When I saw the cut to the low income energy assistance programs proposed by President Obama in his budget, I knew that meant more energy/utility shut-off notices for people already struggling all over the United States. The cold day in hell has arrived for many patients and many caregivers who already find their budgets bursting from the costs of healthcare insurance, co-pays, deductibles, and out-of-pocket medical expenses, and their bank accounts strained from the loss of income and unemployment that has marked recent months for millions and millions of people.