Non-Holiday Holiday Expenses

nonholiday-holiday-expenses

The holiday season is coming, and I can’t stop thinking about brain surgery.

In July, Vox magazine did an informal assessment of the cost of the blood clot surgery that Senator John McCain underwent. Because he would be the deciding vote in the Senate’s repeal of the Affordable Care Act, the discussion in Vox’s article centered on what that same surgery might cost someone with no health insurance at all. Their best guess, determined based on both public reports on the name of the procedure and Mayo Clinic estimates of their own costs to perform that procedure, was $76,000. It is an impressive cost, and one which would be daunting to anyone, let alone someone struggling financially to the degree that they cannot afford health insurance.

Imagine you have a child who needs that surgery in one of the states where CHIP funding (federal Children’s Health Insurance Program) is about to run out. If the budget passes as currently proposed, the program dies, along with tremendous numbers of tax breaks for middle-income families.

Fast forward to the holidays, and the cost of a procedure like that leaves no money in anyone’s pocket for even a string of blinking holiday lights.

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The Phones Our Insurance Saved Us

Our family, unlike the majority of Americans, has spectacularly good health insurance. It’s provided by an employer, and because of my husband’s combination of high-demand skills, excellent work ethic, and good luck, we’ve had the same coverage for more than a decade. Here’s how it works:

Every two weeks, my husband’s employer deducts $196 from his paycheck for our medical insurance.

Despite that, beginning on January 1 each year, we pay for 100% of the cost of every doctor’s visit, every prescription, every blood test, and every other medical cost until we have spent either $1,500 per person or $3,000 total for our family of four. That means that, until we have reached into our own pockets and paid $3,000, our insurance has not even begun to kick in.

After we’ve spent $196 every two weeks and $3,000 for medical costs, our insurance begins to pay 80% of every bill that comes in. We pay for the next 20% of each bill — a welcome change from the 100% we’d been paying before that.

As a family, once we have spent $7,000 on medical costs, our insurance begins to cover 100% of whatever medical expenses come next. Let’s review, then, the cost of medical care for our family in a year when someone gets really sick:

 

insurance-costs

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Huddle Up

winter-1Every day, there’s something new happening that scares me.

In fact, every day, there are multiple things — here in the US, and other places in the world. It feels to me like we are balanced on a saucer held on the index finger of someone walking barefoot across a sea of marbles, and — moment by moment — people are plummeting over the edge. I wake up from my spot nearer to the middle of that saucer than 90% of the people on this planet, and I look at the news and try to decide where I will throw my tiny threads of possibility today.

It feels desperate. On the worst days, it feels ridiculous.

As this year ends, I am reminded of the years that my friends and family made contributions to causes that would likely never, ever affect them. Though I tried not to be a broken record, I did occasionally reach out to friends and family via social media and other means to support the charities working on research, advocacy and support for the conditions with which my daughter suffered. When her primary diagnosis was eosinophilic esophagitis, I asked for support for APFED, The American Partnership for Eosinophilic Disorders. After she had her second cardiac surgery, we suggested people make donations to Mended Little Hearts. These were good causes — they are good causes, and I’ll continue to support them even though my daughter’s health is no longer affected by these conditions — but the people we asked to contribute or share stories or raise awareness were likely largely oblivious to their existence before my daughter’s diagnosis awakened them.

In the last few weeks, the pitched voices of a number of needs in the wider world and in my community seem to have amplified. Part of that is due to #GivingTuesday, a campaign to encourage charitable giving after the materialistic trifecta of Black Friday, Small Business Saturday, and Cyber Monday. Part of the onslaught of need has also come out of the recent US presidential election, which has given rise to a level of societal panic I can’t remember seeing ever before in my adult life. Causes about which I care deeply — civil rights, women’s health, the social safety net, immigration and international diplomacy among others — seem to need support more than ever. I find my personal politics pinpointed perfectly as my friends add me to Facebook groups daily, my email inbox fills with requests, and every news story seems to offer me an action item.

This holiday season, there are so many bigger needs than those that affect my family. This holiday season, the needs affect my whole world.

I’m doing a few things differently this season, and while I don’t dare tell anyone reading this that my plan should be theirs, I’m finding it useful to think about what I can do to help in three ways:

  1. Actions that help the world
  2. Actions that help my community
  3. Actions that help my family

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The Boy in the Next Bed

ricardo

When my daughter Sammi was just over a year old, she had surgery to repair a congenital heart defect. After the worst of it was over and she was nearly — but not quite — ready to go home, they moved us from the ICU to the general ward of the children’s hospital.

In the ICU, each child has her own tiny room — about twice as wide as a twin bed — with a glass partition at the end of it. On the other side of that partition sits the child’s personal nurse, up on a stool next to a computer that monitors a host of vital signs and other measurements. That nurse has no other patients. When shifts change, two nurses fill that tiny space for thirty minutes, conferring and learning so that the new nurse has all the information necessary to sit vigil for the next shift.

In the general wards, the supervision is quite different. So are the rooms. When we got to the door, I went in and dropped all our stuff unceremoniously on the nearest chair, then stopped in my tracks.

“There’s someone already in this room,” I whispered to the nurse, pointing at the curtain and then at the loud tv tuned to cartoons. Continue Reading…

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In Defense of Compassion

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Most of my adult life has been propelled, in one way or another, by compassion.

As someone who began making a career in internet technology during the dot-com boom, I was always uneasy with what on earth I was doing by pushing pixels across a screen for a living. Who did I help, making web sites to prop up the egos of CEOs and corporate shareholders? It took me years to press my way into service to something with more value to humanity. By 1999, I was using the pixel-pushing skills I’d learned to support the voices of non-profit organizations. Necessarily, the budgets and the ability to innovate came later to these organizations. I could not charge them money they did not have; it was not greed that motivated their protest. My prices as a freelancer changed to reflect this. I adjusted and leaned toward compassion.

Then, when my children were born in the early 2000s, my entire life became an exercise in compassionate listening. A baby cried, unable to manage her emotions or get her needs met in any other way, and I held her. I sang to her, I soothed her. It seemed unconscionable to behave any other way. Another baby was born, this time sick and in pain, and she cried even more and for far longer than the first one had. My compassion was called upon constantly, to weigh my own needs against hers and to ask myself whether she had any other means of expressing her misery, any reserves of patience or space in her brain to make the developmental leaps a child with a full stomach and no pain can make. She did not, much of the time, and I needed to dig deep to find my own untapped wells of compassion. She needed every drop I had. Continue Reading…

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