HSA

It’s a new year and one of my resolutions is to give this woefully neglected blog a little more attention.  So what have I decided to write about on this auspicious kick off you ask?  Well I’ve decided to write about:

The shiny new health insurance policy we have been blessed with this year.  My employer, and in their defense this is a national trend,  has switched us to a HSA/High deductible plan.  It saves a little on your premium, it saves a lot on the company’s premium, and you can save up for when you get sick since the HSA or “health savings account” can roll over into next year if you don’t use it.  This sounds good right?  We’re pretty healthy, well here comes the sticker shock.  Since you will be paying 100% of the first $3000 you might be surprised to find out that the doctor visit is between $60 and $90.  Multiply that  times how ever many are in your family and it adds up fast.  Now just suppose you need a prescription every month, thyroid around $160 per month, suppose you have a child with ADD, $330 per month, suppose you have more than one.  You’ll burn through that $3000 pretty fast this year…and next year and the year after.

The move to shift health care costs off of employers is national, and I can’t say it’s bad, but the shift to the employee is awful.  I can afford this, or at least it won’t break me, but what about all the people just getting by?  Obamacare was supposed to fix this but it seems like it just made it OK for employers to shift the costs faster.  Wages are stagnant, costs are going up, this system is going to crash and crash hard.  The sad part is it doesn’t have to be this way.

The Fun Size

Well, it’s the day after Halloween and we are left with the “cushion” of several bags of candy that we got just in case the handful of trick or treaters that make it down our 200 yard driveway somehow morphed into a shuffling mob of candy zombies. Well they didn’t so I’m here in my office mustering the courage to set all that chocolate free…unfortunately some of the “Fun Size” bars aren’t going to make it, I am weak!

In the course of my culling of the candy herd, I have notice that the Fun Size bars are…thinner. I think they are the same length and height, the wrapper is even the same size, but the thinner bar has a lot more freedom in the wrapper than it used to. I can only assume that:

  1. They have managed to pack more fun in a smaller package.
  2. They have reduced the fun by about 20%.
  3. There have been cases of too much fun in years past and thank god now we have some regulation.

I suspect it’s number 1 because I seem to be here in my chair just jittering to go release some of this stored fun.  Apparently they contain plenty.  An informal poll of parents of small children indicate that there has been no reduction of wall bouncing fun.  Well I gotta go.

LISTEN TO US!

Right now, the rich and powerful are trying to marginalize the group called “Occupy Wall Street.”  They are saying that this mix of blue collar and professional, working and unemployed, fearful and the foreclosed, this group of regular people, don’t have a coherent message, that no one knows what they want.  Well it’s true that they don’t have a public relations rep, or a lobby group but they do have a unifying message.  Their message, and it runs through the whole spectrum of people involved is…are you ready:

WE ARE SICK AND TIRED IF BEING POWERLESS!

Yup, that’s it.  As individuals, they feel they have no voice against injustice.  They are:

POWERLESS to stop being abused by BANKS,

To demand an interest rate that approaches inflation instead of 100 times less than inflation (0.01% last time I looked).

To stop them from using fees as a gotcha profit center.

To demand accountability for their actions and for the use of our bailout money for…what?

POWERLESS to demand that our Government represent us instead of Corporations and whoever can buy their time and attention.

Why can’t we have a choice during an election, we are forced to pick who will do the least damage, the leper with the most fingers and then we are told that we are responsible for his actions.

POWERLESS to control the actions of Corporations.

The corporate person has all the rights that we have but is not held accountable for his actions, his only goal is to maximize profits, and he has a lot more resources to achieve his goals.

POWERLESS to stop the Wall Street and Corporate boards from dismantling and corrupting key institutions for short term gain.

POWERLESS to stop the Health Care Industry and the Insurance Industry from preying upon us at our most vulnerable and blocking every effort to reform them with fear, mistrust, and misinformation.

POWERLESS against a media that is more interested in selling the show, or representing a viewpoint (or an owner), than delivering news and information that could be used for informed decision making.

Here’s a real shocker for you, the Occupy Wall Street crowd and the Tea Party crowd are after the same thing, empowerment.  Unfortunately the Tea Party seems to think the problem is Government and want to remove of it as much as possible.  I believe that the Government is the only one with a stick big enough to represent us against the true enemy of individual and corporate greed and power, unfortunately they appear to be uninterested in representing us.

“The Question” and Yo Mama

If our society is to continue with any resemblance to what we think of as traditional American Society, we, as a people, need to start using “The Question.”  The Question is what you should ask yourself when given a choice or opportunity. It’s a simple thing really, you turn to yourself and ask, “Is this the right thing to do?”

I’ve had long talks with one of my more conservative coworkers about this and he tends to get hung up defining answer, but I contend that the important part is that you ask, with heartfelt sincerity, The Question. The answer, born of whatever rationalizations you can convince yourself of, is for you to work out. For instance, we’d like to give you $30M a year to be our CEO…is this right for the company, for myself, for my family, for the country? Can I justify my taking money that could go to hard working employees or for growing the company?

How about this, if I lay off a division of my company my bottom line will be high enough this year to get a big, multimillion dollar bonus. Is this good for the long term life of the company, or will short term gain benefit me at the cost of many. If you can convince yourself it’s right than do it, the answer to The Question is not nearly as important to society as that you asked, wrestled a little and then decided on an answer you believe to be honest. There are too many situations to make rules, but we have to find a way to institute a societal effort to do the right thing, an expectation that everyone is doing what they think is best. Think about this, if we disagree with someone, say a company president, a politician, or and insurance adjuster, but you believe they are doing their best to answer The Question, we are far more likely to cooperated to find a way to work together.

How is this different from what we have now? After all, we have laws and rules. True, but is it legal, or will I get in trouble, are not questions upon which a good society is built. Game theory has shown time and again that cooperation is mutually beneficial to all, individual benefit at the cost of others is a short term, unsustainable approach…unless you have so much power that others are forced to play on your terms. There have always been those who take at all costs, it’s just that now many of these individuals are out of reach of society as a whole. Worse, the example is bleeding down into society in general and the altruistic are seen as chumps.

Hence, part 2 of our problem, the Mama. If you are in a position of power, wealth or authority, and you are using it to acquire more power, wealth, or authority without asking “The Question,” your Mama should be calling you up and telling you, “Son (or daughter), you are shaming me by taking advantage of all those people.” Instead, it’s more like, “we are so proud of our son (or daughter), they are doing so well, look at what they bought me.”

I’ve tried to teach my kids that doing the right thing has a cost. It might be that you don’t take that last dollar for something you’re selling, but instead ask for a fair return. It might be that you give something back that you don’t have to, like the wrong change at the supermarket; the cashier might have to make your “windfall” up out of her pitiful pay. It might be that you don’t take all of that raise you are offered because the gas prices are hitting the lower wage workers harder than you. It might be that you are injured or even killed trying to help someone.

Sure we’ll get hammered by some opportunistic scum from time to time, but eventually they will be found socially unacceptable, instead of being held up as examples of captains of industry. We can’t wait for others to change, we can only change ourselves…and put pressure on those around us.

We, as a people, need to hold those who are willing ask “The Question” and to pay that price in esteem, instead of that they are somehow naive chumps, so our mama can call us up and say good job, I’m proud of you.

Saturday

Last Saturday around noon I was about to fire up the lawn mower and mow my lawn for what I hoped was the last time.  Unbeknownst to me, fate had other ideas.  It had pretty much decided I was going to spend my day under a car in the middle of nowhere.

My youngest son is a struggling musician.  He had decided to travel over the mountain to the “Treasure Mountain Festival” in Franklin, West Virginia.  He was going to meet a friend of his and they were going to seek their fortune by casting their musical pearls before the crowds.

The phone rang, I picked it up, “Dad, the brakes went out on the van, don’t worry the van is ok.”

“But are you OK?” I asked in my most fatherly tone, calm, considered.

“Yes, it’s in the church parking lot across from Snowy Mountain Road.”

Turns out he was about as far from anything as he could be on this trip.  Luckily, there was a parking lot across from the stop sign he blew when his brakes stopped working.  It doesn’t behoove a parent to think too much about close calls.  Either you would end up constantly stressed up like a violin string, with the accompanying squawks of a novice fiddler, or you just keep your kids at home, safe and underfoot.

My initial inclination was to tell him to wait there, I would come and WE would fix it.  Before I could say anything, he said that he had called someone and they were coming to get him.  He and that someone have been having a rough patch lately so I figured what the heck, I can fix it.

Now this is a ’91 Astrovan.  I swear that in the night, the nuts and bolts in these things swap between metric and English.  When I work on these things I can never remember which bit is metric and which bit is not so out to the garage and load ALL my tools in the car, wrenches, sockets, a jackstand, big hammer, little hammer, pry bar, flashlight (in hopes on not needing it), and a piece of cardboard, because you never can tell where the boy has parked (and hence what you have to lay in).

An hour later I arrive.  I quickly find where the line has ruptured, which as it turns out is not too bad a place.  I don’t think it will be too bad to fix.  I even get it apart with less difficulty than I have any right to expect.  Fate is toying with me.

The part off, I drive 20 minutes to Franklin, site of the ongoing Treasure Mountain Festival; food, music, Civil War reenactment, and a great parade.  A lot of towns in West Virginia are built in a wide spot along a river.  A lot of them have one road in, one road out, and no good way around.  From the direction I was coming, Franklin was like that.  I pulled up to the parade route just as it started.  The Treasure Mountain parade is something to behold, bands, dance school exhibitions, civil war characters, politicians, and tractors.  There was probably 20 minutes of John Deere tractors alone, and I got to see them all, because all the stores in Franklin were closed for the festival anyway.

The parade clear, I head up the road another 40 minutes to the next town, Petersburg.  Sure enough, I see a good sized part store.  They should have just what I need.  I pull up to a dark store and see that they had closed 20 minutes ago, that would have been about when I saw the Indians in the parade.  Well, the Indians were cool, the all shot their guns and I wouldn’t have wanted to miss them.  Besides, this gave me an opportunity to practice my organic language skills.

The next town is Moorefield, another 30 minutes or so.  There was indeed an open parts store with everything I needed, tubing, tubing flair tool, tubing bender, tubing cutter. I left the store considerably less weighed down by negotiable worldly assets.

The road back was beautiful.  It runs a good bit along the river, and with the leaves turning, and the sunset was worth the cost of having to work in the dark, and dark it was.  With the help of my blazer’s headlights and a variable brightness flashlight (you could adjust the brightness by banging it), everything went pretty well.  For those of you who don’t do auto or house repairs this translates as, I didn’t break anything else while I fixed this.

With everything back together, I put the tire back on and lowered the car.  I put away my tools and took it for a test drive.  The brakes still need bleeding but they work well enough.  I have to leave the van for him to pick up since he’s spending the night with a friend so I threw in the keys and head home, it’s about 10pm.  About half way home I remember that I went from letting the van down to putting the jack in the back.  I had skipped an important step; I hadn’t tightened up the lug nuts.  So, back I go hoping that he hadn’t come to get it, not because the wheel would fall off.  I knew where he was spending the night and it wasn’t far, but because I didn’t want to have to tighten the lug nuts in his friends yard.  As luck would have it, it was still there and I got away with it.

I finally got home around 11:30, my wife was a little worried since I told her it would only take a couple of hours.  I was gratefully wrong.  What kind of story would that have been?

Health Care, What’s Broke? (Besides me I mean)

We are in the midst of what some call a health care crisis in this county.  The insurance companies say the medical costs are rising too fast.  The employers say the insurance costs are rising too fast.  We just see the cost of our health care rising, in many cases, out of reach.  We seem to pay more and more for less and less.

Is there anything in the system that we can fix?  Hmmm, well let’s take a stroll through the system and see if we can see what’s broke.

We take our child to the doctor, the doctor looks at him and prescribes some treatment.  If we are lucky, it works and our child gets better.  Seems like that part of the system works ok, even though sometimes with a serious illness a doctor is only about one step removed from shaking a rattle.  Still there is an honest effort to make the patient better.  A service is provided

Now in most every doctors office there is a person behind a desk whose whole function is to figure out how to get paid by the patient’s health insurance company.  They submit the bill and sometimes the insurance company pays it.  Or sometimes the insurance company pays some of it, or rejects it.  Then it’s this person’s job to bill you for the balance of the bill, SURPRISE!

In your mailbox you get a bill from the doctor that tells you how much the insurance company paid and how much you need to pay, only wait, this was a covered expense and you already paid the copay so what’s up with this.  So you pick up the phone and call the insurance company, maybe for an hour or more, at work!  Finally you think you have resolution, only to find out someone has dropped the ball and you get another bill, this one overdue.  So on the phone again, at work!

This has gotten so bad that there are companies whose whole function is to deal with your insurance company for you.  Yup, you or maybe if you’re lucky, your company (who is probably tired of all that time on the phone) pays someone to make the insurance company do what you pay them to do.  Kind of like hiring someone to watch the kid you hired to mow your lawn, hey kid you missed a spot.

So let’s see, we have a doctor who provides a service and you who, in a roundabout way, pay for it.  You pay for it with your premium, and with the portion you employer pays, which is really just another form of your wages.  So don’t let anyone say you don’t pay your own health care.  The only advantage you get by having it through your employer is he gets a better deal per person than you can ever get by insuring the whole company.

History Lesson, insurance was invented to spread risk.  If 100 ships go out to sea and in a year 10 are lost, all 100 owners will put a small amount into a fund and whoever happens to own the 10 lost ships splits the fund.  Next year you do it all over again.  If a trusted company holds these funds and invests them or loans them they can make a profit with the money, until they have to pay the owners of the lost ships.  It used to be that way for health insurance until some smart guy realized that if we only insure healthy people, or only insure cheap stuff, we get to keep all the money not just the return on the investment.

Today we have an insurance company who wants to maximize profits.  They collect all your premiums in the form of money deducted from your wages and the wages you never see in the form of EMPLOYER CONTRIBUTION.  Then their goal is to keep as much of this money as possible.

Wait, wait, the doctor performed the service, you got the service, why should the insurance company get to keep all that money, what did they do?  On top of that they are difficult enough to deal with that the doctor has to hire a specialist.  They are difficult enough to deal with that you have to hire a specialist, and for what?  In the end, doctors get paid by all of us.  Sometimes I pay for your child’s ear infection, sometimes you pay for my wife’s heart attack, but WE pay for EVERYTHING!  Insurance companies just skim off all they can and then pass through what they have to.  Insurance companies could evaporate tomorrow and if it was done right, we wouldn’t even know they were gone.

So why does it seem like we so intent on keeping this bloated parasite of an industry intact?  Well, of course there is the obvious answer that they have bought considerable interest in our government but that isn’t the only answer.  Take a look at your retirement fund, I bet it’s pretty heavily invested in health care industry.  HMO’s and insurance companies own a good portion of your retirement, and of grandma’s as well.  If we dismantle the insurance industry we hurt a lot of people in fixed income.

They are kind of like the parasitic worm that causes river blindness, if we leave it alone it destroys our eyes, but if you kill it, it can drive you mad.  So we leave it in place, root hairs wrapped tightly around some of the most economically vulnerable, and in the mean time the industry subverts our government with millions of dollars and pays the high level insiders even more millions in annual salary.

You know what?  I think I’d rather be mad than blind.