Category Archives: Healthcare

politics

Obama has come out with some positive proposals lately.  When I read that he was pushing for free community college I was super excited.  For about five seconds.  Then I realized it has zero zilch nada chance of passing congress and that it was political grandstanding on his part.  I think it’s a fantastic proposal and well worth spending money on – and I’d be willing to pay higher taxes to support it.  I could go on about why it’s a great idea, even if it’s pricey, but it’s pointless.  It’s not going to happen, at least not during Obama’s presidency.  Seriously the best thing about Georgia is the Hope scholarship.  I’m not sure what it’s status is today, but fifteen years ago, it was an amazing thing.

Then, today I read he’s pushing for six weeks paid maternity leave for federal workers.  On the one hand, this would be a great thing.  Are there federal workers out there not currently getting paid maternity leave?  My NASA counterparts get six weeks, don’t you, even without sick leave?  So, I’m a little confused.  Second, what about the rest of the country, all the non-federal workers who actually need the leave?  If this was really important to Obama he would have brought it up sooner.

On the bright side, I read that the percent of families suffering major financial insecurity due to medical costs dropped five percentage points in 2014 (from 2013, I think.)   I think it’s safe to say that Obamacare gets the credit.  That is a plus.  I just hope the Republicans don’t dismantle Obamacare.  While it’s obviously not a great system, I have yet to hear any counterproposals.  My first would be, how about the US stops funding the pharma companies all on its own and the rather smug Europeans and Canadians get to start pulling their weight?

I read in the NYT the other day that people with health insurance use the emergency room more than those who are uninsured.  Remember when we were going to save money by insuring more people because they’d stop using the ER?  In retrospect, that POV was rather insulting to the uninsured.

Harvard health costs

Cry me a river.  Don’t get me a wrong.  Employees should always advocate for themselves, and I don’t blame Harvard employees for doing so.  However, anyone who works in the private sector will have little or no sympathy for Harvard professors being forced to pay $20 co-pays and have a $250 deductible.

My benefits cost has gone up, and my actual benefits have gone down year after year.  This is at least in part due to Obamacare provisions that, in some cases thankfully, don’t benefit me – 1 million lifetime max being made illegal, healthcare for kids 21 to 26, and no longer being allowed to deny people with pre-existing conditions.  I don’t oppose any of these provisions, but you don’t get anything for nothin’.  If you factor in healthcare, while I got raises, some years, the healthcare cost negated that raise completely.  However, it’s hard to call it a paycut, because Blue had to shell out a lot of extra money as well to cover the 80%/50% (individual/family) share of the premiums.

Five years ago, I had excellent health coverage.  Now I’d describe my health care coverage as OK.  Thankfully, no one has had a serious illness to really test it.  It’s certainly not cheap on Cobra.

legalizing pot

These days I have no stomach for reading about sick kids.  It’s not like I ever enjoyed it, but lately, I can’t help but replace the child with L in my mind.  I’m no big proponent of marijuana legalization.  It annoys me when my neighbors smoke pot or when people smoke pot at parties, or pretty much any time when I’m around.  However, I have never understood why medical marijuana should be illegal.  I think a doctor should be able to prescribe whatever a patient needs to make them better, and marijuana should certainly be an option.  I’ve read two stories recently about young children whose lives appeared to be massively improved by marijuana.  In the first case, the child was taking these unbelievably powerful drugs which were basically killing her – and were still not doing a great job stopping the seizures.  But her doctors were hesitant to recommend marijuana, something so benign by comparison.  The second is the headline on CNN today.   This child said  “mama” for the first time after marijuana finally mitigated her seizures after everything else had failed.  Among other things, it’s so inexpensive compared to some of the drugs around.  It just breaks my heart reading about these poor kids.  Thank God they’ve finally found something to help.

We moved yesterday.  I had more contractions yesterday  than I’ve had the entire rest of my pregnancy combined, but we got through it.  Now our house is complete chaos.  I had breakfast in a mixing bowl with a baby spoon and B’s cereal.  Hopefully we’ll be able to get a little bit organized tonight.

proud

I’m so proud of my sister.  This is her second quote – this time on Yahoo finance:

“We’re pleased to integrate Teladoc into Castlight. In doing so, we can help our employer customers realize even greater benefits from their telehealth service than if it is a stand-alone company benefit,” said Maeve O’Meara, vice president of Product Management for Castlight Health. “The power is in leveraging the Castlight platform, making it that much easier for an employee to find and use Teladoc when they need it.”

The fact that her company is doing something worthwhile is all the better.

this and that

What better way to start the new year than by reading the news?  First I find out that Mr. Duck Dynasty, who prior to his anti-gay comments I had never heard of, is saying you should marry women at 16.  Really, who cares?  This guy is clearly a moron.  Why are we giving him CNN headlines?  It’s simply spreading his message to people who would never otherwise have heard it.

Then, I see that Sotomayor has issued a stay on the part of the healthcare law that requires providing plans with birth control.  It was unclear to me from reading the article who that affected.  I believe very strongly that women should have access to birth control.  On the flip side, I can see how some very small groups should be able to get an exemption, such as a charitable order of nuns.  Schools and hospitals, in my opinion, should absolutely not get an exemption, and it’s a little horrifying to me that so many of our hospitals have these close religious ties.  I really wish the Catholic church would get over its objections to birth control.  It just really doesn’t make sense to me.  The world would have a serious populations problem without birth control.  Sex only inside marriage – OK, I can see the rationale.  By no birth control inside marriage?  Why ever not?  I take this personally for two reasons.  First, morning sickness was debilitating for me during my first pregnancy.  I think it would physically extremely harmful for me to go through several pregnancies like that.  In general, I think it’s unhealthy for most women to go through more than 5 or 6 pregnancies.  (There are always exceptions, and the younger you start, I’m sure the easier it is.)  I suppose there is always the rhythm method.  Second, the primary treatment for PCOS for someone not trying to conceive is the birth control pill.

There have been lots of pregnancy and birth announcements on Facebook lately.  A friend from my prenatal water aerobics class (pregnancy), my first cousin (birth), a former co-worker (pregnancy), and former high school classmate (birth) just to name a few.  I suppose people used to find out about these things by reading birth announcements in the newspaper.

 

incognito

There’s no such thing as a free lunch.  From the NYTimes – Digital medical records don’t save much money (if any) and have mixed results in improving care.  I’m too lazy to link, but I also found it extremely unsurprising to learn that increased preventative care does not save money.  Reducing costs most likely means reducing quality of care, but here in the US, we subsidize the rest of the world in many ways, and we’re probably at a place on the cost-benefit curve where the slope is fairly low.

We had a rough time getting I to sleep tonight.  But she is so adorable, basically at all times.  I love that she loves playing games these days.  She loves peekabo.  She’ll play with her blanket, with her bib, with whatever she’s got handy.  She loves it when I play, and she’ll pull the blanket off me or whatever I’m hiding under.  She ever plays with inanimate objects.  Today, she was covering up the dinosaurs on her pajamas and playing peekabo with the dinosaur.  So cute!

She thinks the wave sign means Daddy.  Basically, at some point I realized I should teach her to wave.  Waving is just not something I do normally, and we never started with I around, so I started saying “Hi Daddy” and “Bye Daddy” whenever B entered and left the room.  We have done Hi and Bye with other people as well, but B comes and goes a dozen or more times a day, thanks to his work-at-home scheme.  These days, if I say something about Daddy, she’ll start waving.  It’s so adorable.  If we walk by his door, she sometimes starts the waving sign with her hand.

I also love that she loves books.  She loves books above all things – textbooks, board books, regular kids books, novels, even catalogs.  She just loves flipping through them, turning the pages over and over, examining this and that.   I bring home stacks of books from the library for her and me to look through (as if I don’t have enough on my shelves.)  We used to read through all her books regularly, but it’s become much harder because she has so many, between the ones she owns and the ones we have out from the library.  We read all of them yesterday, and it must have been 20 books.   Her favorite book is O Is For Orca.  I can’t really recommend it because I don’t know what she sees in it, but she just loves it for some reason.

Today, she learned to “play” the xylophone for the first time.  She got two xylophones for Christmas.  Playing a xylophone is more complicated than you’d think.  You have to manipulate the mallet such that the end strikes the keys and then is lifted again.  She’d done it by accident a few times, but today she was able to do it with some consistency.  Naturally, every successful effort was greeted with plenty of applause on my part.  Until today, I’d gotten much more use out of the xylophone than she had.  (My favorite tune is The Gift to be Simple.)

insurance rant

Becca linked to an article about a woman who was annoyed at having to pay largely out of pocked when she had a baby. Lately, I’ve been thinking a lot about the difference between insurance and a health care plan. Insurance, per google’s definitions, is either “promise of reimbursement in the case of loss” or “A means of indemnity against occurrence of a uncertain event” or ” form of risk management primarily used to hedge against the risk of a contingent loss.” In other words, it’s money you pay to someone in case you have a problem with your health. It’s not a system where you give someone $10 a month to pay your $100 monthly health bills. You give someone $10 a month to pay your $5 a month health bills in case they become $100. If they’re already $100, the health care company is going to want at least $105 a month and perhaps $200 a month if initially high bills imply a higher risk of increase.

Anyway, what health insurance company in their right mind would pay to “insure” a married childless 25 year old woman against the risk of pregnancy? It doesn’t make any sense. Let’s assume 50% of privately insured couples between 25 and 35 will have a baby in that time period. Either everyone can pay $10000 for those babies, or the 50% that have the babies can pay $20000. I’m not sure the former method necessarily makes more sense than the latter.

Next, the author says, “After several years in Europe—where coverage was, as goes the cliché, comprehensive and nearly free . . . .” Coverage in Europe is *not* free. Everyone pays for it with extremely high taxes. And perhaps that’s right and reasonable. However, calling it free is ridiculous. In fact, I would say anyone who moves to Europe for a few years to have a baby or other expensive health care events is ripping off their fellow citizens, since they skipped paying the taxes their entire lives that pay for this stuff.

It seems like people should form cooperatives to negotiate better deals with insurance companies. These cooperatives could be extended the same rights as employers. I know my employer re-negotiates our healthcare every year, and my payments haven’t gone up at all in the last 3 years despite constant benefits as we’ve grown larger and our bargaining power has increased. Negotiating to become a member of a cooperative would be interesting since the cooperatives would obviously want to seek out young healthy members. Anyway, some kind of negotiating power is obviously needed.

Society should probably bear the cost of childbirth, and that’s how employee-based health care works. A company has a mix of old and young, single and married, so only a few people are having children at a time. Everyone pays for it. However, an individual planning imminently to have a child railing against an insurance company for not wanting to pay for it is silly. Insurance companies are for-profit establishments. I read so often about people complaining about not being able to find “insurance” for existing problems or complaints. Insurance is protection against future catastrophe, and that’s why you have to buy it when you’re healthy or else expect to at least pay for your existing complaints. Let’s not blame the insurance company. Blame the government for not mandating coverage, perhaps.

Also, the writer says she shows up at the hospital thinking she’s covered. Apparently they had to search for a company with maternity coverage – and they didn’t check what the limit was? My insurance comes with a little book explaining what my benefits are. It’s 30 pages with large writing and really not all that complicated. Some things are covered; other’s aren’t. I’m surprised this clearly articulate journalist shouldn’t figure it out.