We are, every one of us, subject to stress.  Some of this stress, if prolonged and unrelieved, will kill you.  It does this by raising the blood pressure, causing unhealthy eating with its associated health problems, providing the random stroke here and there.   Death by stress, the kind that makes us feel utterly powerless, is the death of a thousand cuts.   Multiply the cuts by five if you are poor, because they will come at you at a fairly vigorous rate.  

The life expectancy for poor people is shorter than for affluent people.  The way poverty kills is as interesting as it is sickening.   I have been learning about it daily as I try to get the medical services I buy insurance to help me pay for in the wealthiest country on earth.    

I must point out that I am not poor, though I have no steady income, or unsteady income either, for that matter.   I am not a candidate for pity or sympathy, my subsistence life is a matter of choice based on my priorities.   In 2010, when my mother died, I inherited enough to live for a few years while focusing on the program I was trying to get into public schools.  The money was not enough to retire on, but it was enough, if I lived frugally, to keep me afloat until I can figure out how to make a living.  Fortunately for me, I have never coveted most of the things that money can buy.  I own virtually nothing, beyond the mountain of boxes of paper I am too weary to sort through.  

I am aware that a case can be made that I am living the life of a mad person.  As is true of my kind, the idea that I may be living the life of a mad person does not unduly bother me.   The life I am subjected to, constantly, for living on an income less than 200% over the artificially low poverty line, on the other hand, bothers me continually.   It is the bitter taste in my mouth I often wake up with.

Today, for example, I woke to this note from a lawyer who was helping me on my “appeal”, congratulating me on the overturn of New York State of Health’s January 9, 2017 error that forced me to pay double the legal rate for my monthly premium.  I will now, or at some point, be paying the legal amount for health insurance, based on my taxable income, rather than the full amount.

You won, congrats! NYSOH has 30 days to comply by redetermining your eligibility for tax credits. Provided they do so, you should expect to start paying a lower premium – my guess is for September.

It makes no difference that this redetermination takes, literally, about five seconds using their own on-line calculator.  They have thirty more days, under some obscure federal law regulating the exact parameters of how agencies may fuck with poor people.   You can’t reasonably expect a simple error to be corrected in less than 170 days– not if you are powerless to threaten legal action.  

I read this email as, directly above my bed, an hour before my alarm was set to wake me, the woman recently sprung from the lunatic asylum began caterwauling her imagined vocal exercises.   A dog, hearing this shrill, tuneless whine, began to bark in protest.  I listened to my voicemail.  

It was not the promised call back from the nephrologist’s office I have been waiting for, but a detailed demand from the office of the dermatologist I will see on Thursday about the form of referral I must have sent to them to avoid paying the full, uninsured price for the visit.   A paper referral, like the one I brought to the nephrologist at the same hospital, will not do, the message informed me.  It must be electronic and it must contain the dermatologist’s full name and NPI number and other information, which is recited in detail.   The message ended by giving me a fax number for my primary care doctor to send the “electronic” referral to.

I thought of the stack of medical bills on my kitchen table.  It is a large stack. The bills from the first months’ visits and tests for my kidney disease are close to two thousand dollars.  This is no problem, my deductible is two thousand dollars.  The bills from the hospital demand a number fifty percent higher than the number my insurance company tells me I’m responsible for.   Somebody is right, somebody is wrong, it is up to me to figure out what I actually owe and to pay the proper amount.  Overpayments will not be refunded.  

It is the accumulated devilish details of one’s powerlessness that kill a person. I could whine on in this vain as the hysteric upstairs continues to keen, but it would be less than pointless.   I want to lay out exactly what it’s like for the poor person receiving any government benefit— or handout, as it is often phrased.

 We live in a country where the law permits a billionaire to take an enormous tax loss in a given year, like our president did when he lost $919,000,000 one year, and pay little or no tax for decades as a result of that enormous loss.  It’s a good deal for a very wealthy citizen, no question.  The tremendous saving is well worth the fee you will pay to the tax attorney to set the legal scheme in motion.

If you are not wealthy and receive any sort of government benefit, on the other hand, you will be subjected to more stringent requirements.  You will have very tight deadlines to comply with these requirements.  Miss any single one and you will be removed from the program with little or no right to appeal.  These things are absolute.  

If you are disabled and get a subsidy toward your rent, and you receive a notice to attend a face to face meeting to redetermine your eligibility, or even if you don’t receive it but the agency has prepared such a notice, you will lose your benefits for failing to attend the face to face.  I was involved in many cases in housing court where this happened.  It can take a year or longer, if ever, to have these benefits restored, provided a skilled advocate exerts herself heroically enough on your behalf.   You know this is fair, because you are a fucking loser.  

OK, we all know it’s not fair.  But de minimis non curat lex— the law does not concern itself with trifles.   Your paltry little housing subsidy is nothing compared to the millions a wealthy person stands to save by shrewdly using the tax code.   You will be homeless, with nobody to blame but yourself.  What do you want the rest of us to do?   Be realistic.  We are in an existential war against Terror while politically motivated alarmists are trying to convince us that strip mining the earth and burning everything we find is harming the earth beyond repair.  

Who are you going to listen to anyway, the wealthy, telegenic personalities of the mass media or some artificially poor fuck whining on a blahg in an attempt to drown out the howling of a mentally ill woman upstairs?  Besides, I am reminded that it is summer, time to relax.  Why do I allow myself to get worked up like this?  Jesus.