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My Health Insurance Horror Story

I guess I should weigh in on this subject since the left is documenting the Obamacare Clusterfuck atrocities.  Be sure to visit Lambert at Corrente for the latest updates in the series.

So, my horror story started in February, right after I made an offer on this house.  I was looking forward to moving to PA because the cost of living here in Pittsburgh is orders of magnitude less than it is in NJ.  While that might be a slight exaggeration, the most significant savings I was anticipating was going to be in the cost of health insurance.  My COBRA, already at a whopping $987/month, was running out at the end of April and I couldn’t find an affordable substitute in NJ.  Every plan I looked at was about 50% higher than I was paying in COBRA *with* cost sharing for two healthy people.  I mean, it was absurd.  So, unless I moved to PA where the cost of insurance was about 1/4th the cost, I was looking forward to going without.  You just can’t do that when you have kids.

Enter the kid.

The kid developed a health condition in February that required several trips to the hospital.  We’re still not totally sure what is wrong with her but it was very serious and scary.  She’s missed a lot of school because of it.  Thank goodness I had health insurance at the time because I honestly don’t know how I could have afforded it.  It would have bankrupted me for sure.  We have learned since her hospitalization that CHIP would be unavailable for her in NJ because to be eligible, she would have had to be uninsured for 6 months.  I don’t know what hard assed Republican in NJ dreamt that rule up but it screwed us when the insurance ran out at the end of April.

I scrambled to find a replacement policy in PA.  Now that I’m a resident, I could qualify for the lower rates.  But since she now has the dreaded “pre-existing condition”, my rates were going to be higher.  I started shopping around before the insurance ran out, because as we all know, you can only get insurance, jobs, loans when you don’t need them.  Almost all of the insurance companies I called did not cover her condition.  I finally found one in Pittsburgh that is probably designated a “silver” policy next year.  There’s a steep deductible, 20% cost sharing and her drugs are covered only partially.  But there was one other catch.  She could not be denied coverage as long as she was on my policy but they reserved the right to charge me double for the policy on my portion because of her pre-existing condition.  So, I am paying $870/month for this individual policy.  I’m looking into a CHIP option for her in PA because my income is pretty low right now.  Maybe that will take the sting out of this plan.

The thing that ticks me off about Obamacare and health insurance policies is that there is an underlying assumption that the higher prices of the policies and mandatory cost sharing is going to teach us a valuable lesson about the cost of healthcare.  And you know, I get that.  I’ve worked with people who are in the upper middle class bracket who think that just because they have insurance, they must see the doctor every couple of days and then detail all of their ailments to their colleagues.  Or senior women who get attention they crave by visiting one specialist after another for vague maladies.  There’s something about relating these ailments to an audience that gives them satisfaction and a reason to live but, frankly, these people bore me to tears and I resent having to shell out money on their fibromyalgia and third course of antibiotics for a cold when what they really need is 30 minutes a week with a psychologist or a vocation.  We also shouldn’t be spending money on chiroprators and acupuncturists.  I don’t want my insurance dollars going to your back cracking quack when you should be seeing a physical therapist with a scientifically proven track record.

Hey, if you’re offended, go read someone else’s blog.  I have no obligation to support your fondness for quackery or tendency towards exhibitionist hypochondria.  Insurance is not for fun and games.  My employer provided health care was there for my and my family’s health.  It is not supposed to be an all-you-can-eat buffet like the kind you get on a Royal Caribbean cruise.  You know, where people gorge themselves on heaping piles of food that their already bulging waistlines suggest they do not need?  But it’s there and they paid for it so they feel entitled to overindulge.  That’s wasteful and people who abuse their health care should be ashamed of themselves. Health care is a necessity, not a fricking free-for-all.  Take it seriously.  Chalk my unsentimental attitude up to my no-nonsense, efficient military health care childhood where there were no bells and whistles and no one was there to give you unnecessary attention.

But my experience is not about appreciating the cost of care.  My experience was about getting care, period.  I wasn’t looking for the most expensive hospitals or drugs or doctors and we certainly didn’t seek them because we were feeling neglected or indulgent.  We sought them because the need was great and urgent and there was no opportunity or possibility to shop around. And for that, we are getting slammed with this insurance policy that will seemingly never decrease in price.  Furthermore, I’m healthy as an ox but the cost of my share of the premium has doubled so as to cover the kid’s share which couldn’t be rejected.  Maybe you think that’s fair but it’s certainly not “spreading the risk”.

She’s fine now, or at least she’s getting better.  We still need to see some specialists and that will be paid out of my pocket until the deductible is reached.  I’d pay it no matter what, reaching into my IRA for her if that’s what it takes.  But we shouldn’t have to do this.  From what I know, the cost of services are not controlled at all by Obamacare.  All the burden of spending less is on the patient and their families, even when such costs cannot be avoided.  And yes, some people will still go bankrupt until we as a nation get our collective brains and wills together and tell the health care industry that we’ve had enough of exploitative profit mining.

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Wednesday: What’s wrong with EJ Dionneism?

I realize that I am about 36 hours late to this party.  But did you ever have a topic that has been swishing around in the brain for a couple of weeks but didn’t quite know how to write it?  It’s not that the topic doesn’t have a theme song or plenty of examples.  In fact, it’s just the opposite.  This topic has so much material to work with it’s hard to know where to start.  Sort of like cleaning a very cluttered and dirty house, but I’ll get to that at the end.

So, EJ Dionne, one of the few ostensibly “liberal” bloggers wrote a silly, misguided, male-centric column the other day in the Washington Post about the campaign year decision that the Obama administration made to enforce the “free contraception for all!” rule for women with insurance regardless of who was providing the insurance, including the Catholic church.  The red beanie guys have been on Obama’s case for months now trying to get him to back off on this.  But Obama, smelling an opportunity to get back in the good graces of women, has decided to make this a campaign issue.  You can bet that this will be cited in the campaign literature delivered to the houses of women between the ages of 17-52 who have been data mined with pin-point accuracy as caring about these kind of things.

For Dionne, the Catholic schoolboy, this was an unwise decision for the president to have made.  If Obama wants to increase his chances of winning this year, he should have appealed more to the religious right.  Never mind that women requiring birth control outnumber Catholic bishops and cardinals, it is much more important to the Dionnes out there that we not upset the beanie boys.  In actuality, Obama tried to work out a deal with the bishops so that they didn’t have to provide the contraception but they would have to inform their female enrollees how they could get it.  They wouldn’t budge.  So, the administration told the church there would be no exceptions.  I don’t know why this is a praiseworthy act.  It should be so routine that none of us should even be aware of it.  Birth control is good.  Free birth control even better.  No one would have batted an eyelash about this in the 70’s.  But that was before the religious had to be appeased.

Here’s the part of Dionne’s column that bugged me the most:

Speaking as a Catholic, I wish the Church would be more open on the contraception question. But speaking as an American liberal who believes that religious pluralism imposes certain obligations on government, I think the Church’s leaders had a right to ask for broader relief from a contraception mandate that would require it to act against its own teachings. The administration should have done more to balance the competing liberty interests here.

Yeah, you know, as an American liberal, I don’t see it this way at all.  I don’t think religious pluralism imposes ANY obligations on government.  The only rights that religion imposes on government is the right to exist without having anyone shoving stuff down the gullets of the individual members of that religion.  For example, the church must offer contraceptive coverage.  The individual members of that church don’t have to use it.  No one can force you to  prevent pregnancy in this country.  But EJ has it backwards.  EJ thinks that it’s OK for the religious to force certain people, specifically women, to obey its proscriptions whether they are Catholic or not or even whether they believe in God at all.  When did the Constitution allow for the 4th century thinking of a collection of men in a different country to direct the lives of women here in the US against their own consciences?

It is unacceptable for any religion to direct the consciences and behavior of American women against their will.  It is especially egregious when the fallout of this coercion affects their ability to choose the number and timing of their family.  It violates their first amendment rights of freedom of religion.  It probably violates their civil rights as well.  It’s just wrong, EJ.  The Catholic church has a right to exist in this country and conduct worship services that are open to the public and that’s it.  I don’t remember any other parts of the constitution where it was allowed to impose any other obligations on government.

But let’s take EJ’s theory to its logical conclusion.  Let’s say that religion is allowed to impose obligations on government.  We’re not talking Taliban or Wahabbi territory here where there is only one flavor of religion.  This is America after all and we still have a religiously plural society.  Let’s think of another example where there is religious pluralism where the fundamentalists have been pandered to in the manner that EJ suggests.  How about Israel?  Recently, the ultra orthodox fundamentalist Jews have been having a field day in Israel screaming and spitting at little girls, having fits over women singing in public and denying female scientists the right to receive professional awards at ceremonies or speaking about their expertise.  These last two examples were the decisions of the governmental minister of health.  All of the ugly details about what Israeli women are experiencing even though most of them are not ultra orthodox, can be found in this NYTimes article, Israel Faces Crisis over Role of Ultra Orthodox in Society.  And here’s the money quote that shows just how wrong EJ is:

They have generally stayed out of the normal Israeli politics of war and peace, often staying neutral on the Palestinian question and focusing their deal-making on the material and spiritual needs of their constituents. Politically they have edged rightward in recent years.

In other words, while rejecting the state, the ultra-Orthodox have survived by making deals with it. And while dismissing the group, successive governments — whether run by the left or the right — have survived by trading subsidies for its votes. Now each has to live with the other, and the resulting friction is hard to contain.

In other words, if you start making deals with the religious right for votes, they’re going to want something in return.  And this *something* tends to bite women in the ass. Give them an inch and they’ll start humiliating female scientists at professional conferences. The reason why the religious right have been able to get away with it for some time now is because of men like EJ and Chris Matthews types who never have to live with the results of those deals.

But nevermind.  Women already know this.  And they know it will get worse the more politicians pander.  Now it’s birth control, pretty soon, it will be allowing employers to discriminate against women without cover.  They do it now anyway and I could swear it got worse after the 2008 election because after all, the president and his party got away with vicious misogyny and discrimination without being held accountable.  What women in the private sector is going to be able to successfully challenge the old boys club now?  Party on, boys!  That’s why the layoffs initially hit men hardest but spared women in public sector, education and health care jobs, but when it comes to hiring back in the corporations, it’s helpful to have a penis and a male supervisor or director who lunches only with other males and doesn’t see the women in his groups as real people needing real jobs.  That’s why it is not uncommon for the majority the women in a department to lose their jobs in a layoff but not the men.  Yes, this really happens.  I have witnessed it myself.   That’s why men get internal job interviews and not women.  I thought I was crazy until the company doctor told me that she heard the same complaint from many, many women in my company.  They are passed over, shoved out, laid off and never heard from again.  It’s partially because no one challenged the shit that happened in 2008 or laid down the law in subsequent years or formed an exploratory committee to find out why it’s happening.  No one gives a shit.  It’s just women.

And why doesn’t anyone give a shit?  Have you seen how many male column writers we have in major American newspapers compared to females?  Have you ever read the evening round up on The Plum Line when male blogger after male blogger is cited with a bare sprinkling of female opinion thrown in as a garnish?  We hear mens’ opinions 24/7 ad nauseum.  And their stupid, clueless opinions usually give a pass to the religious right and their stubborn insistance that we all obey the writings of another bunch of male columnists  from the end of the fricking Bronze Age who swear, without any proof at all, that they were taking dictation from God himself.

Enough, already.  There are many of us who no longer believe in the god of the bible.  There is a growing movement of non-believers, atheists, panentheists, freethinkers, skeptics and agnostics who do not agree that the religious impose ANY obligations on government outside of the right to exist.  At the very least, the religious should have to prove to everyone that what they believe is real and rational beyond a shadow of a doubt before they impose any obligation on anyone.

So, until the red beanie guys can show conclusively, incontrovertibly and with all of the tools of the scientific method at their disposal that there is an actual God  and that this God actually cares and does not want women to put substances in her body to prevent the conception of children, they should keep their unfounded, harmful, discriminatory impositions to themselves.  At the very least, God should be required to make an appearance in a form other than a talking herbaceous wildfire hazard before we are forced to pay any more attention to the religious right or any politician who panders to them.

Including Obama.

Friends, has this ever happened to you?

I started hearing a thumping noise last night. Didn’t think much of it. Probably just a piece of loose soffit. It’s come undone before about 10 years ago and if I recall correctly, took about 10 minutes for the handyman who had a long ladder to pin back up. Except for the nasty, anonymous note one of my neighbors put up, demanding that I “fix it immediately, some of us like to sleep!”, it was no biggy. The damage to the house was minor. The damage to my relationship to this neighbor was irreparable. I know who left the note and did not offer to help me fix it. But I digress.

The sound got more insistent this morning when I woke up. “Oooo, that sounds expensive”, thought I. But my imagination is always much worse than I think. So, I fired up the coffee pot, jumped into my clogs and checked it out.

This is what I found:
20120114-140544.jpg

Needless to say, my imagination completely did not keep up this time around. Not only is the siding gone, so is the vapor barrier. I can almost hear the heat escaping from the house singing, “I’m free! I’m, free!”. If only that we’re true. Sadly, PSEG does not discount the natural gas for “The wind ate my siding” excuses.

In the annals of unemployment during the worst recession/depression since the 1930’s, this is one of those unexpected expenses that people like me dread. Insurance will probably cover this, but I have a hefty deductible and the bit of padding I built into the reserve fund has just taken a big hit.

It goes without saying that politicians are out of touch.

New GOP Rep. Andy Harris gets irate over lack of instant health insurance

Yes, Dr. Harris, newly elected congresscritter and anesthesiologist, has gotten what my Dad would call a “Rude Awakening”.  From Steven Benen’s Political Animal post at Washington Monthy, we get the following exchange related by someone who was there:

“He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care,” said a congressional staffer who saw the exchange. […]

“Harris then asked if he could purchase insurance from the government to cover the gap,” added the aide, who was struck by the similarity to Harris’s request and the public option he denounced as a gateway to socialized medicine.

Harris, a Maryland state senator who works at Johns Hopkins in Baltimore and several hospitals on the Eastern Shore, also told the audience, “This is the only employer I’ve ever worked for where you don’t get coverage the first day you are employed,” his spokeswoman Anna Nix told POLITICO.

Steve adds:

Harris wants to know “what he would do without 28 days of health care”? I don’t know, Andy, what have tens of millions of Americans, including millions of children, done without access to quality health care for years? Why are you entitled to government-subsidized health care, but they’re not? What will those families do after you repeal the Affordable Care Act? Wait for tort reform to magically cover everyone?

What an embarrassment.

{{RD pauses}}

I’d laugh but I don’t think this is funny.  I can just imagine someone like Harris expostulating loudly over the fact that some poor woman whose family is recently unemployed and can’t pay for COBRA couldn’t afford to pay the bill for the epidural she had during childbirth.  It’s not funny that his 5 kids will not be covered until February.  It’s not funny that he’s been sheltered from the reality of the probationary period that everyone I know has to suffer through.  It’s not funny that some district in Maryland will be represented by a dolt.  And it’s not funny that he will presumably learn nothing from this, given his party affiliation.

Satisfying, but not funny.

Sotomayor Round-up: It’s about more than abortion

But if you are of child bearing age, stock up on Plan B.

Realistically, the Republicans have already won the Roe v. Wade battle.  Anthony Kennedy is persuadable, given the right case.  He nearly caved on Webster v. Casey back when Sandra Day O’Connor was on the bench.  She had to talk him out of it but it was touch and go for awhile there.  Kennedy only reluctantly agreed with her in the end.  There’s no Sandra Day around anymore but there are a whole lot more blustering, former altar boys on the bench.

Sotomayor may not be an Antonin Scalia but the sense I am getting from her is that she’s no Souter either.  I was stunned to learn from Gibbs that Obama never asked her what she thinks of Roe.  It’s probably because he doesn’t need to know.  It’s beneficial to both parties for Roe to stay on the books.  So, it’s likely that a test case like Webster will never come up again.  No, instead we will have more of the kind of cases where the right to have an abortion remains but the actuality of obtaining one is very difficult.  Maybe we’ll go back to the days of the early 70’s where you had to take a trip to New York.  And Sotomayor will probably be just fine with that.  It allows her a certain amount of cognitive dissonance.  She never has to outlaw it or condone it outright.  She can be technically pro-choice while being practically pro-life.

This doesn’t come as any surprise to those of us who followed Obama’s rhetoric on the subject last year.  It was above his paygrade to comment on it but any such decision needs a supermajority from all of your friends, family and religious authorities.  Women, you can’t do this by yourself.  Your eency-weency brains and underdeveloped sense of morality require the assistance of others wiser than you.  If you decide you want an abortion after all, they can shame you for being a wanton woman and if you decide to put the kid up for adoption they can call you heartless and non-maternal.  If you keep it, you will be a burden to your family.  Gosh, don’t you miss the olden days when it was everyone else’s business to know what is going on in your life and pass judgment on it?  I doubt that Obama appointed a truly pro-choice nominee because the evangelical base might desert him.  He’s not too worried about you 20 somethings.  I mean, where else are you going to go?  As long as he is also technically pro-choice, he’s going to be heads and tails better than any Republican, right?  Oh, right, they already have 5 votes to overturn Roe.  Funny, they had that *before* the 2008 election too.

I sure feel smart that I voted for the woman:

Sotomayor has accumulated a record on church-state issues, insurance cases and employment law.  I haven’t read everything and I don’t claim to understand all of it anyway.  But my sense is that she is very deferential to authority.  Maybe that’s why George H. W. Bush appointed her as a judge in the first place and why she was offered by the Democrats to the Republicans during the last administration.  It may very well be the case that her upbringing will have an impact on her judicial temperament but not in the way Republicans fear.  In fact, they almost seem to be playing tar-baby with Sotomayor.  What kind of person comes out of an ethnic, urban, working class, Catholic upbringing, who spent years in a parochial school and excelled at pleasing those paragons of virtue and authority, the formidable Catholic nun?  What kind of person does that produce?  I mean, other than Maureen Dowd and Chris Matthews?

Yeah, imagine Chris Matthews on the SCOTUS.  That’s Sotomayor.

Laughter: The best medicine (an Open Thread)

Well, I’ve cleaned up after my bleeding ears and was ready for a laugh. Where better to go than the New York Times?

Health Insurers Ease Stance on Pre-Existing Conditions

WASHINGTON —The health insurance industry said Tuesday that it was willing to end the practice of charging higher premiums to sick people if Congress adopted a comprehensive plan that provided coverage to all Americans.

The industry’s flexible position on the issue came as a surprise to lawmakers, and could make it easier to reach an agreement in Congress because it narrows the issues on which insurers are ready to fight the Democrats who control Congress and the White House.

Insurers said they were still staunchly opposed to creation of a new government-run health insurance plan, which, under many Democratic proposals, would compete directly with private insurers.

In effect, insurers said they were willing to discard an element of their longstanding business model, under which insurance policies are priced, in part, on the basis of a person’s medical condition or history.
. . .
Insurers said that they could accept more aggressive regulation of not just their premiums but also their benefits, underwriting practices and other activities. Such strict regulation, they said, would make a new public program unnecessary.
. . .
In November, two weeks after the presidential election, the industry said it could support legislation requiring insurers to accept all applicants, regardless of illness or disability. In return, the industry said, Congress should require all Americans to have coverage.
. . .
However, the two executives said that insurers wanted to retain the right to charge different premiums based on the age, place of residence and family size of subscribers.

Do they think we’re idiots?

  1. They are generously going to stop refusing customers (or charging more) for pre-existing conditions
  2. Congress will require that WE ALL must purchase insurance
  3. They still might charge more depending on how old we are, where we live or how many people we have in our family

And THAT proves we don’t need a public option for health care. . . . .

(Rolling on the floor laughing hysterically)

Feel better now?