Wonderful birthday present

I finally got unemployment in the middle of the night on the night of my birthday [hey, I happened to be up at 3 AM looking at my bank account, expecting a whopping 94¢, and instead two payments for both missed payments in March were there.], which was a complete surprise, as I was still watiting a month after my appeal for a scheduled date for the hearing.  In fact, I'm still getting correspondence about how that will be scheduled soon. (?) But no, I received the paperwork today. [I called yesterday to make sure before I touched any money]. That's the good news. The bad news is it's going to throw me off Medicaid, just that amount, never mind that I'll get paid twice more this month--or I'd just taken a distribution I haven't gotten yet out of my retirement because I didn't have any money coming in while I appealed and had bills and, well, had 94¢. I have Medicaid until the end of the month, anyway. If I have a job by then, it shouldn't matter. Otherwise I'll either have to get another insurance at 1000 dollars or so a month that won't cover hardly anything or do COBRA (and I checked, I have till May 4th to do it) and pay about $1300 for medical + dental a month--but I'd met all my deductible AND my out-of-pocket expenses so would literally only pay premiums, no copays, medication co-insurances, or any other medical costs. Any ER, surgery, or MRI at an in-network facility (and most are) would be $0.00. Hopefully, it would be for a short time. And unemployment only runs partway through June. In other words, I need to find a job pronto, anyway.

I did apply for a cataloguing position in my hometown (Danville), and I have one near there to apply for at the Garrard County Library, a children's librarian position as well. There's a librarian position here at UK, but I want the career coach at the Alumni Career Centre to look at my curriculum vitae and give me some feedback, since you don't normally see much written about format or what to put in those, and it's required.

I also just applied tonight for two UK research positions that are primarily training, and they're in the same department, making a lot more money than I ever have, and they sound very intriguing. The job descriptions were very vague. I'd like to interview just to learn more.

So far I've had four interviews, and I've been shot down on two of them, but two are still pending, so fingers crossed, both with the state. So, we'll see...

Reflections on 2017

2017 was an incredibly difficult, terrible, horrible, no-good year.  I say, good riddance.  In 2017 I:

• Lost my mother to end-stage liver disease.
• Lost a job I'd been at for twenty years, that I loved.
• Was unemployed for several weeks, with all the uncertainty that brings.
• Had a lot of general anxiety.
• Spent an inordinate amount of money on keeping my health insurance going through COBRA.
• Watched the country and the world go down the tubes in terms of politics [in my opinion].
• Dredged up childhood fears of nuclear Armageddon thanks to the insane, narcissistic morons in charge of two major countries with weapons of mass destruction.
• Watch what I thought was a great relationship (not mine) unravel due to addiction on the part of one spouse, despite all efforts of the other.

Some good things did work out for me in 2017:

• I managed to ave for the new building or donate most of the professional medical library I worked in to India, including the journals. 
• I was only unemployed for seven weeks, having been requested back at my old employer in a different capacity due to higher volumes to do contract work--no benefits, but it kept the lights on.
• I moved in with a friend to share expenses, someone who I've known for 30 years, whom people have always said we should live together, which we've always resisted, and it's working out really well.
• Moving forced me to put my therapy into practice and completely de-hoard my belongings.  Some are in storage.  Many were donated or discarded.  I wish I could have gotten everything to charities, but still, I donated a lot. I'm now basically living in a room with a bookcase bed with drawers, two nightstands, and the use of a cedar chest and closet, and I'm much happier to not be crushed under mounds of stuff accumulated over my (mostly) adult life.
• I recently was hired by my old employer as a regular worker.  While it's for quite a bit less money than I had been making as a librarian, I have full-time work with benefits and was able to go back to regular health insurance, etc.  I like the people I work with, I'm still very invested in the work the non-profit does in caring for children with disabilities and musculoskeletal issues, and it's nice to still be around people I care about.  If the right library job came along, I'd certainly apply.  But right now, at least I'm working and doing okay.
• Thanks to living with a great cook who makes healthy vegetarian food (as opposed to just bread and cheese, my mainstays), I've lost weight.

Things I hope will work out in 2018:

• I'm learning to de-stress with my work responsibilities and handle the volumes and duties necessary.  I want to continue improving so that I don' t really feel overwhelmed like I did in the first few months I worked.  I'd like to get to a point where I don't just come home exhausted on big-volume days wondering why I am doing what I'm doing.  I want to do what I'm doing and loving it, or barring that, find a job that I love being there for.  That's one reason for the lack of blogging; I simply am too tired most nights, because I've given my all at work.  I think that's getting better, though.
• I hope I can make changes to improve my health.  Watching my mother die of liver disease was very disturbing.  She smoked and had an unhealthy relationship with food and exercise for most of her adult life, had the misfortune to have diabetes (our entire family on my maternal side is pretty much diabetic, pre-diabetic, or at risk for it) and COPD (much of that was from smoking, but her father and I both also had/have asthma and breathing issues, so there was already an underlying propensity).  When the only thing that could have saved her was a liver transplant, she was still smoking (or at  least vaping), wasn't exactly compliant with her choices, and pretty much ran out of time between those and her age, although she was only 69, which these days is fairly young to die, especially when your mother lived with diabetes into her nineties.  What I realised was that with the exception of smoking (which I have never done), a lot of her food issues and genetics were passed down to me.  We were both overweight, although she dieted regularly when I was young, and that scarred me a little, and I've resisted it partly for that reason.  But I could eat much more healthily and not emotionally.  The diabetes gene is there, but I could improve my illness through lifestyle changes such as eating well and moving more.  Her fatty liver and eventual non-alcoholic cirrhosis may have had a genetic component but is common in diabetics, but it too can be helped through wellness changes.  When she was my age, her main indicator of what would eventually kill her was a few liver enzyme lab results that were slightly off and had been for some time.  I've had that same issue for awhile.  You know what happens when you go into this syndrome?  For one, you're more likely to get liver cancer.  My mom did, and they did an ablation and the tumour got better, but her bloodflow through the liver was impeded, so then when that happens, your ammonia builds up (as well as other toxins) to the point where you get very confused (she once put a Bic lighter in the microwave thinking it was soup, and my stepfather managed to catch her before she hit it on), and you have pints of fluid on you that have to be drained by parencentis (think of a big needle drawing fluid out of your abdomen).  You have to take LOTS of a liquid laxative that is awful and deal with the inevitable consequences to keep the ammonia and fluid from building up.  It's horrible.  She was in and out of the hospital for weeks on end in the months before she died, often unable to speak or be understood, and when she was finally put into hospice, my step-father said it was a terrible way to go, that she was in a lot of pain.  So it was a blessing when it was over.  I am so glad my step-father was there every step of the way.  Whatever anyone can ever say about him, he was a very good husband, and I wish him all the best.  He dealt with my mom's illness, her death, the death of their dog, his mom's infirmities (the lady's in her 90s), and a whole bunch of drama related to his sons' addiction issues.  I so wish him a much better 2018, too.

Okay, I guess I'd better start working on those notes.  But first I'm going to have dinner.  Good night.

So it's been an interesting week, anyway

It was very busy at work. One day we had over 200 on the schedule and over 150 showed up. That was a record, I think. It will only become more normal, though, now that we're taking over the university's paediatric orthopaedic clinic. But with a lot of teamwork, it went pretty well.

I didn't hear anything about the Owenton job until Friday. They went with another candidate, I suspect because they realised I couldn't take the position. There were just too many drawbacks. I wish I could have made it work. But I still have other local applications out there, and there's a Lexington Public Library children's librarian position that just opened yesterday to apply for. I also applied for a position at Shriners in the department I'm working in. The pay range is less than I have been making, but no real commute and EXCELLENT benefits, and I think I could make it on a little less money. I think the Owenton job was mainly so I could see what was out there, especially in the other counties. For example, Boyle County library is advertising a children's librarian position for a little over $13.50 an hour. The LPL one averages about $42,000 a year. That's a big difference. But the health plan is probably the most important aspect for me. There was no way I could have taken a pay cut AND paid that much in medical expenses. With Shriners, I basically didn't pay out anything beyond my biweekly premiums and the before-tax deduction for my flexible spending account, which paid for the $1500 maximum out-of-pocket expenses we had (yes that is not the deductible, that's the out-of-pocket cost, as the deductible was $150). If I can get the patient access job at $16 an hour, I can just make it, and it would be worth it just for the insurance, really. In the meantime, I'll seek a librarian job.

Speaking of making it, after more than 25 years of living on my own, and 14 years living here at the apartment complex, it looks like I will be moving. I have a friend with whom I'm going to move in so we can share expenses. The only trouble is it's not a very big house, and there's really not room for most of my stuff, which would have to go into storage. I would basically have to get a daybed and have a few things from the apartment, but generally, most of my things would be stored elsewhere. It will take some getting used to, and like I said, I haven't lived with anyone for years and years, and we've always said spending too much time together might not be the best plan, as we're both set in our ways. There will have to be a lot of compromise on both sides, I'm sure, and we'll have to make sure we each get some alone time, as we're both introverts. I'll have to break my lease, but that's not too difficult here, you just give notice and an extra month's rent. I'm thinking I could move in by August 1st. I've already found a daybed at Amazon that has lots of storage under it in the form of drawers and sliding doors, a back that has a bookcase/storage as well. I'd need to have a hamper or two, my lamp, my Bluetooth speaker that's four-feet tall but very thin for listening to music, and not much else. There's a small closet. I'm looking around the apartment to judge what can go and what needs to be gotten rid of, and what might go. I should bring a few small things such as my iron and ironing board for pressing my interview suit, but things like books, CDs, and most of the kitchen stuff can go into storage. The aquarium might be able to go to Brenda, along with the fish inside it, as there's no room there, and she's a hobbyist. Most of the bookshelves come apart and fold down, actually, so that will help. The biggest things are the chest-of-drawers, a dresser with a mirror that comes off, the bed, which comes apart, a table that has the top come off, the computer desk with removable hutch, and maybe two other bookshelves and a microwave cart. The plants will go with me, of course. My, there are a lot of them! I'd basically be living in the living room. But it would help him a great deal, and force me to minimise things quite a bit, which is probably a good thing. The main drawback is he absolutely dislikes and will refuse to have Wi-Fi, and my new computer does not have an Ethernet plug, but I can use the old one in the library, get a USB-Ethernet adapter, or uset his one using my phone's hotspot. The speaker is Bluetooth, not Wi-Fi, and I have unlimited data so I can listen to music from my library or Pandora. Anyway, we're going to give it a try. This is a friend whom I have known for 30 years, and I've been friends with him for at least 28. He probably saved my life and sanity by posing difficult questions at the time that I was married which led me to leave my husband. He is like an older brother, and if thie helps, so be it.

I got up early this morning

for an appointment with, ironically enough, my sleep doctor, who was on the elevator with me as we rode up to his office. He's pleased with how much I use my CPAP and ordered more supplies.

I got gas (I was on my light again), came home and took my medication and ate breakfast, and then went over to YKWIA's, as he was going to go to a library programme, but he had a lot to do at home, so he decided not to. Instead I came home and worked on a job application, this time for a non-library job at the hospital across the street, a patient access job I was pretty well qualified for that is full-time from 3:30 pm to midnight. So I got that in, after having to go through a math and vocabulary test, and so I can tick that off. I just got the mail, and one of the things I received was the mandatory eligibility time, which is next Tuesday at 9 am over at the career centre. I have a notebook full of my job applications, so I'll take that with me.

I also got my AFLAC continuation papers and a duplicate card for UnitedHealthcare. So it was productive mail today, with just one advertisement, from Spectrum (Time Warner Cable).

A is going to call me in a little while for a ride. I think this afternoon I'll work on the entertainment centre, which my counselor and I agreed on as the next step in the de-hoarding process. I'll be able to break that down and get rid of it; it's about 30 years old. :)

I don't think it actually got to the mid-30s last night, but I covered the window boxes with Hefty bags, and so I took them off this morning after my appointment.

Okay, I guess I'll listen to some music and check with A on his schedule. I'll write later, hopefully.

I've somewhat recovered from Election Day

Both in physical terms (I went to bed about 2 am that night, and got a grand total of four hours' sleep, so I was pretty tired yesterday) and emotionally. I'm not really upset Hillary Clinton lost--I never cared for her candidacy, or how the Democratic National Committee behaved, for that matter, and I was a Bernie Sanders supporter. I, too, am angry about the failure of the two-party system to provide decent candidates. I know a woman will be president, after all, and never got behind Hillary Clinton being that woman. I thought it was silly of people to vote for her simply because of her gender. But I have to admit, I fear a Trump presidency even more, and was terribly upset (although not particularly surprised, actually) that he won. I knew there was a good chance. A very wise friend had pronounced a sooth that Hillary Clinton would never be president. He also taught me a long time ago that our democracy is flawed and that Trump's candidacy and election were totally understandable, especially in an environment where 'reality' TV is considered entertainment, celebrity is valued over hard work and intelligence, money rules, and a good part of the country has been simmering for some time ready to rise up and boil over. People will study how this happened; I'm not sure you can put it simply in terms of white vs. other or rural vs. cosmopolitan. As someone who studied history pretty thoroughly, I know it's never as easy as that. It will certainly be one for historians to write books about, that's for sure. Oddly enough, I was the one, not A (who was always a Hillary supporter (even against President Obama) and was absolutely convinced she would win), who took this the hardest. YKWIA actually hugged me last night, in my funk. He said 'I wish I could tell you it will get better, but we both know it won't. It'll be a long eight years.' 'Eight!' I said, 'Please tell me it'll be four.' He said, 'No, people will be so entertained by Trump that they'll vote for him again.' He refers to the state of America now as 'Trumplandia'. But it's not just the Trump win. Our entire government is now in the hands of one party, a small number of people with a great amount of power, I'm not sure that is a good idea, whether Democrat or Republican, and even the Kentucky state House, which has been Democrat for 90 years and may have been the only one in the South to be Democrat, went Republican, and we have a conservative governor whose first actions included shutting down the most successful state exchange for insurance in the country. YKWIA also said I was reacting, or even overreacting, unexpectedly. I think part of it was that I'm facing the uncertainty of losing my job in just four-and-a-half months, and now I have no safety net at all, in terms of things like health insurance. If the Affordable Care Act is repealed, I will most certainly not qualify for any, as I have diabetes and am on insulin, at least any that I can afford. Of course, the plan was always to get a job before that happens, but at least I had a backup plan. Well, Plan B just went out the window. So I'll have to make sure I waste no opportunity and find another position, one with benefit--soon.

A little troubled tonight

I went to the gynaecologist today,  and I have to admit,  I'm a little concerned about my health. At the very least,  it looks like I may have a urinary tract infection. But I also have to have a transvaginal ultrasound due to some symptoms that could indicate a condition,  endometrial hyperplasia, that could (in some cases)  lead to things such as uterine cancer and hysterectomy. I'd never heard of it.  I have risk factors like obesity,  never having children,  and having diabetes and polycystic ovarian syndrome.  It's an overgrowth of the endometrial lining of the uterus due to hormonal issues,  especially too much oestrogen. It can cause bleeding outside of normal menstruation.  Dr Elkinson wants to rule it out,  at least. It is treatable with hormones. She also checked my thyroid because that could be why I'm hot so much.  Now it may just just be normal perimenopause,  so I'm not going to panic just yet.  But it's not something you want to hear when you're about to lose your health insurance in six to nine months. I also had the normal Pap smear and breast exam (I had a mammogram in April). She was very thoughtful,  when I explained that I hadn't been sexually active in awhile, and used a small speculum.  It still hurt though--there are reasons women tend to put this off. Anyway,  with that I think I've covered all the preventative health screenings I need for awhile--I'm not due for another colonoscopy till sometime between 2020-2023, for example.  I at least got what I could while I have insurance. I really need to start comparing Affordable Care plans,  I guess.

I'm home,  I'm tired.  It's been a busy week. I'm going to try to get a nap in.

I really need to stop eating at the computer

I just vacuumed out the keyboard with a little device I probably bought twenty years ago, then took alcohol swabs and cleaned the ergonomic keyboard I have at home thoroughly, and also the mouse. I got a lot of crumbs out of the keys, some schmutz, and generally got to see how icky the stuff that came off on the swabs was. It was getting to the point where my keys were sticking and kind of gross to try to type on. Now the keyboard is much happier. It's kind of weird because in addition to being curved for an ergonomic fit, it has buttons for things like the calculator, back, forward, to bring up the Internet or mail programs, or even zoom in. I don't use those special buttons much, but they are useful.

So what I wound up doing tonight was getting some rest (I didn't really nap, I just got off my feet and spent a little time under the fan relaxing). Then I went to Kroger and got some very healthy things like veggies, fruit, orange juice, cheese, and Morningstar Farms products. Most everything was on sale, so I scooted in at a fairly low price (not the $29 mentioned in the earlier article, but still, less than I normally spend). I'm trying to save as much as I can for bills.

I dropped some creamer off at my friends' house (half-and-half is a staple there), then came on home and put all the groceries away. A wants me to do some political research, and I couldn't stand the thought of typing on the dirty keyboard much longer, so I went ahead and cleaned it. Part of the problem is it's too high to go under my desk on the drawer, so it's always exposed to anything that I'm doing. But on further examination I've found that the front piece that makes it so high actually comes off, and so when the that's removed and the legs are put down, the whole thing does, in fact, slide under the drawer. Eureka! I think it's more comfortable for it not to be elevated as well. Thank you Microsoft for allowing it to be customised. And I still have the wrist rest and all the special buttons. Silly that I never really looked at the bottom (I only did because I noticed a tag saying there was a health warning under there) to see that the front piece had tabs and slid off. Instead I've been, if I wanted to slide the drawer in, propping the keyboard vertically on the floor against the computer tower/print stand.

I got some Vitamin D while I was at the store. I'm supposed to take 2000 IUs as directed by my doctor, since I'm deficient in Vitamin D (apparently many people are, as I know several people who have been on it or told to take it). So I got some of that because I'd been out for awhile, and went to put the tablets into my pill bottle with the rest of them, and they're not tablets, but tiny capsules, akin to Vitamin E, but smaller. This is going to be fun to juggle in the morning. On the other hand, they go down much easier, I'm sure. That makes a total of seven injections of three different medicines, thirteen pills (eleven medicines), an inhaler, allergy eye drops, a chewable multi-vitamin, and a nasal spray that I"m taking, although the inhaler is as needed. In the summer months I add another couple of pills since my ankles swell in hot weather. Oh, and an Epi-Pen when I start my allergy shots in a week or so. Plus diabetic supplies such as glucose meter, test strips, lancets, pen needles, etc. Thank God for health insurance (which covers everything but the vitamins), and also cell phone applications that will tell you when to take all this stuff. This is one reason I'm so concerned about the loss of my job when the hospital downsizes to an ambulatory medical centre in two years, and also why, if I don't find a decent job by then with benefits, I am happy that Obamacare is an option, because in the old days they would have just denied me health insurance due to my pre-existing conditions.

Okay, I suppose I should go do that research A wants me to do. He wants to know more about the candidates running for Kentucky offices before the primary in May. I should educate myself, too, so we'll just kill two birds with one stone there.

This is not right

Million-dollar baby: Hawaii vacation leaves Sask. parents with massive medical bill

A Saskatchewan mother says she is facing more than $900,000 in medical bills after giving birth unexpectedly in the United States and being told the costs won’t be covered by insurance.

Jennifer Huculak was nearly six months pregnant when her water broke while on vacation in Hawaii in October 2013. After a lengthy hospital stay, Huculak’s daughter, Reece, was born prematurely and required a two-month stay in the neonatal intensive care unit.

Before her trip, Huculak said she purchased Blue Cross insurance and got the green light to travel from her doctor.

And the Canadian couple even bought insurance from Blue Cross Blue Shield, only to have the claim denied. Thankfully the little girl did well considering she was born so early. But this sort of bill is staggering.

Three positive thoughts, day five

1. I am recovering nicely from surgery, for which I am grateful.
2. I have insurance which paid for the surgery, for which I am grateful.
3. I have a job and career that I love (and by the way, the job helps pay for the insurance that paid for my surgery, for which I'm grateful).

Okay, that's the last day. I think that was a nice exercise. It did rather make me feel better.

Very good news, indeed!

Experts praise 'historic' mental health, addiction parity rule

The rule guarantees that health plans’ co-payments, limits on visits to providers and deductibles for mental health benefits match those for medical and surgical benefits. It also ensures equal treatment for residential and outpatient care, a long-sought benefit in the mental health community.

The rule could affect 62 million Americans, including about 23 million Americans who meet the criteria for substance abuse disorder, administration officials said.

“For way too long, the health care system has openly discriminated against Americans with behavioral health problems,” Sebelius told reporters on a call after the announcement.

When I first got my job at age 30 and finally enjoyed having health insurance after years of not having it, I finally was able to get help for issues such as bipolar disorder II. But I discovered that my mental health care had co-pays at twice the rate of going to other medical providers. That eventually changed, and I am very glad I have decent behavioural health coverage that has good parity with other medical coverage now. But many people in our country are either not covered for mental health, or have substandard coverage or more costly coverage. It's important that this be more readily available, as you only have to turn on the news to see the consequences of untreated mental illness, such as mass shootings (although actually, mentally ill people are much more likely to be victims of crime than instigators). I'm so glad that this is being put into effect. And treating substance abuse is just as important. This will save lives, hopefully.

Why my insulin will have to change

Express Scripts stops covering key Big Pharma drugs on clinical, cost-effectiveness grounds

Specifically, they stopped carrying Novo Nordisk's NovoLog FlexPen, which I inject before each meal. I did check, and there is a version of Humalog (which is on the accepted formulary for 2014) that has a pen version, called Humalog KwikPen. I'll ask my endocrinologist about it when I see her on Halloween.

So it's time to sign up for benefits for 2014 and I've been to my seminar on changes for the coming year. My insurance is changing to a co-insurance model, something that I've never had before with United Healthcare. There is a deductible of $150, a maximum of $1500 out-of-pocket expenses (for the individual plan), and medicines are 20% of their total value. I checked with my pharmacy and it looks like I will pay over $500 a month for my meds for the first three months of the year, after which I'll hit my max and they will be covered at 100%. I don't have an extra $500 a month for that, but I do have a flexible spending account, which takes pre-tax money out of each pay cheque but the elected funds are available to draw via a card on January 1st--so that will save me. Actually, I think I'll pay less out-of-pocket with this model than with my co-pays as they are now, which is a relief. Also, the pricing per pay cheque for the health insurance went down a bit for those of us who don't smoke and who agree to fill out an online health assessment (which I've already done). So that's good. There were lots of rumours and fears, I think, and of course smokers are not happy. But it took a couple of days to really sink in and understand the new plans. I think I'll be okay. And for those who grumble about the Affordable Care Act (also known as 'Obamacare') spurring the changes (and I know there are several doing that), granted, there were liable to be repercussions, but since I probably won't have any health insurance in 2015 through my job, unless I find a new position (as the library and I are not going to the new building once it's built and they move), I for one am happy there are alternatives out there for people with pre-existing conditions like diabetes to buy health insurance and get help paying for it. (Although the best of all possible outcomes would be finding a job before that comes to pass that includes health insurance benefits.)

I got an annual statement from the IRS

today, detailing my payments through May. I've made three since then (including the infamous double payment in June). The upshot is that I'm more than halfway to paying them off, and my last payment should be December (or at least if there is one in January, it will be a few dollars for interest). This is rather heartening, as it has been a hardship. This year I paid my taxes on time, and next year I may actually get a refund, as I will (hopefully) have only one job to deal with this year and everything should be paid off by then. So, the end is in sight. Hurrah. Of course, after that, I need to start paying on my student loans which are currently in forbearance since there was no way I could do both. So I'm not sure there is a car fund in my future, but maybe if I could put a little from each paycheque in, it might take awhile, but it would get there. Still, I may not be able to start until the beginning of the year (see below for why).

The end is in sight for physical therapy, as well. It looks like I need to go maybe two more weeks. The pain's been gone for awhile and I can actually feel my fingers again. I've checked with the optometrist to see how much my contacts will be, but they couldn't find my file earlier, so I'll have to check back tomorrow. I'd like to get them before my flexible spending account goes empty, but still have enough to fund the PT sessions. I think my vision plan will pay most of it. I only have about $350 left, so it will drain quickly, plus I have two specialist appointments and my regular doctor next month. The specialists and the PT sessions are $40 a pop. That's $300 by the end of August. Then there's my medicine and diabetic supplies, which runs about $275 a month after insurance, and that I'll have to pay out of pocket, so things are going to be very tight for the rest of the year. Some are more vital than others; I'm tempted to go off my medicine for the triglycerides and ADD. That would be $100 in savings right there. But I'll try to keep them. It's a shame when you have insurance--decent insurance, mind you, that pays for a lot others won't, but you still are trying to decide what you can get to keep you healthy.

The value of health insurance demonstrated in a new study

First Study of Its Kind Shows Benefits of Providing Medical Insurance to Poor

When poor people are given medical insurance, they not only find regular doctors and see doctors more often but they also feel better, are less depressed and are better able to maintain financial stability, according to a new, large-scale study that provides the first rigorously controlled assessment of the impact of Medicaid.

Among other things:

The study found that those with insurance were 25 percent less likely to have an unpaid bill sent to a collection agency and were 40 percent less likely to borrow money or fail to pay other bills because they had to pay medical bills

I know having health insurance has been perhaps the single-most important thing for me in terms of staying alive and keeping afloat. Even when I was only working part-time at the hospital, I was fortunate to have benefits, although I had to pay a little more for them than full-timers. But I had health insurance. That, combined with a medical flexible spending account, helps make sure I have money for bills rather than spending everything on my health.

At the beginning of the year, I ran the numbers and found that my medicine alone without insurance would cost over $1100 a month. When I was working two part-time jobs, that amounted to 85% of my take-home income. Now it would be 69%. Now I could just pay for medicines and eat--but not doctor's bills, rent, or utilities. Back when I was working two jobs, it would have been worse.

That's one reason I think it's incredibly important for everyone to have access to affordable health care. Also, I think we as a society pay less in the long run if people have access to preventative care and are not forced to use emergency services for things that aren't emergencies.

Oh, this is so wrong

Insurer targeted breast cancer patients to cancel: Government: Software flagged new cases, sought reasons to drop policies

None of the women knew about the others. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders — more than any other health insurance company in the United States.

The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women's specific cases without a signed waiver from them, citing privacy laws.

There's even a name for the practice. It's called rescission. And it is so very, very wrong. I hope the government wins its case. And unfortunately, although men are also victims of rescission, it's very much a women's issue:

"It's not like these companies don't like women because they are women," says Jeff Isaacs, the chief assistant Los Angeles City Attorney who runs the office's 300-lawyer criminal division. "But there are two things that really scare them and they are breast cancer and pregnancy. Breast cancer can really be a costly thing for them. Pregnancy is right up there too. Their worst-case scenario is that a child will be born with some disability and they will have to pay for that child's treatment over the course of a lifetime."

The article looks at several factors in depth. Check it out. Also, WellPoint has lots of subsidiaries. One of the women spotlighted in the article is from Louisville. Her carrier was Anthem Blue Cross of Kentucky, one of the largest insurance companies in the state. It might be good to investigate who your insurance company answers to. Mine is UnitedHealthcare, which is part of UnitedHealth Group, one of other 'big' insurers nationally. So far, I can't say anything particularly negative about my care; they've done very well, although as time has gone by our benefits have lessened over time, but that's a 'what can the company afford' sort of thing. Still, I must say, my continued well-being depends on my health insurance, given my diabetes, among other ailments. Losing it or having it drastically reduced is a fear of mine.

A real breakfast

I normally have a Pop-Tart out of the vending machine for breakfast. Today I'm having 2 scrambled eggs, 2 pieces of hearty bread with spreadable fruit (blackberry) [I forgot to get butter when I went to the store], a banana, and even a little Toffee Nut coffee.

One of the side effects of Strattera is nausea, which can be counteracted by taking it with food, particularly protein. Hence the eggs.

I had a little trouble sleeping last night--I kept waking up, particularly after 6:30, although since I didn't go to bed until after three, I stayed in bed until 9:30. So much for sleeping in. But I have a lot to do around the house today, including cleaning and setting up the aquarium, so it's just as well, I suppose.

My hair is very wavy this morning, since I didn't comb it after the bath last night and it's about 2-3 inches shorter now. I kind of like it, although I'll take a shower later (I bathed in salt water last night, not using shampoo, etc., so I'll need to actually get clean) so who knows how it will turn out then. I may let it dry without combing it and see what happens; sometimes it works, sometimes it sticks up in strange ways, which is why most days it's mostly straight and curls around at the ends. I have the type of thin, baby-fine hair that you can use volumnising shampoos, mousse, and even hair spray, and it will fly away and refuse to do anything, looking decent for about two hours before reverting to the norm. And gel just makes it look greasy. If I were famous and monied, I'd hire a personal stylist, for I sure can't do a thing with my hair, despite years of reading women's magazines. I'm better with makeup, but I don't use it that much.

I'm thinking of changing that this year, as 1) it shows I care a little about my appearance, something that I obviously do not judging from my norm, and 2) at age 41, there are imperfections that are best dealt with by make-up and moisturisers (I never thought I'd ever have to use moisturiser, having had so much trouble with oily skin when young). My main problem with my face is that I'm too ruddy. Physician's Formula makes a green sub-foundation that's good for that. I used to have some, but I have no idea where it got to, and it probably isn't any good anymore. The last time I went to use my eyeshadow, the applicator disintegrated in my hand--that tells you how much I use makeup. Foundations tend to dry out on me, too.

My eyes are probably my best feature; they are largely without wrinkles, have a natural purple tint to the lid, and are open and bright. They're a nice shade of hazel brown. Unfortunately, I am so nearsighted that my glasses make them look smaller, and makeup doesn't really make much of a difference. I am thinking of getting contacts this year--the type you can wear for a few days during the day and night. It's not just vanity; I see better with contacts (the correction is more precise for some reason, in my experience, maybe because they're close to the eye), and I'm having trouble seeing some smaller print road signs and books even though I don't think my prescription has changed per se. We'll see. Once I verify that my flexible spending card is working properly in the new year, I'll make an appointment.

Speaking of which, theoretically I can get the prescriptions I've been off of for the last 2 weeks-a month due to lack of money for medical expenditures on my card. I'm going to go to the pharmacy today and see if I can get them filled; I've been off my glipizide, Provigil (which is now replaced by the Strattera), Tricor, and for the last week I haven't been able to get a hold of Abilify, although I managed to get some samples before that. I have stayed on the Lamictal and Janumet through everything. Lamictal's an absolute must--if you go off and go back on the likelihood of a life-threatening rash increases. Besides, I needed to make sure something was keeping my brain chemistry on an even keel through the holidays, right? :)

This year I elected to have about $3,000 taken out of my pay to cover my medical flexible spending account. That should hopefully get me through the whole year. It means my pay will be smaller (it had been about $2,200 this year), but my co-pays are doubling for doctors' visits, and the medicines are going up, too, so what can you do? I actually have until March of 2010 to spend it, so I don't think that will be a problem. At least it really does help out through the year, and since it comes out as pre-tax money, it saves me quite a bit on my medical expenses.

Reason #5,634 NOT to go to Wal-Mart

I found out about this via YKWIA, who in turned heard about it from T:

Brain-damaged woman at centre of Wal-Mart suit

The human cost of Wal-Mart's great prices

Debbie Shank vs. Goliath

Wal-Mart Rethinks Its Move on Deborah Shank

Summary: Eight years ago, Deborah Shank was stocking shelves for Wal-Mart. She went out visiting yard sales and was hit by a large truck, nearly killing her and leaving her with permanent brain damage and memory issues. She is currently in a nursing home receiving care.

Shank's family sued the trucking company and won enough money to pay legal fees and put money into a trust fund to take care of her future care. That's when Wal-Mart stepped in and sued the family based on something buried in the fine print that allows them to recoup medical costs through covered employees' settlements. Most people would never see that fine print, and if she hadn't signed that agreement she would not have had any health insurance. They wanted more than the trust fund could cover, leaving the family with no way to pay for costs and actually further in debt. The family lost the case at every level. The Supreme Court refused to hear the case, giving Wal-Mart the victory.

Mr Shank divorced his wife so her Medicaid benefits would be greater. A survivor of prostate cancer himself, he works two jobs to pay for his family.

A week after they lost the case, they lost something far greater. Their eighteen-year-old son, who had been deployed in Iraq for two weeks, was killed. Even though his mother attended the funeral, her memory is such that she will speak as if he were alive and when reminded of his death, grieves anew as if being told for the first time.

Apparently after all the bad publicity (and who wouldn't have predicted that), Wal-Mart has now come out and said that they won't take the money from the Shanks.

That's good. But it should tell a lot of people to look at the fine print of their own health care plans (or at least look at the laws in your state--many prohibit this kind of thing). It does make you wonder why Wal-Mart even tries to rehabilitate its image. It puts its foot in its mouth at every turn.

The only time I step into a Wal-Mart is if I've received a gift card (as the money has already been given to the company). I'm rethinking that. I could just pass it on to someone who will use it gladly. I have to think of my own conscience, whether it's for Bangladeshi workers, gays who face discrimination in the job, or the Deborah Shanks of the world.

And a heart-wrenching one

Teen dies hours after insurance company reverses denial of liver transplant payment

No one really knows if a liver transplant would have saved Nataline Sarkisyan. Her liver failed two weeks ago after a three year battle with leukemia. But at least one set of doctors said that the procedure, deemed uninsurable and experimental by Cigna, had a survival rate at six months of 65%. A hundred and fifty nurses rallied outside of the company's building. Then the decision was reversed--but by that time Nataline was in a vegetative state. She was taken off life support just hours after the decision was made. Her family is understandably devastated. A lawsuit is planned, but it will be difficult to prove wrong-doing.

Still, red tape and hurdles are the last things anyone needs in such dire circumstances. Our health care system should be based on the idea that a person should be able to get the care needed to maintain and improve his or her health. It shouldn't matter how much the person makes, who their carrier is, etc. The challenge is providing universal health care without causing even more red tape though, isn't it?

Interesting, ethically and medically

Face-Transplant Patient 'Satisfied': Some Who Criticized Procedure Are Impressed With Results

One of the US centres that is mentioned in the story as being interested in doing face transplants is Kleinert Kutz and Associates, who did the first US hand transplant. The Lexington office branch of that practice did my carpal tunnel surgery. I feel a bit like I'm playing six degrees of separation. My surgeon's in a different practice now, but I'd recommend either Kleinert Kutz or Dr William O'Neill of Bluegrass Orthopaedics if you ever need hand surgery.

It's funny, I'm very lucky that I live in a very medically- and specialist-dense town, and since I live within a couple of blocks of a major hospital (St Joseph East), there are a plethora of physicians and specialists whose offices are nearly in my backyard. Not to mention the fact that I have top-notch insurance through UnitedHealthcare. They paid every penny of my surgery, which ran about $10,000 altogether. I had no idea how crippled I'd become. Now I can use my hands freely. I've heard horrible stories of how much nerve conduction studies hurt since I had mine. I had no idea. My carpal tunnel was so bad I didn't really feel any of it. So I'm glad to have my mobility back, to be able to feel my hands, and to have them not draw up in pain at night. Plus, if I were ever to have children (let's face it, it's not bloody likely), it would cost me $10. Period--just the co-payment of the first office visit. Wow.

Of course, I went for years without insurance, so I really appreciate it more. I probably had a broken foot years ago, for example, when Bill fell on me. I just hobbled around in pain for months. Not to mention the various blows to the head I've had that I never went to see about. Hmm...maybe that really is part of my problem.

I'm not out of the woods in terms of medical expenditures, though. I have a flexible account that helps with any of my co-payments. But I'm on a slew of medications that are in the upper tier of what the insurance will pay for, so my co-payments are mostly $45 a pop. My flexible spending account ran out at the end of November (so at least I used it all--you lose the money if you don't--and it was much better than last year, when it lasted until May); but for December I really am struggling with enough bills that I simply can't get all my medicines. There are 2-3 absolutely vital ones; the rest I'm not filling until January. I normally take 7-9 depending on time of year (I take Lasix and potassium in the summer, when my ankles swell). I'm taking the opportunity to chuck Avandia entirely. I haven't felt any difference than when I took it, and there are just too many studies stacked against it. If my blood sugar tests show my sugar still up, I'll see about going on Actos. Otherwise I'll keep with just the Janumet, if Dr Nesbitt concurs. I found some samples of one of my drugs 'my smart medicine' as one friend puts it, so I'm using those for now. And of course, there's one I take that can cause a horrible skin-sloughing rash if you stop and go back on it, so I'm staying on that one as a priority. :) Plus I have plenty of metformin, so I'm temporarily on that instead of the combined Januvia/metformin Janumet. And I found some extra strips so I can check my sugar levels.

I know, it's not ideal, but it means $45 in drug costs this month rather than the normal $277 I'd spend a month out of pocket (with insurance!) ($291 in summer), with the occasional albuterol ($7) and then any over-the-counter medicines I get. (I'm off the aspirin, for example, now that I'm out of the boot). That flexible spending account is a lifesaver. I opted for the same amount next year since part of the expense this year was my glasses, which I shouldn't need again. That should get me through the year okay. I do have one doctor's appointment this month, too, but I've budgeted for that.

Okay, didn't mean to make this all about me, but I guess the article was just a jumping point for my thoughts. Hopefully January will bring a new debit card (we're going with a new provider this year--I hope they're as good as the last one) and I'll get back on track again.