2006-02-27 - 3:40 p.m.
Unfortunately, just a few days after the most wonderful thing that�s ever happened to me, I went from feeling sky high to down in the dumps. Nya�s mom does not approve of us getting married. At this time. Which, in my fears, is a diplomatic way of saying �ever�. She feels there are too many unresolved uncertainties, too many �what if�s. This raised a whole world of doubts and disappointment and general horror. Although I�ve somewhat come to terms with it over the last few days, I�m still not ready to fully think it through here yet.
But right now, I�ll begin to approach a tiny aspect of the questions she raised. I�ll talk about health insurance, boring-ass health insurance, which has become an unexpectedly important factor in my life. Nya�s mom read the recent entry about me cracking my head on my coffee table and expressed alarm that I said I didn�t have health insurance right now. First of all, I spoke incorrectly. I actually did have health coverage then and will through the end of the month tomorrow.
I�ve been insured through Blue Cross of Massachusetts. Alithea�s old job at MIT covered me as her �domestic partner� and I was able to keep the policy independently after her job ended (and we ended) through COBRA. (See, trust me, the tedious details of my insurance coverage are exciting reading! What?) I suspect domestic partner coverage was enacted to provide protection for same-sex couples who couldn�t get legally married. But no one ever asked about our genders, just had us affirm that we lived together. (Of course, now that gay couples can get married in MA, what will become of domestic partnerships allowing insurability?)
Now my Massachusetts insurance doesn�t pay for most medical care outside New England. I think E.R. visits actually are covered. But even if I�d realized I still had a policy, I probably still wouldn�t have gone to the hospital after I fell because, like I said, there really wouldn�t have been much they could do. However, even with my policy not subsidized by an employer and me paying the full cost, it was still cost-effective to get my chemotherapy treatments in Boston when I flew back East anyway for holidays and stuff. Complicated, but cost-effective.
After tomorrow though, my 18 months of COBRA coverage runs out and I need to get a new policy (hopefully one in Illinois). And I certainly need insurance coverage. MS certainly isn�t the most expensive condition you can have, but my chemotherapy treatments don�t come cheap. These days, I am a power-user of health insurance. My health plan pays a lot out for me, more than I pay in. I wouldn�t insure me for any price. However, although getting new coverage involves jumping through all sorts of hoops, there are laws now that say I have to be provided it.
God bless Senator Ted Kennedy (who is otherwise generally a useless tub of lard, even if well-meaning), sponsor of the 1996 Health Insurance Portability and Accountability Act (HIPAA). One of the provisions of this says basically that once you have employer-sponsored health coverage, you can�t be denied new coverage when you change jobs. It even allows a 63-day gap where you can be uninsured and still be considered to have continuous health coverage. Treatment for pre-existing conditions must be reimbursed as long as there�s been continuous insurance.
So I�m now getting a small-group health plan for my business. A small group can be only 2 people. Like me and Nya. I�ve met with a payroll processing service (the representative made a housecall without even being asked!) and we�re both going on (minimal) salaries to make us official insurable employees. I was unexpectedly reassured when the payroll woman told me that small business owners do this all the time, put themselves on salary (when you think about it, not really a substantive financial transaction) to get insurance.
I�ll be so relieved when it comes through. Health insurance worries have occasionally literally kept me up at night. I suppose this might be easier if I still lived in Massachusetts, one of the few states where acceptance into individual-payer (non-employer-sponsored) coverage is mandated by law (and the cost is relatively low for some reason). But it�s ridiculous to think I have any regrets about being here in Chicago where the love of my life can pursue her dream (and might I add how impressively she�s doing it � Second City classes, material and role in a show, etc.).
�But wait,� you may be saying. �This all sounds ridiculous! Surely, the government provides simple, straightforward health care for the disabled. What about Medicare? What about disability payments?� It�s funny you should ask this. I recently had the same thoughts myself and looked into the matter with an interview at the Social Security Administration. The short answer is that the federal government does indeed provide a net of sorts for the disabled and indigent. The caveat to this is that to get any benefits, you better be prepared to sign on for a permanent life of enforced poverty.
No kidding. To get Supplemental Security Income (a monthly check for the princely sum of several hundred dollars!), you must never have a net worth in excess of $2000. This includes assets like your old beater car, 401(k) accounts, savings bonds, stock holdings � everything. Most pertinently in my case it includes any corporate equity, like the 100% of No Pity Mobility I own. And some person�s job at the SSA is to ride herd on recipients and make sure their net worth never exceeds $2000. (I can just see the enforcement here � �You have Top Ramen! But you should only be able to afford Nisin!�)
You can also never earn anything substantial either (like in excess of a couple hundred per month). And lest you think I should just transfer all my assets to Nya so that I can qualify, such transactions are very carefully scrutinized (perhaps by the same guy keeping tabs on the ramen). �Spending down� must be done cautiously. The shining light at the end of this tunnel is that you may get to become a lifetime ward of the state. After at least 24 months of this joy, you may qualify for Medicare health coverage.
I asked my interviewer what happens if you die in the meantime due to a lack of health care. She said that there was probably some sort of state-administered stopgap program. But she wasn�t sure. I said that this seemed like a ridiculous choice between permanent destitution or going it alone. She sadly agreed that that was basically the way of it. There is no middle ground. Either you�re a full-time impoverished crip or you�re on your own. Not really even a valid choice.
I know there are those who have few family or social financial connections, can�t make their own way (perhaps due to the severity of their disability), and have no other option but to go down this path. I guess I�m glad that the public sector provides a last-resort safety net to catch such people. But that ain�t me. Give up everything � all assets, all future income, my business, probably Nya � to become the wretched of the earth? Well, I suppose we could all shoot ourselves in the head too. I�m not stubbornly resisting out of misplaced pride. There�s simply no true decision process here.
So an Illinois-covering, No Pity-sponsored health plan will start soon. Meanwhile, in case you�re wondering, my head has healed up nicely.
� 2006 Geoff Gladstone
Sign My Guestbook!
powered by SignMyGuestbook.com
�
