Saturday, January 04, 2014

Why Obama Should Hire A Pit Bull to Reform the ACA Healthcare Marketplace

Have a got your attention?  I'm trying to create a post that will attract the most internet trolls to every gather in one spot.

But while I have your attention, what I really wanted to address is my new health insurance.  While everyone else was complaining about the glitches in the system or doing stories on how inaccessible it supposedly was, I somehow managed to enroll.  Three times.  And, having been through the process three times now, I can say that the glitches are definitely gone, but that doesn't mean that there are no problems remaining.  But the biggest glitch is not the system or the offerings, but that we, the citizens of the United States, have no idea how to choose a plan, because we've never had the opportunity to choose before.  I approached the choices with a bit too much confidence.  I have had insurance through employers previously, but this is different.  When choosing from my employers' plans, I had a choice of expensive or more expensive, so there was very little to consider as far as the details went.  When I was cut from my employee benefits, I took on the full expense of the plan, paying $600.00 a month until my eligibility ran out after 18 months.

My first choice under the newly available plans:  a new insurer with a zero deductible and coverage for the cardiologist and ENT that I used to see regularly.   But after reading the small print, I realized that they actually offered very little in the New Orleans area outside of those specialists.  For example, if I wanted to go to the ER at Baptist, it wouldn't be covered.  I would have to go across the river.

My second choice was a more expensive plan, that had low co-pays and a relatively low deductible, but at $500 a month, I started thinking that although I do see specialists with isn't that often!

My third, and final, choice was with Blue Cross Blue Shield, with a $500 deductible, a broader range of options for urgent and emergency care, but slightly higher co-pays.  Total premium: $366.00 a month.

And, yet, in spite of my paying the premium myself, I'm constantly confronted by really angry, repellent complaints that I am relying on a government handout of some kind.  And these accusations come from people who are getting tax breaks, credits, refunds, etc--which, under their own eyes, would qualify as another form of a "government handout."

My current job, which I can't get into at this moment, involves talking to people about healthcare. To be clear, I'm not selling insurance or working for a provider, but the question of insurance comes up with frequency, and what I have come to understand, quite vividly, is that Americans have no idea what insurance actually is.  They don't know how it works.  They don't understand that employee benefits are actually paid out of employee salaries.  They don't understand that a drug store discount card is different from insurance.  So, with the basics of how this system works kept from their grasp, how can they be expected to understand how to sign up for insurance, or why being insured isn't a terrible, terrible thing?

Friday, January 03, 2014

The Curious Case of Janet Malcolm

Back in the 1990s, when I was in grad school at Columbia University, Janet Malcolm was at the center of the ongoing debate regarding the ethics and responsibilities of journalists.  Her controversial essays and profiles were so much the center of the debate that there was very little discussion of her technique or even, at times, her subjects.  The conversation was always about Janet Malcolm.  What did her latest piece reveal...about her?  Where her choices moral?  Was she fair?

I hadn't thought much about her until recently, when something brought her to mind and decided to include her work in the reading list for my upcoming essay course on Ruzuku.  And it turns out she has a new collection out, Forty-one False Starts: Essays on Artists and Writers.  How timely!  The New York Times Book Review offers a great assessment of why Malcolm is so interesting, and in the case of my class, worthy of discussion on a craft level even if she may not be a writer we all want to emulate: "...what the reader remembers is Janet Malcolm: her cool intelligence, her psychoanalytic knack for noticing and her talent for withdrawing in order to let her subjects hang themselves with their own words."  

The first line in her book The Journalist and the Murderer"Every journalist who is not too stupid or too full of himself to notice what is going on knows that what he does is morally indefensible."  She goes on to detail the ways in which author Joe McGuinness gained the cooperation of Jeffery McDonald by convincing him that his book Fatal Vision would exonerate him of the murders for which he was accused.  Instead, it did the opposite.  How did Malcolm get her material for this book?  By turning McGuinness's own tricks on him.  

I'm still reformulating my opinion of Malcolm.  What are her crimes?  It seems to me she, on one hand, elevates herself above her subjects, while on the other, she lowers herself beneath them.  In doing so, she allows readers to call her motives into question.  But is she, maybe, more willfully transparent than other writers in the way she presents herself to readers?  And if so, is that wrong?