Examined Lives

*New!* Clause to deny freelancers health coverage

Sent today.

 

*

October 20, 2009

 

Horizon Blue Cross Blue Shield of New Jersey

Appeals

 

Dear Sir or Madam,

 

I have just been told by your Customer Service department that you will not cover hearing aids for my 8-year-old daughter, as mandated by Grace’s Law [state law that mandates paying for hearing aids for kids 15 and under], because our policy is self-funded.

 

That you would use this clause to deny coverage for my daughter for this very expensive equipment is unconscionable. Because we have the bad luck to have to pay for our own coverage, having been laid off two years ago, we are denied?

 

I realize that our particular policy does not cover durable medical equipment. But to be told that we are not eligible for special assistance in this unique case, while others who are lucky enough to have their employer pay your bills do enjoy this benefit, is simply unfair.

 

I hope you will reconsider this decision.

 

*

-BurbMom

 

 

 

Hot air

Was going to blog today about something entirely different, but like everyone else, was transfixed by Falcon Heene, the Colorado boy who, for a while there, appeared to have taken flight in a hot-air balloon. As it turns out, it was a false alarm. While the authorities sent everyone possible to chase him—even the Denver airport was affected—he had apparently fallen asleep in a box in the attic where he'd been hiding, worried he'd get in trouble for somehow letting the balloon loose. 

Already, the post-game quarterbacking has begun, and I'll leave that to the experts, but here's what the debacle taught me: Sometimes, we really do make a mountain out of a molehill. Not all disasters end up disastrous. 

Let that be a lesson to worrywarts like me. Seriously. 

P.S. Could there have been a more appropriate name for the boy than Falcon?

Visit msnbc.com for Breaking News, World News, and News about the Economy

—CityMom

My own bizarre health care tale

There are plenty of scary health scare stories circulating out there vis-a-vis our proposed health care reform. This one went blind without coverage; this one will go blind if we change our current system. And so forth.

I've already added my own two cents here -- $751.23, actually, the amount we pay each month for a family of four, as both The Dude and I freelance. That covers hospitalization and related tests and a stipend for sick and well-care visits. Everything else, we pay for should we need them, including drugs; rehabilitation; home nursing if needed; mental health care. On top of the monthly premium, which is about 1/3 of what we pay for our mortgage and taxes each month, and is more than we spend on food and transportation. 

Oh, and it's roughly twice what we put away monthly for the kids' college fund.

So, I get sick.I think it's a cough and I'll get over it, but it doesn't go away. It ebbs and flows; some days better, some days worse. I have other stuff to attend to, like kids with their own coughs, and deadlines. Finally, I'm Sick. You know. When you just can't function anymore.

I go to the doctor, who diagnoses a bad bronchitis. We discuss the small possibility of pneumonia, and she says, given my health care policy, that we should perhaps hold off on getting a chest x-ray for now, because that would be forever on my health care record. The takeaway message:  It could imperil my current and future insurance coverage.  Apparently, if you actually get sick, the insurance company doesn't have to pay. Come again?

She also gives me drugs (suitable for both bronchitis and pneumonia) for free. Expensive drugs, drugs that would have cost me some $200 in co-pays on my former employer's plan. I imagine they might have cost some $400 out of pocket. I'm happy, because I really need that money to buy a new computer, because I need it to earn my living and contribute to the hopeful renewal of our glorious nation's economy.

But wait! Who's paying for those free drugs? Do pharmas really have that much profit, to give so many samples for free? Because this isn't the first time I've gotten freebies, and I know some of my other freelancer friends have as well. Or are they taking the costs of these samples out somewhere else, like raising prices for people who can afford them even less than I?

As for the chest x-ray -- I think we're test-happy in this country, and it's one reason for the ballooning health care costs. When my neighbor is told to get an MRI for a stomache, you know something's wrong. But three days from now, if my chest still hurts, what next? Do I wait it out a little more, or risk potential bankruptcy from having no insurance?

~BurbMom

Why I loathe my fellow man

Just got back from a weekend in D.C., filled with the warm 'n fuzzies over the history and grand intentions of our great nation. Honestly, I had thoughts of fleeing recently; first, when faced with my dismaying freelancer health care bill each month and second, having to have the face of an insane, blathering t.v. idiot shoved in my own face everywhere I looked, along with the inanities of imitators and followers, grunting cruel lies, personal slurs and vague threats.  (No, not Sarah Palin.)

It's a mark of how hard it is to disagree with the basic premise -- our health care system needs an overhaul -- that folks have to resort to incendiary, ridiculous stunts, instead of any kind of real discourse.   

But D.C. reminds you that we have and will endure. Plus, I read the Dalai Lama's latest book, or one of them: The Little Handbook of Inner Peace, which is all about getting rid of your anger by finding compassion for fellow humans. I would try, I vowed, to find some common ground with this rabble, because I'm an idiot every now and then, too.

Then I read about this, and I'm right back in a nasty place of rage and contempt. Why do we cross the line, time and time again? Why are we so uncouth?  Why are we always drinking the K*ool Aid? Is it just in this country, and if so, why?  I know parlimentarians shout at each other in the U.K., but that's amusing rather than this, which is scary and primitive.

As we lined up for our scheduled tour of the White House last weekend, we were told there was a "delay" due to security reasons, which explained the crowds, guards with oozies and general angst.  We are heading for a police state. Is that what you want? Thanks, yammering yokels, for handing this victory to Bin Laden.

The complicit silence of our leaders in all of this is even scarier. They're indirectly responsible, if not overtly getting into the act. Shame on all of you, on all of us. I should be protesting all of this myself, in the street somewhere with a sign, instead of plonking away at the keypad in the safety of my kitchen.

~BurbMom 

When political rhetoric goes awry

The healthcare debate is coming to a full boil, and intelligent, productive discourse is headed out the window. Wasn't it just 10 months ago when the nation appeared to be celebrating the arrival of change? Plus ca change, and all that, it seems. 

What I detest the most is the hypocrisy. Why resort to vitriol and name-calling when you claim to represent true concerns? Don't you know that just weakens your position and cheapens your approach? I'll leave it to CNN's Anderson Cooper, and David Gergen, in this clip from the Huffington Post, to make some sense out of this: 

 

—CityMom

Paul Krugman on Ted Kennedy

A short-but-sweet remembrance of Ted Kennedy from New York Times columnist Paul Krugman: 

I remember the days, several decades ago, when Ted Kennedy was treated — mainly, but not only, on the right — as a figure of derision... And now he’s remembered as a great man. The thing is, he didn’t change — he always was.

For more on the death of the legendary "Lion of the Senate," click here. For tributes, see below:

Go, Barney Frank!

I don't always agree with Massachusetts congressman Barney Frank, but the way he took on one woman at a contentious town hall meeting on the thorny subject of universal health care was admirable. When someone refuses to discuss with logic, how can one respond with anything but this?

Just as it was about pretty much any issue during the election, we can't seem to have a facts-only conversation about this topic. Eye on the ball, people. Eye on the ball. 

—CityMom

An ode to John Hughes

Pretty in Pink was by no means a perfect movie. Jack (Andrew McCarthy's character) barely knew Andie (Molly Ringwald), and he was a little smarmy, plus that trick he does with the computer where he sends a pic of himself wasn't invented yet, anyway. (This was pre-text message era.) I preferred Sixteen Candles, but that politically incorrect stuff about Long Duc Dong did offend. And it was a little disappointing in The Breakfast Club when goth girl Allison (Ally Sheedy) prettified herself to hook up with the jock. 

But no matter. John Hughes was a genius. He made movies that captured teenage ennui, and there was plenty that had, until him, not yet been said about it. Besides, he gave us Ferris Bueller's Day Off, which, in my book, is pretty much perfect. 

And now, John Hughes is dead, felled by a heart attack yesterday while visiting Manhattan. He was a huge talent who walked away at the height of his career. As one Web site poster said, "He wrote the soundtrack to my childhood."

In tribute, here's a look at the trailers of some of his best films:

The Breakfast Club

She's Having a Baby

Ferris Bueller's Day Off

 

 —CityMom

On fidelity

How cavalier are we these days about being faithful? Caitlin Flanagan takes on infidelity in a recent issue of TIME Magazine. Flanagan has a few good points, saying marriage—"a fragile construct"—is being assaulted from all fronts, "buffeted by affairs and ennui, subject to the eternal American hope for greater happiness, for changing the hand you dealt yourself." Instead, there's much talk of passion, of falling in love. To wit: 

"Sanford"—the governor Mark Sanford who's been in the press lately—"told reporters the affair had begun "very innocently," which reveals that he still hasn't been honest with himself about the willfulness of his actions. When a married man begins a secret, solicitous correspondence with a beautiful and emotionally needy single woman, he has already begun to cheat on his wife."

Good on her for calling him out. And for the most part, I agree. There's nothing more tiresome than someone who refuses to call a spade a spade. Infidelity doesn't just "innocently" happen overnight. It may sneak up on you, but pay close attention and you'll realize you've been hearing its footsteps—faint as they may be—for quite some time. For some reason, you just expected them to be much farther than they were, and suddenly the source of those footsteps is right behind you, ready to plant a kiss on your neck or a hand on your back. 

But where in the piece is the discussion of how circumstances like these happen? And how sometimes relationships just don't work (not that infidelity is a solution)? Or how two people forget they're both responsible for taking care of a relationship and that, like a plant, it'll wilt without both water and sun. Relationships don't falter in a vacuum (except maybe in romantic comedies and soaps).

And what's the deal with statements like these: Few things hamper a child as much as not having a father at home. Though there's wisdom in it, the entire sentiment isn't totally wise. Race, class, education, how you're parented (is that even a word?), etc. etc.—all that comes into play. Some of the best, most well-adjusted people I know came from homes without fathers. 

Examining how we feel about fidelity—or, as it were, the lack of it—is necessary, but saying that it's a must to keep an intact household because kids do "best" when a dad is around doesn't advance the conversation all that much. My two cents. 

—CityMom

R.I.P. Michael Jackson

Yes, he was freakish. But oh the talent! Michael Jackson, rest in peace. It feels like he was lost long ago when all those accusations hit the news, and maybe before with the hyperbaric sleeping chambers and breathing masks and nose jobs gone awry. But today I just want to remember the music.

--CityMom