Thinking about Health Insurance, as one does when one is SICK

Howdy. I'm still sick.

Those expensive antibiotics? I'm halfway through the seven day script, and I dunno, they haven't kicked in the way I thought they were going to.

I should clarify something about their cost. If I'd walked into the drugstore and bought the seven pills without any insurance, they would have cost me $233.99 - or $33.43 each. I do have insurance, but since this was the first non-generic prescription I'd filled this year, I hadn't yet met my deductible. So, I had to pay $100 deductible PLUS the $30 co-pay that I'll have to pay on any future scripts, for an outlay of $130 for the seven pills.

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One of the things that the scare-mongers use in lobbying against nationalized single payer health care is that it would limit choice, that you won't be able to see the doctor that you want to see. Well, in point of fact, that's already happened. Managed care, with networks of doctors, has pretty much limited one's doctor choice to a doctor who is in your network - unless one has the resources to pay out of pocket for care.

And there's a problem with that.

A couple of years ago, I had some growthy thing on my forehead. I went to the in-network dermatologist THREE times, it came back THREE times. I gave up and went to the fancy Fifth Avenue no-insurance-at-all doctor and he fixed it - it's never come back and the scar is invisible. And you know? That kind of pisses me off, because - in that case anyway - the fancy expensive doctor actually WAS better than the insurance paid hack.

A friend, a new real-life friend who happens to have a blog, who I met last month at the birthday party of a very old friend (who also happens to have a blog), recently had a health issue that wouldn't go away. She called it "the itis", and it hung around for five months. She finally found another doctor, out-of-network this time, and guess what? Cured! Again, the out-of-network turned out to be a better doctor.

My sister-in-law asked me for a recommendation for a doctor because she's got terrible bunions. As it happens, I know who the foot doctor is - three different people that I know have had him operate on their feet - he's the best, period, end of story. She called up - yes, ma'am, a consult will be $450 and we don't take any insurance.

I don't know what the moral of these stories is. But they're just indicative of another way that the system is broken. I hope it gets fixed.

2009 Just Posts

The Just Posts is a monthly roundtable of posts that "lift up our planet and all that inhabit it" begun by the inimitable Jen and Mad , and later handed over to Holly and Alejna. The latter two took it upon themselves to re-read all of the 2009 Just Posts, culled it down to a bunch of semi-finalists with the help of volunteer readers, and then put together a list of finalists in twelve different categories.

I'm thrilled to have been chosen as a finalist in the "SOCIAL JUSTICE as advocacy/service : Posts related to INFORMATION AND ADVOCACY" category, and of course, I hope you'll go vote for me. But even better would be for you to go over to either Holly's post or Alejna's and read through some or all of the great posts. They are moving, and shocking, and funny, and informative.

Charity vs. Democracy

Maybe you've heard this. Chase Bank is giving $5,000,000 away via Facebook . Sounds great, right? All you have to do is vote for your favorite charity, and tell everyone you know. Actually, in the first round, you can vote for 20 favorites, so you can horse trade with your friends.

It's crowdsourcing philanthropy! A new model for the new social media! Charity by the people!

But the problem is that it’s a popularity contest that rewards those organizations with the greatest social networking savvy and not those with the greatest impact and/or efficiency of operations. Arguably, a small organization with terrific grassroots skills but mediocre delivery of a dubious service could win a million bucks - and then fritter it away on pizza and airplane tickets. There's no vetting, no due diligence.

Forgive me for being a deeply cranky cynic, but this whole thing just looks like Chase spending $5,000,000 to make itself look good by tossing some spending money at a handful of charities. Sure, the top vote receiver will get a cool million, but 106 organizations out of 500,000 will split $4 million (the last million will be doled out by ”a special Advisory Board led by prominent national philanthropists...to the nominated charities of its choice").

Keep in mind here that Chase got $25 BILLION in bailout money last fall - $5 million is chump change.

This isn’t philanthropy, it’s marketing. And what’s more? They’re making the 300 million Facebook users do all the work.

Stigma // Taboo

"The In The Know Short Film Competition sought to eliminate the stigma of infertility and encourage couples who have struggled with infertility to share their stories and lend support for other couples hesitant in openly discussing their journey."

I know. Who'd a thunk it? An infertility film festival? But I was there the other night, as the guest of the very lovely Mel, Queen of the Stirrup Queens and The Land of If, who happened to be one of the judges. We had drinks and snacks, we saw the three films that made the finals, and Mel and I talked about the ballet.

But go back and read that opening paragraph. Stigma. A few of the speakers at the event used the word "stigma", and it rattled me, enough so that I had to look it up in the dictionary, because there is nothing better than pulling a redolent dusty dictionary off the shelf for some aimless archeology.

Stigma: 1. a mark of disgrace or infamy; a stain or reproach, as on one's reputation

Or

Stigma: In sociological theory, a stigma is an attribute, behavior, or reputation which is socially discrediting in a particular way: it causes an individual to be mentally classified by others in an undesirable, rejected stereotype rather than in an accepted, normal one.

Being infertile does not disgrace you, it doesn't detract from your character, it doesn't mark you in any way, it doesn't make you into an outcast. However, it is something that people don't generally talk about, a taboo subject.

Why is that? And what can we do? Talk about it.

After my husband and I got married, we stopped using birth control and started trying to have a baby. And whenever anyone asked, I coyly deflected the question of "when are you going to have kids" with "we have cats". I did this so successfully that when I told people I was pregnant - eight years into the marriage - they said "we thought you didn't want children". If I had talked about it, perhaps someone would have suggested a medical investigation sooner - because I just didn't realize that yeah, your fertility decreases as you get older. In retrospect, I was an idiot.

Besides the happy production of a child, the experience of doctors and needles and dildo cams and surgeries and so many blood draws it's amazing that I'm not anemic made me hyper-aware of other women struggling with infertility - almost as though I developed a sixth sense for it, an intuition. And once you start talking about it, it's there, and there, and oh, there too. It's everywhere. It's one in eight couples.

Reading infertility blogs was my gateway into blogging. After reading for a while, I started writing, and while I'm in no way an "infertility blogger", having come to blogging after my fertility treatment days were over, I still feel a resonance there, and it's how I met Mel in the first place.

Incidentally, there's a fine irony in the phrase "stigma of infertility". One of the definitions of "stigma" has to do with something at the very core of conception - the release of the ripe egg from the ovary.

"A stigma in mammalian reproductive anatomy refers to the area of the ovarian surface where the Graafian follicle will burst through during ovulation and release the ovum."

Infertility isn't a stigma, and it shouldn't be a taboo.

From the Rain Comes Hope

It's overcast again, just like it was last year. Actually, it's more than overcast; it's raining and drizzling, stopping and starting. And once again, I'm glad that it's not that shockingly brilliant bright blue sky punctuated by smoke and horror.

This past April, President Obama signed legislation to recognize September 11 as a federally observed National Day of Service and Remembrance. How does one participate?

Just set aside a little time this 9/11 to plan or perform at least one good deed that helps someone else who may need assistance, or to support a cause that you care about. You choose.

As my contribution, I'd like to first point you towards the August Just Posts, as rounded up by Holly and Alejna. As ever, they've compiled some good posts to read, including, if I may pat myself on the back, my post about the cost of a colonoscopy.

Second, if you missed it, there was a special issue of the New York Times Magazine last month, focused on women, and "how changing the lives of women and girls in the developing world can change everything". The centerpiece was an article by Nick Kristof and Sheryl WuDunn, excerpted from their new book Half the Sky.

There’s a growing recognition among everyone from the World Bank to the U.S. military’s Joint Chiefs of Staff to aid organizations like CARE that focusing on women and girls is the most effective way to fight global poverty and extremism. That’s why foreign aid is increasingly directed to women. The world is awakening to a powerful truth: Women and girls aren’t the problem; they’re the solution.

Kristof and Wu, helpfully, included a sidebar labeled Do-It-Yourself Foreign Aid, and so, in the spirit of this National Day of Service and Remembrance, I am going to send a donation to the Friends of Edna Maternity Hospital, in support of the Edna Hospital in Somaliland, and with the hope of helping to alleviate obstetric fistula.

How will you participate?

A Just Post Call For Help

Those fine Just Post women are hanging up their hats this week. For the final Roundtable, they put out this query:

Dear Readers, What say you? Are you a pragmatist or a Heart of Gold? Or are you some other kind of hybrid altogether? Will you join us in becoming an ongoing financial supporter of a cause you believe in? Will you write about it on your blogs or in your tweets? Will you help to raise money AND the profile of organizations that desperately need aid?

And that's what we are asking for as our farewell gift. Send us your link by the 8th and we'll include it in our last Just Post Roundtable on the 12th.

I've always worked for non-profits. Always. Except for stints at Publisher's Clearing House during summers in college, or part-time at a law firm while in graduate school, all of my employers have been non-profit arts organizations in New York City. All four of them (yes, four jobs in 22 years, I put down roots) have depended on the kindness of individuals (and corporations and foundations and government) for on-going support - because even though there's always a bit of earned income, it's never enough.

Can I tell you how much we appreciate that help? We really really do. Even a check for $5 means something - because that person took the time to sit down and write a check for $5, and put a stamp on the envelope, and dropped the contribution in the mailbox. And that $5 is going to be good for something - it'll buy some socks or a ream of paper. And if 13 people give us $5 each, we can buy a pair of pointe shoes for a twelve year old girl, who would never otherwise have the chance to dance. And 100 gifts of $5 - hey, that's $500 - pretty soon you're talking real money.

Opening up the return envelopes from our end of year campaign is one of the high points of my job, and it's not even my job. I just pitch in and help because I really like opening envelopes with checks in them, especially the ones from people just like you and me. Sure, a big check from a swank foundation is fun too, especially when it's for five or six figures, but the little ones really tug at the heartstrings.

As a result, I take my own personal charitable giving seriously. It's certainly not a lot of money - I haven't got a lot of money - but I try and spread it around to places where it seems like it'll do the most good, and that mean something to me.

In 2008, I made cash contributions to 34 different organizations (and dropped some stuff at the local thrift shop which benefits the American Cancer Society). One organization got three separate gifts, but that's because I'm on the board and there were several campaigns and an event. A few gifts were made because of specific requests by friends or acquaintances (like walk-a-thons, or the $50 gift to Rockefeller University requested in lieu of a present by a friend who turned 50). Others were completely local (the volunteer fire department, the library, the volunteer ambulance corp, the nearby hospital).

Some gifts were made as a result of news items. After the Hurricane Ike, I sent a bit to the Austin Food Bank. The Holy Apostles Soup Kitchen was profiled in the New Yorker; they got a gift. Planned Parenthood got a contribution in memory of Sarah Palin. And I sent a bit to CIMIT after reading an article in the Times about their project to build incubators out of car parts.

Of the 34 organizations, 16 were repeat gifts - I've given to them one or more times in the past five years. I give to my college every year. On my birthday - which is just before the end of the calendar (tax) year, I send the New York Times Neediest Cases Fund my age in dollars. This year, they got $48. Next year, it'll be $49.

Oh, and I have rules. I always slip a note in the envelope asking that they not add me to their list, and that they don't solicit me more than once a year. If they fail to respect that, or if they don't send me a thank you note, I blacklist them.

I'm not telling you this to toot my own horn. I'm telling you this because a little here and a little there adds up, and giving becomes part of your life.

The Just Posts have been a wonderful spotlight on causes that move people, on issues of justice across the board, from access to health care to poverty to volunteering. And so in honor of one of the women who founded the Just Posts Roundtable, my first contribution in 2009 was a modest gift to an organization that helps the homeless.

You can help too. $5 really can make a difference.

Little Hats and Just Posts

Those splendid Just Post bloggers put out the penultimate edition of the Just Posts last week - go check out Mad and Jen and Su, and click through to some great posts about making the world a better place.

My post about turning old tee-shirts into hats for Haitian babies was included, which inspires me to show off another found material baby hat that I made.

This tiny knit hat is made of scrap yarn that I found in a drawer at my mother's house, little balls of yarn leftover from other projects, none of which were enough for a full project. So I picked out complementary colors and just kept changing yarn.

Yesterday, I mailed that hat off to Save The Children, for their Knit One, Save One project - the caps will be collected and sent off to babies in need of warmth.

I'm a kind of terrible knitter - I have two lots of yarn at home in a box because I'm just terrified about making the sweaters that I got them for - but little tiny hats, either for newborns I know, or for needy babies I don't? That I can do.

Just Posts Kvelling

I'm thrilled to be on the list of Just Posts again for November. Thrilled. Especially because while I nominated one of my own posts (yes, that's kosher), a second of my posts also made the list. The whole list is at Mad's and at Jen's. Check out the many voices of conscience.

In the past month, since I wrote a Blog Action Day post about the environment, I've been on a junk mail rampage. If there's a postage paid return envelope, I return the address panel marked "REMOVE FROM LIST". If there's no envelope, but there is a fax number, I fax back the address panel, marked in the same way. If I have to, I resort to using the web or (horrors) the telephone. I've faxed back 62*. I didn't keep track of the phone/mail/internet removal requests, but maybe there were another twenty.

But I have a new outlet for my crankiness. My mother-in-law told me about a website where you can enter your name (and variants) and decline various catalogues. I don't know if it'll work, but it feels like a pro-active thing to do. So I declined five yesterday.




*Yes, I kept them in a pile and counted them yesterday before I threw them out - I'm some kind of a crazy person.

Respect and Old Age

My mother’s lived in her house since 1972, and the people across the street were there before her. They were a sweet couple of teetotallers, he a Methodist minister, she the cookie-baking minister’s wife. He died five years ago. She’d been doing well, but fell a couple of months ago and landed in a nursing home. Bang zoom: her kids put the house on the market, moved their mom to a facility in the mid-West, held a tag sale, and filled up a dumpster with the detritus of two lives.

It’s so sad.

The tag sale was yesterday. It was run by a hostile incompetent hired gun – the place was a mess and the stuff was priced completely erratically and mostly unmarked (so you had to ask, whereupon she made up a price on the spot). You’d think that someone running a tag sale, working on commission, would want to maximize the income by keeping things presentable, by clearly pricing everything, by acting knowledgeable and helpful. In this case, you would be wrong.

There were still spices in the kitchen cabinets and Q-tips in the bathroom. For all I know, they were for sale. There were clothes in the closets and piles of linens on the floor. There was no order to anything.

My mother and I wandered around – I found a handmade double wedding ring quilt in a heap upstairs, and asked how much. $5, said the hostile incompetent. So I bought a quilt for $5 – I don’t need it, but I couldn’t walk away from it. There was a handsome mirror in the dining room – my mother said she’d been asking $400 at the pre-sale earlier in the week. By yesterday, the price was down to $75. I went back at the end of the day and offered $20. She countered with $30. I left. About 10 minutes later, my husband showed up – I sent him across the street, and he came back with the mirror for $25. And my mother went over and came home with a little upholstered rocker for free – earlier, the hostile incompetent had been asking $60. So erratic.

Once the tag sale was over, they starting heaving things into a dumpster. Plaques given to the minister. Antique clock parts (his hobby was clock repair). Dishes. Books. Christmas ornaments. Napkins. Space heaters.

It’s so disrespectful.

It’s so wasteful.

My brother and sister and their spouses and a family friend and a neighbor headed across the street after dark and, wine-fueled, dove into the dumpster with flashlights.

It seemed right to rescue some bits of their life. A pressed glass citrus reamer. A crochet hook. A pinecone-shaped iron cuckoo clock weight. A Horatio Alger book.

It could have been done so much better. They could have found a way to let her stay in the house. They could have found her a place to live in the area - where she has friends and neighbors and acquaintances and church folk - instead of shipping her off to the middle of the country where she'll know no one but her dead husband's elderly brother. They could have hired a more sensitive person to run the tag sale. They could have been more respectful of her stuff, her life, her things, his life, his hobbies, their life. They could have packed off much of the stuff to thrift shops, to shelters, to people to whom the stuff would have made a difference. A space heater tossed in a dumpster does no one any good. A box fan...the same.

It sounds like I'm blaming her children - and in part I am. But it's also our society. We think nothing of discarding things and people, we disrespect the past. In that is our curse for the future. It's environmental. It's societal. It's human. We should do better.