Wednesday, August 26, 2009

Getting schooled on health insurance

Here's my health care horror story to add to the list of millions more out there. Mine has a surprise twist, so maybe it's a mystery/horror story. (Many of you have already tuned out, not getting to the third sentence in this carefully crafted credo created to craze contented crowds. Yeah, another health insurance tale of woe. Yep, I'm with you! Except I got mine, so I don't need to read yours. Well, if you did get this far, bear with me a little more.) It's fun with math time!

First, a little background. For the vast majority of my life I've had employer-based health coverage. It got more expensive and it covered less over time, but I had coverage. Just over two years ago my wife and I found ourselves without employer based coverage. We got an individual plan - paying a lot more and getting a lot less.

One more, seemingly unrelated, piece of information. I applied for and was accepted to a graduate program at Hamline University. I am pursuing my Master of Nonprofit Management degree over the next two years, giving up my Thursday nights in exchange for some structured study of what the heck I have been doing the last twenty years of my life.

So, let me weave Chapter One and Chapter Two into a strangely united Chapter Three. Quentin Tarantino won't have anything to worry about from me. However, the story shows just how messed up we have become on this health insurance thing.

Earlier this summer, after getting the happy news I was accepted to Hamline's program, I busied myself in the online universe of Forms to Fill Out. Submit your vaccination history here! (Check.) Complete your financial aid loan package here! (Check.) Register for fall here! (You get the idea.)

Then, amidst the cacophony of links, there was a small glimmer of incongruence. A link that caught my eye, given the painfully large checks our family writes for what is often referred to as health insurance and what I usually refer to as protection money. (An aside: Think of it this way - I would have spent less money on medical care if I just paid cash out of pocket and didn't carry any coverage. But of course, the Insurance Industry is there in my ear saying "Nice house you got there. It'd be a shame if you got into a major trauma and went bankrupt without us, wouldn't it? " And so I pay on the off-chance that anyone in my family gets hit by a bus.)

So I click over to this link. It says, rather unpretentiously, Waive Health Insurance. A few clicks later, a different links says Request Health Insurance.

Hmmmmm.... Click. Click. Click.

Turns out, as a graduate student at Hamline, I can waive health insurance if I am of the privileged class with good employer-based coverage. Or, I can opt in to their group plan if I don't have better options. Click, click, click. Turns out, I can cover my family too, at a less-subsidized rate, but they will allow me to buy them in. Huh. Turns out, this is all strikingly less than I am paying now.

I now really love Hamline.

OK, fun with math time! Fire up your favorite spreadsheet program (I personally favor the old stand-by Excel 2007, but this is a matter of taste. Any good tabulator will do). Take what the health-insurance community calls a good rate for really bad coverage. Add to that the annual deductible ($1,000 per person in our case! And that was the good deal. *sigh*). Now, subtract from that very, very large dollar amount the new, more reasonable price for group coverage of the same family. Also subtract the new annual deductible ($50 per person. Yes, five percent of what I had to pay under individual coverage).

That's a big number on that line. In fact, that number is greater than the total I am paying in tuition and fees as a graduate student in the Master of Nonprofit Management program. In fact, I am saving my family money by going to graduate school.

Yes, you read that right. Check your spreadsheet, call your health insurance broker (and I've called more than one looking for a better deal) and, if necessary, check your eyeglasses prescription. I am making a profit by going to graduate school over what I would have to pay for bad health insurance coverage.

Joseph Heller would be so proud. And yet would likely have a hard time believing it.

So, if anyone is wondering if our system is broken, maybe they need to get a little education. If our President has been unable to get this system fixed in two years, my wife will be enrolling next. She gets her MFA, we save money on health insurance. Let's hope our Members of Congress can get schooled as well.

Sunday, August 23, 2009

Kindles and libraries and sharing, oh my!

Must... resist... Kindle... don't... need.... toy.....

I love technology for technology's sake. I really do. I will run to an overcomplicated solution to a simple problem every time. Well, everytime it doesn't cost me money. As it turns out, I am a cheap son-of-a-gun. So, I get slowed in my purchasing - if not my lust - for new gizmos and gadgets gleaming with gears and glowing with green gases.

As of yet, I don't own an iPhone. I don't have a Roku box for my TV (although I do have a Soundbridge for music in my kitchen). And I don't own a Kindle.

It's not that I don't look longingly at these pretty pieces of processing power. But to really make use of any of these devices, you have to spend money regularly. The Kindle is (almost) completely replacable - for free - at your local public library.

I should state for the record that I am a little fanatical about libraries, much as am I with technology. So take this fan-boy post for what it is. I started working in a library when I was in high school, and I got to see what people were checking out. I found more interesting books by re-shelving someone else's interesting books than by looking for cool stuff on my own. I love the idea of sharing a book. After all, how often do I really go back and re-read a book? In my case, pretty rarely. There are too many new ones stacked on my nightstand, thank you very much. So, what happened to all the books I paid for rather than borrowed from a library?

They became trophies.

I had conquered them and put their carcasses on a shelf for visitors to my home to inspect. Sometimes I'd lend them out. Mostly, they collected dust, like the trophy I got from the American Legion in 1984.

Seems like a waste, really.

When I got married and moved in 2004, my wife and I had to take a look at what books were coming along for the ride to our new home. How much stuff were we going to move with us, and what could go? Well, the paperbacks mostly went to books for prisons projects. The hardcovers that were worthwhile went to Books for Africa, some stuff went to the library as donations, and a select few we kept. Some we do go back to, and some have such deep meaning that keeping that particular momento seemed worth it.

None of the sharing things can happen to books purchased for the Kindle.

You can't give them to friends, you can't donate them to the library, you can't send them to prisons or to Africa. You can pay your $10 and have it forever, but the next person to enjoy that book is going to have to pay $10.

Unless they go get a copy from their library.

I go to the library with my kids at least once a week, more faithfully than we go to church (mostly because the kids never complain about going to the library). The kids still have books they own, but I like passing on the message that we should be sharing materials. Not just for the cost factor, although that counts (did I mention I'm cheap?). It's a good ethic. When my son needed the next book in a series the moment it came out (and library wait lists can be long - I'm still waiting for Slumdog Millionaire), we bought the book so he could enjoy it, and when he was done, he donated his copy to the library so the next kid won't have to wait so long to get a copy.

And he'll always know where his copy is if he needs it again. In the interim, it won't be a trophy on a shelf, it will be spreading the joy to the next person.

We don't have to limit ourselves to libraries to share media. I like that route, but there are sites like or I hope to hear about a new feature on the next generation Kindle that let's you check e-books out of libraries and share books with friends. Then I'll be a little closer to giving in to my techie side and joining the Kindle army. For today, I'm back to logging into my library account and seeing what's due back for the next patron to enjoy.

Friday, August 14, 2009

Republican Hair Man

I met my wife, Elen, in 2003. She liked my hair, and still does. Then in my 30s, I had a full head of hair that had a good wave to it and was just starting to show a little silver. I often said I had Newscaster Hair, as if someone from the local TV news had injection-molded a template and I ordered one off the shelf. Now into my 40s, there is a lot more of the silver, but still lots of hair which makes me happy and angers my friend Shawn, who is not so fortunate and who feels the universe has been unkind to him.

But I digress.

So I have what I called Newscaster Hair, but what Elen's good friend Jesse and she called Republican Hair. As Elen and I continued to date, I was referred to as Republican Hair Man. We all found this rather funny, cuz ya see - I'm not a Republican. Get it? It's the whole facetious/irony thing! We slay us.

But I digress.

This all came back to mind recently as I was completing yet another Facebook quiz of some kind. (If you don't know what I'm talking about, you obviously have interesting things to do with your life. Good for you!) The quiz asked about a pet peeve or something, and it just came to me that I get a little irked that people that don't know me assume things about my values based on how I look, and those things are never assumed the way I would like them to be. I look like Republican Hair Man. I'm a tall, well-spoken, sober, white guy. Ergo: I think it's funny that women shop too much and married people are in shackles and we're really doing gay people a favor by keeping them out of state-recognized marriages because marriage is just heck anyway! Get it? Cuz ya see, a tall straight white guy with good hair must think that's funny!

Or not.

When I was young, I wore my hair longer and I had in-your-face political buttons on my jacket and backpack. I had "Dump Reagan" bumper stickers on my beat-up car. (Side note: Many law enforcement officers misread "Dump Reagan" for "Ticket this uppity little hippie in the junker"). It was only later in life that I gave up on looking angry, and accepted the Irish salt-and-pepper mop that defines me to some as a Friendly. As someone you can tell off-color jokes to and not get in trouble. C'mon, he's one of us. Can't you just see it?

So this begs a question. It makes me think about the assumptions that come into my head when I see how people look. Which ones do I act on and which ones do I not notice? I am aware of my own Republican Hair Man bias - where I sometimes get cautious about stating my values in front of people who look like I apparently do. It's silly, I know, but I do catch myself wondering if people that look like me are going to start railing against a socialist take over of the health care system or some equally absurd idea. I may even be more careful about bringing up my support for a government-sponsored health care option. Or not.

The flip-side of this is also a trap for me. I see people in dreadlocks and hemp clothing, I make an assumption about their values. I see people that don't have much money and are loudly shouting on the bus about the evils of government, and I'm taken aback that their values don't match what I expect them to be.

I'm an unabashed leftist trapped in a right-of-center body. I've come to accept my transpolitical identity. Sometimes it's even fun to shock the heck out of someone who, with a smirk of knowing, jokes with me about how Government Interference is Ruining Our Lives. I then, sometimes, calmly mention that I think it is wrong that government policy perpetuates oligarchy - to transmit wealth (via the tax code) to some based solely on their birth and start others with zero for the same reason. That has taken the wink out of an eye or two in my time.

I probably shouldn't think that is fun. Oh well, one more thing I can't assume about me from looking in a mirror.

Thursday, August 6, 2009

Garbage isn't healthy - but health care can be garbage-y

We have a private trash hauler system in Saint Paul. I understand those haulers have regulations on them, and taxes (solid waste fees - whatever) they pay to dispose of my non-recyclables. From what I read in the papers, there are more than a dozen residential trash haulers barreling down the streets of Our Fair City to remove the unusable stuff in our lives. Civilized places tend to have one truck doing this work, but I digress.

The Saint Paul City Council is considering maybe doing a study to maybe think about whether there is a better way to do this. Here's where some interesting parallels to health care can be uncovered - and I use the word "covered" intentionally here.
  1. People with money have coverage. If you are well off, you have health insurance and maybe think of the rest of us as annoying for whining all the time that we either pay *way* too much for it (as in the case of my family with no employer-based coverage and with people who actually have to see a doctor on occasion) or we just can't get it at all. Same thing with garbage collection. When the system is voluntary and based on private haulers, people with money call someone and get it taken care of, and can't imagine why some people who don't have money don't have a private hauler taking away their unnecessary items.
  2. People without coverage hurt the rest of the system. So, let's assume you are one of those folks who can't (or yes, in some cases won't) pay for private garbage hauling. Maybe you've spent every last dime on medical bills. Who knows. In any case, you don't have $20/month or more to pay for hauling. So, you maybe slip your garbage in with your neighbor's and hope they don't notice. Perhaps you take a bag with you when leave the house and walk by the dumpster at the local church and pitch it in (after all - it's a church - aren't they supposed to relieve you of your sins?). Maybe, just maybe, it gets real bad and you simply leave the stuff in the alley and hope for the best. If so, feral cats or squirrels or whatever are going to open the bags and now your old garbage is floating on the breeze into your neighbors yard, the public streets, or into our storm water run off systems and so into the Mississippi. Those of you thinking back to the "free rider" problem from PoliSci 101, you get a gold star.
  3. Private interests are vested in making money off the current system, so we don't get change. Yes, some of these people making money off the current system are very nice people. They are family businesses and they smile at you and they are not vampires. I get it. However, is the benefit those people get a good trade-off for the problems we have in the current system? This question is not rhetorical. If you really think so, please help me understand and perhaps I'll get on your side.
  4. People wanting to solve the problem are labeled as promoters of "big government" taking away "our freedoms". Me, personally, don't much care about the freedom to pick a garbage hauler. But sure, some people will lose some choice here. Is it enough of an issue to derail solving the problem? See number 3 again. I'm teachable (I hope). Tell me why this is more important than stopping free-riders from making churches pay for dumping and for having trash blowing in our streets.
  5. People without money need more from the system than those with money. I've been poor. Not abject poverty, and not for long periods, but I've maxed out a gas-station credit-card (the only card I had then) just so I could eat. Yes, I charged groceries at an Amoco station because that was the only way I was going to get them. Again, I digress.

    My point is when you are poor, you work with what you got. You take donated furniture and electronics. You buy second-hand clothes. If you buy new you're buying cheap, fiber-board stuff from discount stores. You know what happens to this stuff? It wears out. Fast. Then you have to dispose of it. And guess what? That costs money. Sorta like people without health insurance try to get by on the cheap until their bodies break down, and then it gets expensive. Fast.
So, City Councilmembers and my fellow Saint Paulites, let's consider these issues and get some more facts. Then perhaps we'll see if universal coverage makes sense in a much smaller universe than just health care.