In Portland. The drive was uneventful. Drove through a couple rain clouds that were stunning.
This morning I went to a doctor for an assessment of my work-related physical symptoms. Had a couple tests done and then got a flu shot. I felt like crap before the flu shot, and now I feel like I have the flu on top of that! I wish I could just sleep...
Non sequitur, I highly recommend reading
Lord of the Rings to you if you haven't yet. It's good. I love the detail with which he created that world. I have to say that I still love the movie tremendously and it's adding to my experience of reading the book. I'm able to imagine scenes from the movie as the book progresses, which has turned out to be helpful due to the fact that I'm half conscious when I'm reading the book before bed. I may have to reread it again once this degree is out of my life.
On the way down here, I listened to a couple podcasts about deaths due to prescription drug abuse (they said that the annual mortality rates from prescription drug abuse are the same as annual breast cancer rates?). Seems like it's a big issue. My guess is that it's psychologically less of a concern to the public than breast cancer because:
- We can't control breast cancer (or at least in 2013 we think we can't control it or prevent it), so it's a scary outcome. However, people can choose to put pills in their mouths, so the general concept of prescription drug abuse is leagues more preventable than breast cancer. I suspect this is why it's less of an "outrage" to the public, because it's not some doomed fate disease.
- I also think it's more of a blame-the-victim cognition that's leading to less public concern about prescription drug abuse. Because drugs have been associated with "weakness" or "poor person's disease" or something along those lines, I think most of the public just doesn't think that they will end up becoming a prescription drug abuser anytime soon. On the other hand, half the world (maybe more) can get breast cancer. Breast cancer is likely a more high "risk" scenario for most of the public, which motivates their concern.
- As far as outrage goes, it would seem much more outrageous to me that we have the same death rates for prescription drug abuse and breast cancer, yet one is preventable. That seems pretty ridiculous to me.
- In other words, I believe there is more psychological distance between any one person and prescription drug abuse as opposed to breast cancer. And I believe that even though we probably have all used prescription drugs at some point, the controllability of the situation (controlling how many drugs to put in your mouth versus controlling how much cancer to give yourself) might mediate our anxiety about cancer. Maybe this is what leads us to be more concerned about one than the other. I'm partially delirious and feeling like I have a fever, so please don't hold me to these initial hypotheses. :)
Just my initial thoughts, anyway!
Warning: Long rant against misuse of data in politics below!
Also listened to an update on the healthcare exchanges available in October. I'm curious to look more into the economics of this. For instance, most poor people sounded really whiny when they called in
to complain about the possibility of getting $125/month healthcare (because they are paying $0/month now, so the increase seems large to them).
$125/month is AMAZING! However, they probably aren't seeing the
value of what they are getting because of their dire financial circumstances (even though I
thought that they would be subsidized, so I'm not quite sure how valid their complaints are? I keep hearing that if you make under $45,000 you would get some help, so I'm not sure what all the details are here).
Motivationally and psychologically, I like the concept of forcing people to get healthcare or charging them a penalty to avoid the negative impact that uninsured people have on the economy. I'd like to get more into this later, but I'm sure most people can agree that any time you really stop to think about insurance you'll feel frustrated due to some decision making aspect. It's easy to convince yourself that you can use the money each month on something more "useful" or more "likely" to occur. For example, it's very "frustrating" to think about pouring $1,000/month into a landlord's pocket, rather than investing money into your own home. What are my options in that situation? I could become homeless and save close to $1,000/month and store that money in the bank until I can buy my own house, or I can rent the place.
Another line of thinking: "I've never even been pulled over by a cop and never been in an accident. Why do I have to pay $70/month or $50/month in car insurance?!?" This would be my line of questioning due to my history, which I definitely don't put stock in and don't really ask myself anymore. I know that I don't have enough savings to cover the loss of an entire car in one fell swoop, so paying a little to "rent" my insurance each month is fine with me. Also, I have now dropped my comprehensive and collision so there is even less incentive to feel ripped off due to my "never having been pulled over or in an accident" record.
I can tell you that my experience with the current insurance system of today was horribly frustrating and wrong. One of the worst parts about quitting your job (in the past) was that you had to apply for private health coverage (like Aetna) or take COBRA coverage from your employer. Health insurance killed me last year financially because I couldn't get private healthcare (they said I had a preexisting condition) so I HAD to take the COBRA option, which just so happens to be equal to whatever your employer was paying for your healthcare plus some more. Geez, I
wish I'd had the option to get $125/month healthcare last year. As of the current state of things today, you can't apply for cheap state coverage unless your COBRA runs out.
When I quit my previous job I was unemployed (I quit so I had no unemployment benefits) and there was no option of reasonable healthcare for me...no private insurance, no state option because COBRA was offered, so I was stuck with COBRA. I had to pay $475/month in health insurance premiums + copays + $500 deductible! I spent nearly $600/month on healthcare! If I quit my current job, this is still one of my major concerns because I would be forced to take the COBRA coverage of $675/month + copays + premiums...~$800/month!! That's crazy. My healthcare would be as much as my rent. I don't know if this will change with the new law, but I hope it will. So this topic is very important to me and I hope that there is a way to avoid COBRA coverage as an unemployed person. Otherwise, I may be stuck in this job just because I can't afford the healthcare premium of COBRA, which is really stupid.
It may be possible for me to get private healthcare under the Affordable Care Act if they can no longer reject me for a preexisting condition. I hope this is the case. It's an enormous list of preexisting conditions. The problem with the polls being reported in today's media is that most people aren't aware of the value that the ACA provides. One of the New York Times surveys sampled from 1,000 people (out of 316 million Americans) -- a pretty darn small sample size, and I seriously doubt that it was representative in that it included people who had experienced first-hand the benefits of the ACA. Personally, prior to 2012 I had no clue that I myself would be rejected from private insurance due to a preexisting condition that doesn't even interfere with my daily functioning (I'm not disabled, I don't have cancer, and people wouldn't even notice my condition). I thought that sort of rejection was reserved for "really sick people". FYI in case you've never had to deal with this, here is a list of conditions that could have gotten you rejected from private healthcare before the ACA!!! It's crazy!! I mean, they could have at least charged me a higher rate and accepted me...I would have totally been okay with that. But to reject people flat out with these things? It's a
big list...
This list included the following conditions: alcohol and drug abuse, chemical dependency, acquired immune deficiency syndrome (AIDS), Alzheimer’s disease, angina pectoris, anorexia nervosa, aortic aneurysm, aplastic anemia, arteriosclerosis, artificial heart valve or heart valve replacement, ascites, brain tumor, cancer (excluding skin), cancer (metastatic), cardiomyopathy/primary cardiomyopathy, cerebral palsy/palsy, chronic obstructive pulmonary disease (COPD), chronic pancreatitis, cirrhosis of the liver, congestive heart failure, coronary artery disease, coronary insufficiency, coronary occlusion, Crohn’s disease, cystic fibrosis, dermatomyositis, diabetes, emphysema/pulmonary emphysema, Friedreichs’s disease/ataxia, hemophilia, active and chronic hepatitis, HIV positive, Hodgkin’s disease, hydrocephalus, intermittent claudication, kidney failure, kidney disease, and kidney disease with dialysis, lead poisoning with cerebral involvement, leukemia, Lou Gehrig’s Disease/amyotophic lateral sclerosis (ALS), lupus erythematosus, disseminate, and lupus, malignant tumors, major organ transplant, motor or sensory aphasia, multiple or disseminated sclerosis, muscular atrophy or dystrophy, myasthenia gravis, myocardial infarction, myotonia, paraplegia or quadriplegia, Parkinson’s disease, peripheral arteriosclerosis, polyarteritis, polycystic kidney, postero-lateral sclerosis, psychotic disorders, silicosis, splenic anemia, True Banti’s syndrome, Banti’s disease, rheumatoid arthritis, sickle cell anemia and disease, Stills disease, stroke, syringomyelia (spina bifida or myelomeningocele), tabes dorsailis, thalassemia (Cooley’s or Mediterranean anemia), ulcerative colitis and Wilson’s disease.
Individuals were also identified who reported that they had “ever been diagnosed” with the following conditions: coronary heart disease, myocardial infarction, other heart disease, angina pectoris, stroke, emphysema, cancer, and diabetes.
Individuals with five common conditions — arthritis, asthma, high cholesterol, hypertension, and obesity (BMI > 35) — were included in the second measure, as were individuals who had “ever been” diagnosed with arthritis, asthma, high cholesterol, or hypertension. These conditions were found to result in a denial, an exclusion of coverage for that condition, or a higher premium for individuals in all but one of the seven underwriting guidelines we examined.
In addition, individuals who were currently being treated for neurotic and related disorders, stress and adjustment disorders; conduct disorders; emotional disturbances; and including attention deficit hyperactivity disorder (ADHD) were included in the second measure, as were individuals who had ever been diagnosed with ADHD. These types of mental health conditions were identified in the underwriting guidelines as conditions that would result in denial, waiting periods, condition exclusions or higher premiums. Information from ASPE-conducted interviews with insurance commissioners indicated that individuals in treatment for mental health conditions were generally denied coverage in the individual market. Given the conflicting evidence, a conservative approach was used and these conditions were included in the second and not the first measure. Had these conditions been included in the first measure, the estimate of likely to be uninsurable individuals would have increased from 19 percent to 29 percent. (ASPE DHHS, 2011)
Honestly, to my awareness I don't even know what condition on that list I have, so I don't know why I was denied. Their claim was that my rejection was due to "multiple risk factors." To my memory of the list from 2012 when I applied, the list was much longer and included more common problems when I was rejected. However, Aetna has stopped publishing their list of pre-existing conditions due to the ACA making rejection based on them illegal, so I can't find the original list from them. I seem to remember non-cancerous cysts and things like depression also being. I think the vast majority of people I've ever met have had one of those conditions above at some point, and if they had ever had to apply for private health coverage they would have been rejected. No wonder insurance companies rejected people with all these things...that's basically every disease!! Lol. I'm sure it's very profitable to insure people who don't have any of those things -- you reap the premiums from healthy people who don't get sick! Let's just choose to not insure the people who are sick and we'll get rich.
What if the car insurance companies said the same thing? Do you think people would be outraged then? What if you tried to apply for car insurance and you were rejected due to a "pre-existing condition" because you rear-ended another car when you were 20 years old. Do you think people would think that was fair to flat out reject someone based on that? No it's not fair to flat out reject someone...just charge them more and be on your way!
Seriously, they were allowed to reject people for being treated for a stress disorder or ADHD or asthma? Wow. I very seriously hope the polls regarding the ACA today are sampling from people who are aware of these issues, because I fear that most of the polls coming out about the ACA are not surveying people who are knowledgeable about this. If they had surveyed me 2 years ago about my "agreement with the ACA law", my opinion would be very different than if they surveyed me today after actually seeing the value that the ACA has for me and others and how greedy the insurance companies are. I seriously doubt that most people are aware of the fact that they themselves would in fact be denied private health coverage if the ACA didn't go into effect. I certainly wasn't aware, but it was an expensive lesson for me that cost me thousands of dollars in the 6 months I was unemployed last year.
The issue here is that it's invalid to survey people about something they know nothing about. Would it be valid for me to be included in a random survey about specifically what I think about the football regulations of today and what I would change about them? No, because I have no experience with football or watching it! It may be valid to survey me and ask, "Are you a football fan?" and use that as a summary statistic, but don't ask me what I think should be changed about football, because I know nothing about it. Similarly, don't ask uninformed Americans what they think about the ACA when they have no clue how it would affect them (because most people will continue to get benefits through their employers and will never have to face the situation of getting individual healthcare), and then use that poll as "information" to support your politics. It's wrong to be making public policy by asking people's opinions who have no clue about what value the ACA provides. At least FORCE them to read about the ACA before giving an opinion...I hope the poll agencies have though about this... I heard a study found that young, uninsured people tended to initially "not support" the ACA when questioned, but when they were given a quick overview of what the benefits of the ACA actually are, they changed their minds and supported it. I can't quote the source of this, but I'm pretty sure I heard it (so it must have been on the radio recently). This is my point, that the polls being used in the political arena to gauge "support" from the American people are likely wrong and unreliable. It's possible that the polling agencies providing this data that the politicians keep quoting is reliable and good, but how do we know? How reliable is a question if someone says "no support" at first but then switches to "support" after hearing basic facts? We want their true opinion on the law, not an uninformed opinion. Give me information about football and then I will make my opinions -- I won't make my opinions based on my complete lack of knowledge of the sport.
Well, that's all I have today. I'm way behind schedule due to the additional testing at the doctor this morning, so I'm going to try to get some progress on my draft before I pass out. Hopefully the flu feeling goes away after I get some sleep!
P.S. - I should note that I am a firm believer in providing SOME support to people in need, but am also a firm supporter that we should try to wean them off the support ASAP. For example, give people unemployment benefits but phase them out or make stricter requirements. Since understanding more about the specifics of the unemployment benefits equations, I have become more conservative on the issue. At a previous job I had coworkers who worked in the unemployment division. There was one person who had a Master's in finance and had a lot of experience, but he had been laid off. He was able to claim unemployment for a long time because he "wasn't able to find a job" -- in reality, he wasn't able to find a job that replaced the job he held before getting laid off, which was a very high-level position. In other words, if you are a CEO and get laid off and can't find any CEO job openings to apply to, you can claim that you can't find a job. In reality, I think the standards need to be lowered so that people are forced to take a reasonable alternative. There are some rules governing this, but it is outrageous to think that people won't take a job that's a step down just so that they can pay their bills and get off unemployment. I'm particularly against this mentality after what I've gone through in the past few years -- I took jobs that weren't my ideal job so that I could get experience during the recession. They only paid about half of what I was "worth". I believe more people would get jobs if they expanded their horizons and took similar and related jobs. Sometimes you just have to do that to get by. It's something I learned as I entered the workforce in 2009, which was one of the absolute worst years to enter the workforce in at least the last 100 years. I think my generation and those younger than me will be affected by that reality for a long time to come.