A momentous year in health policy — and the people who put it into perspective

Wynter Przybylski with her mother, Lisa Przybylski. Photo courtesy of Lisa Przybylski

Wynter Przybylski with her mother, Lisa Przybylski. Photo courtesy of Lisa Przybylski

It wasn’t the cold of the day that deeply chilled the six-year-old’s parents, although, with a low of three degrees, Feb. 28 this year was colder than average.

That winter day little Wynter Przybylski of Brewer was diagnosed with acute lymphoblastic leukemia. Soon after Wynter’s cancer was diagnosed, a tumor was found on her spine and, before it was removed, it caused a spinal stroke and paralysis. Wynter has had multiple rounds of chemotherapy. On Jan. 5 she will enter Dana Farber in Boston for a bone marrow transplant, a grueling procedure that offers the best chance for a cure.

No doubt, this has been an important year in health policy.

But let’s not forget that health care is about people — patients and providers, their care and their communities.

One of them is a little girl with a big smile and a positive attitude who, hopefully, will have a long and happy life. Wynter’s mother Lisa (Cash) Przybylski was my student some years ago, and her little girl has been through a lot.

Community has mattered. There have been local fundraisers and an incredible Make a Wish trip. Still, money remains an issue. While they have insurance, it didn’t cover a $3,000 stairlift. And as Wynter’s mother tells me, “The biggest thing is that I need to stay with her for months in Boston, but the bills go on” with “no income coming in.” If you can help, you can donate at youcaring.com; search for “Wynter Przybylski” and find “Cancer messed with the wrong girl.” Follow “Shine on, Wynter” on Facebook.

And then there’s Dr. Pamela Gilmore, who discovered the growths for which I would need major abdominal surgery. After sending me for tests that yielded results no one wants to hear, Gilmore took time at the end of a busy day to help me brainstorm questions to ask the specialists I would visit. She was there for me when it looked like I had cancer and when, post-surgery, it turned out I didn’t, helping me and being so very professional and competent and kind.

Gilmore was a great doctor and, most unfortunately, this has to be said in the past tense, as she died unexpectedly on Dec. 22. Her obituary, describing her as “dynamic, intelligent, articulate, sharp-witted, loving, caring, generous, and concerned,” resonates. In her short 52 years, she started a practice “to provide health care to underserved women in the Bangor area.” Let her life be a model and her memory a blessing.

For 30-something Peter, 2014 was the year he lost his health coverage. Because of the blood clots that plague him, he can only work part-time. He also has asthma.

But Peter is one of the people Gov. Paul LePage called an “able-bodied adult” who actually has a serious chronic illness. Because the Supreme Court ruled states could decide whether to expand Medicaid and LePage blocked expansion in Maine, Peter no longer has MaineCare. Now his illnesses can’t be managed because he can’t afford the inhalers and medicine he needs, nor the tests to monitor his conditions.

While regaining health insurance would matter the most for Peter, you can help him get his medicine by donating through a crowdsourcing fund called gofundme, at http://www.gofundme.com/j83arg. If our community pitches in, Peter will be able to breathe easier.

Looking beyond these three to health care in America, 2014 was a year with a huge increase in the percentage with health insurance. According to Gallup, the year started with over 18 percent lacking coverage, and the third quarter ended with 13.4 percent without insurance.

States that expanded Medicaid have more gaining coverage. Now Texas’ incoming governor is considering adopting the expansion model Utah officials negotiated with the federal government.

In Maine, more than 40,000 signed up for insurance through the marketplace, with an average premium cost after the subsidy of $99 a month. According to the CEO of the Maine Health Access Foundation, “We have heard from assisters of people literally breaking into tears when they sign up and find out they have a $20-a-month premium, because for 20 years they haven’t been able to afford insurance.”

Open enrollment at healthcare.gov ends on Feb. 15.

With hope for Wynter, Peter and everyone else facing medical and coverage challenges, and to a happy and healthy new year.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.