Tuesday, November 26, 2013

Healthcare.gov and the Small Church

So I spent some time on Healthcare.gov today, the questions being 1) How hard is this, really? and 2) Is there a comparable plan to my employer's healthcare plan (the UUA's Highmark Blue Cross/Blue Shield) that would cost less money?

Last night I created my user name and password, and then was booted out of the system because it was under maintenance.  Fair enough.

I went back in today.  I had to answer some security questions that prove that I'm me.  It turns out the government has more handy access to facts about myself than I do.  I had to chase down the information of what year my car is. 

Then I had to provide information on the members of my family, including how much money we make, before taxes.  That's complicated.  How do I classify my housing allowance?  I decided to just put it in as income before taxes, even though it won't be taxed.  What about my husband's income?  Well, he's an adjunct professor.  We never know how many classes he'll be given in a given semester.  I decided to just make a wild guess, and give an annual amount, because there's no way to figure out a monthly amount -- all the months are different, depending on where they fall in the semester and how many classes there are.  Then I had to look up how much I pay in student loan interest.  That was fairly easy, but required rebooting my computer, since Excel decided to crash, which is where I needed to go first to get access to that information.

After that break, I came back in the evening and put in some more information.  It was confusing to answer when I might be eligible for insurance in 2014 through my employer when they hadn't asked me yet if I had insurance currently from my employer, but I just said January 1st for 2014.

Finally, the demographic information was complete.  I am not, I was told, eligible for Medicaid.  Then it seemed to pause as if that was the end.  The screen wasn't completely comprehensible as to where I would go next.  But I figured that out, and found out that I had to tell them that we're non-smokers and a couple of other things, and then I could see plans.

So I think I can say that this wasn't too painless.  It was millions of times easier than when I applied for insurance 10 years ago coming here.  I was pregnant at the time (I did have to tell the government that I'm not pregnant right now, but I think that wouldn't have changed my eligibility, I hope, unless to make me more eligible).  I had to get a copy of my marriage certificate from Chicago, because my husband's last name is different.  Chicago momentarily lost it, making me think maybe we weren't really married -- a great thing to tell a pregnant woman going through a move, job change, pregnancy, and stresses about health insurance, by the way.  If it hadn't been the case that my previous insurance had been through my church, I would have not been eligible for any plan we could find in Michigan.  The plan I was on in Massachusetts was a plan that was local to that area, so there was no sense in keeping it.  Finally, we found the one single Blue Care Network plan in Michigan that was forced to take me.  Never mind that they had fired me back in 1993 following a health problem, I was glad to have them.  It took me MONTHS to get this worked out, even with a health insurance agent's help.  She still sends me Christmas cards -- they're always the first to arrive.  I will forever be grateful to her.  And that's a better story than two years prior to that in the enlightened state of Texas where because I was overweight (and hadn't been on an employer's plan) I was only able to get catastrophic coverage. 

MILES easier on Healthcare.gov.   OH SO MUCH easier.  MONTHS easier.  HOLY COW easier.  It took less than 24 hours of total elapsed time, and less than 4 hours of actively working on it time. 

So, what were the options?  My healthcare insurance is, I think, going to cost my church and me $1301 per month next year on the UUA's plan.  It's considered a "gold" plan according to the UUA.  What does healthcare.gov have to offer?  Well, they have no catastrophic plans or platinum plans to offer, and a lot of the others.  But I want a gold plan, as that's what I've become accustomed to, and because of the number of doctor visits, tests, and more that my husband has had in the last couple of years with some big-ticket health problems.  And I'm no spring chicken.  So there are 10 gold plans.  They range from $919.25 per month ($500 deductible, $10K out-of-pocket max, $30 co-pay/$50 specialist) to $1469.88 (0 deductible, $8K out-of-pocket max, $40 primary/$60 specialist).

The UUA plan for 2014 will have an $1600 deductible and family out-of-pocket maximum of $4800.  Our co-pays are $20 primary/$30 specialist. 

Turns out the closest plan to this, "Priority Health MyPriority MyHealth Access Gold 1000," with $2000 deductible and out-of-pocket maximum of $5000 with 20/20 co-pays is $1311 per month.  Other plans go up and down on the various numbers, but the closest ones are all in the same ballpark. So the UUA plan beats it slightly on all parameters, including price, except for the specialist co-pay.

So the good news is that the UUA's plan is very competitive with comparable plans.  And the bad news is that "Obamacare" didn't bring us cheaper, better healthcare.  It actually brought us healthcare for the average small business employee that is going up 9.3% this year along with deductible increases.  So that's sad for me, who had held out hope that while it would get all those uninsured people a better situation it might actually take a load off the small church, as well.  It seems that is not to be the case.

Science Fiction & Thanksgiving

**SPOILER WARNING**

This is what is on my mind this morning, as I come back from a weekend where I went out to the movies twice, once to see Catching Fire and once to see the Doctor Who 50th anniversary special.  There's a common thread that runs through both the recent Doctor Who seasons and the Hunger Games trilogy, and that is the effects of war on the survivors and the ethical struggles before and after making a decision to kill innocents in order to end a war.

It's not really in Catching Fire that this question occurs; it's actually in the next book, Mockingjay.  In it, there are two parts that I'm thinking of -- first, there's the decision by District 13 to bomb children and aid workers to advance the rage against the Capitol.  Here's the description of when Katniss learns about the weapons that will eventually be used in that way:
This is what they’ve been doing. Taking the fundamental ideas behind Gale’s traps and adapting them into weapons against humans. Bombs mostly. It’s less about the mechanics of the traps than the psychology behind them. Booby-trapping an area that provides something essential to survival. A water or food supply. Frightening prey so that a large number flee into a greater destruction. Endangering off-spring in order to draw in the actual desired target, the parent. Luring the victim into what appears to be a safe haven— where death awaits it. At some point, Gale and Beetee left the wilderness behind and focused on more human impulses. Like compassion. A bomb explodes. Time is allowed for people to rush to the aid of the wounded. Then a second, more powerful bomb kills them as well. (Kindle Locations 2381-2387)
Gale and Beetee are contemplating something unthinkable to Katniss:  large-scale killing of innocent people in order to get at a few desired targets.  And then, there's the question posed to Katniss and the other surviving victors by Coin near the end.  President Coin says:
"In fact, many are calling for a complete annihilation of those who held Capitol citizenship. However, in the interest of maintaining a sustainable population, we cannot afford this....  What has been proposed is that in lieu of eliminating the entire Capitol population, we have a final, symbolic Hunger Games, using the children directly related to those who held the most power.” (Locations 4675-4682)
Coin presents these options as if they are the only choices -- mass killing of all Capitol citizens, or a Hunger Games, killing innocent children to satisfy those whose rage calls for complete annihilation.

Katniss is not the person really making these decisions, despite the illusion that the victors get to decide between two false choices, but she is haunted by the decisions she has had to make, and haunted by the knowledge that people she knew and cared for have been involved in these decisions.  It is President Coin who made the decision to kill innocents to stop the war sooner, and to give into the two evil choices of mass annihilation or hunger games to satisfy political unrest after the war has ended.  We don't see in Coin any regret, any awareness of the level of evil.  We only get that through Katniss, who has willingly been her Mockingjay.

In Doctor Who, the Doctor has been haunted for the last several seasons by the decision he made to destroy his home planet of Gallifrey in order to end the Time War.  We haven't known a lot of details about this until recently, and whether or not he thought he made the right decision, only that the decision left him in a world of regret and sorrow.  In the 50th anniversary special, we get to hear him say for the first time that he has counted the number of children he killed, and that his decision was wrong.  Fortunately for a Time Lord, he is able to undo, or, rather, not do that decision.  He makes another choice, and Gallifrey falls no more.  It doesn't erase his centuries of sorrow at what he thought he had done, but it changes the final outcome.

In the real world, we don't get to stop time and go back and put Hiroshima and Nagasaki in a pocket universe to protect them.  The Pequot Massacre isn't averted by our sending an arrow through Captain John Mason at the last moment.  Science fiction often lets us off the hook about feeling the full weight of the horror -- our heroes, eventually, make the right choice.  But what science fiction also is letting us do is know that there is a number to be counted for the degree of comfort and safety we hold.  Were we as good as the Doctor, we would hold that number in our heart and know it, and know the decision was wrong.  Of course, were we as good as the Doctor, we wouldn't actually have pushed that button after all. 

I want our world to be more like the Doctor and less like Coin.  But I fear that the opposite is true and our world is much more like the District 13 or even the Capitol, which in the end seem much alike.

It's a sad message I'm taking into Thanksgiving this year.  But after a Sunday of sharing the pulpit with a local Native American friend, talking about the truth and myth of Thanksgiving, this is where I'm at.  Ultimately, I conclude where I did on Sunday, that what I, at least, am feeling now is the need for the holiday time this year not to be so much about giving thanks as truth-telling.  Thanksgiving is becoming, for me, less of a Passover story of exodus, and more of a Yom Kippur, a day of atonement. 

Thursday, November 21, 2013

Generations and the loss of JFK

The fiftieth anniversary of the assassination of John F. Kennedy is tomorrow. And with this anniversary I'm reminded of what a major moment this was in the history of our country and in the lives of most Americans who were alive and old enough to understand it fifty years ago.  It's one of those moments where people remember where they were and what they were doing when it happened or when they heard.  People remember it as a "Turning Point" where there was a "Loss of Innocence." 

I don't remember it.  I was born after the fall of Camelot.  I was born into a world where the Loss of Innocence had already happened, the Turning Point was past, and we were in the age of cynicism.  I have some sympathy for Steve Friess who wrote an article in Time titled "Five Reasons People Under 50 Are Already Tired of JFK Nostalgia" and Nick Gillespie who wrote in The Daily Beast, "JFK Still Dead, Boomers Still Self-Absorbed."  Those of us younger than the Baby Boomers have been steeped in Boomer nostalgia for as long as we can remember.  And right now we're hitting the 50th anniversary of all those Major Moments.  (And for those of us in Generation X, the only thing worse than Boomer nostalgia is people talking about how Boomers need to make space for a new generation -- the Millennials.  It's particularly annoying to see Boomers cede ground to their own wonderful children, leaving out the forgotten generation between.) 

I'm not as cynical as all that--most of the time.  I do think the Turning Point marks a Loss of Innocence and was a Major Moment, but I do think that it was primarily that for the Boomers.  Our country had had crooked politicians before.  Our country had had war before.  People had seen death and suffering before.  The Loss of Innocence that happened at this shot heard round the world was the Loss of Innocence of the Boomer generation.  This moment is terribly important -- for them.  And that, in and of itself, is worth spending time reflecting upon.  Their grief, their fear, their shattering loss, all of that was very real and very important, then and now. 

I saw how important this death was for my Boomer friends during the first presidential campaign of Barack Obama.  There were so many comparisons being made between Barack Obama and JFK -- youngest presidents, change agents, Caroline Kennedy saying Obama will be "A President Like My Father."  There was such fear that I heard from Boomers of assassination.  It was almost as if someone like Obama, who was being closely associated with Kennedy in many minds, was already marked for assassination.  The fear I heard from some Boomers was very real and very present in their minds.

So, yes, Kennedy's death continues to matter.  And to not understand the impact it had on this large American generation, in particular, is to ignore a large pastoral issue in our country -- a very real grief that continues to need to be honored and understood.

As someone born after the death of JFK (and RFK and MLK, for that matter), the only thing I can relate it to is the fear and shock we (and maybe this is stronger for those of us who are younger) after September 11th, 2001.  September 11th, 2001 is a date that I mark before-and-after.  Before 9/11 we lived in a country that had not had a major attack on our soil in fifty years.  After 9/11 we lived in a culture of fear where many things would be done differently -- the way we travel being the most obvious example.  Before 9/11 we lived in a country where fear of hijacking was minimal, and we would assume hijackers wanted to take the place to a location of their choice.  After 9/11 we understood that the goal was death.  Our heroes became those who managed to crash their plane themselves in the fields, rather than into the terrorists' target.  I know I've had arguments with at least one Boomer over whether or not 9/11 should be memorialized in our culture.  For them, it's not as pivotal a moment.  Their Turning Point had already  happened; 9/11 was awful, but not seminal.  For my generation, however, 9/11 was a Turning Point.  For me, happening at the beginning of my ministry, I feel like it changed my profession, my understanding of the mission and purpose of ministry.  It was a big Turning Point.  But I hadn't lived through JFK.  The biggest cultural moment for me prior to 9/11 was the Challenger explosion. 

These are called "Flashbulb Memories" -- the memories of events that are so strong that we can remember everything about that particular moment.  And unlike all the other 1960s nostalgia we'll be hearing about, JFK's assassination was a Flashbulb Memory moment, as were the deaths of Martin Luther King, Jr., and John Lennon, and the Challenger explosion and September 11th, 2001.

So, Gen X and Millennial friends, we need to get over our cynicism and stop rolling our eyeballs.  This nostalgia and sharing of 50th anniversaries is going to go on for a while.  Probably it'll go until 2019, as we mark the anniversaries of the peace movement, the civil rights movement, etc.  We've got the anniversaries of the assassinations of Malcolm X, Robert F. Kennedy, and Martin Luther King, Jr. yet to come. But what we need to do is cut through the surface level, the media level, that we'll be hearing about, and talk to people about what this moment really meant to them, how it changed them, why they continue to focus on it, what it's deeper meaning is.  We need to get past the nostalgia and into the real work of the grief and fear, and the way it continues to shape our country.