A Letter to Santa: All I Want for Christmas is my Health Insurance Card!

Preface           

            In December of 2013, I drafted: A Letter to Santa:  All I Want for Christmas is my Health Insurance Card!  It documents my October – December 2013 Obamacare nightmare. The good news is that Santa came through! Not only did I get the one card requested, Anthem issued me THREE (3) different insurance cards!  After many, many phone calls, I was advised by Anthem to use one of the three cards and promised that the other two policies would be cancelled. After using the “correct” insurance card for my January physical, I continued to receive invoices from Anthem for the policies that were supposedly cancelled. Hours on hold yielded assistance from two friendly Anthem agents. EVERYTHING appeared to be fixed! I was down to one, fully-operational policy! And then, on April 26, 2014, I received an invoice from my doctor for $495. for my “free” annual physical! So, my Obamacare Odyssey continues.  Since Santa was so effective, I guess I should’ve worked with the Easter Bunny to confirm that the one “freebie” promised by my new policy would actually be free!

            Incidentally, the invoice details that the Preventive Physical costs $235.  Urinalysis for urine I don’t remember providing costs $15.  Electrocardiogram costs $90.  TDAP vaccine costs $95 and the actual administering of the vaccine costs $60.  So….even if I, eventually, get the physical “free”….I’ll still be paying $260 for the other services that, Pre-Obamacare, used to be “free” as well. (I think I want to change my letter to Santa…I want a time machine…I want to go back in time to when the affordable premiums I paid for my health insurance actually provided me with a co-pay for my prescriptions and physicals that were actually completely free!)

                        A Letter to Santa:  All I Want for Christmas is my Health Insurance Card

Dear Santa,

            I’m asking you to travel to another dimension on your holiday run this year, a dimension not only of sight and sound, but also of mind; a journey into a wondrous land whose boundaries are that of the imagination. Your destination? No, not the Twilight Zone. It’s the Obamacare Zone. 

            You see, Santa, all I want for Christmas this year is my health insurance card, proof that I truly have healthcare insurance. I’ve never had to trouble you before about such things because obtaining health insurance coverage used to be a rational, organized, efficient process. But after almost three months of struggle, you are my last hope! Since the Affordable Care Act forced Aetna to cancel my affordable policy, I have been making every effort to obtain less affordable healthcare insurance. I’ve been a good girl this year, Santa. Computer savvy, fairly fluent in the insurance-speak of deductibles, co-pays and the many tiers of generics and non-generics, I started shopping early, as early as the first day the exchanges opened. . 

            After looking at the options on the Connecticut Healthcare Exchange, I cringed at the premiums.  So, I decided to go directly to Anthem and pursue a catastrophic policy. If I wanted to maintain a monthly premium close to my pre-Obamacare one, I had to raise my deductible from $5000 to $15,000.  On October 2, 2013, I filled out Anthem’s six page application and sent it to them.  Weeks later, after several follow-up phone calls, I was told that the catastrophic plan I wished to purchase would be phased out due to the Affordable Care Act.  And, I had applied too early.  Even though underwriting was now outlawed, I needed to apply no earlier than sixty days from the date my coverage was to start.  I should resubmit my application, for a policy that would be eventually cancelled, on November 1^st.

            Not wishing to jump through hoops for a temporary plan, I returned to the Connecticut Healthcare Exchange.  In absolutely no time, I had applied for an Anthem Bronze Plan that was definitely not as good as my current plan, but would only cost me an extra $1500 per year in premiums.  Then, I waited.  What was the next step? When would my policy and my all-important insurance card arrive? After a week, I started to make calls. The Connecticut Exchange directed me to Anthem. Anthem Connecticut connected me to Anthem California, who, subsequently, jockeyed me back to Anthem Connecticut. Throughout my quest for policy validation, I was put on hold many times and subjected to music that was so loud and irritating that I would almost beg to be water boarded at GITMO if, it meant that, somehow, the music could be stopped. Finally, a friendly voice came on the line and informed me that she couldn’t talk to me.  Anthem wasn’t licensed to sell the Bronze plan listed on the Connecticut exchange. She cheerfully advised me to call back sometime in November; hopefully, they’d have licensure too sell and discuss that plan by then.

            Worried that waiting until six weeks prior to my current policy’s expiration might leave me holding an application for an insurance policy that Anthem was not licensed to sell, I returned to the Anthem website. It linked me to their shopping site called HIX Application Capture.  It sounded a bit like a code name for a super-secret military hostage-taking mission, but I proceeded anyway. Once again, I keyed in my personal information in order to obtain an Anthem Core Direct Access w/HSA-cadg plan for an estimated monthly premium of $419.19. But…there was no premium guarantee.   At that rate, I would be paying $1800 more per year to get coverage that I believed would be (no official plan documents were available yet) close to my current AETNA plan. They might charge me more. They might provide me with less. Prior to Obamacare, I would never buy an insurance plan without an absolute guarantee of the premium price nor would I buy a plan with a vague guarantee of what was covered. But, I was desperate.  The clock was ticking.  I even pre-paid the estimated premium with my precious credit card number.  Fear of no health insurance coverage now surpassed my fear of identity theft.  HIX Application Capture was a hostage-taking mission, after all! And the hostage was me.

            Two days later, a packet arrived from the Connecticut Health Insurance Exchange.  It informed me that the Connecticut Exchange had advertised inaccurate coverage for the Anthem Bronze plan listed on their site. I should read the corrected pages of said policy and decide if I still wanted it. I didn’t. Anthem wasn’t licensed to sell that plan in Connecticut, yet.  I checked “NO” in the box, dropped the envelope in the mail and waited for my insurance card to arrive for my more expensive plan, a plan that Anthem was licensed to sell in Connecticut. The wait time promised was two to three weeks. And when the three weeks expired, and no word, no e*mail, and no insurance card arrived, I called Anthem, and used the HIX customer feedback instant messaging system, and called, and waited.  Half of the time, I was stuck in a continuous loop of non-existence.  I was out-of-category. I had already submitted an application so I didn’t fit the Shopping for Insurance category.  I couldn’t use the Applicant Category because I needed an application number to access it. I was given a Control Number but it wasn’t an Application Number. Tricky stuff.  Round and round I went, lots of hold music, lots of cheerful voices, lots of promises, lots of waiting.

             Finally, Santa, on December 4, 2013, with 27 days left on my AETNA coverage and only 20 days left until to your sleigh’s Christmas Eve run, I reached an Anthem agent, a very friendly agent.  She told me, promised me, assured me that I existed on her screen.  I was right there in front of her.  I didn’t have to worry.  She told me, promised me, assured me that within two weeks, (I had been given that two-week promise a month ago), I would receive my official documents including my hallowed insurance card.

            Desperate and exhausted, I begged, (we hostages often do that)

            “Can you screen print the page that proves my existence in your system and e*mail or fax it to me? You see, Aetna has offered to extend my coverage if I’m willing to pay $560 per month rather than the $278 I used to pay them.  Since I already paid Anthem $419.19, I really can’t afford to pay them for coverage as well IF I actually do have coverage. But, I need proof from you.

            “No, I can’t printscreen.”

            “Can you e*mail or fax me a letter that approves my coverage?”

            “No, but I can send you a letter. I don’t have your ID number yet. But, I can send you a letter with all the numbers I do have.”

            “How long will that take?”

            “About two weeks.”

            “You mean the two-week time frame it is going to take for my official plan documents to arrive?”

            “Yes.”

            “Is there anything you can e*mail, fax or text me so that I have written proof that I am approved in your system, and that I will be covered?”

            “No. But, you can write down the numbers I do have.”

            The high-tech modes of instant communication do not exist in the Obamacare Zone. No faxes, e*mails, or text messages could be sent, even the federal government’s own technological solution, their website, won’t operate! Prior to Obamacare, insurance companies were even willing to use overnight mail services. But, alas, such services exist no longer… at least not in the Obamacare Zone.  I would be given the time to find paper and my trusty No. 2, yellow Ticonderoga pencil.  I found them. I wrote down an AMI#, an App C# and a Ref#. Two of the numbers were the same except one of them had five zeroes in front of it. I could relate to zeroes, the process had made me feel like one. Numbers are supposed to make you feel better. I don’t.  And now, I wait, again.

            There’s a lot of waiting and wondering in this new Affordable Care Act dimension, Santa, a dimension not only of broken websites and sounds of torturous hold music, but also of mind; a journey into a wondrous land whose boundaries are that of the imagination not documentation. You must rely upon your imagination, fantasize that, yes, proof of healthcare coverage will come, maybe, in time for Christmas.  Maybe, it’ll arrive on your sleigh, Santa! You can probably pick the policy up on the Island of Misfit Toys! Delivery should be easy. Just look for the sign post up ahead.  But, beware! You will be entering the Obamacare Zone, where everything is free for the poor, affordable for the rich, and paid for by the middle class, a group that will soon exist only in the land of imagination along with the Easter Bunny, Elves, and you, Santa. But until then…I’ll still need that health insurance card.  Santa, you’re my last hope!

Sincerely,

Mary M. Glaser

Simsbury, C

Money Can’t buy Love for J.P. Morgan, but Do You Wanna Know a Secret about Washington?

                In Money Can't Buy Love at J.P. Morgan Chase, John Carney states “the point of many new rules is to prod big banks to shrink.” I think it amazing that our government believes that well-managed, profitable businesses like J.P. Morgan should be smaller while the U.S. Government, with all its budgetary, bureaucratic bumbling, should become bigger. Milton Friedman once said, “If you put the government in charge of the Sahara, in five years there’d be a shortage of sand!” The shortages and waste in the Federal Government make the London Whale of J.P. Morgan look more like a minnow.

                Two days after April Fools’ Day this year, the State Department’s Inspector General warned that “significant financial risk and lack of internal control at the department has led to billions of unaccounted dollars over the last six years.” Auditors couldn’t find 33 of 115 contract files…totaling about $2.1 billion and of the 82 remaining files, auditors said 48 contained insufficient documents required by federal law.  Additionally, the Bureau of International Narcotics and Law Enforcement issued a $1 billion contract in Afghanistan that was classified as “incomplete.”

                 And our Government does more than just lose taxpayer money (see chart below), it squanders funds on projects like 3-D pizza printers and a $300 million Army surveillance blimp that doesn’t work.  In Senator Tom Coburn’s annual Wastebook, one hundred examples of egregious government waste costing taxpayers $30 billion in one year are documented.  As for vilifying and fining J.P. Morgan for lack of oversight and unethical behavior?  Recently, the Inspector General stated that the lack of oversight at the State Department, “exposes the department to significant financial risk…creates conditions conducive to fraud, as corrupt individuals may attempt to conceal evidence of illicit  behavior by omitting key documents from the contract files.  It impairs the ability of the Department to take effective and timely action to protect its interests, and, in sum, those of taxpayers

                Yes, government regulators are determined to shrink big banks by pedaling the powerful platitude of “systemic risk.” Did J.P. Morgan fail the U.S. Government when begged to rescue our country from economic catastrophe? No, two failed institutions were purchased because J.P. Morgan was big enough and strong enough and well-run enough to stop the dominoes of disaster from falling, dominoes set in motion not by well-run banks but by our government. Our government initiated the recent financial disaster. Because politicians were selling the “Chicken in Every Pot” propaganda that everyone should own a home, even if too poor to pay for it, regulators winked at loose mortgage underwriting standards. And when people started to default on their mortgages, that started the cradle of the crisis rocking in the precarious tree top of easy money…and down that cradle came…baby and all.

                But, our government won’t shoulder that blame; it is easier to point fingers at big, bad businessmen who know how to budget, build, employ, and invest in the future of our country.  Meanwhile, the U.S. government has a total of $788 billion in unaccounted funds and government waste that could be utilized to repair infrastructure, improve education, and ignite the economy. John Carney’s article is right. Money Can’t Buy Love at J.P. Morgan Chase, but our government had better beware. Next time it needs a powerful bank ally to financially Fix a Hole Where the Rain’s Getting In, it may need to build an ark.  Because if our country wins its war on banks and whittles them down to size, the only places big, powerful banks will exist will be in countries that don’t like us very much. And we’ll find out just how lucky we are seeking help from banks Back in the U.S.S.R.!

Mary M. Glaser

Simsbury, CT

Agency	Project	Amount	Time Spent
Department of Agriculture	Smuttynose brewery - 3 brew tanks	750,970	1 Year
Department of Agriculture	Improper payments to farm producers	16,000,000	1 Year
Department of Agriculture	Improper loans	208,000,000	1 Year
Department of Agriculture	Alabama Watermelon Queen Tour	25,000	1 Year
Department of Defense	Soccer Field in Guantanamo	750,000	1 Year
Department of Education	Student Aid Scams	1,400,000,000	1 Year
Department of Energy	Initiative for Proliferation Prevention (A Cold War Program)	15,000,000	1 Year
Department Of Justice	Conferences	58,000,000	1 Year
Department of Labor	Dropouts from Underperforming Job Programs	118,000,000	1 Year
Department of Labor	Overpayments	148,000,000	1 Year
Department of Labor	Consumer Fraud	14,000,000,000	1 Year
Department of Transportation	Contract Mismanagement	157,000,000	1 Year
Economic Dev. Agency	Fake Cyber Threat Purge	3,000,000	1 Year
FAA	Oklahoma Empty Airport	450,000	1 Year
Federal Grant	Book Vending Machine	35,000	1 Year
Federal Institute of Museum and Library Services	Star Wars Event	365	1 Year
General Accounting Office	Overlapping Programs	95,000,000,000	1 Year
General Accounting Office	Bank Fees for Empty Accounts	890,000	1 Year

- See more at: http://www.thefiscaltimes.com/Articles/2013/07/24/The-Government-Is-Wasting-More-Money-than-You-Think#sthash.IX6YiEiT.dpuf

- See more at: http://www.thefiscaltimes.com/Articles/2014/04/04/6-Billion-Goes-Missing-State-Department#sthash.AeFuZhRi.dpuf

- See more at: http://www.thefiscaltimes.com/Articles/2013/12/17/10-Most-Absurd-Stories-Government-Waste-Year#sthash.0AIpzwiM.dpuf

Misguided New Guidance for Student Promotions

In today's Wall Street Journal,  New Guidance for Student Promotions reveals that NYC schools are adopting a more subjective model of assessment, “teachers will compile promotion portfolios for students at risk…in a departure from the past decade’s heavy reliance on test scores to determine which students advance to the next grade.” Over the course of two decades, I have taught in New York, New Jersey, and Connecticut. As for this new(?) promotion portfolio approach?  All I can say is," Been there, done that, got the T-shirt!" As a matter-of-fact, back in the early 1990’s, designing a T-shirt logo to demonstrate reading comprehension was one of the alternative assessment options available to those students who just didn’t test well.    

Subjectively graded, promotion portfolios can be misleading. At the start of one school year, most of my ninth grade students were barely able to write a decent paragraph, no less an essay.  When I was caught, during an observation, teaching very basic writing skills, I was told to move on because my students had mastered the five-paragraph essay as evidenced by their portfolios. Upon further review, the “artifacts” and rubrics in their portfolios confirmed essay-writing mastery. An amazing essay was even enclosed as proof in each of the portfolios.  Of course, after discussing the situation with a fifth grade teacher, I discovered that it was the final essay, a product of eight weeks of instruction, four corrected drafts, three conferences with a teacher (who provided paragraphing and punctuation advice), a couple of peer feedback sessions and; then, in some cases, the final essay, to be forever filed in child’s promotion portfolio, was typed by the student’s mom, who tweaked it to perfection…just a little. 

Even though I offered writing and reading help to my students after school, most didn’t think they really needed it. After all, very little writing was required of them. The new curriculum encouraged the use of technology to demonstrate comprehension, express creativity or to analyze research.  Power Points, blogs, webpages, and movies were assigned rather than the writing of an onerous essay, short story or the dreaded thesis paper.  As for reading, students were allowed to self-select their books so frequently that few had the reading stamina to handle selections of any depth such as The Scarlet Letter, The Grapes of Wrath, or the plays of Shakespeare. Instead, they read summaries for assigned books in Sparks Notes and Pink Monkey or located a movie version.  And when allowed to self-select, a few of my graduating seniors revealed that they had only read one book in high school, but read it over and over again! One student said that he had only read two books in his life! He re-read The Lemonade Wars five times in elementary school and Fahrenheit 451 whenever a self-selected novel was assigned in high school.

While I disagreed with many of the models of instruction and modes of assessment implemented, I had no choice but to comply…most of the time. For example, in one high school, it was decreed that Stand and Deliver instruction was too authoritarian! There must be a cooperative learning community! Over the summer, desks were removed and replaced by folding tables and chairs. I remember my dilemma when I was told that twelve of my twenty-nine students had to be seated in the front row because of attention deficit issues.  I didn’t’ have desks.  Therefore, there was no front row!   Some of my students were over six feet tall, and one of them weighed almost 240 pounds! Fitting students around a table and positioning the tables so that everyone could see the Smartboard was a nightmare! And talk about a distracting dynamic! Even the students without ADHD had trouble concentrating sitting hip to hip with a classmate!   

Finally, I offer you the anguish of a mother. Her son advanced from grade to grade via his promotion portfolio.  At the age of eighteen, it was discovered that he couldn’t read and write well enough to pass the proficiency test required to graduate.  He was then assigned an extra class every day.  It had only twenty students.  The students were seated at desks, organized into neat rows, and all  eyes were faced toward the front of the room.  At the front of the room was a teacher, who was standing and delivering the instruction these students so desperately needed and had needed for a very long time. The mother of that boy remained in my classroom after a parent/teacher conference and quietly asked me, “Why did it take so long for my boy to get this kind of teaching? How can a kid go through years of school and wind up with nothing? Thank God for those tests! If he hadn’t failed them, no one would know to help him! How does such a thing happen? There should’ve been more tests…and sooner!” 

I agreed with her,then; and I agree with her, now. We need more rigorous, objective, standardized tests; and the tests need to be administered every year starting in the third grade. Then, the results of those tests have to be evaluated immediately and used to re-design instruction accordingly. Tests are measurement tools.  When a scale warns us that we have a weight problem, we don’t throw out the scale and buy one without numbers so that we can be happier when we weigh ourselves. Rather than fix assessments so that more students can pass them, focus on fixing the problems the tests are revealing! Maybe it’s time to retire the student-centered model and challenge our children to challenge themselves via an achievement-oriented model.   Because one day, these students will become adults who must face a test that can’t be fixed: Can they do more than survive, can they thrive in a complex, highly-technological, global economy? Their ability to excel on that test should be the criteria used to form new guidance for student promotions!

Banking on the future of America?

 In John Carney’s WSJ article today, When Less is Far More For Big Banks, it is suggested that “Higher levels of capital allow banks to better withstand shocks…leverage constraints may damp returns on equity, (but)…they reduce risk to shareholders and creditors.” Carney points out that regulations forcing banks to hold more money is good for the banks. But, is that how we should be defining a bank, as a money holder? As a former English teacher, I wonder about definitions. So, I looked up the word bank.

The term bank has passive, inactive, noun definitions.  A bank can be defined as a place where capital is kept. A bank can also be defined as the accumulated funds of a gambling establishment. I think government regulators are fixating on the noun-ness of banks. A noun orientation makes it essential to erase, via regulation, the risk of banks becoming gambling establishments. High capital requirements will, supposedly, do that and turn banks into big, unbreakable piggy banks full of money that must never be gambled!

The term bank also has vibrant, active verb definitions. To bank, can be to transact business: to deposit funds so that others who need funds can borrow them. Borrowed funds can be invested and then paid back to depositors with interest, and jobs, and innovation, and ideas that propel humanity forward. Idiomatically, the expression to bank on can mean to have confidence, to rely upon, for example, “To bank on the future of America!”

Government regulators have to decide which definition of bank they are trying to achieve, the passive, but currently, politically-correct definition? Or, the dynamic one?  And their choice is a very important one because it will determine if we will ever be able to bank on the future of America again.

Mary M. Glaser

Words of the wise before I dare to surmise...

Keep me away from the wisdom which does not cry, the philosophy which does not laugh and the greatness which does not bow before children.

Khalil Gibran