December 3rd, 2013

bilbo

the Blue Cross/Blue Shield blues

I’m dealing with a situation with my insurance company that simply should not be allowed to happen. It’s not the insurance company’s fault, I don’t think, or my doctor’s, or even mine. I’m not trying to point an accusing finger at any of the individual players involved. That doesn’t make it okay.

A little over a year ago, I was diagnosed with tendonitis due to too many hours spent hunched over a computer and library books, and too much pressure on my elbows due to an unfortunate habit of propping my head in my hands while reading.  Those problems are since fixed, but the thing about tendonitis is, once you acquire it, it’s fiendishly difficult to get over it in anything resembling a long term. It gets better, and then it gets worse. I’m functional, but quite often in a fair bit of pain when it’s a bad day. Which is why I’ve been in physical therapy for the last several months: a combination of pain management and building up muscles so it’s not such a huge problem.

I have a prescription documenting this, from my school’s health center which is the first gatekeeper in my student health insurance plan. I typically have to go there before getting seen by any kind of a specialist. Which is not unusual. I did that.

When my school’s health center suggested PT, I dutifully called up my insurance’s 1-800 number. Told them what my prescription was for. Got a referral to a specific PT clinic in my neighborhood. Went to said clinic, presented my insurance card, and was told they did indeed accept my insurance. My information was passed on to their billing department (this is one of several clinics in a chain, with one administrative office), and someone I have never met but I trust is fully competent at her job verified that i did have insurance their clinic accepted.

And so therapy began. Back in… June, I’m thinking? It was before summer school. Can’t remember how far before. But a while.

Come November, the clinic chain’s billing specialist told my clinic’s manager that my insurance hadn’t ever paid a cent for my care. First they said they needed something in writing that it wasn’t an accident (first I’d heard of it) and a treatment plan from my PT clinic, which they provided. At which point, said insurance informed my PT clinic that they weren’t paying for it because it was a long-term condition that couldn’t be treated in a certain number of sessions. Also because it wasn’t caused by an accident.

To be clear: I don’t mean that they weren’t willing to pay for any more treatment. I mean they’re also not willing to pay for any past treatment. Which means, despite the fact that I jumped through all the requisite hoops and had no indication from anyone that things weren’t handled smoothly, I may wind up on the hook for thousands of dollars in medical bills for an elbow that still requires periodic treatment going forward.

Also, while waiting for this whole mess to get sorted out I haven’t been in therapy (though I have been doing my exercises on my own, as I always do). So some old problems flared up again, enough that today I did a session at the no-insurance rate.

Obviously, I’m a bit irked because I feel like I’ve done everything I can and have been left with a rather raw deal. What’s truly maddening, though, is this: even if I had my medical bills paid, there’s still something very wrong about this system. I had to see at least two doctors I wouldn’t have had to see if not for insurance to get started. My “choice” in doctor was hemmed in by what doctors took my insurance, and I had my treatment halted abruptly for the better part of a month because of a billing snafu.

The thing is, though, this is just my experience of a system I’m coming to realize is fundamentally broken. Granted, my insurance isn’t great, and I would buy more comprehensive if I had it available to me (indeed, will under the ACA this summer if I don’t have a job with decent benefits). But even if I had the most comprehensive insurance around, it would still be insurance. It would still be a company whose business model was built on restricting my choice to only some doctors out of financial necessity, and that really, rationally, is best served by denying me treatment entirely. I would love a system where I get sick, go to a doctor, and my treatment is determined by her expertise rather than what my insurance company is willing to pay for. Also, where I can be sure I’ll actually not end up on the hook for major bills because the stars were out of alignments or the odds weren’t in my favor that day.

All of which leaves the obvious question why I bother with insurance, if it’s s awful. Setting aside the fact that it’s no longer legally an option to go uninsured, at least not without paying a fee, even before, it wasn’t really an economic possibility because doctor’s offices typically charge the insured less than they need to break even because they can’t afford to lose the business. Which typically means that the self-pay people end up subsidizing the insured people.  That bothers me.

As does the fear of what would happen if anything even marginally serious happened to me.

As does the thought I’m not just supposed to be seeing to myself, but making sure everyone around me has access to a doctor, and the closest my society comes to doing that seems to be through an insurance company that’s supposed to pay for your health-care to normalize the costs. It’s far from ideal, so very far, but checking out of this system doesn’t seem likely to actually help thing.

But really, at the end of the day? The fact that this is better than nothing at all doesn’t change the fact that this all feels very wrong somehow. I’m not sure what the better alternative is, but something still seems off about all this.

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NB: My health insurance isn’t actually through Blue Cross/Blue Shield. That was me trying to be clever and play on words. I have no reason to think that company is any worse than nayone else.

Originally published at Faith Seeking Understanding. You can comment here or there.

bilbo

on Keeping the Christ in Christmas

An old yardsign from KeepChristmasAlive.org, designed " to remind people of our traditional American Christian heritage."
An old yardsign from KeepChristmasAlive.org, designed ” to remind people of our traditional American Christian heritage.”

Last week there was a specific day when I came across quite a few people riled up about folks not keeping the “Christ” in “Christmas.” Mostly it was online, but I also ran across it in overheard conversations offline as well. Which, you know, got me a bit riled up as well. I started counting around mid-afternoon, and from that point on I heard three people complaining about stores wishing Happy Holidays rather than Merry Christmas, and two more complaining about the Xmas abbrviation; I think there were sevenn or eight conversations I overheard that day, all told. Something about that focus always seems distinctly un-Christlike to me, and also not particularly fitting given that Christmas is about love and peace and togetherness, so it feels like failing at Christmas spirit as well.

(Sidenote: This abbreviation actually has a long, fascinating history in Christianity. It’s not a modern invention to write out the name of Christ from the holiday.)

The line doesn’t have to be offensive. Directed at my fellow Christians, it can be a good reminder to focus on the things that matter about the holidays and not get carried away with the glitz. It can mean to make time to read something meaningful to mark Advent, or make it to church for the weekly wreath-lighting, or (even better, and this is not either/or kind of or but one that opens us up to a both/and): a time to remember that Christ the King spent his first nights shivering in a stable and that many of my fellow humans who bear the thumbprint of God just as much as I do still are shivering and hungry. It should be a call to recognize our shared humanity, to reach out to those who are suffering (and to keep reaching through January and beyond, but baby steps…). Also perhaps to remember that Christmas, the Incarnation, is the beginning of how God broke through the tribal walls of the ancient world. The baby born in Bethlehem was not meant to be simply the God of the Jews, but the God of anyone who’d follow Him.

Which is what makes the way this phrase is usually used so frustrating. The gripes I noticed last week of “Happy Holidays” vs. “Merry Christmas” and the “Xmas” abbreviation do seem to be the most common. Typically these seem to be cultural signifiers that the person saying them honors a specifically Christian holiday. It’s an affirmation that Christianity isn’t just the biggest of the various holidays people celebrate. It seems, at least in my experience, to be about getting people to say “yes, we are all like you; yes, your traditions and way of doing things are the most important, indeed, the only ones worth mentioning at least right now.”

I will gladly wish my Christian friends a Merry Christmas. I’ll gladly share it with people who are happy that I’m celebrating a holiday meaningful to me, even if the religious holiday isn’t actually important to them. And I’ll even share it with people who aren’t religious, who just enjoy all of the non-religious aspects of the season, the family and friends and food and quiet nights together and music and decorations and kitschy old movies and, yes, even the picking out of gifts for the people in your life. That’s Christmas, too, though for me as a religious Christian it’s never going to be all there is to Christmas. And on the flip side I’ll say a happy Chanukkah to my Jewish friends (which I just realized I haven’t actually said online; a happy Chanukkah to all who celebrate it!), much as I wished a good Diwali last month and an Eid al-Fitr back in September to people I know who celebrate those special days. When my friends celebrate something that’s meaningful to them, I like to share it with them.

To my mind, you can’t both insist everyone wish people a Merry Christmas and at the same time expect the word to hold onto a specifically religious connotation. It just doesn’t work that way because most people saying it won’t be particularly religious. Even if they claim the Christian religion, even in America where we have so many churches and so many people ticking off the Christian box on surveys, the vast majority of people won’t invest a lot of time and effort into their religion. It’s something that gets them into a church for an hour on Sunday morning, and that’s if you’re lucky; most likely, it’s how they think of themselves culturally but may not actually affect their life that much except at special holidays when they get together with their extended families. And for other people, it doesn’t impact their lives at all. Even if I could get all those people to say the words “Merry Christmas,” they probably wouldn’t mean the same things I do when I say them.

And that’s really okay. It doesn’t keep me from keeping the Christ in Christmas, although focusing on whether other people do rather than doing it myself probably does. It’s kind of like Thanksgiving prayers when I was a kid: I could either listen to the prayer and actually pray it, or I could crack my eye open because I suspected my cousins weren’t really praying and I wanted to check if they were making silly faces at each other. But I couldn’t do both.

I’ve been thinking about this issue a little, and yesterday I happened to be listening to my Fiddler on the Roof soundtrack (yes, this is a normal occurrence in Casa Marta), and the “L’Chaim!” song struck me as offering a good third way:

In this song, Tevye, Lazar Wolf, and pretty much everyone who happens to be in the local pub are drinking and dancing loudly to celebrate a wedding Lazar Wolf’s just arranged with Tevye’s daughter. This attracts the attention of some of their non-Jewish neighbors. If you know anything about turn-of-the-century (or previous century) Russian history, you may know Jews and non-Jews have a *cough* difficult relationship. At best – when a group of Cossacks darken the door of a Jewish celebration, it often doesn’t end well. This time, though, they start playing music and dancing along with their Jewish neighbors. They’re doing a thoroughly non-Jewish dance, but it’s a clear attempt to join in on the celebrations:

Zachava zdarovia
Heaven bless you both nazdrovia
To your health and may we live together in peace

The thing is, they’re joining this celebration as non-Jews. TO try to dance a more Jewish dance would probably seem inauthentic to all involved; Tevye is the only Jew to really take up their dance, and that’s when he’s specifically invited in. He seems to be the only one. But the fact that they are celebrating this as non-Jews doesn’t keep them from honoring what’s being celebrated. It doesn’t require them to say “this is how I would do it,” or to become Jews, either. But the message gets across: “I recognize this is important to you, and I want to celebrate it with you.”

In my experience, most non-Christians and nominal Christians respect that the religious side of the holiday is important to their more devout neighbors. They get that there’s more than Santa Claus and Macy’s at work here, even if it’s not at work for them. Even if Santa Claus and Macy’s isn’t even part of their yearly celebrations. That’s fine. It’s even good, and you get lovely blends of different styles that enrich the celebration for everyone when this happens. Imagine if the Russians had just tried to do the same dance as the Jews and hadn’t brought their own style to bear. it wouldn’t have been anywhere near as marvelous of a scene. It also strikes me as a much more thoroughly Christian approach to the holidays, to welcome our neighbors in and share warmth and love without requiring they do it just the way we do. Because if there’s one area where Jesus pushed our boundaries. “Which of these do you think was a neighbor?” indeed.

So to close: Ná merye i turuhalmeri! (That’s Quenya, and if you can understand it we have quite enough in common to be getting on with, whether we celebrate the same holiday in the same way or not. And even if you can’t, I still like you anyway.)

Originally published at Faith Seeking Understanding. You can comment here or there.

bookworm

many happy returns, Az!

As soon as LJ kindly reminded me that you've survived another trip around the sun, a phrase popped into my head right away:

You want weapons? We're in a library! Books! The best weapons in the world! This room's the greatest arsenal we could have - arm yourselves!

When I discovered you were a fan of Doctor Who, I wasn't the least bit surprised: you're really too intelligent and too much a bibliophile not to get a laugh out of certain parts of it. So in the tradition of offering gifts on the day, enjoy some Doctor Who-themed funnies.

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And, because no birthday is truly complete without cake, enjoy some gingerbread with apple cider mixed in for flavoring, with sinfully yummy cream cheese frosting.



Many happy returns!