I WOULD RATHER DIE

I received an envelope from my health insurance company's pharmacy benefit manager. The outside of the envelope said I needed to act or my prescription costs would go up. The envelope contained three sheets of blank paper. I am not exaggerating. There was nothing but three entirely blank sheets of paper.

My husband had received a similar envelope, but at least his envelope contained instructions. He had to call and have his prescriptions switched to their mail order pharmacy rather than the local pharmacy where we've been getting our prescriptions filled for over a decade. Someone had to maintain the system that sent out the letters. Someone had to answer his phone call. Someone had to contact the prescribing physician to have the prescription transferred to the mail order pharmacy. The prescription needs to be individually shipped directly to our house rather than delivered, along with a cartload of other drugs, to the local pharmacy. That seems like a lot of overhead, but what do I know?

Presuming that this was their intention with my three blank pages, I looked online at the account they made me set up for administering my prescriptions. It said I had to call them. I called the phone number they listed. I had to give my date of birth and zip code to a machine and explain in a few words why I was calling. Not shockingly, it didn't understand when I asked why they had mailed me three blank pieces of paper, so I was handed off to a person.

Then again I had to give my date of birth and zip code to a customer service person whose first language was definitely not English. (I have nothing against people who speak English as a second language—my husband's first language is not English. But I do have something against outsourcing customer service lines to other countries where companies can underpay people.) 

She told me I had no prescriptions on file. Weird since I had gotten a different letter from them saying that I had recently filled a prescription, including what it was, and that it was super important for me to take it as prescribed.

She put me on hold then came back and told me she was transferring me to United Healthcare. 

I am not insured by United Healthcare. I hung up.

So my husband dug up the letter he had gotten and gave me the phone number he had called. I got WORD FOR WORD the same computer script but with a different AI voice.

After I again told the machine my birthdate and zip code and that I wanted to know why they had sent me three blank pieces of paper, I got a person, this one at least US-based. I explained. She put me on hold. She came back and said she hadn't forgotten me and put me back on hold. And again. 

Finally, she asked for my local pharmacy zip code, my prescriber's name, and for the list of medications. There is ONE. And they are going to...contact my doctor and get the prescription transferred and mailed individually directly to me.

TO BE CLEAR, this prescription costs $9.14 plus $5 shipping for a 90-day supply through Cost Plus Drugs. This cost includes the cost of manufacturing, a 15% markup, and $5 in pharmacy labor.

Can someone with a Nobel Prize in economics explain to me how OptumRx's paying for half an hour of a customer service representative's time, plus all the other IT infrastructure, in order to transfer the prescription to their internal mail order pharmacy rather than my local pharmacy could possibly result in any institutional savings on a prescription that costs $1.20/mo to manufacture?

I finally got an appointment to see my primary care provider, who was utterly unhelpful. I'm getting semaglutide from the internet. She won't write me a prescription so that my insurance will cover it, despite the fact that I fit the prescribing guidelines. She won't write a prescription for anti-anxiety meds unless I make quarterly visits. She insists I need blood work, a mammogram, and a visit to a gynecologist. No. I'm not doing it. 

This is the last straw for me. 

I would honestly rather die than "be a smart healthcare consumer," make another phone call, look at another website, read another explanation of benefits, make another appointment that won't be for four to six months in the future, choose another health plan and cross my fingers that it will be the "cheapest" option.

I'm out. I will die when god calls me home rather than participate in this corrupt, stupid system for one day longer. No more meds, no more tests, no more visits, no more. I don't care if a mammogram or a PAP test would detect cancer. I'm not getting chemotherapy or surgery. I'm not taking any more blood pressure meds. If I have a stroke or a heart attack, nobody call 911. Just let me die. IDGAF.

6-7 and the Death of Meaning

At 21 and 23, my kids are securely Gen Z, and I will defend so much about them and their generation until I run out of breath. Their commitment to social justice, to inclusion, to combating toxic masculinity and rape culture, their embrace of democratic socialism are all proof that Gen Z is the best thing Gen X has done. All those participation trophies and filling buckets with kindness and zero tolerance for bullying created a wonderful group of young people who are more engaged politically and more compassionate than any cohort in history. I am incredibly proud of them.

That said, their "humor" is just unbearably stupid. And Gen Alpha is so much worse.

Back in MY day™️, there was a certain genre of SNL skit where the writers just repeated the same thing over and over and somehow we were supposed to laugh. It was a lot of why I stopped watching SNL. Part of the basis, I guess, was making fun of dumb people, which I don't find clever. Don't get me wrong; I'm a terrible person and I sometimes find the things dumb people do funny, but I would never want to then go further and actively mock them for it. It's too mean-spirited for even my black heart, and it's not funny.

Flash forward twenty years, and as Gen Z began to create their own content and memes, to use the modern terms for youth culture, Antonio especially would show me things he found hysterical and I literally did not understand why he was laughing. It wasn't just, "I think that's offensive" or "I personally don't think slapstick or pranks are entertaining," but just...how is it supposed to be funny? I seriously just did not get it. Is it ironic? Does it highlight an absurdity about the human condition? Is it a clever play on words? Is there something utterly unexpected going on? No?

Maybe the first version of the internet version of this bullshit that I remember was the "I can has cheezburger" cat meme. Like, ok. Cats want fast food, and they speak English but poorly. Ha ha? And it got worse from there. I remember staring blankly at an Instagram post that Antonio showed me and searching for any way in which it might have been entertaining, and I could come up with nothing—not even something to roll my eyes at.

When I discovered that the George Michael song "Careless Whisper," had become weirdly popular with Gen Z and I was a little flummoxed as to why THAT song. An older Gen Z, or maybe she's a millennial, explained it away as "it's a meme." What does that even mean? It's funny because...it gets sent around? It's not even like Rick Rolling, which is less about Rick Astley than the surprise of expecting one thing and getting a nineties one-hit wonder instead. That it's "Never Gonna Give You Up" hardly matters. At least I understand THAT.

This week after hearing in grown up media about these damn kids on my lawn and their 6-7, I ended up looking it up and it has NO MEANING. Some kids just repeat it, meaning...nothing. Is it just to annoy adults with senselessness? Is it "you don't get it cuz you're an Old"? Back in MY day™️, we had lots of "you don't get it because you're an Old," but it was "you don't get the combination of anger and ennui expressed in grunge," not "you don't get it...because there is nothing to get." 

And being the over thinker that I am, and wanting to defend young people because us Olds have historically been shitty to young people, I want it to be something profound. I want it to be a critique of Late Stage Capitalism or a statement about the existentialist shallowness of modern corporate media or an example of cognitive semantics.

But in the end, yeah, I guess it's probably just not that deep, bro.

Acting for Dummies

You know what would be awesome? (And not at all because I most definitely need it, preferably by Wednesday.) A remedial acting class. Not Stanislavski telling you to remain in character from casting through to the final performance, not Meisner using sexual battery as a fun teaching tool, not how to research and invent a historically accurate backstory that fleshes out your character's motivation.

Rather: This is a stage. Stage right, stage left, up/downstage (and why it's called that). This is how the lights work and how to "find your light." This is the "fourth wall" and what that means. This is how rehearsals work. These are the technical aspects that you can expect. These are the conventions about sets and costuming. And above all, these are the illusions about which audiences are expected to suspend their disbelief.

Because I have spent my whole life thinking that if you understand and empathize with your character, if you think about how they would speak and move through the world, how their voice and body would be affected by their situation and state of mind, you should be able to act.

And I have discovered, on the eve of tech week—also a term to be discussed in my imagined remedial class— for my show, that my idea is WRONG and there is NOTHING natural about acting. You are NOT supposed to act like your character would. You are supposed to act like an actor on stage. And now I can't unsee it.

To whit: people on stage are terribly RUDE to their fellow characters. They spend 90% of their time, even while having the most intense, heart-wrenching conversations, looking at that invisible fourth wall rather than their scene partner. Their bodies are nearly always facing one direction in this diegetic world. They should not be moving (or not moving) like normal people because that is apparently boring to watch. (This never would have occurred to me personally because I genuinely enjoyed all 3.5 hours of Jeanne Dielman, 23, quai du Commerce, 1080 Bruxelles. In fact, I think it could have been longer. Yes, I am, in fact, also boring.)

But here I am, my lines all memorized, thinking about how my character would behave in this space were it real, how she would speak to the other characters. And IT'S ALL WRONG.

We open in five days.

Shit.

Panic! On the Sofa

 I'm not depressed. At least not yet. 

But I have this pulling-in sensation that seems like it is a prelude to depression. I have gone through this before, when it seemed like the thing to do was just to stop talking to anyone, stop looking at social media, prepare to disappear. The thought of interacting with anyone to pursue publishing books is just too much. 

I am struggling to find things to say to even the few people I (sort of) want to interact with. The kids call and I have nothing to say. Lucy calls and I have nothing to say. I spend part of my afternoon thinking of things to talk to Jose about when he gets home from work so that he doesn't worry about me.

I'm not sad. I'm a little panicky. But I'm having a hard time looking forward to anything. I just want to sit here and knit down my stash until I die, which, admittedly, will take a while. 

But I am being PROACTIVE. *eyeroll* I am going to theater auditions for roles I will never get and acting classes where I can pay to make people watch me perform, and more importantly, I go to places where people smile and hug me when they see me. Even if it's acting, I'll take it.

Crushed and Shaken to My Core

The American people were given a choice of a black woman who promised to restore women's bodily autonomy and to tax the ultra-wealthy in order to help the elderly stay in their homes, invest in infrastructure and green technology, which creates jobs while mitigating climate change, and pass common sense gun restrictions. Or they could choose a proven fraud, rapist, and liar who promised the impossible task of throwing out all the fucking Mexicans, Muslims, and trans people, to murder his opposition, to raise everyone's taxes, thereby crashing the economy, and to put a vaccine denier in charge of public health and a failing businessman in charge of slashing a third of the federal budget, causing "temporary hardship."

And by affirmative choice or indifference, the American people went with the grotesque, vulgar carnival barker.

We deserve the suffering that is coming, and it is a tragedy that we will drag millions of people in the rest of the world down with us.

For the first time in my 50 years of life, I no longer want to be an American citizen because we are truly the stupidest, cruelest people in the world.

Healthcare in America: the Joke That Refuses to Keep on Giving

We finally got Cigna to approve the type 1 diabetes treatment that Maggie had been getting for four years before we switched insurers. So, yay? I still have a two billing problems to deal with, but at least she is going to live long enough for to see that get straighten out.

But for myself and my non-life threatening problems...

Skin Care

Just before my mom died in 2022, my skin rebelled against me. I had a rosacea flare, pityriasis rosea, and eczema all gang up on me at once. I made an appointment with a dermatologist...for four months later, by which time, two of the three had resolved by themselves.

In the mean time, to treat my rosacea, I went online and got a prescription for low dose doxycycline and a cream that I was amused to see contained, among other things, (not covid-killing) ivermectin from a compounding pharmacy that does not bother with insurance. I had to upload a couple of the worst selfies I've ever taken and within a few days, I had my meds. Within a couple of weeks, the disfiguring bumpiness of the rosacea was under control. Some redness, evidently, I'm stuck with for life. It cost $50/mo out-of-pocket that insurance wouldn't cover, but it was at least being treated nearly immediately.

When I finally got in for my dermatology appointment, I saw a physician's assistant, not the dermatologist, who also prescribed the low dose doxycycline plus prescription strength azelaic acid. Insurance declined coverage on Oracea—40mg/day doxycycline retailing at $700/mo—but was willing to pay for generic 50mg/day caplets at less than $20/mo retail. Can someone please explain to me why it costs 35 times as much for 20% LESS of the drug. (Yes, yes, they are *slightly* different formulations, but FFS.) Similarly, they declined coverage on $450/mo Finacea foam, but paid for a generic $50 gel formulation of 15% azelaic acid. It's hard to blame the insurance for "suggesting an alternative."

When insurance changed, I stopped refilling my prescriptions for a couple of years. I use most of my energy for arguing with healthcare on taking care of Maggie. But I had a terrible breakout starting last month, and I knew exactly what I needed. I called the dermatologist. Another four month wait for an appointment. So I went online to my insurance website which referred me to a Telehealth visit—it says skin care right there on the website! I paid, made the appointment, and within 10 minutes I was talking to a doctor. Except it turns out that the harried doctor seems to have wholly misunderstand my need. He sent a prescription to the pharmacy for a 7 day course of doxycycline rather than ongoing low dose doxycycline. That is NOT what I needed. 

Soooo... I went online, uploaded more bad selfies, and for less than the cost of the Telehealth visit, I am getting enough low dose doxycycline to get me through to my dermatology appointment. Again, insurance won't cover this. 

General Health

After my mom and my brother died in quick succession, I figured I'd better go at least get a physical to see if my heart was about to give out too. It took—I shit you not—a year and a half to finally see my doctor. When I initially called, the "first available appointment" was—you guessed it—four months out. Then he went on medical leave and the office kept postponing every couple of months. After a YEAR of this, I explained that I really needed an appointment to get my blood pressure meds renewed, and I finally saw someone else in the office to get a quickie blood pressure check and routine blood work. 

Mental Health

In the mean time, I was, not shockingly, depressed. I went to find a therapist, and the few who were accepting my insurance and accepting new patients had—you guessed it—a four month wait. So I went online again and got a prescription for an antidepressant from a company that does not accept insurance, but will provide prescription meds through the mail within a couple of days rather than waiting months to see a doctor. Another $49/mo out-of-pocket for generic Wellbutrin XL, which would be entirely covered by the insurance if I could just get in to see my own doctor. *sigh*

Weight Loss

In the interim, I got a lovely letter from my insurance saying they would subsidize weight loss programs, including Noom. So I signed up for Noom, and, what with my aforementioned high blood pressure and tragically demonstrated family history of heart disease, I fit the diagnostic criteria for weight loss drugs. They shunted me into their new Noom Med program, and for $400 (partially paid for by my insurance!), I got an appointment with a nurse practitioner, orders for some blood work, and then a prescription for Wegovy. To my utter astonishment, my insurance approved it!!! Only...there was none to be had because of the shortage of injectors. I waited six months with the pharmacy saying every two weeks that they had placed a special order. Then my insurance changed again, and the new one was not paying for any part of Noom Med, and there was no guarantee they would pay for the Wegovy when Noom requested pre-authorization. Oh well... Guess I get to stay fat.

Except that if you care to, and can afford it, you can pay $200-500/mo out-of-pocket for compounded semaglutide, the same drug as Ozempic/Wegovy but without the nifty injector, through any number of dodgy websites with minimal medical supervision. 

Erectile Dysfunction

All of the above applies to erectile dysfunction meds, though this is clearly not a problem I have. 

Summary

It is easier and faster to pay out-of-pocket, without seeing a doctor, for prescription drugs that SHOULD BE COVERED THE INSURANCE, WHICH I DO HAVE AND AM PAYING A FORTUNE FOR!!!

Best healthcare in the world, eh?

I Am a Professional Actór! 🤣

Because I'm an idiot, I did end up trying out for another community theater play with Maggie. Somehow, probably because Maggie was cast as the lead and because not enough people auditioned, I actually got a small part!!!

It was directed by the same man who directed August: Osage County a couple of months ago, for which Maggie and I tried out, and in which she was cast until it turned out her conflicts for rehearsal were exactly opposite that of her scene partner. 

Unlike the three previous plays for which I auditioned, I had not read the script beforehand because it is still a work-in-progress originally written by the director's son when he was in college twenty years ago. I may not have auditioned if I had read it. The play is...something. The playwright took Charlotte's Web and presented it as a sort of psychotic fever dream of a woman on trial for murdering her infant. It is clever. Possibly too clever by half. It needed a couple of trigger warnings: dead babies and child sexual abuse. The ending just does not make sense given the content of the play. It's three hours long. And nearly all of the actors double as farm animals. Without any change to costuming. Like I said, it's...something.

But the experience was well worth it. I got to do a show with Maggie before she goes off to college. I got to do a show at all! And if and when I find something else for which to audition, I have a credit and I know some people in the local theater scene! 

I went into the show (foolishly) confident that I could "act." It turns out I did not know what acting entails. I can memorize lines. I can pretend a wide range of emotions. But other aspects surprised me. I didn't think about what it means to be physically on stage with a bunch of other people. Blocking was new. Figuring out what to do with myself when I am not the one speaking was unexpected. I found it challenging to ignore the distraction of people, especially the director, talking while we were supposed to continue rehearsing. I had not fully considered that when you do scenes over and over again, you need to act like you don't know what other people's lines are about to be! Or worse, that you may need to figure out what to do when THEY don't know their lines. 

I have a lot to learn. 

But I got paid a (tiny) stipend—seriously, toddlers in Thailand make more per hour. 

So by the most literal definition, I am a professional actor. LOLZ.