Health Care

Monday, February 12, 2007

Jay: Trying to Come Up With Something to Post…

Landed me on this one, as I wait for this week’s host to publish CotC so I can do my thing updating links and announcing it.  Just some rambling around our health care costs…

We pay $764.94 a month for health insurance.

Last year we paid $1050.00 by check for co-pays and uncovered items to the medical center we use, less a refund from an overpayment I made, plus cash for some of the copays, probably balances out at about the $1050, give or take $50.

We paid the hospital $500 for the co-pay for Valerie.  Rates changed during the course of the year, but extrapolating forward that would be $10,729.28 for a year.

Plus prescriptions.  Which the latest news Deb tells me about negotiations on Romney’s evil health plan would have to be included as part of the minimum required insurance one must purchase.  That is, our insurance would cost more due to Romney’s lunacy.  A reasonable guess at the new cost of our insurance would be, say, $915 a month, bringing it almost up to the same cost as rent.  And to somewhere between breaking even and, more likely, costing more than the cost of prescriptions out of pocket and insurance combined.  Especially if there are co-pays on the prescriptions.  I complain sometimes, but we aren’t that bad off prescription-wise, after the sometimes massive discount AAA membership provides.

I’m rather impressed with the sheer volume we pay the doctor, apart from insurance.  The implication of the copay amounts is about $4000 a year retail in visits, plus lab work.  If we paid cash, even without a discount (like doctors are allowed to do that under the agreements they have with insurers), we’d be somewhere between breaking even and saving money, with the exception of maternity coverage.

Self-insurance makes a lot of sense, possibly combined with cheap catastrophic coverage.  The trouble is, we’re sometimes scraping to make the co-pay, so it requires actually putting the money aside and being ahead of it, and never having to touch the money for anything else.

Anyway, just rambling, inspired by some of the more exact figures I came up with for the past year.  I know how to solve the entire “health care crisis” in a few simple steps, but that’ll have to be another post sometime.


05:22 PM | BusinessKidsMassachusettsNewsHealth CarePoliticsStupidity • (0) CommentsPermalink

Friday, December 29, 2006

Jay: Quick Hand Me The Sudafed!

Oh wait.  I might make drugs out of them thar useful pharmaceuticals, so we can’t risk that, no matter how much congestion has spread to my chest, and no matter how fucking insane the entire concept of the drug war was from its inception.

What is it about that whole thing anyway?  Not one President has the balls to say “hold it, this isn’t working, no matter how unconstitutional, costly, or harmful our tactics”?  Is there a real-life mind control ray focused on Washington to banish that particular hope of rationality?  Perhaps a conspiracy exists to keep the criminal element rich and powerful while increasing the government’s power?  One might almost think so.  Since they decided they didn’t need an Amendment for this one, it’ll be far harder to repeal.  Clever.  Tricksy power grabbers.  We hates them we does.

But I digress.  The plague is if anything worse today, and now we all four have it at some stage or another.  Yay.  Worse, I have no choice but to go to Wal-Mart for provisions.  We’re out of Maalox and a few other key things.  Sad.

I’m tempted to try to buy a bed for Sadie while I’m out.  I wanted to check Building 19 before resorting to Wal-Mart and/or BJ’s, but that means even more out and abouting.  We think the problem is her actual bed and its size, possibly combined with its location and that of other stuff in the room, with maybe a touch of lighting issues all wrapped up in “protect me daddy.” She can be in her room, even on her bed, in the dark, with us, no problem, as long as it’s not involved with actually going to bed.  Considering that she turns completely sideways on a queen size bed and stretches most of the way across, the toddler mattress isn’t cutting it, and maybe a twin will be small.  Current theories include that she had a bad dream - she does have a rather Calvinesque imagination - or fell out of bed one too many times, or maybe got herself caught and trapped or hurt by the bed rails.  She tried to explain to me the other day, but the several animated sentences were all in Sadie tongue.  Based on that, she seems to have a problem with the ceiling, which makes no sense unless inspired by a nightmare.

Anyway, hopefully she’ll get over it Soon.  At least she timed it for after Valerie started sleeping mostly through, sometimes even doing Sadie’s more normal “sleep like a teenager” routine.

At least ranitidine is still legal.  I’m out of that, too.


05:41 PM | KidsNewsHealth CarePoliticsStupidityTotally RandomPermalink

Wednesday, December 20, 2006

Deb: Jay already mentioned that it’s my brother’s birthday today…

So it’s kind of wild that Flea would choose to post about the Hib vaccine today.  You see, that brother had epiglottitis when he was a kid, and he’s had about 24 bonus birthdays since then.

I cannot say enough times how fucking happy I am that folks don’t have to go through that anymore.  Even better, kids don’t have to DIE of it anymore:

The vaccine has made Hib epiglottitis almost disappear. Flea knows board-certified Pediatric ED docs in practice for 15 years who have never seen it. This news won’t make the front pages, but the virtual disappearance of Hib-related disease constitutes a public health triumph that has changed dramatically the practice of Pediatrics in this country.

This is a modern miracle, people.  And anybody who thinks it’s a bad thing can kiss my ass.


02:40 AM | KidsControversiesNewsHealth Care • (0) CommentsPermalink

Saturday, December 16, 2006

Jay: So, The Diabetes News…

Believe it or not, I am unsurprised.  I’m not surprised that an abrupt breakthrough has been made to cure diabetes.  I’m not surprised the types 1 and 2 are more closely rooted than believed.  I’m not surprised that the root of the problem is neural.  I’m not surprised diabetes is more related to MS than thought.

Sometimes the biggest obstacle is the possibilities we hide behind our believability threshhold.

We were due for a major disease breakthrough.  We were due for a rethinking of the “it has to mean you’re fat” denigration of diabetes.

The fundamental interconnectedness of all things angle is fascinating.  Diabetes is considered at least somewhat a genetic risk, and runs in both sides of my family, especially my skinny little grandfather who came up a few months short of reaching 90.  MS seems to be more minimally genetic, though my sister does raise our odds a tiny bit.  Diabetes and MS are both immune diseases.  My sister had gestational diabetes; the only sign of any form of it in my generation.  My perception of my sister as “not the same,” which turned out to be MS, covers the entire post-partum period.  And now it seems diabetes and MS both have neural connections.

Not that I expect a pill that will grow a new kidney any time soon, but I certainly hope the relatively barbaric treatment and perception of diabetes can be slain as expediently as possible.  The findings need to be proven out and acted upon as fast as possible, without the disease industry getting in the way.


05:07 AM | NewsHealth Care • (0) CommentsPermalink

Tuesday, December 05, 2006

Jay: It’s Always Something

(Written much earlier.  When I tried to post they were doing server work that affected BB, so I had to hold it for later.)

I just love the confluence of awkward cashflow and things coming up that need the cash I’ll have in a week or two. Or three.

We have the opportunity to buy a minivan for $500 that runs well, has high yet gentle mileage, has an almost perfect body and a nice, clean looking engine, and is known to need certain work soon that even if it runs several hundred bucks would be worth it.

Amazingly, as of 36 hours ago, it was not gone yet, even though I’ve already waited nine days and counting to get paid uncharacteristically late and then let it take two business days to clear and be officially available, since it’s all electronic now and can be cleared almost instantly so we still have old-fashioned “gotcha” waits.

I can just eke out enough to buy the car and probably get by for groceries and sundries, if the new, much larger month I billed Thursday is paid within the net 15. Mind you, not only do they almost never exceed that, but also they usually pay within a week. So I plan to call the bank on their “two business days for local checks” thing today, despite knowing that they once overdrafted me on the third or fourth business day. Which was what led me to ask them exactly, eventually. And for what it’s worth, it was as Bank of America they said two days to my face, and as Fleet that they did the three or four day thing. We all know Fleet was the height of evil and Bank of America is just the best.

So in the midst of this, yesterday I broke a tooth.

Doh!

It’s not even especially painfully, though I have felt sort of nauseated or like I’m coming down with something ever since, and it’s ever so slightly temperature sensitive.

I wasn’t even aware I had one in sufficiently bad condition to do that. But there it is. Next to last, upper right molar, with a gaping, jagged hole about 1/3 of the tooth in size, facing the back and scraping my tongue raw. It was Deb I was worried about sending to a dentist soon, not me.

We were going to look for a dentist more local than my old one, who is in Duxbury, and try to find one who would be especially gentle with Deb. I could go to mine. I’ve basically blown off going for a few years, I think since 2001 but I could be remembering wrong, since I stopped being able to afford it, after I no longer had dental insurance to make it less unaffordable. That and I’d had all the major work caught up. My first year back to the dentist I had five root canals. Later I had more. And lots of crowns. In fact, it was the $2500 to buy the previous van that decided eliminated my plan to replace a pulled molar with an implant. Glad of it, too, because I don’t miss the particular tooth at all. However, the one that broke is the focal point of most of my chewing, which is overwhelmingly right-sided. But I digress. Heck, that tooth is the one that forced me onto the blood pressure treatment train and landed me with my current doctor. And they still had to give me a valium to make the BP low enough to pull the tooth. I am not sure how extracting this one would work, even if it would be the low cost solution.

What I really want is to be able to go in and say “look at this tooth… no, this one, ignore the rest, what can you do about it and what will it cost?” You go to a dentist and they want to do the cleaning and then the checkup and then make a list of all the teeth that could use any attention and line you up for a series of appointments to work on every last one.

I feel bad going to my old dentist after blowing her off once we got down to semi-annual checkups plus anything those might lead to. She’s definitely of the above school. One time in 1993 I had a totally rotted rear molar that just needed to come out. I was able to go down the street in Billerica, where I worked, see a guy who looked at it said “yup, it’s rotted” and pulled it for a grand total of $50. That was great! But I’d like a little more thought to go into this one, because it’s not clear to me it’s that gone. Though the extent of the damage implies needing a crown, and those were running I think $500-600 each when last I got a few.

Anyway, work calls! I’m late anyway, and now there’s a near-emergency incident waiting for my attention.


06:14 PM | BusinessNewsHealth CareTotally Random • (1) CommentsPermalink

Sunday, October 08, 2006

Jay: Pictures and More

This picture didn’t quite capture her reaction, and was so dark I had to lighten it, but it suggests the way Sadie beamed with joy when everyone gathered around and started singing happy birthday after the cake was set in front of her.

Then she was like “okay, I’ll dig in!” Before we got the cake out from in front of her and cut her a slice, she had started painstakingly picking off just the yellow icing that spelled happy birthday.  That is how she eats cake; pick off frosting, color by color, then work on the actual cake.

My mother made the cake, which was really cute, decorated with cookie-based insect decorations.  Sadie made a beeline for it, long before the food was even served (we were early even though that wasn’t our intention), and wanted to start in on it as soon as she caught a glimpse.  It was as if she knew that one was for her.

This was last Sunday, at an end of summer/group birthday party, held in the church cellar because it rained.  There were birthdays for Ryun, Sharon, Martin, Sadie, Marc and Dan.  So Sadie’s was one of three traditional cakes plus an ice cream cake.

Here’s a happy picture of Valerie and Deb…

I’d been feeding Valerie, and here she is trying to squirm off my lap…

Valerie on the loose:

Sadie eating her cake, accompanied by her “rumble truck,” which was a huge hit present.  Pull the string and the truck rumbles and vibrates.  Sadie learned to work it readily, having not really had a string pull toy before.  Funny thing is, Valerie taight herself how to work it just yesterday, which I wouldn’t have expected.  Then again, Valerie figured out this morning that she could tunnel between shower curtain and tub when in the shower with me.  Sadie never did that.  Then again, Sadie didn’t get to hang out in the tub during showers at that age.

Speaking of Sadie, looking back, I see I never posted about her checkup!  That was Tuesday the 3rd.  No shots this time, but it was still torture.  Except the part where they pricked her finger to do glucose and hemaglobin tests; that was fascinating.

The nurse, the same young and reticent one who didn’t get a good neasurement of Valerie, got a height that was way off.  I measured later, got a reasonably certain 34 inches, and that was what the doctor went by.  It’s dead on 50th percentile.  And is of great interest in the context of the “half of adult height at two” rule of thumb.  The nurse called her weight 26 1/2 lbs.  The digital scale said 26.2.  Her head was 50 centimeters.  Besides the 50th percentile on height, I guess weight is between 25th and 50th, and head circumference is off the charts above 100th.

The doctor suggested, to the point of writing it on a prescription form, that we get her high white last shoes, “like the old Buster Browns they don’t make anymore,” to encourage her feet to point straight.  Which is funny, because she’s still on her way to that going away on its own, the way the orthopedic specialist said it would, and we love it when they suggest we spend money we can’t afford that is of questionable necessity.  Oh well.

It was weird leaving there without making another appointment, but if the next one is a year out, then yeah, they wouldn’t line up that far ahead.  But then they forgot to send us to the lab for other blood tests that were due that nobody mentioned, so now one of us has to take her back to see the vampires.

Here’s a fuzzy attempt at getting a picture of both kids with their great grandmother, with great-great granddaughter Emily roaring into the picture:

Good one of Valerie and her great-grandmother:

Nose!

Sadie loves grapes.  She ate the entire bunch except a couple I took.  The only problem in giving her grapes is she wants to share with Valerie, and for Val they have to be peeled and cut so she won’t choke.

Queen Valerie surveys her domain…


02:32 PM | BirthdaysFood & CookingKidsPicturesNewsHealth Care • (0) CommentsPermalink

Tuesday, September 26, 2006

Deb: Because it makes you feel like ASS.

And people know when you’re lying to them:

That’s what Mehra calls an “education gap,” in which clinicians don’t sufficiently communicate to patients the “value and side effects of beta blockers to patients.” Some patients assume that depression, fatigue and sexual dysfunction occur due to beta blockers, but studies indicate that the “frequency of [these] side effects is so low that we over-attribute [the side effects] and stop the drugs.”

Bullshit.  Beta blockers make you feel like ass. 

And exercise takes a lot of time, and cooking right takes more time, and if you’re scared you’re going to die are you going to spend all of your spare time trying to fend death off and then wondering what for? or are you going to do something you like to do when you aren’t slaving to keep your health insurance?

I know from experience that it is completely fucking impossible to simultaneously change pretty much everything about your personal habits overnight, no matter how afraid you are.  (Ever try to eat when you’re pregnant?  If you followed every rule, you’d exist on air.  But you’d have to move to an unspoiled mountain peak before you’d be allowed to breathe it.)

Doesn’t seem that hard to figure out, but I’m just some dumb blogger chick.  What would I know?

(ADDED): Actually, if I had to tell these fellows what to tell people, I’d tell ‘em to be honest about that the side effects can be bad at the beginning, but that you do get used to the drugs a bit and you stop wondering how death would be worse a few weeks after starting the things or increasing your dose.  You may never feel quite exactly the same, but the new normal tends to be acceptable if you wait it out, at least in my experience.  Telling people that it’s all in their heads is counterproductive at best.  That’s the sort of thing that makes people write off everything the doctor tells them from that point on, and then where are you at?


12:36 PM | NewsHealth Care • (5) CommentsPermalink

Tuesday, September 19, 2006

Deb: Use it and lose it.

There’s been a lot of talk at our house about the various ways people want to “fix” health insurance, and the one thing that’s become perfectly clear from all of this is that all of them are designed to bring costs down by keeping people from actually using it.  One side wants to tax cheetos until nobody needs it, since we all know thin people don’t go to the doctor.  If that fails, they’ll put the government in charge of the whole shebang, so that you’ll die of boredom waiting on hold to get an appointment.  That’s cheap.

The other side is anxious to get a “free market,” which so far as I can tell means altering the regulatory structure of the insurance industry in such a way that anyone who might actually use insurance will be priced out of the market.  Oh, and fat people, too, natch, because everybody knows that thin people don’t go to the doctor.

So you can understand why I laughed so hard I that started to cry when I got the following from Jay, who had locked his keys in the truck and had to call AAA about a week ago:

As I made sure my keys were not in the truck when I locked and walkedaway from it, I was thinking that I should not be allowed to haveAAA, because I used it, and my using it cost the people who have it but don’t use it money. Heh.


03:09 PM | NewsHealth Care • (0) CommentsPermalink
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