Tuesday, July 30, 2013

Health Insurance redux

more on the saga of health insurance for our daughter, son-in-law, and grandson on the way...

One month before Christian lost his job, his employer switched health insurance providers.  That is always a pain as you have to find out whether your providers are still covered and if not, find new ones... but that was more complicated for them.  Neither insurance covered the birth center and midwives they were using for the pregnancy and birth.  They had negotiated coverage with the first insurance company - Anthem Blue Cross.  After all, midwives and birth centers are way cheaper than doctors and hospitals.  It made fiscal sense for them but it was a hassle for Christian and Alexis.  They were in process of trying to negotiate the coverage with the second provider when Christian was fired. 

Fast forward a few weeks...  Every time you do a web search on COBRA, an ad pops up for Anthem Blue Cross as a COBRA alternative.  So Christian contacted them... and they told him they would not insure his family as pregnancy is a pre-existing condition.  It didn't matter that they had been insured all along and until a month ago, their insurance was with Anthem Blue Cross... they are not eligible for insurance from them.  Luckily, they do still have the option of COBRA.  As I understand it, that continues with the provider they had when Christian lost his job so they begin negotiations again.

As I said in my previous post, the Affordable Care Act cannot kick in soon enough.

Wednesday, July 17, 2013

Health Insurance... the ACA can't come soon enough

Two weeks go my son-in-law lost his job.  That is bad enough under the best of circumstances... but the circumstances are anything but "best."  My daughter is 7 months pregnant.   They have health insurance through the end of July... but the baby is due in September.  They had decided to do their birth at a birth center with a midwife which involved negotiating with their insurance company to begin with...  They live in one of the most expensive areas of the country .  Of course, if they move, they have to find medical systems for the birth of the baby and find health insurance.  If they stay, they have to figure out how to pay rent plus get health insurance.  Christian got a job quickly although that income will render them ineligible for any government aid... and he is not eligible for health insurance at his new job for 90 days.  Of course, he has not started as they wait for his drug test to return from the lab.  And there is the ever there and overwhelming shadow of student loans which equal monthly payments higher than rent in most areas of the country.  Those bills have made it impossible to accumulate any savings... so there is no money for COBRA or as a buffer against other costs.   The ACA would make things easier for them... but it doesn't kick in completely until January.

My son has not had health insurance for over two years... and that makes us very nervous.  He is an athlete and plays basketball, softball, and flag football at least twice a week.  One injury and his life would be a mess.  John rarely gets ill but when he does, he does.  Since childhood he has run very high fevers.  A year ago, he got some sort of virus and woke in the middle of the night with a fever of 104.  You can imagine the fear and the number crunching that went on that night... does he got to the ER?  The bills would be far beyond his ability to pay.  Even to wait and go to Urgent Care in the morning would be devastating to his finances.  He was able to get his temperature down and he went to Urgent Care the next morning.   His income is minimal so he will be eligible for the MediCal part of the ACA beginning in January.  It is not good insurance but it is something and I will breathe easier.

The same day Christian was fired, I received a note from MMBB, the benefits board for our denomination.  As of January 2014, MMBB will no longer offer health insurance.  Since moving to California we have gotten our health insurance through them.  It is a reasonably good plan but is extremely expensive.  Due to California insurance laws, the only other option for me would be to get insurance as an individual.  Because of my familial hyperlipidemia no insurance company would offer me insurance at any price.  Through the years, the MMBB medical plan became the plan of last resort for clergy in my denomination.  Anyone who could get insurance elsewhere did.  This led to an increasingly smaller and higher risk pool in a demographic group that is already higher risk than the general population (clergy tend to be older and have more stress and lifestyle related problems than the general population).  That adds up to obscenely high premiums.  My church pays health insurance premiums that are almost equal to my salary for my spouse and me.  Our son is eligible to be included but the cost is so prohibitive that neither the church nor us can shoulder that additional cost.  It is not an easy situation for the church but without this option, I would not have been able to accept the call to this church.

Because of the expense, I have been asked to search out other options every year for the past few years and each year have received the same answer from the broker - "not insurable at any price."  It doesn't matter that we've known about the condition since 1987, it has been under control by medications, I've had no incidents, and every test shows that my coronary arteries are healthy.   I assumed that this year, I would be asked to investigate the insurance exchange set up via the Affordable Care Act.  I did not expect that there would be no option via MMBB.  It does make sense that we go with the exchange.  The price for roughly equivalent coverage looks to be at least 30% less than the church is currently paying and according to the ACA, they cannot deny me coverage because of my condition.  Still, the letter felt like a punch in the stomach... and every headline that I see stating that groups are trying to completely derail the ACA literally reads like a death sentence for me.  Without the medications I likely would have died within a year or so of my diagnosis in '87.  Indeed, the meds were new enough that they were unsure whether they would really help someone with my condition.  One cardiologist told me,  "We're hopeful, but just in case, get your affairs in order."  If I had to stop them now, it might take a couple of years... and then I would begin having heart attacks. 

One might say, "you could continue the meds, you'd just have to pay for them."  True... sort of.  The meds require regular blood tests, require a physician to monitor them and prescribe them (our experience in CA is that the primary care physicians don't want to do this so I'd need to see a cardiologist), and none of those costs are inexpensive.  At this point, they are still significantly less than what the church has been paying in premiums but one small incident...  Add that my wife is likely going to need a hip replacement in the next year or two...

Others might ask why they should shoulder any of my medical risk or costs?  That is a real question and comes down to how one feels about community responsibility or the fact that we've been paying health insurance premiums for these years, supporting costs for the health care of others (and salaries and profits for the health insurance industry).

All of this is just to rant about a system that is clearly broken, looks to get better in 2014 but still is not nearly what it needs to be, and which is frightening and frustrating for me.

Sunday, July 14, 2013

Race in America

I'm white.  That fact has shaped my experience of life from day one.  I grew up in a mixed neighborhood in the city and experienced the civil rights era as a child.  I know what racism looks like and I've experienced it up close and personal... from my side of the equation.  As I look at the USA today, I see that we have come a long way in regards to race, but anyone who thinks race is a non-issue is naive, blind, or just plan stupid.

Yesterday a verdict of not guilty was handed down in the George Zimmerman trial.  I wasn't there to hear the testimony or arguments so I can't make a judgement as to whether or not that was a reasonable verdict.  I can say that it was all about race.  Had the races of the two parties been reversed and a black man had shot and killed an unarmed white teen walking home from the store, the arrest would have happened immediately and the trial would have been short and to the point with that black adult now in jail.  Everything about that evening had to do with race.  I would guess that Zimmerman may have been afraid, but was that fear reasonable?  No.  It was based on racial stereotypes and prejudices.  Had the boy been white, Zimmerman would not have even noticed him.  And I am positive that Trevon Martin was afraid.  My black male friends have all told me that from the time they were little boys their parents ingrained in them that they could only walk in certain ways and act in certain ways when in public or they would be profiled and could end up being victims of violence, often times from the very police who were supposed to be protecting them.  They were warned that at times, one could die for Walking Around Black or Driving While Black.  Martin was walking home, being followed by someone in an SUV.   He knew the possibilities.

There is no way that I could minimize the terrible thing that George Zimmerman has done and I cannot but hold him responsible for the events of that evening.  He took the life of a young man with no reasonable justification.  (That he went on Fox News and said that it was God's will that he be there only infuriates me more).  Still, the situation is not so simple as one racist man acting out.  The events of that night and the jury verdict are indicative of a sickness in our culture where black youth are devalued to the point that one can be killed with virtually no ramifications.  We have a legal system that incarcerates young men of color  at nearly 10 times the rate of white men.  Through them in jail and take away any hope of a future.  A report by the Department of Justice found that blacks and Hispanics were approximately three times more likely to be searched during a traffic stop than white motorists. African Americans were twice as likely to be arrested and almost four times as likely to experience the use of force during encounters with the police.  Every measure shows that African American men are more likely to experience injustice in the legal system.  I believe that is simply an indicator of societal values.

Tuesday, July 09, 2013

when a win is not a win

Some of you have followed Cambridge Drive Community Church's struggle with the Safe Parking program in Goleta.  The city of Goleta has an ordinance allowing churches and other non-profits to allow folk who live in their vehicles a safe place to park and sleep for the night in their lots.  As a way of protecting anonymity of the program participants, the permitting process is simple and quick with minimal notice given to the neighborhood.  We felt that the program was a no brainer and so did not share the plan beyond the minimal number required.  Among those neighbors there were a few folk who were very upset by the idea and began to spread incomplete information through the rest of the neighborhood.  That got a number of others riled up and things became ugly.  Those folk appealed our permit and we won.  They then appealed the appeal with the hearing taking place last night.   The planning commission tied which deferred to the previous ruling and the permit stands.  It was the final hearing in the statute and stands.

So... we won... but nobody did.  The neighbors against the program have succeeded only in making people mad and driving a wedge into the community.  The New Beginnings Counseling Center who administer the program did not win because while the permit stands, there are a bunch of very vocal very angry people who will work against any other lots they contract for homeless folk.  The needy have not won because even if someone does come to sleep in our lot, they will likely be surrounded by some angry folk, rooting for them to screw up.  The church did not win because while there are those in the neighborhood who feel we are doing exactly what we need to be doing, others have nothing but contempt for us.  It is possible that New Beginnings could even decide that the atmosphere is too charged and possibly unsafe for a client who likely has already been abused and lives in constant fear and so not place a client in our lot.  There were strong hints that some may pursue a lawsuit.

I don't know what we could have done to avoid the anger short of not pursuing the ministry.  And that does not feel like that would have been the proper course either.

I am still amazed at the animus some folk are feeling regarding the program and really cannot begin to understand the depth of anger.  At the same time I have been reminded both by church and non-church folk that I/we need to be loving, supportive, and seeing the best even of those who are telling half truths about us and misrepresenting our motives.  That's my call in this situation.