The next great cure?

What do Louis Pasteur, Jonas Salk, Sigmund Freud and Barack Obama have in common?  They all championed controversial medical revolutions and if not for their bravery in the face of conflict, billions would have died.  Sterilize instruments to kill invisible bugs?  Inject disease particles to build immunity?  Look into our subconscious to explain everyday behavior?  Give basic healthcare to everyone?  Ludicrous.  That is why we named these advances after these men.

As an oncologist who has seen the fatal cost of our patchy, imbalanced and unfair healthcare system, I have to be at very least hopeful about ObamaCare; AKA the Affordable Care Act (ACA).  The list of benefits is so vast that whatever glitches happen along the way, I know that cancer patients will be helped:

No pre-existing condition exclusion: so the 31-year-old programmer with Stage 1 breast cancer can change jobs without losing insurance.

Healthcare coverage by parents until their child is 26: so families will not lose their homes paying for Hodgkin’ s disease in a 22-year-old.

Guaranteed payment by insurers for patients entering experimental trials: So, patients with any insurance can be involved in research, and everyone benefits from the latest advances.

Free healthcare screening: So that my 58-year-old neighbor with a family history of colon cancer gets routine exams and life saving colonoscopies.

Uniform healthcare insurance standards: So that the 45-year-old man with stomach lymphoma I saw last week, does not have to suffer and die because his employer brought a health policy, which excluded chemotherapy.

All health insurance must cover at least one drug of each type: So patients do not have to choose which insurance by which drug they are taking, and prey the doctor does not change his mind.

Emergency room visits do not require preauthorization and they cannot be charged as out-of-network; So that Monday morning my patient with lung cancer does not stumble into and collapse in the office after having a fever all weekend.

Psychiatric parity: So that the 41-year-old Mom with advanced melanoma, two kids and a mortgage, whose husband just walked out on her, can get counseling and support.

Insurers must cover hospitalizations without a lifetime cap on health costs; So that more than half a million families each year in America will not go bankrupt paying inpatient bills.

Guaranteed physical therapy and rehabilitation; So that my patients who are cured of cancer have a real chance to get back to real lives.

Prenatal care: So that the national disgrace that is a ridiculously high infant mortality rate will stop killing babies and I can hear children playing outside my window instead of tears.

Health insurance for tens of millions of people: So that they can get care and, hopefully, their caregivers will be paid.

-Finally, and critically, health insurance and policies written not in lawyer-businessman language, but in clear English and every person is guaranteed the right to appeal any coverage decision.

 

I know that such a massive, complex undertaking, giving medical care to an entire nation, will not go without a hitch.  Rumor has it that Pasture kept burning his bands, Salk broke dozens of syringes and Freud, well Freud himself needed therapy.  Nevertheless, ObamaCare is a chance. A chance for us toward move toward a compressive, modern, world-class health system, instead of medical chaos, which may hurt as many as it helps.

My physician colleagues are concerned about the affect of the ACA on their relationship with patients. Doctors worry that information system enforced standards, increased volumes and decreased reimbursements may make it difficult to give personal care. These are important issues and protecting the quality of individual care is vital.  Still, I find that when I close the door to the exam room, that it is still just me and the patient and I can deal with the demands of a new system if it means that millions do not need to go without hope.

What is happening in Washington baffles me.  I cannot imagine any of us want to live in world where decisions already made, have no meaning.  For physician’s whose word and honor is the key to our bond to patients, that leaders would fail my patients so badly is horrifying.  My patients would be distraught if I told them I was going to order one treatment, but gave them another.   They would be desperate if I told them to come for a critical test, but locked the door.   Their worlds would collapse if the price for treatment were all their savings before we could even begin.  I would be betraying all that I know if I told patients they would live, but planned for them to die.

It is time to move on with this next step in a healthcare revolution, which started 150 years ago.  We can change, rebuild, add to or subtract, but for now and future generations we have to try.  Simply turning our backs on such an exciting future would be the same as spitting on our hands before operating, inviting polio to return, and treating psychiatric disease with pity.  We are smarter than that. We are better than that. We deserve more than that.  Let us move forward, not back.

50 Comments

  • gopja
    So many valid points, which most of are not trumpeted in the mainstream media circus as they should be. So many changes for the good!
    • James Salwitz, MD
      We do see to have missed the overwhelming good while fighting about the detail. jcs
      • Robert P Hogan, DO
        The article was very good. Is medical insurance a right or priviledge? Is is no public option. All citizens are to buy insurance from Insurance companies whose true goal is to make money. I have written to Hiliary and our president and sugested to look North at Canada, but this is too money from the lobbist to even consider this. I do believe insurance is our right to have this. It's a good start but I'm worried that this coming too fast without proper education about this new healthcare system for all. PS I though you had a beard before.
  • Thank you, Jim. Hope you don't mind if I share on FB. You know, my best doctors, who deal with the most challenging cases, are supporting the ACA as well even with the kinks that are sure to come. But we have to start somewhere.
    • James Salwitz, MD
      Please feel free to share ... the conversation itself is vital. jcs
      • meyati
        I've heard that about the details from an oncologist-and that I'm too detail oriented. The details are the quality of my life. I don't think that it's easy to be an oncologist. The pain in my doctors' faces was palpable when they gave me the prognosis. The oncologist looks at the overview, the latest research,and how the majority of the patients are affected by something. Being a patient gives me a narrow focus, and that focus is narrowed on if this will help me and my family.
  • alyce
    Thank you for putting this important issue in a non-political way. You always put the patient's health and the doctor and patient relationship first.
    • James Salwitz, MD
      One of the advantages of being at the bedside is that my patients remind me every day of life's realities. Thanks, jcs
  • Many of us here in Canada feel saddened and puzzled by the outrage and opposition by so many Americans to your ACA. I and all other Canadians already have access to the benefits you describe through our universal health care system. As a heart attack survivor, I paid not one penny out of pocket for my E.R. visits, all of my cardiac diagnostic tests and lifesaving procedures, my CCU bed, all nursing care, and cardiologist's followup visits now and forever - nor will I ever worry about my family facing crushing debt because of my cardiac event, or being denied future care because of my pre-existing condition. I won't face medical bankruptcy, worry about losing my home or business, or have collection agencies hounding me as many heart patients in the U.S. have described to me. And Canada provides what is ranked as among the world's best health care coverage. It's certainly not a perfect system (supplementary benefits like dental care and drugs outside of hospital are still not covered in every province), but it seems far superior to the nightmare alternatives you so correctly outline here. Thanks so much for bringing a much-needed sense of humanity to what's become a political nightmare. I hope all Republicans are reading you.
  • Janet Visokay
    Well said! Any illness cancer included of course, brings such horrific consequences that to address the financial part is enough to put the poor soul over the edge. I speak from experience sadly.
  • Thank you for posting this timely article. Very sensible words! Now, any chance you'd like to run for Congress?
    • James Salwitz, MD
      My wife is the polico in the family ... one is enough, but thanks for the support. jcs
  • Magda Kowalczykowski
    Thank you for posting this -- you really paint the big picture here, and put everything in perspective. We are finally catching up to the rest of the world when it comes to identifying health as a human right, not a privilege.
    • James Salwitz, MD
      Absolutely. We also make a giant mistake if we believe we can ever have a healthy nation, if we do not have healthy people. jcs
  • Kris in AL
    Dr. Salwitz......of course everyone should have access to comprehensive healthcare....but what about those who choose NOT to work? Should they get another major entitlement just because they have a heartbeat? What about the cost? Who should pay for this new, massive entitlement? Just those who work via payroll taxes? Should we borrow $200-300-400 BILLION more a year to do so? I'm ALL for extending our Judeo/Christian values, including caring for the sick and injured to ALL those who need it......but not to those who choose not to work, Should those who make 400% of the "poverty line" get substantial subsidies from the government? PS... you forgot to mention that if the young refuse to participate in subsidizing those who are older and/or ill, Obamacare will become a bigger financial disaster for the country.
    • James Salwitz, MD
      I have several thoughts. First, every major analysis shows approximately $600 billion waste in healthcare, so the money is there, with dollars to spare. Second, I view quality healthcare not just as a necessity for each individual, but also for the nation. A sick country cannot compete or lead on the world stage. Therefore, healthcare, either as a moral or practical matter, is a necessity. As a nation, we long ago agreed to all chip in to pay for necessities such as the military, police, infrastructure, emergency services and education. If the young (or anyone else) refuse to pay for necessities like these, than you are correct, we are doomed. jcs
      • meyati
        Why isn't there a focus on medical fraud? Do you really think that an agency that's being investigated for fraud can be successful in protecting the integrity of a national-compulsory medical program-and IRS does not have experience in medical care, unless you qualify knocking back a few shots at 'Vegas as medical care. Sorry about the run on sentence.
  • Sharon Powell
    What could be more refreshing than having someone intimately involved with medical care write an objective and educated view of our country's medical care! I am often saddened by the inaccurate reports on the Affordable Health Care Act. The internet has allowed outright lies to go viral with no one checking the validity. Imagine the surprise of my friend from Norway who was told by an American that Norwegians over the age of seventy are cut out of all medical care! Fortunately he has a sense of humor at such an absurd statement and we both had a good laugh. I enjoy your writing. Sharon Powell Roseville, MN
    • James Salwitz, MD
      Thanks very much. Norwegians over 70 are indeed cut out of health care, but only if they are visiting the USA. jcs
      • Liz
        LOL
  • I keep thinking of "The Mental Traveler", William Blake. how an idea goes through various stages and is eventually remade again, hopefully better until it is challenged once more and undergoes the process again. The ACA will go through the process as well. Thanks for this post!
  • One of your very best - and most important "big picture" - essays. I forwarded the link to CNN producers who have written me since I posted my story on CNNiReport - http://ireport.cnn.com/docs/DOC-1041280. I hope they contact you. Your eloquent voice deserves a national audience. Thank you for the historical perspective and for all you do. You keep hope alive for all of us, not only those under your care.
    • James Salwitz, MD
      Thank you very much. Enough is enough. jcs
      • Dialogue and praise for those with insight is very worthy! Never too much information! Thank you again!
  • Liz
    And then, of course, we have the 26 or so states that have decided not to expand medicaid. If you live in one of those states (as I do) and don't make enough money to have an income high enough to get a subsidy for premiums (that would be me) then none of your statements will hold true. Unfortunately. As someone who is unemployed, paying COBRA and living at 73% of the poverty line, not only will I be homeless next month (because paying COBRA is a higher priority than paying rent and I am about out of money), I may not even be able to have my Nov apt at MD Anderson because I owe them too much money and I don't have enough left to make a big enough dent (not to mention I will owe more after that visit). Even if I manage to pay them enough I will be sleeping in my car since I have no money for a hotel and MDA does not help out of state poor patients. As someone with a PhD and who has worked ever since I was 16, I think I need to move to Canada (I have worked in Canada, the UK and the Netherlands and experienced all three of their health care systems - systems that give health care to all) because even though each of those systems have flaws (and while I still might be homeless in any of those countries), at least I could continue to get medical care. Fortunately, as someone who has had a string of cancers, none of them need chemo at the moment (knock on wood). Too bad this country does not value my life or contributions (I have top teaching reviews, been voted best teacher, have several international research awards and publishing awards, two best reviewer awards, started several orphanages and schools in a least developed nation, and have managed to raise an adopted daughter with many psychiatric issues and brain damage who actually graduated from high school and is not in jail (although had one baby 5 months ago and has another one on the way - 2 out of 3 isn't too bad as the first two were not a given LOL). But in my state (MS) my life apparently is not considered valuable enough to merit access to health care. Our governor, yesterday, stated he was "proud" of not expanding medicaid. I hope karma bites him in the rear.
    • meyati
      A few days ago, it was announced that we just took the title of the poorest state away from you again. Then right now this state is more violent than Louisiana. Here in NM, we say -thank god for Mississippi and Louisiana, they bump us back to #2 or 3 for poverty, poor medical care, rapes, school drop outs, teen pregnancies, high employment, but some how NM seems determined to take the title away from your state and LA. NM now distinguished to be the only state that had wages drop in the last year, 30 cents an hour less. You need to say-Thank God for New Mexico. I have a national security clearance, lost all spousal military benefits after 37 years of marriage-he drove off with a blonde younger than our youngest child. I'm a member of Phi Kappa Phi-and was in a state program that taught gang-bangers. You and I studied the Greeks, and we realize that life isn't fair to everyone, but do the others have to rub our noses in it, as though we are dogs that pooped on a $10,000 silk Persian rug? Please read my post below, about how ACA is affecting my hard working student grandson. These PollyAnnas think that many students have Corvettes, party no-stop, etc. The ACA is going to ruin the life of many poor that are trying to get through university programs. I can take my fate, but I despise what ACA is implementing through IRS, and how it will destroy the lives and futures of the 20-30 year olds. Thank you for letting me know that I'm not alone.
      • Liz
        I think the points that were made in the original blog post by Dr. Salwitz point out exactly how access to health care will make a critical difference to many, many patients (young or old) with cancer and other diseases. I do not think this is the place to debate the law. That was not the point of his post. Instead he was pointing out how it will help his (and other) patients get the care they need. I think it would be a shame if we hijack his post.
        • meyati
          With due respect-the success in ACA will come from dealing with reality, and part of reality is dealing with the financing and administration of ACA. I believe that there is a fallacy in the financing, by believing that most 20-30 year olds do not see a doctor or get medical care, so therefore they must be healthy. They ignore the fact that perhaps they don't get care because they absolutely can't afford it. Dr. Salwitz wrote about what I hoped for. Of course, even proven programs can have bumps, dead-ends, and curves. But the reality is that ACA can fail most Americans, if it is not financially realistic about funding. Don't blame me, blame the Supreme Court about its ruling about state's rights. Blame the Republican governors that were party in causing this rip in the fabric, with their challenge about ACA that went to the Supreme Court. You reminded me that New Mexico isn't the only state with these problems. I'm a Democrat-people have called me a Communist in some instances. I do not have an agenda, except for seeing how ACA is failing the youth, and through this failure can cause the financial failure of ACA. As far as an agenda- for years the most feared words in America were "IRS". IRS still has a shock and awe-fear factor. I still don't see how IRS is qualified to administer ACA. I am entitled to have an opinion. As far as Dr. Salwitz, I find him to be articulate and wise. I'm a fan of his, but this is a discussion.
      • Liz
        The IRS is not running health care or the programs. All the IRS is doing is being involved in whether or not someone has health care, since that will be reported on W-2's and the associated fines if they do not.
  • meyati
    About Liz-I also live in a state that's not expanding Medicaid-the opposite is true. Last time I applied for food stamps and medicaid, I earned $7.00 a year too much. I have a national security clearance, belong to Phi Kappa Phi, and I now collect social security. I believe it was Forbes that said Medicare was moving to have the lowest income recipients to transfer to medicaid through a clause in ACA. I know that I was contacted by my senior care plan to do this after I was diagnosed with incurable cancer. This contact was by phone several times, and by mail. Coincidence? cancer brain? I have a grandson that's covered through medicaid and SSD-he's felon with a warrant out on him for car theft. I'm grateful that our society is compassionate to the weak, which he is.He has brain damage, but he can remember how to break and enter and hot wire a vehicle. I just do not understand why IRS and ACA will make my other grandson, a full-time student a criminal with thousands of dollars in fines that he can't discharge in a bankruptcy.He's honest, works part-time and volunteers for any extra hours. He owes for tuition and his books, and that must be paid off by Jan. 1, 2014. What will they do, put him in prison? Because he's honest, working to pay for his tuition, attending classes, they will find him. Meanwhile the other grandson will be out in the wind and getting care. What experience does the IRS have with investigating medical fraud and running medical programs? I am a Democrat that regrets signing any MOVE-ON petition for ACA. Once again the government screws the working poor.
  • Liz
    At most universities students have access to very low cost health insurance (low cost in a large part because their pool is almost all young people). There are also companies that offer student only health insurance you can buy if your school does not offer their own program (my daughter had that because it was cheaper than getting a family plan the year she was in community college which did not have their own plan). If the school is a residential one, they usually have a student health service he is already paying for in his fees that covers, with no additional fees, the kind of care you get in a family practice doctor's office (that is the other reason why student health insurance is often dirt cheap - they aren't covering regular doctor's visits at student health services since other fees cover that). If he is under 26, even if he is married and doesn't live at home, he can be covered on his parent's family plan. The fine, the first year, is less than $100 and they are not jailing people for not paying that. There are low interest student loans that many/most students take out. I have close to $100,000 in student loans almost entirely due to getting my first cancer in grad school and the health insurance offered by the university had no out of pocket limit. Had I gotten this cancer under ACA there would have been an out of pocket limit for my student health insurance and I would not be drowning in student loan debt. Incidentally I had minimal family risk of cancer and have had a bunch of them, including one that has no cure. You'd better hope that grandson is luckier than I was. While in grad school I also got hit by a car while I was walking on the sidewalk on campus. The cost of that ER visit alone was more than I paid the entire year for health insurance premiums and was covered in full (driver of the car was uninsured so my health insurance had to pay for it). If I had not had insurance my debt would have been even higher. In life we have choices - gamble things will be fine and take risks, decide we can't predict the future and cover our rears. If we gamble wrong and lose we are in trouble. This goes for more than insurance. I gambled that because the odds were so low I wouldn't get breast cancer on the other side I therefore only had one mastectomy. I lost that gamble. Then as icing on the cake I got a different non-curable cancer on top of the second breast cancer that same year. At least in the second and third cancers (unlike the one I had as a grad student) my out of pocket expenses had limits and I didn't become homeless due to needing treatment. Now, unemployed (with an EEOC complaint pending over that, but that office is currently closed) I am struggling to pay rent and COBRA. Had there been a subsidy (which I can't get since I live in the wrong state) the day I started COBRA, I would still have had financial issues but my money would have lasted a lot longer and I wouldn't be facing homelessness in November and no health insurance at all shortly there after (my state is not expanding medicaid). While the odds are low, just as they were for me, of having catastrophe happen, bad stuff does fall out of the sky and randomly hit people. With no safety net in place the results are frequently devastating. Insurance is a safety net. With your grandson gambling that no catastrophe will happen to him, I hope he is right. His student loan debt will be far higher paying for catastrophe than paying for bronze level health insurance.
    • Liz
      opps - typo, meant to say the odds were so low I WOULD get breast cancer on the other side... not WOULDN'T
      • meyati
        He does not have the money- I do not have the money for him. What part of "We do not have the money" is hard to understand? Before the 1990s, the university provided free health care for full-time and graduate students. This included C-sections, burns, car wreck injuries, etc at the teaching hospital-which is one of the top 10 in the nation. Then they provided low-cost insurance that provided complete care, and the uninsured had a $15 clinic fee and they could pay the bursar later. In 2001. For more comprehensive care an uninsured student was on their own. The insurance doubled by 2001. By 2006 it went to $1,900 for a school year and excluded summer coverage, even if you were a student, and pregnancies were no longer covered, unless you got a rider for extra cost. The only insurance that had better care for a cheaper price was carried by the Independent grocers association. One of the doctors that I knew applied to the grocers association for his office staff. I'm the one that gave him the contact number. I do know what's going on at our university. Some families go to Ol' Miss, We go to UNM. Just because I am a life-time member of Phi Kappa Phi, that does not signify that I'm well-to-do, or lucky. My grandson delivered pizzas all day in early August and was given $3.25 in tips. I seldom drive now. I gave him my car, so he could have a better chance of being hired. His uncle took him to construction sites, phone call centers, etc.He applied online for Home Depot, Walmart, etc. We seldom have job openings in this city. This city is currently listed with Detroit, as not being able rebound from the recession. I make the car payments-I bought it while still able to work, I pay the car insurance, and parking permit fees. I cannot pay anymore. My son helps, but he's also helping others in the family. His X-wife is an electronics engineer that can't find employment either. There are no jobs here-- The cities are flooded with ranching and farming families that will do anything to earn a nickle, because of the 5 year drought. We had floods 2 weeks ago, that ruined what was left of crops, and killed livestock--5 years of drought, 3 years of massive forest and prairie fires, because of the drought, and 2 weeks ago the flood of the century. We still have isolated villages. People, counties, and state are doing what can be done, but you know about the federal government. Many people here cannot afford to pay a penny extra and our state is reducing the Medicaid and food stamp load.
        • Liz
          There is no need to be rude to me (eg what part of X do I not understand). Life is full of choices and some of them suck. For example I could wait to be evicted and get 1 or 2 more months where I live but I am not choosing that because I do not want to ruin my credit and make it even harder to rent in the future. I am not thrilled by that choice, however the alternatives, in my opinion, are worse. One choice that he has as a student, that I do not have since I am finished school, is to borrow money for things that are a priority. That is how I paid for my first cancer. That was a choice. Yes my debt load is crushing now, but that is better than the alternative. If health insurance is not a priority then he doesn't need to borrow the money. He will not go to prison, he will be fined, in 2015, for 2014 less than $100 provided he even made enough money to qualify for a subsidy. If he did not, then he will not be fined because none of the rules apply to anyone who has too little money to qualify for a subsidy and lives in a state that did not expand medicaid/can't get medicaid because of the rules in that state to qualify. Based on what you have said, it sounds like he is home free on that one and neither of you have anything to worry about in terms of costing either of you anything, jail, fines or anything else related to the new law.
          • I love the back and forth dialogue..helps achieve many perspectives. I have a 19 year old son, who has coverage till Dec. under Cobra and his dad's former employer. we are in our early 60's. The stress he has been subjected to and the lifestyle differences of people his age in this area..affluent central NJ..where everything is more expensive. J&J, Merc..major employers....Do not underestimate the importance some people place on partying and socializing...I never could afford to through HS and College.
          • meyati
            You said it well
  • To get back to the main theme, this was a great column, Dr Salwitz. BRAVO! I guess it provided an excuse for a few rants, too. Many folks take exception to positive change, precisely because it's change.
    • Kris in AL
      But I thought we did not have to change our plans....doctors....etc? I thought it would lower our insurance costs? I thought we'd have more choice? (Sorry about the sarcasm)
    • There are many variables involved. Regardless of change, there will always be those that benefit and those that might not and also need for major or fine tuning..to work out the kinks. Implying change is always good is a false premise. The ACA hopefully is more helpful than hurtful!
      • meyati
        I just hope the kinks are worked out so that the 20-30 year olds aren't disenfranchised, and they can become the needed money makers to support this new system and social security. I wish for them to prosper-live well-and have the same opportunities that most previous generations had.
        • My wishes as well. I just watched a move "Looking for Superman", by Guggenheim...about our public school system..2010 I think. Gives cause for concern. I would recommend it.
          • Sorry for the typing errors. I check but they still appear wrong sometimes.
        • meyati
          Jill, Thanks for your understanding of this aspect of the problem, and bring it up. I taught junior math at a troubled high school. I call it gang central. I had capable students told by counselors that they weren't qualified for the university. I tried to find ways around that for them. That's when being a Phi Kappa Phi, a national honor society, member to be helpful. One was 300 lbs-all muscle. I took him and his parents to the UNM football coach, and he was signed in as a "walk-on". Then he was allowed extra tutoring that allowed him to succeed. He owns a physical therapy company now and is a dedicated alumni that helps others.. We're having a crisis with student loans for this age group now. I owe $45,000 in federal student loans myself. Getting a loan isn't always feasible for some of these students-that's why they are working and taking their pay to the bursar's office. Thank you for your compassion for this age group.
          • I finally received my BFA and was pursuing an MFA or MA when I had my early cancer diagnosis and then was pregnant. I have to laugh..I came from a middle class white background..WASP..so to speak..but was independent and working two jobs sometimes to make ends meet. I could not get financial assistance in 1981 . I worked my way through college, initially my parents allowed me to live home and provided some transportation to and from the train station..I ran newspapers in the morning for my train fare. I applied for a loan in my senior year at Rutgers as a Mason Gross student..finally I received $2500. a semester and a Pell grant and work study. I met my husband who was a grad student and owed much more. we paid our loans off and most of our medical bills by the time my son was two or so but than were holding credit card debt. Many of the Laws have changed (8% interest over 10 years adds up) Sally Mae issues etc. What is interesting is the money that get's invested in education for some students who never really have much of an income down the road for many reasons. I worked in the financial industry for 6 years....
          • meyati
            one day I went into the Bursar's office to pay gym locker fees. They told me theyI had a $3,000 FASFA check for me. I thought that I had collected my monies. I went in to see the supervisor. The papers we signed, said that the student is responsible for paying off the money, once the feds dispersed the money to the school-not dispersed to the students. I told all of my classmates, who ran to the bursars and picked up loans that they didn't know about, but had to pay back. Since I was an older student, I had a FCU account and records. I was able to prove that I owed over $10,000 in student loans that the school received, but I didn't receive, even though I had to pay the feds back. The head of financial aid had believed that the money was returned to the government, and credited to the students' balances. Nobody could account where the lost monies went. She thanked me and was in tears. Other students had been going in and saying this, but didn't have the records. This hit the school newspaper. The school changed its practice and notified the Feds and other schools, so this wouldn't happen at other schools. This was 2003, Many of us went in every 2 weeks to check on loans. If you read my other comments, my husband left me-I lost many things. This is a poor state, only state where wages went down last year. I paid off Sallie Mae early, but having to pay off the extra $10,000-$11,000 hasn't helped me in paying the gov loans off. As you noted about interest, I'm paying interest on that money too.
          • I am so sorry that this situation continues on. For everyone. Discrimination based on many things..especially lower income families only creates more expenses and problems for this country. One of my housemates when I was at RUTGERS IN 1980-1984 had a masters degree in student advising, minor in art. Her starting salary was about $11,000. at Rutgers. Just being in an affluent family does not make one the smartest or the best..just someone who has more opportunities. Brilliance among the poor may not have no bearing at all. There was a study and following of students with super IQ's many years ago. What was found was the ratio of 'success' or outstanding performance statistics was no different for above average or average students.
  • meyati
    Agreed----
  • hck
    I think I should point out the Gov. Martinez DID finally agree to expand Medicaid in NM. She kept it off the table during the election cycle because it was highly unpopular in her party, but the expansion of Medicaid started in NM last month. http://www.healthactionnm.org/learn/medicaid
    • Mary
      Thanks for the info. I heard 6 weeks ago that they were going to reduce it again. Sometimes talk comes true, sometimes it doesn't. I just feel worn down about everything on the national level, including ACA. I'm proud that this state has been ticking along OK so far. Martinez sometimes makes people mad, She's not always politically correct, but if she ran for President, I'd vote for her. I'm one of many Democrats that put her in Santa Fe. I think the White House is probably a goal because she's been raising money and support in very conservative states for her next election.

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