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How to approach work after a breast cancer diagnosis

 

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A breast cancer diagnosis affects every facet of a woman’s life.

 

While women and their families must prioritize treatment, a host of additional variables, including work, also merit consideration after a breast cancer diagnosis. Work is an important part of life, so it’s understandable if women are concerned about how a breast cancer diagnosis will affect their careers.

With that in mind, women can consider these tips as they share news of their diagnosis with their employers.

Prioritize your own comfort when speaking to an employer about your diagnosis. Breastcancer.org notes that a woman’s comfort level is the most important factor when sharing news of a breast cancer diagnosis with an employer.

Some women may want to inform only a few coworkers they’re close with, while others may find it easier to let everyone know. There’s no wrong or right way to share a diagnosis, so women should prioritize their own comfort when choosing which way to go.

To ensure things go smoothly and your wishes are honored, consider first breaking the news to a supervisor in a private face-to-face meeting or Zoom call.

Decide what you want to share. The Australia-based Cancer Council notes that individuals must decide what they want to share regarding their diagnosis. Women can speak to their physicians to determine how long they will continue working, if their ability to work full-time will be affected by treatment and the projected length of treatment.

Answers to these questions can help women decide how much to share with their employers. If treatment is lengthy and require time off to recover, then sharing such information can help employers arrange to cover your responsibilities.

Take additional measures to overcome side effects of treatment. Breastcancer.org notes that treatment can produce cognitive side effects such as memory loss or difficulty concentrating.

Successful professionals will undoubtedly want to maintain the standard they have established for themselves, and that can be done by taking a few simple steps to overcome any cognitive issues that may arise during treatment.

Record Zoom calls so you can go back and view them, if necessary. Take copious notes during strategizing sessions. Begin using a planner so you can stay on top of deadlines. These simple measures are easy to employ and can ensure women don’t miss a beat during treatment.

Take time off, if necessary. Time off should always be a consideration during cancer treatment. Breastcancer.org notes that various programs can help women meet their financial obligations if they’re no longer earning income.

Some employers may pay full salaries during treatment and not count time off as vacation or personal time, while others may grant short-term disability benefits that can provide some income during extended time off. Explore all your options with the human resources staff at your firm.

A breast cancer diagnosis may require women to alter their work habits and schedules.

Even the simplest tweaks can have a profound impact and allow women to direct much of their energy and focus on their treatment.

Lawmakers should get serious on fraud

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As Russia’s full-scale war against the independent country of Ukraine approaches its 20th month, the role of the United States in arming, training and funding the Ukrainians has become a point of contention between Joe Biden and some of his potential GOP opponents, as well as among Republicans on Capitol Hill.

Does the issue deserve debate? Sure, and I say that as an advocate of America’s support for Ukraine. But if your primary concern is its cost to taxpayers, many other issues should concern you more.

Take benefit fraud, for example. Medicare, Medicaid, Social Security and other entitlements are the main drivers of deficits. In 1973, federal spending amounted to 18% of the gross domestic product. Discretionary programs such as defense, transportation, and education made up 53% of the federal budget, with mandatory spending (primarily entitlements) at 40% and interest payments at 7%.

Today, federal spending makes up a quarter of GDP. The breakdown is now 27% in discretionary programs, 63% mandatory, and 10% interest. By 2053, if present trends continue, spending will approach 30% of GDP. Interest payments will more than double as a share of spending, to 21%, while discretionary will continue to shrink in relative terms.

The math is merciless here. Balancing the budget will require structural changes to entitlement programs. But even getting serious about benefit fraud — about individuals and companies receiving taxpayer money to which they aren’t entitled — would do much more to repair America’s finances than cutting off aid to Ukraine would.

Consider the case of unemployment insurance. I’ve written often about the faulty design and management of the UI system, including here in North Carolina. During the COVID pandemic, state and federal officials made it easier to obtain benefits — and fraudsters took advantage of that to bilk employers and taxpayers.

This happened to me, in fact. I teach at Duke University every other semester. A couple of years ago, someone stole my identity, claimed to have been laid off, and filed for benefits. Despite my best efforts to stop it, the crook got paid.

According to the Government Accounting Office, as much as $135 billion in UI benefits were awarded fraudulently during the pandemic. That’s probably a low-ball estimate. Matt Weidinger, a senior fellow at the American Enterprise Institute, applied the GAO’s formula to a broader base and estimated that improper payments may total as much as $240 billion.

By comparison, the United States has, to date, sent about $75 billion to Ukraine in the form of military, economic, and technical assistance. If we expand the category to include not only spent but requested funds — and not just aid to Ukraine itself but also aid sent to our allies helping Ukraine — the total comes to $135 billion, according to the Center for Strategic and International Studies.

Now consider Medicare and Medicaid fraud. It costs the federal treasury a minimum of $100 billion a year and likely much more. Farm programs, energy subsidies, grant and loan programs, targeted tax breaks for favored industries — these and many other federal policies are plagued by waste, fraud, and abuse.

The GAO estimates that the federal government made $247 billion in improper payments in FY 2022 alone (and that figure didn’t even include some welfare programs such as Temporary Assistance for Needy Families). In other words, benefit fraud costs American taxpayers much more than the war in Ukraine has or will.

That’s not an argument against strict oversight of foreign and military aid. Nor is it an argument that all the White House and Congress need to do to balance federal budgets is to cut out improper payments. That won’t be nearly enough, as I’ve also written about many times.

My point is simply that the political attention paid to the fiscal impact of aid to Ukraine is far out of proportion to its contribution to federal deficits. In a rational world, our leaders would set their priorities accordingly. Alas, that’s not the world we inhabit.

Editor's note: John Hood is a John Locke Foundation board member. His latest books, Mountain Folk and Forest Folk, combine epic fantasy with early American history (FolkloreCycle.com).

Committed to serving you

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This weekend, we witnessed a savage and unprecedented attack on our greatest Middle Eastern ally, Israel. The senseless violence in Israel is sickening, but we must be clear-eyed that this is an unprovoked act of war on a sovereign ally.

There should be no doubt that Israel has every right to defend itself, and the United States should stand shoulder-to-shoulder with our friend in this terrible time.

Reports that Americans are among the hundreds killed or taken hostage are worrying. I am also outraged by the possibility that the Biden administration’s eagerness to give legitimacy and over $6 billion to Iran, the largest state sponsor of terrorists, including Hamas, may have contributed to this attack. I will continue to monitor this situation and will always stand with Israel.

These have been a challenging few weeks in Washington. Our House Republican majority is the only firewall against the extreme agenda of Washington Democrats.

I am doing anything I can to remind my colleagues of this and find a way forward by electing a new Republican speaker. My focus remains on cutting spending, securing our Southern border, and working on behalf of you and your family.

As the crisis at the border rages, Senate Democrats refuse to take any action on the House-passed H.R. 2, the Secure the Border Act, the strongest border security bill in history.

This legislation restarts construction of the border wall, deploys technology to the Southern and Northern border, increases the number of Border Patrol agents, and provides them with bonus pay. The ongoing humanitarian and national security crisis at our Southern border continues to escalate as record numbers of illegal migrants cross into the United States. In August alone, there were 232,972 encounters at the Southern Border — a 27% increase from July and more than double the population of Moore County.

While Washington Democrats allow thousands of illegal immigrants into our country each day, they also refuse to acknowledge the ways their failed economic policies are impacting hardworking families.

Washington Democrats borrowed and spent at record levels under their one-party rule, fueling inflation and propelling our debt to an astronomical $33 trillion.

Because of this, new polling data shows only 28% of Americans are satisfied with the state of the economy.

These are serious issues facing our nation today — yet we have seen troubling times before. In the face of previous conflict and uncertainty, President Ronald Reagan believed that America’s best days were always ahead.

He also knew that uniting under conservative leadership was the only way to secure our freedoms for future generations. I believe in that, too, especially because House Republicans have solutions to each of the challenges we are once again facing today.

House Republicans are focused on cutting wasteful spending, fully-funding programs for seniors, military families and veterans, securing our border, and passing solutions that fulfill our commitment to the American people.

As your Congressman, I am committed to building a safer future for you and your family. As internal debates continue in Congress on how our majority can achieve those goals, know that I will always stay focused on the big picture and the issues that matter most to you.

My goal is to always provide you with high-quality constituent services and be accessible to hear your needs, thoughts, and concerns on the key issues facing our community and nation.

My dedicated staff in our Southern Pines and Fayetteville district offices are here to serve you.
To find out our office locations and office hours, visit Hudson.house.gov or call us at 910-910-1924.

As your Congressman, I will never stop working with my House colleagues to advance common sense solutions that grow our economy, keep us safe, and help you and every American family succeed.

Editor’s note: Rep. Richard Hudson represents North Carolina’s 9th Congressional District.

The Lost Colony and Jamestown — the same effort

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How did The Lost Colony fit in the founding of the English colonies in North America?

Virginia Dare was born at the Lost Colony on Roanoke Island, the first child of English parents in America, and that gives North Carolinians a strong claim to be a critical part of the English colonization effort. But since that colony disappeared without a trace, can we claim that this unsuccessful colonization effort was part of later permanent colonization efforts in Virginia and New England?

The answer: Absolutely, says John May, author of an upcoming book to be titled “English America: An Introduction to The Lost Colony and Jamestown.”

It is scheduled for publication next year by McFarland, a leading independent publisher of academic and general-interest nonfiction books.

May argues that the “founding of the first enduring English American colony was one continuous effort interrupted by war with Spain. The Roanoke Island and Jamestown colonies constitute the selfsame history in all meaningful respects.

Think of Jamestown as the second act of the two-act play but under new direction and with it an all-new cast of characters.”

In October 1584, at the request of Sir Walter Raleigh’s supporters, a young scholar, Richard Hakluyt, prepared a prospectus outlining the “potential political advantages of a colony in the part of North America that had been named Virginia.” Hakluyt delivered a copy to Queen Elizabeth.

The queen offered only minimal support for Raleigh’s venture.

But May argues that the objectives outlined in the prospectus “remained unchanged for the next twenty-five years. But in all those years of trial and error— of one heartbreaking failure after another — the one constant and central presence in the effort was Richard Hakluyt.”

Raleigh, the most prominent supporter of the first colonization effort on Roanoke, had the most to gain.

With a successful permanent settlement within seven years of his grant in 1584, Raleigh would be granted title to most of the eastern part of North America. But Raleigh had stepped aside and become involved in other adventures.

Efforts to establish a colony on Roanoke Island continued, and May tells the stories of that colony in engaging detail, beginning with their biggest problem, the unsuitability of our coast, to support a colonization effort.

“The coast of North Carolina was an inauspicious choice for a first colony. From the seashore island for up to fifty miles, the land is swampy or so low-lying it often floods, and much of it in the sixteenth century was thickly forested wetlands that were all but impenetrable.

“English galleons had an average draft of twelve feet but inlets into the Pamlico Sound — through which Roanoke Island is accessed — were blocked to such ships by shallow sandbars that shift with every major storm.

“Dangerous offshore shallows — Wimble, Diamond, and Frying Pan Shoals — extend miles out into the Atlantic, and seas off the Outer Banks are subject to riptides and cross currents caused by the conflicts of the Gulf Stream and the Labrador Current.

These hazards have caused countless shipwrecks and given to this region of the North American coast the baleful epitaph’ Graveyard of the Atlantic.’”

In May’s detailed account of the Virginia Colony, his hero is John Smith, the rough-and-ready Daniel Boone character who also fought against the Native Americans and still gained their respect.

The story about the Native American emperor Powhatan’s daughter rescuing Smith from execution is based on Smith’s later written account. May says that, although this account is probably not completely accurate, Pocahontas had a real expectation that Smith would become a part of the Powhatan family. Smith’s failure to meet this expectation was a great disappointment to her.

May’s copious research, combined with his great storytelling gifts, make his story of the Lost Colony and Jamestown histories a reading pleasure.

The Lost Colony itself had disappeared without a trace, but there were others who were “eager to take up the baton and see what profits could be squeezed from the great unknown of North America about which Hakluyt promised so much.”

Editor’s Note: D.G. Martin, a retired lawyer, served as UNC-System’s vice president for public affairs and hosted PBS-NC’s North Carolina Bookwatch.

Network nuisance

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I always tell clients it doesn’t matter how good your insurance is on paper if you can’t use it.

In July, I attended a meeting at Cape Fear Valley Hospital where CEO Mike Nagowski and Vice President of Managed Care Bart Fiser announced that due to critical grievances in service, CFV was terminating the UnitedHealthcare Medicare Advantage network at the hospitals and in 2024, all their other providers as well.

Hospitals often have these disputes with insurance carriers. Last year, Duke Wake Med terminated their relationship with UHC for about six months.

This past February, Charlotte Ears, Nose and Throat also announced that they would be terminating UHC unless negotiations were made.

There are plenty of examples in North Carolina alone, but the situation at Cape Fear Valley has one major difference from what is typical in these situations: it isn’t about money.

Mr. Fiser painted a grim scene of doctor frustration and administrative nightmares, and he claimed that Cape Fear Valley patients were receiving around a 30 percent decline rate of services with UHC Medicare Advantage plans, including things like pacemakers.

Furthermore, prior approval was being downgraded months later. A diagnosis of sepsis being downgraded to pneumonia because it didn’t meet the carrier definition was an example I was provided with.

Mr. Fiser also explained that transmitting medical records to UHC was particularly vexing because the online portals often won’t accept files as large as necessary to transmit data.
Oftentimes, CFV must mail paper copies costing as much as $800 and increasing the turnaround time on decisions.

These high declination rates, administrative difficulties, and reneging on prior approval have been so detrimental to patient care that the executive team felt forced to cut ties.

“I didn’t ask for a single penny. We get higher rates with UHC. We were in partnership with them on shared savings. Denials just got so crazy.” said Fiser.

On October 5th, I met with Mr. Fiser again to see if there were updates that would provide me with insights I could use to better serve my clients. One of my questions centered around PPOs. I had spoken with agents and people in the community who had voiced that if they switched to a UHC PPO plan, they would be fine.

Mr. Fiser stated they “absolutely would not be fine.” While the hospital would accept the PPO plans, they would only do so at an out-of-network rate.

I inquired if any headway had been made to repair the relationship and was told there had been none but that “we would certainly listen if they addressed the issues because we want what’s best for the community.”

I point-blank asked Mr. Fiser if there was a carrier they did not have issues with, and he replied, “we don’t have issues with Blue Cross Blue Shield.” No others were specifically mentioned.

During this annual enrollment period, make an informed decision on your plan for 2024 because, to quote Mr. Fiser, “people don’t want to drive 75 miles for service.”

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