Off-the-grid low-cost health care

What’s in our medicine cabinet? We have one shelf above the toilet that is a board made from rough cut lumber; two feet long and six inches wide. On that shelf are all the medical supplies we need for our basic survival. There is 8 ounce bottle of rubbing alcohol, a 16 ounce bottle of Hydrogen Peroxide and small bottles of Mineral Oil and Witch Hazel. One bag of Epsom salts, a tin of bag balm, an assortment of bandages, gauze and tape, a tube of antibiotic crème, a tube of hydrocortisone crème,  and a jar of petroleum jelly. One bottle of Bayer aspirin and one tube of preparation H. There are no pill bottles, no vitamins, no potions or lotions. Two combs, fingernail clippers and a tweezers. What else do you really need?

On a shelf above the head of the bed, I keep a rice pack and a corn bag. Pains are numbed by a frozen rice pack and ear aches eliminated from a hot corn bag. There are only two other products we use in home health care treatments: Traumeel and BioTone body lotion. Both contain arnica which aids in healing. Next to the sink are my toothbrush and a box of baking soda. Why people buy a sugary paste to spread around their teeth to prevent cavities befuddles me. Baking soda not only keeps my teeth clean, but my tongue too; and aids digestion because it is a natural antacid.

Kissing a man without a beard and moustache is like taking a bath with your shoes and socks on. Thankfully Sam wears a beard and moustache. He trims them in spring and fall and I just hate it for the first few days. Sure saves on the mess daily shaving makes.

Upstairs is a claw foot porcelain tub. I take a bath once a week, whether I need it or not. In summer, I am in and out of the pond constantly. In winter, the long hot soaking bath soothes the soul.  Shampoo, crème rinse, Epsom salts, Ivory soap in bath bars and peppermint foot lotion sit on a shelf just above the faucet of the tub. Washing my hair is the first part of my sudsing routine. Taking a pumice stone to the bottoms of my feet is the finish.

Taking a shower once a day is common in the U.S. but throughout most of the world, water is now more valuable than oil. Our obsession with germs is expensive all the way around. The chemical products sold to “kill germs” are also toxic to people. The lack of exposure results in weaker immune systems. There is nothing wrong with getting a little dirty. We strip our skin and our hair of their natural oils with frequent washing.

On Warren Pond

Caring for one’s health is all about sleep, diet and exercise. Such simple and common sense prescriptions are not profitable. Fitness clubs are a huge industry yet walking costs nothing. Swimming in the pond is free.

My ab-buster is a hoe. Every spring I work off that little roll of winter dough around my middle by vigorously hoeing thousands of row feet of peas and beans and other crops. I love to wake up before dawn and, before coffee, grab my hoe and head to the field. Hoeing is not just good exercise. If you take a hoe to those weeds competing with new seedlings there is no need for herbicides. In the early day’s dew, you clip those weeds roots and gracefully turn them over to die quickly in the sun while the seedlings are caressed by the moist dirt.

Baling hay is another body toning experience. I ride behind the baler and as each square bale comes off the end, I grab it and fling it toward the back of the wagon. Then I stack them until the next bale gets kicked onto the wagon. When the alfalfa is rich and thick, the bales come out so fast I feel like Lucille Ball in a chocolate factory. But when I finish a field with Sam and I am riding atop the hay wagon with bales stacked five high, my body experiences an exhilaration known only to marathoners. The sweat drips off, your muscles quiver, lungs feel wide open and you itch everywhere. It is almost as good as sex.

Chopping and stacking fire wood builds upper body strength like stacking bales above your head in the hay mow. Hauling buckets of grain is better than lifting weights in a gym. Squatting to pick peas and hiking along hedgerows to pick berries provide lots of stretches Pilates machines haven’t yet mastered. You don’t need a gym to do calisthenic exercises; the floor works. Dancing to the 12 volt car radio inside on a rain April Saturday night boosts the energy level up.

Sleep, diet and exercise are key to preventative health care. But accidents happen. One day I set my hoe down and ran to answer the ringing telephone inside the cabin. When I came back out, I stepped on the end of the hoe and up came the handle. Popped me hard right in the middle of my forehead. Big shiner the size of an egg. Most accidents can be prevented by common sense. Farming, nonetheless, is one of the most hazardous occupations because of the variety of things that can go wrong.

Everyone gets insect bites or cuts and scrapes. Sam has had a broken left ankle, several broken ribs, strained neck and disintegrating vertebrae and too many dangerous cuts and slashes. This explains why we keep a large bottle of Hydrogen Peroxide on hand. There is nothing better to clean and disinfect an open wound. Sam believes strongly in wet dressings should any infection set in. There is not much a doctor can do for a broken rib; except charge you for an expensive x-ray to confirm what you already know. The body is exquisitely designed to heal itself if given a chance.

Most of the old time and natural remedies work. Chicken soup does relieve common cold symptoms. Garlic builds your immune system. Cranberry juice and rosehips keep your colon, kidneys, liver and digestive system working properly. Drinking more water will alleviate a headache. Sleep is the restorative process for the body.

Dentists and dentures

The retail model doesn’t work any better in health care than it does in education. The profit motive drives most physicians to prescribe unnecessary treatments and medications. This is also true in dentistry. I asked my dentist to pull a tooth and he wouldn’t do just that. He said I had to have a root canal and a bridge. Just three thousand dollars with a 3% discount for cash payment in full.

You may be the customer but once you are in the chair with your mouth wide open, he’s the doctor and you are the patient.

It wasn’t his bill that made me nearly shove him through a wall. When I went into his office to have the permanent bridge put into place, I told him I had just brushed my teeth with baking soda.

“Can I rinse with water first?” I wanted that chalky feeling off my teeth. An hour or so after brushing I was also thirsty.

“Oh no. You don’t need to. This should be applied dry.”

I leaned back and tried to relax.

“This is the easy part. It won’t hurt. You won’t need gas or novacaine. I am just going to apply a little pressure until it glues into place,” explained my dentist.

I opened wide. I watched him apply some goo onto the upper surface of the enamel imposter tooth. Then he inserted it into the gaping hole in my mouth. He pushed up.

“AAAAaaaaargh.” I put my right hand up against his chest and shoved him hard. The pain inside my mouth was excruciating.

He put his hands up in the air.

“What the….?” He exclaimed. His assistant grabbed my shoulders from behind and pulled me back. I put both my hands over my mouth and moaned.

“What is that goo made of?” I angrily grunted. “Hunh? What is it? Some kind of acid?”

The dentist looked at the tube and nodded yes.

“I told you I had just brushed with baking soda. What happens when baking soda mixes with acid? Hunh?” I yelled at him.

The volcanic explosion that had erupted in my mouth scarred me from ever seeking any further dental care. I will let my teeth rot out of my head before I will go back for more torture.

Sam had all his teeth pulled out at one time when he was much younger. At age 36 he was diagnosed with periodontal disease; along with his sister and millions of others during a certain dental fad. His sister had her gums scraped. She has all her teeth now and doesn’t have any indication of the disease.

Sam decided it would be easier to get rid of his teeth since they are a common source for illness and infection. He went to the local Trumansburg dentist and told him to pull them all out. Sam was home for a few days from his trucking route. He didn’t plan to get temporary dentures; no one would see him on the road for the next few months. What did he care what anyone thought about him not having teeth at a truck stop? He didn’t.

So Dr. Dore was instructed to pull them all. Dr. Dore told Sam he couldn’t legally do that in one sitting. Sam said he didn’t care. He was going to pull them all or he wasn’t going to pull any.

Dr. Dore pulled the first eight teeth.

“Keep going. Don’t stop.” Sam said.

Dr. Dore pulled the rest from the bottom. Sam was bleeding pretty badly.

“That’s enough,” Dr. Dore said.

“No. Keep going. Do it. Do them all. I will never come back if you don’t pull them all right now.” Sam insisted.

Dr. Dore kept pulling teeth. There were only four left on top when Sam grabbed Dr. Dore’s sleeve.

“Doc. I gotta have a smoke.”

Dr. Dore stopped a minute and helped Sam sit up. He daubed the blood.

“Soldier. Have your cigarette,” said Dr. Dore.

Sam fumbled through his shirt pocket and found his pack of Winstons and a book of matches. He lit a cigarette with his lips wrapped around the filter. He inhaled deeply. Then he exhaled. His fingertips were bloody where he held the cigarette to his mouth.

He had no novacaine. No pain killers. Not even a drink before he got in the dentist’s chair. The nicotine hit him. He took one more long drag on the Winston and handed it to the assistant. She removed it from the room. Only Dr. Dore saw him throw up the blood.

“Get at it. Finish it,” Sam said.

Dr. Dore pulled the rest of his teeth. He sent him home to bed and told him to take a couple aspirins.

Sam woke up a day and a half later and felt fine. He got in the truck and drove for six months without any teeth. He ate nothing but cottage cheese, apple sauce, runny eggs, oatmeal, cream of wheat, grits, mashed potatoes and meatloaf at truck stops.

Melvin Mitchell fit him with dentures. Melvin and his family lived less than a mile north on Buck Hill. The Mitchells were one of two black family farmers on Buck Hill. Francis and his wife are in their 90s now but they still live next door to the old Mitchell farm.
Melvin Mitchell still fits dentures in downtown Ithaca today. Sam wouldn’t think of going to anyone else. Sam is afraid Melvin will die someday, so a couple years ago Sam had Melvin make him an extra set.

 

Health and farm economics

           Health insurance is a scam. It’s a gambling game and the house always wins. Whether you call it an HMO or Blue Cross, the bottom line is maximum profits.  Health insurance is one of the primary reasons health expenses have skyrocketed. What they peddle is fear.

Family worries about the fact that we don’t have health insurance. What are you going to do if you get really sick or in an accident? I guess I am going to die. We all die. Sooner or later everyone dies. Fears I can face.  Profiteering from human pain and suffering I can’t stomach.

As a self-employed farmer, I don’t pay exorbitant premiums to an HMO or an insurance company. I don’t feel compelled to spend those “benefit dollars” employers take out of earned wages and hand over to the insurance scammers. I don’t seek medical attention willy nilly. And do you know how much I save every year? Thousands of dollars every years.

When Sam or I do need to see a doctor we say we are self-insured; we pay cash for services rendered. Generally, the billing rate drops 50% or more.  We ask questions that can inform us as consumers. When you ask a doctor how much a test or procedure will cost, they are dumbfounded as though expense should not be an issue.  It forces them to practice the kind of medicine they peddle. When Sam sought out a neurologist because of neck pain and the disintegration of vertebrae (caused by turning his head repeatedly as a driver; especially on the tractor), he was told to stop doing whatever was causing the pain and strain. Surgery probably wouldn’t help him.

The neurologist did not bill for his services for more than 18 months and when he finally did it was for an obscene fee for his 5 minutes of practical advice. Sam spoke to him on the phone. He had paid in full for all of the tests, examinations and visits for which he had been billed. What was this bill for? A cruise or a kids’ college tuition credit? If he didn’t need the money in the last 18 months, Sam thought he probably didn’t need it at all. That Doctor never sent another bill.

The Ithaca community is progressive enough to support the Ithaca Health Care Alliance. Initially the brainchild of Paul Glover, the visionary who invented Ithaca Hours, the Ithaca Health Care Alliance is an alternative to insurance. We don’t belong to the Ithaca Health Care Alliance, but when Sam broke his wrist I drove him down to the Ithaca Free Health Clinic. He’d suffered the injury more than three weeks earlier, but the pain and swelling had not subsided.

Sam had put his own cast on his wrist for the second and third week after the break.

“Cut up some of those newspaper strips,” Sam instructed. He’d watched me make papier mache and decoupage. “I need you to make me a paste of flour and water.”

I helped him stabilize the wrist with an ace bandage. Then I dipped the strips of newspaper in the paste and laid it over his hand where he directed. We built a nice cast. It took two days to fully dry.

Then he went back to work using it. Even turning the knob of the door involved using the broken bone. He welded; spray painted; fixed equipment using screwdrivers, hammers, wrenches, and more. He carried buckets of feed and drove tractor. Inside the cast lay a treasure trove of itchiness. He cut it off.

He agreed to let me take him to the Free Health Clinic. The parking lot on West Fulton Street in the west end of Ithaca was nearly full.

“Pull in here,” Sam said. There was a real spot right outside the front door. We entered and saw the sign directing us up a flight of stairs. At the landing, we turned the corner and found ourselves at the end of a long line ten minutes before clinic hours started.

People stood talking to each other. Kleenex boxes passed around. Some people sat on stairs. Others had chair seats lined up outside a lobby door.

“You just getting here? You need to check in?” asked a young woman who didn’t appear to be sick at all. She pointed to the lobby door.

“Yeah,” I said. “He’s got a broken wrist.”

People moved to the right slightly and less us climb the stairs to the left. Inside the door a receptionist sat at a desk and another woman looked over her shoulder facing a throng of sick people today.

“Do you need an appointment?” the receptionist asked.

“Can he see a doctor today? He has a broken wrist.” I said. Sam stood behind me and to my left. For once he let me do the talking; not that it would do much good.

“Oh, my, baby, let me see. Not today. And when finally get to see a doctor here all they be able to do is refer your bones to Cayuga Medical Center. We don’t have no x-ray machines here, honey.” The receptionist looked at us like we were the couple of country hicks we are.

So to the emergency room I drove Sam. Within three minutes he found himself in the care of our dear friend, Rosie Carpenter, registered nurse at Cayuga Medical Center. Rosie is the first licensed wildlife rehabilitator I knew; she’s also a hunter and an exquisite marksmen. Rosie and Roger Linton are a couple who are as odd as Sam and I are. Rosie supervised and advocated for Sam’s medical care for his broken wrist. He left with a diagnosis, x-rays and a cast.

He already knew it was broken and where. He could feel that. Now he had $847 pictures.

 

Deep economics

In a small rural community you can’t go anywhere or doing anything without someone you know seeing you and noticing what you say and do. This makes face to face accountability for your actions a way of life. And in a small town, people never forget. It’s a social system based on trust. Trust is earned. It cannot be bought. Trust is worth more than money.

For example, Sam had a business deal I thought went awry and it vexed me for at least five years. He’d rented out a piece of machinery and the man didn’t pay him. Despite several months of effort to collect what he was owed, Sam just let it go. He had no further business dealings with the man and did not contact him further. Years passed. The man fell upon hard times and auctioned off everything he owned. Sam still didn’t get paid. More years passed. One day Sam got a call. The man wanted to sell a piece of machinery and wondered if Sam were interested. They struck a deal. The money Sam was owed was deducted from the final price the man asked. Sam got the machinery, repaired it and sold it for three times what the man had owed him. Things come around.

Sam sold some of our livestock to a rancher in the Catskills with the agreement that Sam would be paid over time set forth in a contract. The rancher made several payments but then stopped. I was furious. Sam would charge him no interest or late payment fees. Sam told him to pay whenever he could. I couldn’t believe this foolishness. No bank or credit card company would allow this kind of consumer behavior.  That was exactly Sam’s point. When a man shakes hands on a deal, it’s his word, his honor. Good business rises and falls on face to face accountability.

Observing Sam work deals every day that involve little or no cash is a lesson in deep economy. Many more good things have come our way; but being on the butt end of raw deals leaves its mark on memory. You never forget lessons learned from mistakes.

Sam taught me how easy it is to trade and barter informally over time. I might have a lot of ruby red swiss chard or spinach that I know my friend Annie loves. I give it to her without any explicit expectation of payment. Next time she visits she has brought something; a book, a recipe or grapes. Sam got paid with a black lab pup on an engine repair job. My friend Sue and her shepherdess daughter, Marie, bring me a fleece to spin into yarn for them to sell and pay me with a fleece to spin for myself. The Gunnings cut the field of clover hay and bale it for us; they keep half and we keep half. Sam traded two nanny goats for a Dalmatian puppy for my birthday. Somehow we ended up with those goats back and Lucy dog.

Sam is my sex slave to avoid paying taxes: no April Fool

Taxes and death are two things you can count on. I didn’t have to go to school to learn that. Death comes only once but taxes are every year. In New York State they’d like to tax the air we breathe, the sun that shines and the wind that blows and they’d do it too if they could just figure out how. When I moved here from Georgia in 1992 it shocked me to see how much taxes increased the cost of living. But New Yorkers do have things like paved roads, sidewalks and schools.

Taxes serve politicians’ bag of tricks. As the price of gasoline goes up, the percentage of federal and state taxes doesn’t increase but the revenues do. When gas is $3 a gallon, the tax is 54 cents; at $4 per gallon the government collects 76 cents; a 30 percent increase in revenues. The more money the big oil companies make, the more government gets bankrolled. Same with sales taxes; increased consumption of goods means greater government revenues.

We have friends and neighbors who have connected to the grid with their alternative energy systems. Using NYSEG’s consultants, their products, their installers and their lines, the power company will sell you a system on credit then buy any excess energy you generate. Most people end up with a ten year loan.

If you generate more electricity than you consume, then the power company will buy it from you at the price they set and you must pay sales tax as a power producer. The only way to get tax credits for alternative energy usage is to hook into the grid. The real tax incentives assist the big power companies, not the consumers.

Sales taxes are more progressive than income taxes. At least a sales tax is a disincentive to consumption and the tax is spread more equitably. The more you can afford to buy, the more dollars you pay in taxes. And vice versa; the less you spend the fewer dollars are collected. Income taxes, by their very nature, are a disincentive to earn and save.

Sam and I so fundamentally disagree with so much in our society, especially our government, the wars in Iraq and Afghanistan, and our nation’s system of taxation that we try to keep ourselves from supporting it as much as possible. Sam hasn’t made enough money since he went off-the-grid to file any income taxes. We avoid making purchases that require sales tax. Food, heating fuel, and clothing under $100 is non-taxable in New York State.

I am on the books and the farm and business stuff is in my name. I call Sam my sex slave. He doesn’t draw a salary working full time on the farm. I write the checks, but he makes the big decisions.

“You were 40 years old and didn’t have a pot to piss in.” Sam’s assessment of my financial and business sense is harsh but fairly accurate. A 1970 graduate of Odessa-Montour High School with a certificate in welding, Sam has worked as a mechanic, welder, 18-wheel truck driver with experience in HazMat and oversize loads. He has serviced and operated large equipment including bulldozers, backhoes, skid steers, and dump trucks. Sam drives and repairs tractors and other agricultural equipment. He has restored antique tractors and can do body work on any moving vehicle. He owned the largest Cub Cadet dealership in the North East during the 1980s. He has dug wells, ditches, canals, ponds and built roads and bridges, boats, docks, rafts and spillways. He’s built a few houses and a couple barns. An intuitive grasp of all things mechanical, architectural, and engineering, Sam is also a real wheeler-dealer.

I didn’t have a pot to piss in before I met Sam. It’s true. I didn’t own a thing. I rented a house. I had a car loan. I might have had a Kenmore washing machine in the basement but that didn’t mean I owned it except on time and monthly payments to Sears.

I took my one and only sabbatical the year after I met Sam. I took the entire year at half-salary rather than just one semester at full pay. I started school in the real world.

Delivering new phone books for three weeks earned me some extra cash. I explored entire neighborhoods on foot. I collected cans and bottles on all of my walks and turned them in for coins. I sold stuff I didn’t use and didn’t need in a garage sale. Those old vinyl records I had hung onto since the 70s went to a record store for too little cash. I did odd jobs, including reviewing book manuscripts for publishers, pet sitting and repairing sleeves in hand knit sweaters. I taught introductory knitting classes through the Adult Education Program at the Trumansburg School. I found out it was relatively easy to live on half my salary if I just stopped shopping. If I didn’t mention I had a Ph.D. it was also quite simple to pick up jobs.

Being self-employed I acquired an entirely new perspective on business practices. When you work for yourself you have a really hard-ass boss. No vacations, no paychecks, no sick days. You don’t get paid for your time. You get paid for results.

If you are going to sell sweet corn at the farmer’s market, it had better be your best corn. If you try to sell day-old corn and customers taste it, you won’t ever sell corn again. One bad ear and you can kiss that customer and everybody that customer knows goodbye. Corn, peas and beans sell themselves. If they are old and starchy you will only make a sale once. No repeat customers and a bad reputation.

If I wouldn’t put it on my plate and serve it to guests for a meal, I won’t sell it to you. I’d rather feed it to the animals than sell an inferior product. There are many radishes I grow that don’t ever make it into a bunch. Pitted, deformed, or just ugly; some radishes are not market quality. It might have been only hail damage to those fresh onion greens, but I’d rather eat them myself than sell inferior looking onions at market. I can eat my losses. How many stocks and bonds can you chew?

There was a whole new level of integrity to my labor. I believed in what I was doing and the product I was selling. I might not be getting rich quick, but I loved the feeling I got from knowing my friends, neighbors and members of my community bought my produce and came back week after week for more.