The Flaw in "Mom's World"

My mom used to talk about "Mom's World." There was the world outside our apartment, and there was "Mom's World" inside it. In Mom's World, you could have three parents and it was fine. In Mom's World, you could say curse words that you were never allowed to use in school. In Mom's World, you could occasionally make yourself sick on pink elephant shaped cake. In Mom's World, even as a child, you could speak your mind and have your thoughts and feelings respected, even if she had to point out when you were done that you were factually wrong. In Mom's World, you were the master of your own body and sexuality and nobody would judge you for that as long as no one got hurt or pregnant or diseased. In Mom's World, you could lambast the adults who were not deserving of respect. In Mom's World, you could rail against all of the ways that the world was imperfect and idiotic and disappointing. In Mom's World, Mom was deserving of respect. Mom's World was an act of will by this amazing person whom I love so dearly.

But the trouble is that the world outside exists. And it crushed Mom's World. 

I still deal with the bureaucratic repercussions of having three parents. We three whom she raised got in trouble when we slipped up and cursed at school. We got fat from pink elephant cake. No one wants to hear what we think. We are slut shamed. We must perform respectfulness for people in authority over us, regardless of their unworthiness. The world continues to be stupid and imperfect and wrong. And mothers get no respect. 

I feel very close to my mother right now, which is especially painful now that she's gone. 

She "quit working" when I was ten, when my father got a professional job for the first time after college. She never went back to "working." Don't get me wrong. She was busy literally until the day she died. She took care of me, my brother, my father, and eventually my sister-in-law and my nephew. She went out of her way to do absolutely everything she could to make everyone else's lives easier and happier, even as her body was failing her. 

And it counts for nothing but a fond memory in the minds of the five people who benefited from her ceaseless toil. You see, she didn't have a job, or at least not one that came with humanity validating paycheck. 

Seemingly incapable of learning from other's mistakes, I "quit working" when my first child was born. I spent seventeen years "not working," and now, it will be impossible to pick up my career. I could do the work, but no one will believe that. At the very least, whichever "Human Resources"—a truly vile, ironically dehumanizing phrase—flak responsible for sorting through way too many resumes will look at mine for a few seconds and discard it...because I "didn't work" or because it doesn't fit the soulless AI generated idea of what it "should" say.

But more than that, I feel close to my mom for sharing the utter delusion that my own values, my own convictions that drove my actions could carry me through a world to which they are not suited. I am no more fit to exist in the world than she was. She thought that she could enforce her little corner of the world, and so did I. 

But I can't. 

The world is a stupid, fucked up, irrational place run by the worst people imaginable, and my choices are to try to adjust, or to drown. And I don't think I can adjust.

RIP Twitter

 I used to love Twitter. Genuinely, I used to LOVE Twitter. I had a wonderful, rollicking good time with a stilly crew of "Social Thursday" buddies from around the world. Things went sour eventually, but I look on the Twitter era with the fondness that most people have for high school or their fraternity. Probably wasn't really good for me, and it was often immature and stupid, but I loved it.

And the narcissistic idiot who owns it has now, fully and entirely, killed it for me. 

If I ever get obscenely wealthy, I swear that I will hire someone whose entire job is to tell me I am full of shit. Regularly. 

Even apart from the really unforgivable embrace of Nazis and other dudebro racists, who, with even half a brain, renames something "X"? 

I've been saddened and frustrated that the only truly important skill in the world has become marketing. Donald Trump, another immature, insecure sociopath, marketed himself as a business genius and managed to become president, FFS. And Elon Musk branded and marketed himself relentlessly as a genius, even though he's evidently a total moron. He convinced people that he is a technological genius when his only undergraduate degree is in economics. He's not a physicist. He may have bought a physics degree from UPenn. And without anyone to tell him that he has drunk his own Kool-Ade, he has run completely amok, destroying one of the most recognizable brands in social media in a matter of months in order to suck his own dick and promote alt-right accounts. 

Goodbye, Twitter. It was a thing while it lasted.

College Advisement Fails

I've seen many versions of memes of Gen Z just giving no fucks. Young people are shown basically refusing to be exploited, and often the meme creator can't quite seem to decide whether to feel scorn or awe.

Well, they have a lot of reason to be pissed and rejecting bullshit. 

Antonio had a meeting with an advisor at Berklee College of Music the summer after he was accepted, before he enrolled. He asked whether it's possible to graduate in two years as a transfer student. He was told it is. He learned in the middle of his first year that he was more or less lied to. They accept only 24 units of transfer credit, about a semester and a half, and NO other school's music classes. You can test out of some of the core music curriculum, but that's it. So he's going to need a full third year to graduate. At nearly $50K a year, even after his scholarships, that is fairly painful.

After applying to and being accepted at a bunch of STEM universities, Maggie decided that she did not want to study STEM. So she enrolled at community college to study theater, intending to transfer to a four year university. Unfortunately, her community college THEATER PROGRAM advisor waited until after Maggie's first year to tell her that NONE of her theater classes are transferable, so she would need to start as a freshman elsewhere, and maybe she's better off just taking business administration and marketing classes.

via GIPHY

I do wonder what fantastically "useful" degree is required to end up as an incompetent community college advisor. 

Young people have been infantilized under continual supervision, then demeaned for being immature. They went through a global pandemic that cancelled a significant portion of their lives, leaving them trapped for a year with Google Classroom, while they were shamed for spending all day looking at their screens. They're told that they need to go to college to get a good job, while reading about Millennials drowning in student debt they will never be able to pay off. They were told that STEM jobs are the only hope for a stable career, but now we're told that AI is going to make all human intellectual activities like engineering and art obsolete, so the only things we need people to do are menial jobs and gig "side hustles." Or be one of the lucky few at the top with business degrees to whom all the profit is funneling—but let's not mention that you needed to start out with a shit-ton of money to begin with to be one of the oligarchs exploiting everyone else.

(Gen X went through most of this too, though the AIDS epidemic never paralyzed the entire country, before we revolutionized the world with the internet, but nobody ever remembers us, so whatever, never mind.)

So as usual, in summary, #MedicareForAll and #UBI. Because fuck capitalism. And guidance counselors.

Health Insurance Is a Scam

Billing Nightmares 

My daughter Maggie has type 1 diabetes. She's had it for nearly a decade. Her treatment has been substantially the same for the past six years. She has an insulin pump and a continuous glucose monitor that, at some point, were linked to provide her with "hybrid closed loop" insulin delivery, which is fancy way to say that the glucose monitor feeds her blood sugar data to her pump so that it can automatically adjust her insulin dosages to correct for high or low blood sugar. The technology is pretty nifty. 

It's also very expensive, and we have had Platinum-level health care plans in order to pay for this. They are also not cheap. Last year, after double digit annual increases for, like, forever, our annual premiums were nearly $30,000. 

For this staggering amount of money, more than the totality of a full-time minimum wage job, you would think we would not have a problem with getting coverage for a well-understood and well-controlled chronic disease that Maggie has had for literally the majority of her life. 

You would be wrong.

I have been calling a medical supply company (Edgepark) and my insurance company (Highmark, formerly Blue Shield of Northeastern New York) about bills beginning LAST MARCH, trying to get them to agree to charge me the correct co-payment for her CGM supplies: a transmitter and glucose sensors that she needs replaced four times a year. They have billed and process the claims correctly two of the four times. The other two of the four times, they have counted them as "durable medical equipment," which requires a 50% copayment, instead of "diabetes supplies," which is a $15 co-pay. This is a difference of THOUSANDS OF DOLLARS. 

I called Edgepark in perhaps May(?) and explained that they had billed the CGM sensors incorrectly as durable medical equipment instead of diabetes supplies. They told me to call the insurance company because they couldn't do anything without an updated explanation of benefits. I called the insurance company and they agreed that, yes, I am correct. It is diabetes supplies and $15/item. They called Edgepark and supposedly fixed it. Nothing happened. 

Pretty sure I called every couple of months, but finally in August, I started taking notes on my calls. August 18 call, nothing fixed. September 9 call, nothing fixed. October 10, the insurance rep called Edgepark, sent all the claims back for adjustment, and Edgepark was supposedly going to be refund my $466.25 overpayment in "hopefully fewer than 30 days.  

December 8 call, same Highmark rep, but nothing fixed. She recommended I check Jose's member portal—I'm the one who deals with all this shit, but since it's through Jose's job, he is the "policy owner" so I can't see anything—to see whether the claims were re-billed. 

I got two corrected EOBs, and another that is wrong, also from LAST MARCH but with a different Date of Service than the one I overpaid in the first place.

I went to the Edgepark website and listed all the orders and cross-referenced that with my credit card charges. The dates don't match up very well because, in one of those brilliant moves of "economic efficiency," Edgepark has an outside billing service. Last year I paid Edgepark $706.95, including two small, odd mystery charges just to keep getting supplies—every single order should have been a multiple of $15. (I suspect that there were small late fees charged because they would sometimes charge my credit card at time of order then also send a bill for the charge, which I would ignore for a while then have to call and have fixed.) According to their website, I ordered 14 items, which should have been a total of $210. They owe me almost $500. 

Instead, I'm getting hounding emails and calls from the medical supply company, telling me I have a balance of $668.25, and would I like to set up a payment plan? I DO have in hand a corrected EOB for one of those bills. But even more EOBs that say I owe the OTHER 50% co-pays.

It's maddening that Highmark blames Edgepark, and Edgepark blames Highmark. Highmark says Edgepark is using the wrong "pointer code," while the snippy woman from Edgepark billing insisted that Highmark changed everyone's policies nationwide "without notifying them" to cover CGM supplies as a pharmacy benefit rather than a medical benefit and that is what is causing the billing/claims problems. 

I don't know, and I find it insane that sometimes they get it right. Like, who is fucking up and when?

That is problem ONE. 

It's Easier NOT to Use Insurance

Problem two is this: It's easier to get healthcare from sketchy websites than to use my freaky-expensive insurance.

Even with freaky expensive health insurance, it takes four to five months, or, in the case of my doctor, eleven months, to get an appointment with a provider. I'd say doctor, but Maggie's "endocrinologist" is actually not a doctor, but some other sort of (admittedly highly trained and knowledgeable) professional, and the person who sees me at the dermatologist's office is a physician's assistant. Right now, I actually can't get an appointment with my doctor, who is on medical leave and, judging by the way he looked last time I saw him, is probably somewhere in the world dying, may his cranky, arrogant, self-important self Rest In Peace. But my doctor's office hasn't told me that I need to find a new provider. I guess they're still hoping he'll come back? However, they also will not renew my prescriptions...because...I haven't been to the doctor. Catch-22, anyone?

So for my rosacea and depression, it's actually easier and faster to skip my expensive-ass insurance and my unavailable providers, and get prescriptions for creams and Wellbutrin from sketchy sites on the Internet to whom broke doctors with exorbitant medical school debt lend their names and medical license numbers. Evidently, I could also get hair loss creams and pills for erectile dysfunction while I'm there. Huzzah!

My insurance premiums are nearly $30,000 because, rather than providing health care for humans, the American health insurance industry exists to create chaos, paperwork, billing errors, and above all, executive pay and shareholder value. 

American Health Care /sarcasmFont

When my brother died prematurely in July of last year at 50, three months after my mother died prematurely at 69, I made a doctor's appointment. It seemed I just *might* have something to worry about.

When I called in August, the soonest appointment my established primary care doctor had was in...November. Awesome. 

In October, his office called to reschedule because he was going to be on medical leave. Gulp. (Yeah, in all honestly, when I'd seen him in February, I had wanted to get off the exam table to help HIM. He was not looking well.)

I rescheduled for...May. 

Evidently, he wasn't doing much better because they called again in February to reschedule for...July. That's right. At this point we were nearly a YEAR after I'd originally requested an appointment. 

And likely in part due to his absence, the office is oversubscribed for the providers they have on staff because when Jose called to request an appointment, the soonest availability for HIS doctor is...February of next year. 

I decided it was time to find a new practice and went to my insurer's Find A Doc tool. 

Jose's AND my doctor are listed as "accepting new patients."

Like, WTF?

When liberals were making noise in my youth—30 years ago!—about implementing "socialized medicine," opponents screamed that we'd have healthcare rationing and you wouldn't be able to see a doctor when you needed to.

Well...

We still don't have universal, single payer healthcare that is independent of employment status. AND, even if you have insurance, it takes more than half year to see a doctor.

Good job, free market capitalists. We're free to die of preventable disease while we wait to get a prescription for cheap, generic blood pressure meds.

Mother's Day without My Mother

On Mother's Day, my lilac bushes are blooming with flowers. My mother had baby lilac bushes sent to me because she love the smell of the flowers wafting into the apartment they rented while my dad was in basic training at Keesler Air Force Base in Buloxi, MS when I was a baby.

My mom died in April 2022. And her lilac bushes still bloom for me on Mother's Day. That was her intention.

I really miss my mom.

Failing the Long Term Thought Experiment

I've been watching Robert Reich's lectures for his final class on Wealth and Poverty at UC Berkeley. In his first lecture, he presented his class with an economic/psychological experiment I had seen before:

Someone offers you $1,000 to split with another person. If the person accepts, you both keep the money. If the person rejects the split, nobody gets any money. 

Perhaps because he did not present it quite as clearly as I had seen before, only saying that you "split the money," it honestly, genuinely, simply did not occur to me until he polled the class that one could choose to split the money unequally. If I were the person proposing the split, I would, without pausing to consider, offer the other person exactly half. But the idea behind the experiment is that any smart "rational economic actor" would attempt to maximize the amount that he keeps, making a calculated gamble on how little the other person would accept. The truly rational choice for the second person is to take ANY amount of the split because in ANY case, he would be better off with even as little as $1.00 more than he had before the experiment. In reality, people are NOT rational economic actors.

I know. Shocking. 

Someone actually won the Nobel Prize in Economics for coming up with that revelation in economic modeling. 

In related news, economists are often morons.

But I digress.

Prof. Reich hinted that the "problem" with the "Pareto improvement" in question, a situation where at least one person benefits and no one loses out, is that when the benefits are extremely one-sided, it violates an innate sense of fairness that most people have. And the decidedly NOT rational economic actor, when offered a pittance in the face of someone else benefitting greatly, says fuck that noise, and lets both parties lose out.

My own failure to grasp the gist of the economic thought experiment from the beginning leads me to a question that would have me raising my hand every time Prof. Reich mentions the representatives of capital. WHY is it treated as so perfectly, stupidly evident that the overriding goal will always be to maximize profit? And in reality, not strictly profit, or even "earnings beyond interest, taxation, depreciation, and amortization," but shareholder value? That is the bedrock of all economic assumptions in our supposed "free market" system, and it is so foreign to me. 

If I owned a company, I cannot imagine a situation in which the goal would be to make the most money possibly at any cost to my employees, my competitors, the environment, the very social fabric of our city, state, country, world. I would feel positively evil if my company were polluting the water and air, if I were ruthlessly running my competitors out of business to create a monopoly in which I could jack up prices, if I could afford several yachts while the people doing the work that made the business run could barely afford their rent, if I were helping to create a world of Gilded Age-level inequality of wealth and the inevitable social and political instability that must follow. 

And there are at least a handful of business leaders who have come to the conclusion that maximizing profit is not the be-all and end-all of corporation governance. Mark Cuban's Cost Plus Drug Company's mission is to make a REASONABLE profit on generic drugs, a markup of some moderate fixed percentage above the cost of manufacturing and distributing the medications, rather than charging as much as the market will bear for something with a relatively (or entirely in the case of insulin) inelastic demand. 

But it is a terrible tragedy and the cause of much suffering that so many of the people in charge of the world are willing to burn it down in order to maximize shareholder value.