Mona Tailor: KYnect Round 2

mona1November 15th, 2014 marks the opening of enrollment for KYnect, the Kentucky created health insurance exchange. KYnect has made so many strides over the year since they first went into place. They have been a presence at local fairs and events throughout the state. They have shared information about the options, educating the public, and passing out reusable grocery bags so the citizens are aware. Here in Louisville, I’ve seen them at WorldFest and St. James Art Festival. They even opened a store in the Fayette Mall in Lexington, KY this week. Finally, there’s even a mobile app this year! These ways of improving their name recognition are not in vain.

As Governor Steve Beshear stated in his NY Times op-ed last year, Kentucky ranks highly in all the wrong things when it comes to health- smoking, obesity, heart disease, lung cancer, and diabetes. Through the efforts of our state with KYnect supported by Governor Beshear and outgoing Lieutenant Governor Abramson, our state has made amazing strides to improve the health care of its citizens.

Prior to the ACA going into effect last year, 20.4% of Kentuckians were uninsured. Gallup conducted a poll in August, and our uninsured rate dropped to 11.9%. We along with Arkansas had the largest drop in the country in terms of the uninsured.

Beyond the numbers, as I reflect on our patient population, I have seen a drastic difference. To give you an idea, last year, we were so accustomed to having uninsured patients at our downtown Louisville clinic, that we were experts at the Wal-Mart $4 formulary. We knew what inhalers were the cheapest to get our chronic lung disease patients. We knew how to titrate the complicated twice a day 70/30 insulin because that’s what our patients with diabetes could afford. We knew the resources and financial assistance available to hook our patients into the system to be able to just get that imaging or that colonoscopy that would help us provide a diagnosis.

This year, I can count on my hand the number of times I’ve referenced the Wal-Mart $4 formulary. Instead, we are focusing on referencing formularies to find the medications that will be covered on our patient’s insurance plan. The inhalers our patients struggled to afford are now covered by their formularies. The easy to take daily basal insulins which better regulate blood glucose and improve diabetes are readily available for our patients. The only hitch we encounter with imaging and other tests is a matter of finding a time that works for the patient to schedule it.

The Affordable Care Act has had a very positive impact on our state. Not everything is perfect, but this is the best start we have had in as long as I can remember. Rather than repealing the entire legislation, it would be better to fix portions that have been difficult to implement. But please, do not take away this opportunity for affordable healthcare that Kentuckians have access to. Our health depends on it. I hope our Senator recognizes and appreciates this positive impact for Kentuckians as we begin the enrollment process for 2015 this weekend.

Mona Tailor: The Disillusioned Voter

“Well, it doesn’t matter anyway…It’s all been decided anyway.”

mona1I cannot tell you the number of times I heard this phrase yesterday. “It’s all been decided anyway.” This was heard in my workplace, on the twitter-sphere, and even in the locker room of the gym!

These quotes gave away to something else bigger too. No one seemed excited about this election, regardless of what party you side with.

I remember when I registered to vote. I was a senior in high school; able to register since I would be 18 by the time it was November. I was so excited for the ability to vote and so proud I had already done so. I have voted in every election since, only missing 1 year.

I don’t remember ever being so unenthused about an election until this one. Maybe it’s the economy, or the President, or just the overall “nothing is happening” in Washington, DC attitude. Congress has been a display of gridlock with approval ratings that reflect the lack of action in our capital.

Unlike the prior decades of the 40s/50s/60s, it seems that since Watergate in the 1970s, we have become more cynical, and our faith in our government has slowly been chipped away. You run for political office now by refuting the system, and then slowly becoming part of it.

Now, I wonder if there’s anything left to chip away. The faith seems to be at a bare minimum. From what I can tell, I’m not the only one.

In this age of social media, sound bites, and concern for a particular image, is there any candidate or way to help us restore some faith in government and inspire the enthusiasm of the past? Only time will tell.

Mona Tailor: An Independent Voter’s Take on the KY Senate Race

mona1My friends have been asking for my opinion on the KY Senate Race this year. “Who do I vote for?” Frankly, I am not a fan of either candidate at this point. A Courier-Journal tweet yesterday shared a poll saying that KY Voters are mostly pleased with their candidate options this year. I’m really curious as to who they talked to for this poll.

Now, let’s be serious, the state of KY really has only 1 senator working for our state, whose identity will be determined with this election. Like Ted Mosby with his yellow legal pad in “How I Met Your Mother,” here are the pros and cons as I see them.

Mitch McConnell. Pros: He would likely be republican leader if the Republicans win a majority in the Senate. His seniority and experience brings attention to our state and possibilities for Kentucky to help shape national policy. He employs a lot of Kentuckians on his staff. He also affords a lot of opportunities to his constituents. On some level, he truly cares for the state.

Cons: He’s been in office for 30 years. 30 years. Let’s put that in perspective, I’m 30 years old! That is as long as I’ve been alive! At this point, he has become the face of gridlock in Congress, whether he likes it or not, and his staunch positions have probably helped slow our government down more than anything else.

Alison Lundergan Grimes. Pros: She’s a fresh new face to represent us in the Senate. She’s a woman and would be inspiring for young Kentuckian girls to see in office. She says she will be an independent thinker, being a voice for Kentuckians and not succumb to a political parties leaning. She will stand up for what she believes in. Most importantly for me, she recognizes that the Affordable Care Act has been very helpful in our state, and even though not everything has worked well, she is willing to make modifications to the Affordable Care Act rather than repealing it entirely.

Cons: She has very limited experience. She is just completing her first term as Kentucky’s Secretary of State. She would have some growing pains as she begins this position, and would likely need some of the 6 years to just acclimate to the environment as a freshman Senator. Her family connections have been more questionable than anything else. There seems to be some sense of entitlement due to her family connections as a result too.

As good as my pros and cons list is for both candidates, I still have not made a decision about this race. As multiple lobbying groups from across the country pour money into our state, our airwaves have been filled with negative campaigning. The negative ads are ultimately most effective; however, with the current options, they have reinforced my lack of faith in both of these candidates.

I have yet to decide where my vote lies for Tuesday, November 4th. I want a candidate who would best represent us and who would be the best voice for Kentucky.   So far, I’m not convinced. I have a feeling I’m not alone. It’s going to be a long weekend.

Mona Tailor: Mandela

After visiting Lincoln’s birthplace in Hodgenville, KY, my uncle from India shared, “Being in the presence of where great men have been, gives us the opportunity to aspire to some of that greatness.” That quote has stuck with me through the years.

The last two weeks have been filled with reminders of greatness. Our country commemorated the 50th anniversary of John F. Kennedy’s assassination.  I was too young to see JFK in person, but I heard stories from my family members about what he inspired in them. This past week, the world mourned the loss of another leader, Nelson Mandela.  Nelson Mandela was someone I was able to see in person, someone who inspired us all by his own story, and taught us the best way to handle difficult situations.  His response to his imprisonment taught us how to work together towards reconciliation.  His example is something we can all use as we work to deal with others who do us wrong, or perceived wrong.

I was in middle school when I got to see Nelson Mandela in person accepting an award from the Civil Rights Museum in Memphis, TN.  I don’t remember what he said, or if he even said anything at all.  I just remember the presence of greatness.

mona1I did not understand the depth of what this man meant to South Africa until my Sub-Saharan politics class at UK.  Quoting the thesis from my research paper, “The South African nation was able to achieve its greatness and strength by the nationalism of its racially different groups, international scrutiny following World War II concerning apartheid, and the realization that a resolution to the racial conflict was necessary.”  Nelson Mandela had a hand in each aspect of this to help South Africa achieve that greatness.

Invictus, the movie, captures this nationalism that South Africa experienced. Mandela was able to unify a nation over the World Cup Rugby Match. The title of the movie was inspired from the poem, by William Ernest Henley.  Mandela would recite the poem from memory during his time in prison.   The ending lines of the poem  provide the most inspiration of all.

“It matters not how strait the gate,

How charged with punishments the scroll,

I am the master of my fate,

I am the captain of my soul.”

If Mandela could deal with everything he dealt with in his life, we can deal with what comes our way. That is his lasting impression and his sense of greatness for which we can all aspire.

Michael Stillman & Mona Tailor: Dead Man Walking

From the New England Journal of Medicine:

mona1“Shocked” wouldn’t be accurate, since we were accustomed to our uninsured patients’ receiving inadequate medical care. “Saddened” wasn’t right, either, only pecking at the edge of our response. And “disheartened” just smacked of victimhood. After hearing this story, we were neither shocked nor saddened nor disheartened. We were simply appalled.

We met Tommy Davis in our hospital’s clinic for indigent persons in March 2013 (the name and date have been changed to protect the patient’s privacy). He and his wife had been chronically uninsured despite working full-time jobs and were now facing disastrous consequences.

The week before this appointment, Mr. Davis had come to our emergency department with abdominal pain and obstipation. His examination, laboratory tests, and CT scan had cost him $10,000 (his entire life savings), and at evening’s end he’d been sent home with a diagnosis of metastatic colon cancer.

The year before, he’d had similar symptoms and visited a primary care physician, who had taken a cursory history, told Mr. Davis he’d need insurance to be adequately evaluated, and billed him $200 for the appointment. Since Mr. Davis was poor and ineligible for Kentucky Medicaid, however, he’d simply used enemas until he was unable to defecate. By the time of his emergency department evaluation, he had a fully obstructed colon and widespread disease and chose to forgo treatment.

Mr. Davis had had an inkling that something was awry, but he’d been unable to pay for an evaluation. As his wife sobbed next to him in our examination room, he recounted his months of weight loss, the unbearable pain of his bowel movements, and his gnawing suspicion that he had cancer. “If we’d found it sooner,” he contended, “it would have made a difference. But now I’m just a dead man walking.”

Click here for the full piece.


Mona Tailor: Seeing The Dalai Lama

Sunday, May 19, 2013.

Never mind that I had to get up early on a weekend morning.

Never mind that I had to park a few blocks away to get to the venue so I would not have to search for a parking spot.

Never mind the fact that I waited in a line stretching to another state on a bridge for 2 hours to get through security.

Never mind that I did not have time to eat a breakfast or for that matter lunch today.

Never mind that it was so hot I was a sweaty mess by the time the event actually started.

Never mind any of those things from today.

They do not matter, for I had the great fortune of being in attendance today as the Dalai Lama spoke to an audience of thousands in Louisville.

Once I was able to see him and hear his message, any of the above frustrations was gone from my memory. His Holiness had a simple message; we are all capable of compassion. It is our “default setting” as one of the speakers, Dr. Doty stated in his remarks. Sometimes it is our circumstance, our ego, our bias or our environment that clouds this default nature within us.

mona1Regardless, we are all capable of compassion by seeing ourselves in others. Even for wrongdoers, we can show them compassion by separating the wrongdoer from their action. It is a world of compassion, of tolerance, of humanity that we are looking to create “as man has matured” and we have expanded our scope with small acts of kindness. Though compassion makes for a good slogan, this goes beyond words; this compassion in us begins by taking action.

This compassion and kindness towards others is what I experienced in line waiting for this event. In my 28 years in Kentucky, I had never seen a more diverse group of people gathering for an event. There were people of many different nations, languages, religions, dress all gathered for one single purpose. The air amongst the crowd was of understanding, of tolerance, of compassion.

In particular, the individuals around me were amazing. There was the young mother from my hometown of Bowling Green, KY who had offered to both her sons the opportunity to see the Dalai Lama speak, and her 8 year old choosing to come with her.

Then there was the mother and son duo who had flown from Texas to Louisville for the sole purpose of seeing the Dalai Lama speak.

For me, it was an honor to hear the Dalai Lama speak. He exuded a sense of calmness, peace, and serenity. I enjoyed listening to every word he spoke and watching every action he made in greeting every person he came across. You could tell the audience felt the same way. As he spoke the entire audience hung on his every word. He captured and sustained their attention the way he captured mine.

As we all left at the end of the event, the serenity and peace of his presence stayed with us. His compassion inspired you, regardless of faith, to be a better human being, full of compassion, caring and tolerance. “Compassion begins here [points to his heart]”. I truly believe this was a great start to experience this compassion.

Mona Tailor: A Special Martin Luther King Jr. Day.

“Now is the time to make real the promises of democracy. Now is the time to rise   from the dark and desolate valley of segregation to the sunlit path of racial justice. Now is the time to lift our nation from the quick sands of racial injustice   to the solid rock of brotherhood. Now is the time to make justice a reality for all of God’s children.

I have a dream that one day this nation will rise up and live out the true meaning of its creed: “We hold these truths to be self-evident: that all men are created equal.””

                        -Martin Luther King, Jr. “I Have a Dream”. August 28, 1963

monaI remember every Martin Luther King, Jr holiday, our teachers in elementary school would have us watch Dr. King’s famous speech from 1963. His voice echoing for equality was beyond an young child’s understanding, but his emotion was transcendent.

As I have grown up, the memory of watching Dr. King echoes through my mind every Martin Luther King, Jr. Holiday. For this holiday, the words of “I Have a Dream” became even more poignant for me. This year, the holiday to honor Dr. King coincided with the Presidential Inauguration of an African-American President and I was fortunate enough to bear witness.

The crowd in Washington, DC in 2013 must have mirrored the crowd on the National Mall in 1963.  The crowd represented individuals of all ages, all races, all religions, all creeds from all states regardless of distance. It did not matter who they were, or if they knew each other before the event, the viewing of the inauguration was like a reunion between old friends. We joked about the trees blocking our view, we cheered with our first peek of Michelle Obama, and we shared stories about what this moment meant to us.

The most moving part of the crowd for me was seeing the older African Americans. They had braved the cold, braved the crowd, and braved their health to be witness to history.   As I watched the excitement on their faces, I wondered how many of them were able to witness Dr. King’s speech fifty years ago, not as a videotape as I remembered, but as a live event. The emotion of this moment for them was given away by their voices when they cheered, “Amen” during Myrlie-Evers Williams’s invocation. In fifty years, they had come so far from the injustices of segregation to having an African-American President sworn into a second term.

The t-shirt vendors off the National Mall and streets of DC got it right.  Their shirts had a picture of Dr. King and President Obama, with the caption, “Dream Fulfilled”.  What a profound inaugural day. Martin Luther King, Jr. had a dream indeed.

Mona Tailor: Celebrating Diwali and Election 2012

Fall always marks a great time of the year from the changing of the leaves, apple cider, pumpkin patches, (well, pumpkin everything) and for Hindus around the world the auspicious occasion of Diwali, the Festival of Lights. Diwali is the celebration of good over evil as people in the ancient Indian city of Ayodhya celebrated by lighting candles to welcome the victory of King Rama over the evil demon Raavan. On a deeper level, this is a celebration of our own inner light, expelling the evil of ignorance within ourselves and embracing a higher knowledge that we can achieve.

For Gujaratis (the state of India where my family hails from), Diwali also marks the end of the calendar with a New Year beginning the day after the celebration. Think of it like a New Year’s Eve, if you will and presents another opportunity to expel the old and bring in the new. What a fitting time to have the results of Election 2012! (Was it really just a week ago? It feels like it was much longer.)

First, my congratulations to President Obama! I find it so interesting that as you hear the pundits talk about the election, they frequently tell us the “minority vote” helped secure his re-election campaign. It reminds me of that unforgettable TIME Magazine Cover of the “Changing Face of America”, and if one thing is for sure, this election reflected that predicted change from 1993. Not only did minorities help decide this election, they were able to make an impact on the composition of our elected officials. We re-elected our first African-American President to a 2nd term. We elected the first openly gay politician, Tammy Baldwin from Wisconsin to the U.S. Senate. We elected the first Buddhist-American, Mazie K. Hirono from Hawaii to a seat in Congress. Finally, we elected the first Hindu-American, Tulsi Gabbard from Hawaii to a seat in Congress. For a minority in America in terms of religion and ethnicity, this victory was the most inspiring for me.

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Mona Tailor: Celebrating Diwali and Election 2012

Mona Tailor: Dealing with Tragedy

A lot has changed since my last post, people met, places seen, experiences had, and lives lost. Despite how young I am, I have lost a lot of loved ones be it family or friends. As I find others who also suffer loss in the most recent weeks, most recently being the families in Aurora, CO, I reflect on those that I have lost. All those adages we share “time will heal”, “they are in a better place”, “at least they did not suffer”, may be the first thing that comes to our minds, but only hold some truth.

My grandmother passed away after a prolonged hospitalization following a coronary artery bypass surgery about 10 years ago. In those years immediately following, the pain of her loss was the first thing that came to our minds. The painful memory made it difficult to make our peace with it, along with seeing my grandfather’s pain of missing her. Our peace with the it came after my grandfather passed away. Now, the memories that come back are happy ones, but there is still the constant reminder that you will never hear their voice again, see them laugh, or just experience that wonderful hug filled with love as you wrap your arms around your grandparents. With those memories those adages that are supposed to make you feel better really do not make any difference at all.

How do you take that and talk to other people who you realize are also going through the pain of losing a loved one? Well, you cannot tell them you know what they are going through. You have an idea of what loss is, but you do not know what they are going through. Their situation with that loved one is different, how that loved one was lost is different, and how they are dealing with the loss of a loved one is different from you. All you can do is be there to listen, be a shoulder to lean on, and just always remind them that you will be there for them.

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Mona Tailor: Dealing with Tragedy

Mona Tailor: Women’s Empowerment in the Hindu Culture

It’s amazing to see how far women have come in the last century: voting rights, moving into the world of work, while balancing motherhood, and even running for the highest office in the land, President. We have such amazing figures to inspire us: Eleanor Roosevelt, Jacqueline Kennedy, Indira Gandhi, Geraldine Ferraro, Hillary Clinton, and Condoleeza Rice, just to name a few politically inspiring ones.  

In Indian culture, similar to many Asian cultures, parents, especially fathers always want a son.  A daughter also causes excitement, but there is always the underlying thought that the girl will eventually get married, and will have to leave her parents’ household and take her husband’s name.  

In Gujarat [the Indian state where my family originates] the woman takes her husband’s first name as her middle name and takes his last name.  Any children born to them also share their father’s first name as their middle name.  In essence, as a daughter the girl must listen to her father, and when she becomes a wife she must listen to her husband.  In this culture and this setup, I come from a very remarkable group of women, who set their own rules.

My grandmother on my father’s side was a remarkable and strong woman.  In 1933 when Mohandas Gandhi inspired Indians around the country to walk with him in the Salt March, my grandmother wanted to join their cause.  Her mother-in-law was not happy with her decision, gravely concerned that she would ruin the family status and appearance in society by doing such a thing, threatening her to never return to the household.  My grandmother stood her ground, she was part of the Salt March, and returned home to her family, regardless of what anyone thought. This was just one of her many strengths. After my grandfather died, she raised 5 children in rural India on her own, a remarkable feat on its own..  

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Mona Tailor: Women’s Empowerment in the Hindu Culture