. They may just need more information to make a definitive match.”
So I went up to Padre’s room. He was alone, and to all appearances his condition hadn’t changed since Saturday morning. Still hooked up to oxygen. Abuela’s angry cry echoed in my mind. “My son can’t breathe without a machine!”
I stood for a while, looking down at his unresponsive form. Trying, somehow, to connect to the person I’d known. Trying to feel something, whether it was positive or negative. “Why is it,” I finally asked him, “that everywhere I go in this frickin’ county I see or hear or smell something that triggers a memory, but when I look at you, I draw a blank?”
Naturally, the figure in the bed did not respond.
I sat and, with a sigh, pulled out my phone and prepared to do battle with the Leviathan that is the American insurance Industry. It’s part of my job, and I’m good at it, but that doesn’t mean I have to like it. I pulled up some of the photos I’d taken while going through his papers, so I had potentially useful information like his Social Security Number and Kern Cotton’s Tax ID number at my finger tips.
After getting through all the different options on the telephone tree, I was eventually able to connect with a person. I explained the situation and asked if they could confirm insurance coverage for Juan Morales, employed by Kern Cotton. I was transferred to another department, where I repeated the story. And then to a third. Then I was transferred to a “manager” who likewise knew nothing.
After two full hours of transfers, music on hold, chirpy recordings asking if I knew I could find “almost everything I need” on the company’s website, and being asked multiple times for the same basic information, I was finally able to speak with someone who had actual information. The woman was able to confirm that Juan Morales enrolled with Anthem in 2018 and paid premiums. Yes, indeed, he had.
For exactly one year.
After that, he stopped, and his insurance was cancelled, after numerous efforts to reach him had failed, sometime in 2019. The woman was “so very sorry” she couldn’t be more helpful.
Son. Of. A. Bitch! At least he had waited until Joaquim was employed and off his plan!
Again, my eyes drifted to the silent figure beside me. “You just had to leave me a steaming pile of crap to clean up, didn’t you?” I shook my head. “Abuela thought you were the smart one. You’ve got to be a super special kind of stupid to pull this!”
California is a generous state. There are programs for people who can’t afford insurance. There are even programs for the inevitable idiots who don’t get insurance until they have a health emergency. “But you have to apply for them, damn you! You didn’t, and no-one can apply for you. Not without an appointment by the Probate Court! And, they’ll need proof of your income and assets, too.” I wanted to pound my fists on something – or better still, someone! – and restrained myself with difficulty. “Just once, couldn’t you have done something right?”
His chest moved up and down. The monitor made noises. The oxygen continued to flow.
And the man in the bed gave me nothing.
“What else is new?” I asked him, my words bitter. “I guess I ruined your life — the one you wanted to make, somewhere far, far away. But I wasn’t the one who decided to have a wild time during summer break, was I? Do you know how much fun I got to have, when I was a year out of high school? All the great parties I went to, when I was sleeping behind a pinche dumpster? When I was stealing clothes and begging for food, and going fucking nuts???”
Crickets.
“You could have aborted. Gone your separate ways. Had nice lives. Did you talk about it? If all you were going to do was blame me for being born, why the fuck didn’t you?”
The figure on the bed blurred as tears of rage overflowed and seeped down my checks. “Why?” I asked, my voice choked to a whisper. “Why bring children into the world, if you can’t love them?”
I wanted to weep, to rage, to scream bloody murder. I wanted to rip the oxygen mask off and slap his expressionless face until he woke up and, for once in his pinche life, gave me answers.
And, somehow, I still just wanted him to love me.
I closed my eyes tight. They weren’t helping. My fists, clenched around the arms of the hospital’s occasional chair, were lost causes for now. I focused on breathing. On clearing my mind. Feeling the frenzied hammering of my heart, and willing it to return to a normal, steady beat.
I don’t know how long it took before I opened my eyes, but when I did they were clear and free of tears. I looked at the figure on the bed, the man who bore no resemblance to the father I recalled.
He slept on, oblivious to my pain. Oblivious to my life.
“All right,” I said conversationally. “I got the life you dreamed about, and the education you abandoned, so I actually know how to clean up your mess. Amazing, isn’t it? Except I expect you’d hate me for that, too.”
I rose and got my purse. At the door I paused, shooting him a parting look that wouldn’t get any points for fidelity to the Fifth Commandment. “Probably as good a reason as any to do it.”
— To be continued
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Comments
Ah the joys of insurance and
Ah the joys of insurance and paperwork… fishy with the company but Carmen is healing old wounds even if she doesn’t realise it yet.
I like Turtles.
Bad set
Carmen’s old wounds are like broken bones that didn’t knot together properly. The only way to straighten them is to break them all over again. It hurts like hell, and it might not even work .. . but it’s the only thing that might.
Thanks, Alyssa!
— Emma
The fact that Carmen is not just walking away……
After all that her father has done says volumes about her - even if she is justifying her continued help by the fact that, “I expect you’d hate me for that too. Probably as good a reason as any to do it.”
I would have walked away; I did walk away. And never went back - not until his ashes were being interred in the family mausoleum, and that mostly just so I could metaphorically piss on his grave. Although I will admit that I did get great satisfaction out of seeing the looks my cousins gave me, standing there in my women’s version of Navy Dress Whites, not to mention the fact that two of them were forced to salute me! Although it took my staring at them for a moment before they acknowledged the requirement, watching them realizing that they were about to take an ass reaming from a full Navy Captain. Forcing them to acknowledge me, yeah, that almost made the trip worthwhile.
Almost.
I haven’t been back since then, and I probably never will.
Carmen is perhaps a better person than I…….. for I would have let them all rot.
D. Eden
“Hier stehe ich; ich kann nicht anders. Gott helfe mir.”
Dum Vivimus, Vivamus
Arggggh!
Another great story, that you absolutely should write! I know, I know. You think you can’t. But, damn . . . even with your one paragraph sketch, I am seeing the scene at the mausoleum. Old stone and crushed grass . . . the shuffle of feet . . . the awkward looks . . . the woman in white, gold eagle buttons and four broad gold bands on each epaulette, with a glare that can peel paint . . . the cousins, jaws clenched, nostrils flaring, doing what they were compelled to do and hating it . . . and the woman in white making them wait, letting them feel the magnitude of their transgression with every second that passed before she returned the salute with cold perfection, releasing them to go lead their dark, miserable lives. God! What a story!!!
Carmen is a decent woman, and that’s an amazing thing after what she went through. We’ve gotten some hints as to why, but there’s more to that story, I think. I just haven’t written it yet. ;-)
— Emma
The Past Is
There may be do overs but there is only one first time. Life is a one way street with each step forward one may never return to that point again. Carmen was brave enough, smart enough, fortunate enough she didn't stop in her life and kept going. She's now looking back at all the flotsam and jetsam left behind on the past she once traversed.
Hugs Emma, here's hoping you don't write the girl back into the morass she escaped.
Barb
Humans are the only creatures who get pleasure out of the pain of another. Too often they want to share their own pain.
Oklahoma born and raised cowgirl
No mulligans
You’re right there, BarbieLee. As Billie Joel would say, getting it right the next time’s not the same as getting it right the first time.
The past is trying mightily to suck Carmen back, and it has some powerful allies. But there’s are countervailing forces, too.
— Emma
Insurance
I don't understand how people in the modern age can look at the insurance situation in the United States and think it's a superior system compared to just about anything else. The last thing people need to be worried about when facing a crisis is worrying about paperwork or how they will afford it. It's a cruel thing to make families face a decision of either pulling the plug or face a lifetime of bills. There's certainly waste in all these systems but when the US spending is 18% of GDP and the rest of the world hovers around 10% with better results, you are certainly doing something wrong.
Insurance: not great even for the well-connected
I knew the executive VP of finance at a Fortune 500 company. I heard him complain that his employer’s health insurance insisted that his wife and daughter were the same person, listed in duplicate in their system, with different names, birth dates, and social security numbers.
It's the insureds' responsibility
The insurance system is only as good as the insured is willing to see that they have the coverage they need. When my father passed, he went into the hospital that already had his insurance information. He was transferred to a nursing facility where he stayed for two days before going back to the hospital for the last time.
I was his only offspring living in the area, so it fell to me to take care of the final arrangements. Aside from checking him in and having to make the call about resuscitating him the last time, I really didn't have anything to concern myself with. BTW, he was cognizant the first time he went in and so I told them to go with the choice he made then.
After that, I made arrangements for his cremation and internment according to what he had told me he wanted. The money for that came out of his checking account. My three other siblings and I ended up with $1,500 each with another $1500 to go to final expenses. I was never asked by the hospital or his doctor to pay for anything.
That was that.
I'm now on medicare and Kaiser Advantage. I go to the doctor and don't even pay a copay unless It's a specialist and then it's pocket change. I've had three surgeries (gall bladder, broken knee and one node of my hyper thyroid removed) total out of pocket cost for all three, $75. My premiums come out of my social security; I never see the bill.
On the other hand, my 56 year old daughter who never held a steady job it on the Oregon health plan (Welfare) and got her dentures paid for. While I choose to pay as I go for dental work and paid for mine out of pocket.
Each individual needs to take responsibility for their own health care and live (or die) with the results of their choices in that area..
Hugs
Patricia
Happiness is being all dressed up and HAVING some place to go.
Semper in femineo gerunt
Ich bin ein femininer Mann
Fear of the unknown
People may not like their insurance, but it’s tough to sell them on the idea that a completely different system will be better. Especially when insurance companies and other stakeholders who have big money at stake pour gagillions of dollars into media campaigns that stoke their fear of the unknown.
— Emma
Been there
Didn't do this since my dad died suddenly.
I wanted to weep, to rage, to scream bloody murder. I wanted to rip the oxygen mask off and slap his expressionless face until he woke up and, for once in his pinche life, gave me answers.
And, somehow, I still just wanted him to love me.
Without even suspecting his fate, my dad told my older brother to tell my sister he was sorry. I can only hope he had intended to extend that apology to my younger brother and me, but it was not to be.
Love, Andrea Lena
We do not know the day or hour.
Best to seek forgiveness while we can; a lifetime of opportunities can end in the absence of a heart’s beat.
Thank you for your reflection, ‘Drea. I wish your father had been wise enough, kind enough, or just enough of a dad, to extend that apology while he could. Just another of the wounds he left you to carry alone.
— Emma
Another great chapter Emma
I love how down to earth the narrative is as she navigates both the past and present crises. I think you've pretty much nailed the kind of roadblocks that privacy legislation has erected. It's never easy to deal with and even more so if you're not the person the system expects you to be.
Hugs
Patricia
Happiness is being all dressed up and HAVING some place to go.
Semper in femineo gerunt
Ich bin ein femininer Mann
Past and present
Thank you for that comment, Patricia. Weaving Carmen’s past trauma and present difficulties into some sort of coherent narrative has been one of the bigger challenges of this story. I’m delighted it’s working for you!
— Emma
Cavallero
Something is rotten in Denmark or at least at the cotton plant. I've worked for sleezeballs like that and when they start talking about privileged/ confidential information it's time to get digging.
Something rotten indeed!
I know what I’d want to know if I were Carmen. But it might not make a difference, legally.
— Emma
It's Easy To Say
That Insurance is a personal choice, but it's also whatever you can afford and where it comes on your list of priorities. From what I can deduce from outside the system, medical insurance in the USA can be a nightmare and there seems to be no safety net for the poor/less educated. Maybe there is and I'm just ignorant.
We have gotten one side of the story so far, and Juan Morales is in no fit state to tell Carmen what arrangements he may have made and why, although all the signs point to there being none.
The chains of duty bind Carmen to trying to solve the problem, and, whether she likes it or not, the residual love that is never admitted.
There is a safety net for the poor…….
Although how long it will last under the Trump/Musk administration is a topic for debate. And yes, I wrote it that way on purpose because I’m not sure just who is in charge of that particular asylum. Washington is becoming nothing more than a clown car, where Trump continues to try to pack more and more of his clowns into the car. Just how long before it all falls apart is something we will have to live through.
The government provides two main programs for healthcare in this country - Medicaid and Medicare. The basic difference between them is as follows:
Medicaid is for certain individuals and families with low incomes and resources. Eligibility and benefits vary considerably from State to State. Medicare insurance is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease.
Medicare is federal health insurance for people 65 or older, and some people under 65 with certain disabilities or conditions. A federal agency called the Centers for Medicare & Medicaid Services runs Medicare. Because it’s a federal program, Medicare has set standards for costs and coverage. This means a person’s Medicare coverage will be the same no matter what state they live in. Medicare-related bills are paid from two trust funds held by the U.S. Treasury. Different sources (including payroll taxes and funds that Congress authorizes) fund the trust funds. People with Medicare pay part of the costs through things like monthly premiums for medical and drug coverage, deductibles and coinsurance.
Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. The federal government has general rules that all state Medicaid programs must follow, but each state runs its own program. This means eligibility requirements and benefits can vary from state to state. Medicaid offers benefits that Medicare doesn’t normally cover, like nursing home care and personal care services. People with Medicaid usually don’t pay anything for covered medical expenses but may owe a small co-payment for some items or services.
Beyond that, The Affordable Care Act, often referred to as Obamacare, is an additional program designed to guarantee health coverage for all citizens of the United States. While the two share various similarities, they vary greatly in many regards. On a general basis, the Affordable Care Act, aims to provide affordable health coverage to all Americans. On the other hand, Medicaid provides coverage for those in need that cannot afford coverage otherwise.
This basically means that there are multiple tiers to our health care coverage, but other than Medicaid individuals are still responsible for at least a portion of the cost. And even with Medicaid some services may require some payment by the individual. Many of us participate in health care group coverage provided through our employers, with some percentage of the cost covered by the employer and the rest picked up by the individual through payroll deductions. How much the individual pays depends on the plan and the selected level of coverage.
The unfortunate reality is that in this country, healthcare is a big business - and over the recent decades that has become ever more true as large corporations have gotten involved in for-profit hospitals and health care. This has resulted in the closing of many hospitals - especially those in more rural areas, as well as increasing costs to the average person. Altruism in the healthcare industry is apparently either fully dead, or breathing its last dying breath.
I have been fortunate throughout my life to have had the benefit of very good health care, both through the US Navy, and through my spouse’s job. She recently retired from a position in municipal government for the city in which we have made our home since marrying. As such, she was entitled to free healthcare for our entire family through her position - meaning that even while I was still on active duty, my family was covered under her policy. We still benefit from that free coverage since her retirement; since she worked there for over 25 years, we are both covered by the policy for life. The only stipulation being that the coverage changes if we move outside of New York State - something which under the current conditions in this country is not likely to happen!
Add in the fact that her father and two of her brothers also practiced medicine within a few miles of our home, and my families medical needs were very well covered at very little cost to us. But that puts me in a very small, very fortunate, minority. I am far from the best person to discuss healthcare costs or issues due to my singular good fortune in that area.
Yes, I have had my issues with the healthcare industry since transitioning - but they have been few and far between, and relatively minor annoyances compared to the nightmares that many endure.
D. Eden
“Hier stehe ich; ich kann nicht anders. Gott helfe mir.”
Dum Vivimus, Vivamus
Ooops!
A finger too hasty!
I Stand Corrected
Obviously I haven't made a thorough examination of USA systems. They have a poor reputation outside of the country, but perhaps are better than most non-Americans believe. They do sound complicated.
Under our systems there are only two basic levels, which largely preclude employer involvement (unless you are working overseas). We have Medicare, which caters for every citizen and everyone carries a green card which entitles you to healthcare (children are covered through their parents). Under Medicare we are universally entitled to virtually free treatment in hospitals. There are small co-payments for some expensive procedures like MRIs, but they are minimal and can be paid for over time. The main problem is waiting time.
There are always too many people overloading the system, so some operations (particularly electives) may be months or even years away.
Visits to doctors are partially covered. A typical visit costs AUD 90 and about half is refunded automatically. For people on pensions or with disabilities the refund leaves the recipient paying AUD 10 over the counter and that's it.
The other tier is private insurance and as in the USA several major companies compete for customers and offer cover for different procedures at different prices. The benefits are that there is little or no waiting time. For instance, I had my cataracts fixed a few years ago . I nominated the dates for the operations and it cost me about AUD 5000 including aftercare. It's one procedure (regarded as an 'extra') where even cover under Private is fairly low. In the event that you need hospitalization you pay a premium (it varies. Mine is AUD 500) and the rest is covered by the insurer. I was recently in hospital for four weeks and the cost to me was AUD 500, plus, of course, my annual subscription. No waiting; emergency treatment guaranteed in a private hospital with superior accommodation, but it depends on your Plan, i.e. what you pay for. Nearly all insurers cover 'normal' events like broken bones, heart conditions, etc, but there are many 'extras' that you can elect to have covered, like dental, podiatry, and the like, mostly out-patient stuff, dealt with at clinics.
Juan Morales would be automatically covered under Medicare, so there would be no need for an emergency summons to Carmen...and we would have no story!
A superior system
But then, I sometimes simply wish we had a healthcare system that looked like it had actually been designed on purpose, rather than patched together with whatever we could find in the landfill!
— Emma
Cataracts fixed... cost me about AUD 5000 including aftercare.
With only Kaiser (provided by my employer at the time, mine cost me $80 USD. That included all the testing and examinations leading up to the actual operation and two after care appointments.
Two complaints I hear from across the northern border (Canada) and across the pond (UK) are the wait time and getting referrals to specialists. My only complaint I currently have with what I have now is that I can only make appointments six weeks out and if I need to see a doctor RIGHT-NOW, it's virtually impossible save going to emergency. The ER has a high co-pay. I assume that is to keep folks from just showing up there for minor problems that can wait.
Hugs
Patricia
Happiness is being all dressed up and HAVING some place to go.
Semper in femineo gerunt
Ich bin ein femininer Mann
Clowns
Some are the scary kind. Especially Stephen King's ones.
And the situation looks exactly like if he wrote it. With the only difference that there is no Johnny Smith around...
Careful there.
The X-bots will find us.
— Emma
I can’t improve on Dallas’ primer here
Certainly her summary reflects my understanding of federal health insurance assistance programs. As she notes, however, States have considerable agency in how they administer the Medicaid program, and California is more generous than most. But, as Carmen discusses, there’s no automatic coverage. You have to apply, and your eligibility for any poverty program must be determined after application is made.
I think Carmen acts from both love and duty. But I’m less confident that she feels either of those things for the man in the bed. We’ll have to see.
— Emma
We make...
Or break our kids in one sense of the equation that is raising them. In another they have the power to surpass our wildest dreams for them. I always wanted to be seen as equal to or better than my pop. Worked hard to get there, though I'm sure he worried about my path in my early 20's. He died when I was 28 and was a good man and father. Likely knew I struggled, but never said anything - likely waiting for me to bring it up. This chapter brought up a bunch of thinking on that... Unfortunately I'm left with a lot of questions and feeling, much like Carmen is. Very good chapter. Hugz...
XOXOXO
Rachel M. Moore...
Fathers and sons, and the things that don’t get said
Yeah. It’s a lot. The best communication I had from my dad was in a letter, and he was not one for writing letters. It was just easier for him, that way, to say the things he had in his heart.
It would never have occurred to me — never in a million years— to discuss my own gender issues with him. In part, of course, that’s because I didn’t really understand them myself until much later. He was the best person I’ve ever met, and among the most understanding, yet I think it would have been a bridge too far for him. He was an enlightened man for his time, but both parts of that statement carry freight. I think he was happier not knowing.
— Emma
We may be surprised
If you've read my "Silence is Golden" essay, you know that my father (born in 1910) was very circumspect with his reaction to my cross-dressing. I'm sorry that I waited so long to fully come out to him. I believe if I had, I'd have been able to deal with my gender issues much earlier in life. I waited until after I was married and my wife had caught me dressed to come out to my dad. I just showed up at his door dressed with full makeup one afternoon. He looked me up and down then invited me in and we had a visit just like we always had.
Hugs
Patricia
Happiness is being all dressed up and HAVING some place to go.
Semper in femineo gerunt
Ich bin ein femininer Mann
“Probably as good a reason as any to do it.”
okay I have no idea what she has planned,
In the short run . . .
She plans to clean up his mess. ;-)
— Emma
Rendering aid
The depths of these characters is beautiful to behold, each with their own individual stories and the lovely complexity demonstrated in their interactions - which therefore feels grounded and real, and oh so relatable as a result. A supporting cast made solid, enough so that each could be the protagonist of their own tale.
Putting aside the hinted potential chicaneries at her father's workplace (as I'm sure our heroine shall tug on those threads as her discovery process continues), the reasons for helping are marvelously complex and all so human. There are times when one will help another not because the party deserves it, but precisely because they do not. Such moments are a way to declare to the world (and to oneself!) who you are as a person, with the unspoken dare to others for them to attempt to claim otherwise. Instances when the act cares not about the worthiness of the recipient, but only that the giver would think less of themself if they didn't.
These are the decisions that shape who a person truly is - and are never easy, for if they were they wouldn't have the importance or impact. And make, of course, for wonderful storytelling! :)
How to make an author cry?
A comment that demonstrates that you really get one of her characters? Yeah, that'll do it. Every single time.
Thanks, Erisian. Needed that!
— Emma
Insurance gaps
Life happens. When I had to go back to school for my software engineering degree like 33 years agoI was poor as a church mouse and thought for the comparatively small window of time (about 2 years) I would be able to get by without health insurance.
Of course Man plans Gods laugh (I think) and I came down with appendicitis and I could not afford to pay the bills.
Now an appendicitis bill is small potatoes compared to what Juan is going through. I had one x-ray, one ultrasound, surgery and stayed in the hospital for all of two or three days if I recall correctly.
Ironically I could've sued the hospital for malpractice as the Triage doctor in the emergency room had initially misdiagnosed me as having a UTI, even though I told him I had seen a Gastro doctor and he had told me it was appendix. The emergency room had also kept me waiting for like 3 hours before triaging me, putting me at risk for a rupture, even though I stated I had severe abdominal issues. The only good thing is that when confronted with the experience I had, the hospital voided my ER bill. I ultimately did pay off my surgeon though. My surgeon made it clear that I was *that* close to rupture and did a great job on this pre-op transwoman, a true professional.
I had 4 attacks of appendicitis before succumbing.
It was sad that I had the opportunity for dirt cheap student insurance for hospital only health coverage to help out on this and did not sign up for it.
I was THAT poor at the time.
Juan obviously does not have that excuse of course.
It's stories like these . . .
It's stories like these that leave everyone from more civilized countries scratching their heads and wondering why we even tolerate such a crazy-assed healthcare system, much less imagine that it is the very best in the world, that absolute acme of civilization.
— Emma
Yep
In retrospect I was clearly poor enough with only like 500 dollars to my name to qualify for medicaid if that existed back then.
FWIW, I had been laid off from work after only getting my new job for like a year so had no time to gather savings after being previously unemployed for 9 months. Since I was transitioning I could not resort to asking my parents for help, all they would've done was demand I go back home and that was a non-starter.