Showing posts with label entitlement. Show all posts
Showing posts with label entitlement. Show all posts

Thursday, August 18, 2011

The Affordable Care Act: Info on PCIP (And Some Whoop Ass Thunder Rumble!)

The article below this garbled prologue was written by the good folks at PCIP.  I can attest to its accuracy, having purchased this coverage beginning with its very first month of availability in July 2010.

If I could add anything, it would be to plead with people who feel a responsibility to accuracy to understand that the PCIP program is in no way a charity or an entitlement, and that it is run in an admirable "tight-ship" sort of way under the auspices of GEHA.  My premium has been lowered TWICE since July 2010.  It started out at well over $400/month and is now $338/month.

I have even drooled with appreciation at my exposure to actual customer-oriented customer service representatives, each of whom quickly and efficiently answered my questions and cut through the inevitable red tape of a brand new insurance program.  It helps, I'd assert, that the precepts under which these customer service types work make efficiency easy, as a common sense of fairness seems to be the guiding principle.

Why *yes*, the ACA was created by mostly the same idiots we watched screw the pooch a few weeks ago in their criminal attack on The World Economy.

Screw the pooch is a particularly vile militaristic expression, popularized by Tom Wolfe in the novel, and subsequent film, The Right Stuff:

But now - surely! - it was so obvious! Grissom had just screwed the pooch! In flight tests, if you did something that stupid, if you destroyed a major prototype through some lame-brain mistake such as hitting the wrong button - you were through! You'd be lucky to end up in Flight Engineering. Oh, it was obvious to everybody at Edwards [Air Force Base] that Grissom had just f*cked it, screwed the pooch, that was all.

For those of you fascinated by my constant dabbling in dirt, I did some research and it turns out that the  original form of screw the pooch was fuck the dog.

Umm, also integral to your understanding of the Affordable Care Act, Obamacare, is the distinction between screw the pooch and fucking the duck, though one might be considered the governmental correlative of the other. You'll see this explained in the commentary to the pertinent Jennifer's History and Stuff blog post:
Custer screwed the poochWasting time is another quite profane term. It's 'fucking the duck'. There is, or was, a difference. Nobody buys the farm from fuckin' the duck.
Well, not so.  Had President Obama fucked the duck and given up on any meaningful health care reform legislation, thereby effectively screwing the pooch,  I would likely have bought the farm, as a result.

I'm just sayin'.

And, of course, on to what *really* matters, which would be my actual reference underlying that trite and overwrought "The World Economy" nonsense: the completely undeserved assault-and-battery on Haddock family equities! The Haddocks, they ARE the world!  I mean, if no one takes care of the Haddocks, how will The Captain take care of me and Fred, as well as tend to the upkeep of the miniature Wimbledon All English Lawn Tennis Clubbery? Not to mention seeing to the hygiene of the garderobes of Marlinspike Hall, so necessary to the success of ManorFest?  Infrastructure, people, infrastructure!  Oh, God, just the thought of next year's percolating strains of moat algae...




{hum, hum, hum}

What? Oh.  Right!

To prove my assertion that Obamacare is not Welfare, here's a screen capture of the details of what *I* have paid out in deductible, co-pay, and out-of-pocket expenses (NOT including pharmacy costs).  So the next time someone yammers about "socialism" and "entitlement" in reference to the watered-down health care bill that the President spearheaded, refer them to my actual costs.

What is it, then, if it isn't some welfare "ripoff" perpetrated by a bunch of whiners?  It's FAIR.  My costs are exorbitant -- not so much this year as in the past three when we were actively attempting to stop the infection in my joints and long bones, but still, they are higher than most people's average medical expenditures.  The difference is not some sense that I am deserving or "entitled," no!  The difference is that I am actively *sick* and also deal with severe disabilities and pain brought on by a progressive neurological disorder -- to such an extent that when I was priced out of my private BCBS coverage, no one would offer me a policy.  That's the foundational requirement for eligibility in PCIP -- to have been so rejected!







Medical plan detail

Close window



In network
deductible
Out of network
deductible
In network
out of pocket
Out of network
out of pocket
Current medical plan limits$2000.00$3000.00$5950.00$7000.00
Accumulated to date$2000.00$2098.88$5950.00$2199.22




BCBS of Tête de Hergé ended up raising my premium three times in 2009, and finally demanded $1513/month, with a $5000 deductible.  They had also begun to refuse to pay for services that were clearly covered, dragging their feet and making my tending hospitals and physicians request payment many times before moving on to some other delay tactic.

One of my favorites, as well as least-mentioned around here, because it renders me unusually apoplectic, was their assertion that I received not one, but two (and a year apart) policy booklets that had an unfortunate misprint.  That misprint concerned the lifetime cap to my coverage.  My two, year-apart copies both said $5,000,000.  BCBS said, "Au contraire, ma chère!  That was supposed to be $2,000,000." They also scoffed -- in writing, if you can believe their hubris -- at my concern about it, saying that most people wouldn't even have an issue about it, as most people don't max out of 2 million in coverage (negotiated coverage, at that!).  Well, of course, I did.  Max out, that is.  They really do count on us being total hebephrenics.  They do not anticipate things like me turning it all over to the Tête de Hergé Insurance Commissioner... who promptly collected a whole bunch o' "misprinted" policy manuals, including many in their own holdings.

Towanda!

But though they'd lose an occasional battle ("Corporations are people!"), BCBS won the war.  It was highly stressful for all concerned.  It did not exactly improve my health to go a year without coverage, during which time I lost a lot of ground trying to stomp out osteomyelitis. Self pay the $2000+ monthly pharmacy costs for daily meds?  Not likely! Self pay for six weeks of intravenous vanco?  Ya think?  Self pay for removal of a prosthesis and implantation of an antibiotic-laced spacer?  Really?

So... FAIR, to me, is right.  FAIR, to me, is good.  If you must beg to differ, let me know.  We'll talk about it.  Personally, I was profoundly disappointed in the ACA, as the only truly just legislation would have included a "public option."  [Now you may throw words at me!]  To thoroughly confuse you, so long as this country follows the confusion of corporate models with a belief in personal liberty? I am pissed at the people who refuse to pay for coverage but want me to make their health a priority. Who whine and whine about it but don't consider turning off their internet, television, or phone -- who don't move to a more affordable living space -- who consider abusing emergency room services their righteously righteous right, who will pay through the nose for vet services but not "people" assistance. Who eat out on a regular basis, who pay for cigarettes, who put drugs up their nose and in their veins, alcohol in their stomachs and livers, but don't think twice about channeling all that money into health care.  I don't understand people who will not live within their means and are willing to drag others down with them -- children, grandchildren, spouses, live-in lovers -- and us, their neighbors, who end up footing their bills and seeing our own go up as a result.

What truly devastates me?  Watching the mindset passed on to successive generations, watching the belief in the possibility of a better life get actively squashed as a result of a hundred daily decisions to do what is easiest but not best.

Anyway.

Before you have a cow thinking I've betrayed my socialist beliefs -- I've not.  See my original assumption which begins "[t]o thoroughly confuse you, so long as..."  I want that assumption/assertion to change.  But so long as I am stuffed into this ridiculous box of USAmerican denial, yeah, I'm going to go all right wing on your uninsured asses.  Snort!

What's that?  You would if you had a job?  You would if there actually were affordable housing?
My point, exactly.

So "gentle butterfly hugs" all around!  Shazam! [Which is, according to the democratic Wikipedia,  "onomatopoeia for thunder rumble."]


Thunder Rumble!

Please pass this info on to anyone you know who might benefit from it. Thanks!

[If you don't think such people exist in your sphere, well, Towandasnort, shazam, and thunder rumble.]


***^^^ ***^^^ ***^^^ ***^^^ ***^^^ ***^^^ ***^^^ ***^^^ ***^^^ ***^^^ ***^^^ ***^^^ 

PCIP offers health coverage, even if you have a pre-existing condition
Many people who have been unable to get health insurance can now get coverage through
the Pre-Existing Condition Insurance Plan (PCIP), created under the Affordable Care Act.
PCIP is provided through the U.S. Department of Health and Human Services and
administered by the Office of Personnel Management through GEHA in more than 20
states.

Choose the plan that fits your needs
PCIP has been improved for 2011, with better premiums, better benefits and a greater
choice of plan options. PCIP enrollees can now choose from three plan options, with
different levels of premiums, calendar year deductibles and prescription copayments. The
HSA Option provides an opportunity to open a Health Savings Account, a tax-exempt
account where you can deposit funds for eligible medical expenses.

Each of the three PCIP plan options provides preventive care (paid at 100%, with no
deductible) when you see an in-network doctor and the doctor indicates a preventive
diagnosis. Included are annual physicals, flu shots, routine mammograms and cancer
screenings. For other care, you will pay a deductible before PCIP pays for your health care
and prescriptions. After you pay the deductible, you will pay 20% of medical costs innetwork.
The maximum you will pay out-of-pocket for covered services in a calendar year is
$5,950 in-network/$7,000 out-of-network. There is no lifetime maximum or cap on the
amount the plan pays for your care.

Each of the three PCIP plan options:

Includes all covered benefits, even to treat a pre-existing condition, immediately from
the date coverage begins.

Covers a broad range of health benefits, including primary and specialty care,
hospital care and prescription drugs.

Does not charge a higher premium to individuals with medical conditions.

Does not base eligibility on income.

Are you eligible?
To be eligible for the Pre-Existing Condition Insurance Plan, you must be a citizen or
national of the United States or residing in the U.S. legally, have been uninsured for at least
the last six months, and have a pre-existing condition or have been denied coverage
because of your health condition.

Want more information?
Health care options in all states: www.healthcare.gov
PCIP administered by GEHA: www.pciplan.com, (800) 220-7898
To apply for the Pre-Existing Condition Insurance Plan: (866) 717-5826

Monday, January 10, 2011

Storytelling: Who cares?!


The assumptions people make, the games we play.  I'm mightily sick of them.  I'm tired of people who say and do duplicitous, hurtful things but in whose minds exchange their own agency and ownership for passive constructions, in which they are just poor, put-upon peons, subject to anyone's will but their own.  Life is something that happens to them.

"We were getting along fine until x happened..." Beware the passive construction! 

"We were getting along fine until I stalked you on the internet by pretending to be someone else, attempting to befriend your sister, etcetera..." Actually, beware my "etceteras," as well, for they contain a multitude of unexpressed sin.

You know the type of person;  You've had these conversations.

"I was getting by until I was out of work."  =  It sucks that I have no money since I quit my job.

"Christmas won't happen this year because I am so broke.  Excuse me while I use my cell phone, logon to my internet service, smoke a couple of cigarettes, and change the channel on my cable television..."

"I think A but some people say B so I could be wrong, except I don't think so.  Unless ImportantPerson C comes out with B, in which case I will weigh in after everyone else is done."

Stan Fields: What is the one most important thing our society needs?
Gracie Hart: That would be... harsher punishment for parole violators, Stan.
[crowd is silent]
Gracie Hart: And world peace!
[crowd cheers ecstatically]
Stan Fields: Isn't she lovely? Thank you, Gracie Lou.
Gracie Hart: And thank *you*, Stan.
--from Miss Congeniality

I tire, especially, of being informed every few months that my former internet stalker still tells the lie that we were best buds, that ours was a friendship of sunshine and flowers, plus various other untruths, including how she still cares {palm facing outward, attached to forehead, martyr style}.  You know, before I got all upset over a bunch of nothing much!   She also keeps coming up with annoyingly effective, manipulative formulas. Beating her frail chest with trembling hand, she'll say, "I don't hold grudges, I forgive everyone for everything!"  Well, first off, it just isn't true, and secondly, so what?

Her timely desire to claim Retrofitted Sainted Virgin Status does not translate to anything meaningful in my world.  I get that she aches for me and others to feel shame and regret for having treated her so badly (after things just happened, remember!) but, well, so what?

Remember, she suffers from two personality disorders, the most evident one being Borderline Personality Disorder, and the other explaining a good many of the persistent characteristics of her sad life -- Dependent Personality Disorder. I still have the email where she tells me her diagnoses but never pursued treatment for either... now she consistently denigrates anything that might relate to psychiatric treatment.  However, since her most difficult daughter was diagnosed as being bipolar, she will give psychiatry an approbative nod when it fits her emotional need for blame.

Yadda yadda.  So what!?

People love to opine, laying the index broadly aside the nose, that things happens for a reason.  Puh-leeze!  Need I lay out the many situations in which that can only confirm how totally fucked is the cosmos?
[I didn't think so.  Good, my Reader, good!]  Now, that is not to say that I don't believe there are things of benefit to be learned from most situations -- I simply won't allow the tragically nonsensical to be elevated.

Except, of course, when I do.

From the global false-friend turned annoying-stalker scenario above, I learned that there is a lot of validity to the notion that we create our own realities, that our situations are the direct result of our history of choices.

The good news, for me as for her, is that it is wonderfully easy to change that history, to bisect that line.  You change that history by your steady commitment to change.  The hope is that I can string a few days together, love that look, admire that record, and then make it one whole month.  It's like the AA version of self-improvement.  I just got my blue 24-hours chip

I haven't gotten there yet, because in my head right now I can hear a whining, wheedling voice saying another one of my least favorite expressions:  That's easy to say, hard to do.  If I could magically transform one mental habit for her as a "go-away" gift, it would be her understanding of change as some mysterious thing that is fundamentally retroactive.  If anyone were to suggest counseling or psychotherapy, the response includes "Why? I can't change the past and the past is what makes me who I am.  I can't change anything..."

It makes me want to pull my hair out.  And scream.
And, of course, it dovetails well with the understanding that she holds personal responsibilty in low esteem.

All together, now!  So what?

Huh?  What?  You think that I don't warm to my uncaring quite as much as I did at the top of the page?  Harrumph!  You think I weep for the children who [passively] inherent her most active teaching -- you might as well not try, you're doomed, and if you doubt it, just look where you came from, for that is forever where you will be [to keep me company...]?

Here is an offhand, almost final, observation -- I study stylistics as representing the basic character of a person.  Especially when that is all I know of someone, as is the case on the internet.  We all do it but I make a conscious choice to do it.  You should have seen my eyes light up the first time a teacher revealed how to parse a sentence.  Oy, the joy!

(On my honor, I will be receptive and not at all surprised should someone approach me to research why I consistently split infinitives, comma splice, misuse effect and affect, and litter my texts with hyphens.  Why, these things are the verbal topography of my emotional life!)

Hey!  You!  I know you are mouthing "So what?" -- knock it off and wait for your cue.  The point is to affect... er... effect nonchalance about her, not me!

Jeez.


So, anyway... I have learned that this woman telegraphs either a lie or a state of extreme fear/anxiety whenever she plops down four exclamation or interrogation marks at sentence end.  I've tested my hypothesis over the course of two years.  I even think that should the number rise or fall, be 3 or 5 marks in lieu of 4, then their semantic function no longer has to do with anxious fear.  How can this be explained?  It's an attention getter, I'd argue, a literal one, right on the page or computer screen, and the need for [caretaking] attention is a big part of who she is. 

Remember the finer points, though.  I don't wanna be in charge of translation should some bizarre heptad of punctuation marks pop up! 

She has another tell that comes into play with the phrase:  "I, for one, blahblahblah..." That's for those wind-in-the-hair moments of adolescent revolt -- perfectly normal, and assertive, even!  Until, that is, the sentence becomes interminable with the hangdog addition of "but I could be wrong... I usually am.  It's the story of my life."

I dunno.
I dunno.
I dunno.

So what?