Our Medical Insurance Nightmare

Let me be clear… This is not a political post. I have no idea how much of this is due to “Obamacare,” although I know at least some of it is in part.

When I was still working for Warner Bros. we had great, I mean GREAT health insurance. When we decided I would come home to be better able to be available for Joseph’s issues and my mom’s issues, we took the health insurance in mind… But it was fine because we had Poe’s. And then he was laid off three months later.

Poe was out of work for two years. For as long as we could, we paid for Cobra. But thousands of dollars later (while on unemployment), we went through all of our savings. After we exhausted Cobra benefits, Poe needed serious, emergency dental surgery. There went all my retirement savings from 18 years of age. Two decades of savings.

But my kids both have medical issues. Forget about Joseph’s doctors and therapists – his meds alone are over $2k per month. Logan needs EKG’s and Echo’s annually, and eventually will need open-heart surgery. And so… I found a program called Heathy Families. In California, it was an alternative to Medi-Cal. I felt better about using it, because I paid premiums, according to our income, rather than being totally “on the dole.”

Eventually I started my own business, but it’s not a corporation, it’s just me as an independent contractor. Poe eventually found a job in security instead of his chosen field of CADD design. As a contractor, I don’t get employer insurance. Poe is offered insurance… The premiums for which are about 80% of his take home pay. So – we cannot afford it. Even after the updates due to Obamacare – now it’s about 85% of his take home pay. We still can’t afford it.

Eventually, Medi-Cal absorbed Healthy Families, and we were officially “on the dole” due to our income level and my children’s need for insurance. Don’t like it, but I have to take care of my kids’ medical needs. Poe and I haven’t been insured in years.

So here’s a bit about my private parts – so if it’s too graphic for you, I’ve put it below the fold:

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Help Me Understand Obamacare

I need your help in understanding what Obamacare would mean for my family. Please note: I am NOT looking for political opinions. They abound, and I have my own. I’m actually looking for what this literally, practically, logistically means for my family.

Here’s our current situation. My husband’s income (not including my own which fluctuates dramatically) is about $475/week. My husband’s employer provides insurance. At about $350/week (yes WEEK not MONTH). Without telling you our actual expenses, but you can be assured that they are the same things that others pay… Rent, car insurance, utilities, food, gas, student loans, etc. We are frugal. Our truck is paid for (and 20 years old). We no longer use our credit cards, but we’re still paying one off. I coupon, use online deals, etc. Most of my clothes have holes in them, because I pay for clothes for my kids (with coupons) since they really are weeds in human disguise. In other words… We’re careful, methodical, and thoughtful with our money.

Income Approximate (as mine varies) per month: $3,500
Remaining: $200 – currently put towards “extras” or extra debt, and when the debt is gone it’ll go into savings.

If we bought my husband’s employer’s insurance:
Income Approximate (as mine varies) per month: $3,500
Insurance: -$1,400
Remaining: -$1,200

The math doesn’t work – needless to say, we can’t purchase my husband’s health insurance.

My kids, however, have serious medical and mental health issues. Aside from the annual/semi-annual dentist and pediatrician visit, one of my kids has an annual echocardiogram (about $1,500 a year), an electrocardiogram (about $500 a year), one of my kids has a monthly psychiatrist appointment (about $1,800 a year), and his meds ($900/month). So our medical costs NOT including regular well-child visits, OR sick kid visits, is $1,217/mo, $14,600/year. With the well child visits, vaccinations, and when they get sick, it’s obviously more. As a result, we use state subsidized medical insurance for the kids only. I do pay a premium for them, but it’s prorated based on our income. My husband and I haven’t seen a doctor, dentist, or ophthalmologist (I wear glasses), in about 4 years. We would go to the emergency room if we have to for something like a broken bone, or stitches, etc – but thank God we haven’t had to yet. It would probably bankrupt us. For everything else? We suffer. I’ve tried free clinics in our area, but it’s a first come/first served kind of thing to get an appointment, and I’ve yet to actually be able to talk to a real person to try and get an appointment. I kind of need to see a gynecologist desperately.

So. My understanding of Obamacare is… You are required to have health insurance. If you don’t, you pay taxes as a penalty. If you don’t have health insurance, you can use the government health insurance (which doesn’t exist yet). So my question is… Since it doesn’t exist, when do we start getting penalized? How much will the government health insurance cost? What will this (and when) look like for my family?

Again – I’m not looking for political opinions here. I’m looking for what this means, as it stands now, for my family. When I’ve looked into it, I’ve gotten totally confused. Does someone have a website that breaks it down into “real life” for you?

Something You Should Read

First, I want to say that my son’s issues focus more inward than outward (toward himself rather than others). I don’t fear for others when they interact with my son – but I fear for him. My son suffers from mental illness. He’s 12. We are doing everything… everything in our power to help him. Everything we can think of. We’ve done a good job so far. We have. We are responsible. We watch his triggers. We have him in a special school trained to watch for his triggers before it turns into a crisis for him. Because in full blown crisis, he believes that his life is not worth anything at all. Sometimes he uses the tools he’s been given. Sometimes he forgets to – because he’s 12. Now that puberty has been thrown into the mix, the hormones mixing in with his brain chemistry, it feels sometimes like we’re starting all over again. He suffers. I hate watching him suffer. I worry. Always.

But he’s good. He’s kind. He’s funny and joyful. He’s an incredibly gifted artist, and has NO rhythm whatsoever. He loves to read. He’s discovered Harry Potter (the books) now that we’ve gotten past some of his reading learning disabilities. He’s discovered some other authors, and asks me to put on holds for him at the library. He gladly takes his medication, and he trusts and tries with his therapists and psychiatrist. He cooperates with his own care. He really, really tries. His little brother annoys him, and he worships his father. He has a truly close relationship with our cats (I swear animals are here to be healers sometimes). He asks for affection now. He wants hugs and kisses. And his room is perpetually filthy and smells like 12 year old boy. He likes toast for breakfast, loves ramen noodles, and asked for a Nintendo 3DS for Christmas. And for some odd reason his pants have started hanging off his butt, and I’ve started telling him to pull his pants up.

As I watched things unfold yesterday, I thought to myself, “I am Adam Lanza’s mother. And I’m all those other mothers, who’s children he stole. How, oh HOW do I keep from being Adam Lanza’s mother?” And I kept thinking about gun control. Why is the conversation about gun control? IT’S NOT ABOUT GUN CONTROL. STOP TALKING ABOUT GUN CONTROL. It’s about mental illness. For me, it’s about making sure this child, my child, my 12 year old little boy can grow up to be a functioning adult who doesn’t think “I should never have been born.” He made that statement last week. Thank God he spoke the words, though. He spoke the words and we as his parents, and his therapists, were able to help him through it so he didn’t make the statement a reality. Even a year ago, he wouldn’t have spoke the words. You see the guns don’t matter. If it’s not a gun, it’ll be a knife, or a machete, or a shovel, or pills, or a car, or or or… It’s not about the method. It’s about my son’s beautiful, beautiful brilliant tortured brain.

I don’t know what Adam Lanza’s life was like, or what his motivations were, or what his issues were. But one can logically say he must have been mentally ill to do what he did, right? But by God, I’m trying with my child to make sure that I never have to wonder. The fight is so fucking hard from every aspect.

Another mother wrote a heart-wrenching post. One that felt a little too close for comfort. But truth always is. Please read it. I’m no activist. I’m just a mom trying to her best for her son, and hoping against hope her best is good enough for him to survive. But perhaps the next time someone says “gun control” in reaction to a tragedy and senseless loss of life such as yesterday’s (God, such beautiful lives cut short… families annihilated) you’ll remember this post and think, “OK, but what about helping people cope with mental illness? Could that be a more constructive question?”

I love my son who has social phobia, ADHD (inattentive type), myriad learning disabilities, and clinical depression.
I love my mother who is bipolar (and now has Alzheimer’s).
I tried to love my biological mother who had borderline personality disorder.
I tried to love my brother, who was bipolar and hung himself at the age of 52.
I loved my aunt, who was clinically depressed, and killed herself with a shotgun at the age of 55.
And I try to love myself, I have PMD, and deal with these “episodes of thought” every blessed month, as well as depression.
There are more, but feel I can’t state their stories here. Some got help, some didn’t. None speak of it.

I got help. I got my son help. I couldn’t and can’t help my other family members. But, unlike the rest of my family, I refuse to be silent, the secret, the skeleton in the closet. I want my son to LIVE. And so here, I air my dirty laundry. Maybe it’ll help someone out there speak up, for themselves, or for their child. Maybe it’ll prevent terrible tragedies. Maybe it won’t do anything at all. But I refuse for it to be something to be ashamed of.

Voting Day

Today is voting day in the United States of America. While votes happen annually or more for local/state etc… This is the big kahuna – the 4 year Presidential election.

I live in California. There are a few initiatives on the ballot that I think are “heavy hitters.” I was a little bothered that I didn’t even know they were up for anything until I read my voter information. I was surprised at the lack of publicity over the potential changes to the three-strike law, or the freakin’ death penalty. I mean, c’mon. Regardless of your actual stance on the subject, “do we execute these criminals or not” or “dude, do we kill ‘em” might be important. Just sayin’.

Anyhoo… If you have the right to vote? Use it. If you don’t, you have no right to complain, and you’ve just shown your ignorance. I’m sorry if that sounds harsh, but it’s true. If you’re given some sort of say and don’t use it? You negate your ability to complain about the results. I don’t necessarily like everything about how the system works (for example, I believe we should get rid of the electoral college), but that doesn’t mean I’m not going to vote. I consider it a privilege, exercising my right, and a duty as an American. If I want my governmental body a certain way, than I have to use the legal device I’m given. If the rest of populace doesn’t vote my way, at least the hope is that the governmental body will reflect the wishes of the majority of the people of the country even if they’re all wrong.

The folks who don’t vote because it’s inconvenient? “I can’t get off work,” or “I work nights,” etc? No excuse. That’s why we can vote by mail. Poe works nights. He will be asleep, or at the very least not coherent, during the times the polls are open. So, instead, he votes by mail. I work from home (which doesn’t mean my time is my own – the clients expect me at the computer doing the work I’m being paid for). I have two kids. My elderly folks are next door. And? We have odd emergencies other folks don’t seem to have. Such as yesterday when my father came over in a panic ’cause he lost mom. Yes, really. Because I truly never know what to expect around here? I vote by mail.

The folks who don’t vote for reasons like, “it’s one of two evils,” or “I’m Libertarian and my guy will never win” simply don’t fly for me. Awwwwww, boo-hoo-hoo. Figure it out. You’re whining. Be an adult. Which leads me to another opinion.

I think a great majority of folks would agree with the above. But I also think you should REALLY VOTE HOW YOU FEEL. If you truly believe in the Libertarian party, then vote for Gary Johnson. If you truly feel Ron Paul is the choice for you, because he lines up most with your beliefs, then write him in. If you settle for voting for one of the “big guys” because you feel that’s the only way your vote will count, you’re not exercising your rights, you’re settling. I think that if more people would vote how they truly feel, that’s when REAL change would start. I personally am voting for one of the “big guys,” but that’s because I think one of them is the right answer for this election. I’m not settling. If I felt Ron Paul was the dude, that’s who I’d vote for, and let the chips fall where they may, because that’s how I think it should work. True, my guy might not win THIS election. But what if everyone started voting on their true beliefs and gut? What would happen? Would it upset the apple cart? Probably. But would the will of the people have spoken? Yes.

I figure this late in the game you already know what’s on the ballot and where your polling place is so I don’t have to smack you on the back of the head. But here’s a couple of places they’ll be tracking results if you need it:

Have your say. Exercise your rights. Be an adult. Be an American. Vote.

An Example of Good Parenting

I may piss people off with this one, but so be it. There’s a video that has gone viral. It has folks up in arms both for and against. I’m FOR. So here’s the video. And then I break down my thoughts below. *Warning: There is cussing, so no little kids – but hey… Have your teenagers watch it – we’re actually going to have our kids watch it, swearing and all. And the swearing actually comes from the teenager’s post, not the parent.

My thoughts, which I posted as a comment on the video in a highly condensed fashion:

I think posting this video on her wall is a stroke of genius. The folks whining about how embarrassing that is and shame on him? Um. Number one, she opened that door. Number two, he’s posting on her forum – meaning this is the way she communicates with the world. He’s doing it on her turf, in other words. That’s a greater impact, her friends may think twice about disrespecting their own parents, and it’s a step up in consequence from the last time they tried to “ground” her for doing something similar. Does she have the right to bemoan her life, in all her teenage angsty glory? Absolutely. In her own head, in her private journal, or in a rant to her best friend. So – when she took this to her Facebook friends (Everyone repeat after me: The Internet Is Forever.) she crossed the line, and he’s bringing it right back on her head.

Some of the commenters don’t seem to get that she did something similar and had her privileges taken away (computer, phone, etc). They already went down that road, and she apparently didn’t learn anything from it. In addition, the child just didn’t use her brain – she has an IT guy for a dad.

Respect for your parents is extremely important, and really sets the basis for your interactions within the family dynamic. If I birth, clothe, shelter, and feed you, give you love, don’t abuse you, and discipline you so you’re ready for your entrance into adulthood, I demand respect. Period. It’s my job to train you. It’s your job to learn. Pissing me off is basically pissing in your own pond. In addition to making me mad, it just makes your life, and those around you, more difficult. And respect for other humans in general? Dude. I’m so glad he called her on her attitude towards Linda (a lady that cleans their home in a services/barter type situation).

Paying for chores doesn’t happen around here. I do believe we’re going to start giving allowances… Probably based on a point system. The kids need to learn how to manage money BEFORE they leave the nest, and they cannot do that without actually having money to manage. But it’s not going to be based on chores they’re supposed to do. This is a family. This is our home. First, they need to learn a level of responsibility for their own things. Second, this is a FAMILY. It’s a family home. It needs to be run, we all need to live here, and Mom (aka Me) is NOT the slave, she’s the General. Everyone should have some responsibility in having the home run. Not only do kids need to actually learn the stuff of cleaning and cooking and running a home for when they’re out on their own, they need practice doing it. I left home without knowing how to manage money, without knowing how to clean, without knowing how to do laundry, and without knowing how to cook. Seriously. I had to learn everything on my own – and it was hard, because when I made mistakes, I didn’t know how to correct them. I don’t want that for my kids. I did have chores at home. Keeping my room picked up, and emptying the dishwasher and such. But mom didn’t actually TEACH any of the actual skills I would need later. Further – everyone lives here. A family is a unit, and everyone should have a hand in how it functions. We’re a unit, therefore the responsibilities need to be taken as a unit, otherwise they won’t have any respect for the work that needs to be done, and they won’t learn how to have pride in the results of labor.

As for teenagers having jobs… That’s, I think, dependent on the child. For example, I’ve worked since I was 12. I started out babysitting, and as soon as I was 16 (legal to work) I was working. I worked, all through Jr. High and High School. I got A’s and B’s on my report card, spent 4 years in the Band and Color Guard, and worked every.single.day. for 4 hours (half time) after school. I had to pay for my own car insurance, gas, clothes, extras like music, and food (including lunch at school). After high school, I worked full time, and went to school 3/4 time. I paid for my own books. Now, in my own kid’s life, I don’t know how we’ll handle it. Quite frankly, they have trouble in school. I think the added pressure of a job would seriously effect their education, so I don’t know that we’ll go that route. I don’t disagree with it in theory, but we’ll have to see how they mature. With their particular issues, it may, honestly, be asking for too much of them. But I’ll tell you what. With as much trouble as Poe and I have had in life – If I didn’t have the work ethic that was instilled in me, I’m not sure I would have been able to mentally survive.

Computers and kids… Having a computer is a privilege, not a right. Having a phone is a privilege, not a right. Right now, my kids do NOT have a computer. If they need it to do school work, they borrow ours. We have promised them that if they ever bring home all A’s on their report card, we’ll have the discussion of having their own. Until then, it’s up to us. We have a computer I’ll be setting up for them. Right next to me. I take very seriously the concept of The Internet Is Forever. I understand that we’re in a connected generation. But I think people need to learn how to think and survive without technology first, and then use the technology as a tool to make life easier (or more entertaining) later on. Life skills first, make it easier later. My children do not have phones. Later on, when they’re older, and spending more time away from us, we’ll consider getting them. But wanting a phone to be connected to friends (as one of my sons is currently begging me) is not a good reason.

The generation coming forward, and we’re just starting to see effects of, is a gimme, precious snowflake, participation trophy generation. Let’s get one thing straight. Once you’re out in the real world, you have to work for everything. You have to work for your education. You have to work for your living. You have to work to keep your personal environment the way you want it. Hopefully, you’re able to do things you love – but the work is still there. It never goes away, life is hard. It’s up to YOU to make it rewarding as well. I think we do our children a disservice when we don’t teach them this.

Quite a few commenters said he wasn’t being respectful to her and her property. Yeah, um. Who paid for it? He embarrassed her, how dare he? (Oh, that poor precious snowflake). They said he should be brought up on charges with CPS. I found a comment from someone who claims to work for CPS. They said that 1) He didn’t harm her. 2) He didn’t threaten to harm her. 3) They wouldn’t even come out on a call like this.

Frankly, this is my style of parenting. I’ve taken toys away. Not for a time – but for good. Doors come off hinges. Locks get put on things. My kids have issues, they definitely have. But they are respectful of us, to us, to their grandparents, and to other adults. They are well behaved. They try in school. They have “fun stuff.” They laugh. They’re hugged. They’re loved on. And we expect respect, and to live up to their responsibilities, or face the consequences. We fashion the consequences to make to MOST impact possible, and follow through. The grandparents, especially, think we’re particularly harsh. And we do have to toe a weird line of “is this disrespect/disobedience or part of his mental disorder” that most parents don’t have to deal with. But my kids absolutely know what to expect from us, always. I’m not coddling babies here, I’m trying to train developing minds to be successful adults. We must adjust to abilities, and adjust to maturing/changing/developing brains and hormones. But that doesn’t change our style, or the outcome we’re looking for.