Monday, March 28, 2016

Life update

House: still broken. Nothing repaired in the past 4 months, and the main sewer line has backed up into the basement 3 times.

House insurance: Finally settled our insurance claim, after 8 months of fighting the insurance company. Original $17K offer turned into $55K, which was a rather substantial improvement. Thanks to friends and family who offered advice about how to deal with the horrible lying scum who our insurance company forced us to deal with.

Cars: Working. Still liking the new car. Just haven't had time to take it to the body shop to get the minor damage from December repaired.

Dog: Only one trip to the vet, which turned out to be a toenail problem. Thank God for easy.

Health: Not ok. Time-consuming and frustrating. David is recovering from major surgery, with more to come later this year.

Health insurance: About 3 hours a week managing this for the past few months, but it’s now mostly done for the rest of 2016 thanks to the crazy number of claims in February. Mostly time-consuming rather than frustrating.

Lisa’s work: Ok! This remains a bright spot, which is huge.

Michael’s work: Not ok!

Temple board: I failed to have any impact on the board or the Temple, but I feel good about having tried my best. Joining was the right thing to do, and stepping back now is as well.

David: Rowdy, not listening well. Lots of joy, lots of frustration, flipping back and forth repeatedly within minutes. Lots of sweet moments.

David’s preschool: We have a new one for next year, and we have notified the current one that we will not be returning. Good to have the decision made, and we have heard great reports from other parents who have used the new preschool.

City government: I’m pretty sure anarchy would provide better municipal services. But we had one tangible victory when the city made the dangerous two-way street by our house into a one-way street and eventually put up sufficient signage to convince drivers that they had made the change.

Search for where to live: Difficult and slow. We cannot afford the places we like, we don’t like the places we can afford. For place, read both house and community.

Hobbies, friends: Improving. I read a book. I’ve seen a few friends.

Sunday, March 27, 2016

Settling debts

Somewhere in Palatine, Illinois, an envelope will arrive tomorrow bearing our final mortgage payment to Ditech Financial. It has been a long 18 years of payments on this very old house, watching the balance decline to a point where one little insurance settlement does the trick and now we own the place.

It came at a cost. We have not kept up with the gradual decline of the house. The kitchen and bathroom have both missed at least two generations of remodeling. Cheap building materials from the early 1970s were not intended to last this long, and they haven’t. Refinancing the house 5 or 10 years ago to pull money out to do sensible remodels and repairs would have been a fine choice, and it’s a choice that we watched plenty of friends make. Somehow we never got organized enough with plans to do that ourselves. Maybe next year.

So I know this stage won’t last long. We’ll have to borrow money on the house again to do necessary repairs over the next couple of years, or we’ll move to another place and take out a new mortgage. And with taxes and utilities and insurance, the mortgage was less than half of our monthly house expenses anyway, not counting the inevitable repairs. But we decided many years ago that it would be nice to pay off our mortgage if we did stay in the house, and we kept our eye on that ball, and here we are.

I’m also keenly aware that we are incredibly lucky. I bought this house back when an entire house near Boston was only $225,000. The lack of lending standards back then that eventually destroyed our economy also allowed me to “qualify” for a mortgage in the first place. Our income has been stable enough that we never had to miss payments, and we didn’t run into some other crisis that meant missing payments.

Despite the contemporary view that it’s gauche (not just rare) to have a mortgage burning party, I want to celebrate our good luck. After all, graduations and weddings and even birthdays depend on luck as well. I remember my parents burning copies of their mortgage documents in the fireplace. It was the one and only time they ever used the fireplace in the house I grew up in. I’m thinking I’ll use my Weber grill instead, the one made by Weber-Stephen Products of Palatine, Illinois. For just one blazing minute, let them be the Palatine company to hold our mortgage instead.

The magic number is 10

A Conservative shul with an enormous membership might have weekday services every morning and every evening. A Conservative shul with a tiny membership might have services on Shabbat with no regular weekday services. Regardless of the number of services, each service requires a minyan of 10 Jewish adults.

My Conservative shul has a typical membership: neither enormous nor tiny, but smaller than it once was. The interests of that membership in daily services has waxed and waned, and is presently at that awkward point where not enough people show up to guarantee a minyan, but too many people show up to have it be clearly pointless to hope for a minyan. That awkward number is reinforced by minyan game theory, in particular the minyaner’s dilemma.

If you are not personally committed to going to the service, but you definitely want to go to the service if by doing so you will be the 10th adult so that the service can happen, then you need to know how many other people are definitely going and how many other people are in your position. Assume there are not quite enough regulars to make a minyan. The more irregulars there are, the greater the chance that enough of the irregulars will show up to make a minyan without you showing up. But all of the irregulars are in the same position, and they are each making the same guess about the behavior of the others. When there are not enough regulars, the difference between a sustainable service and an unsustainable service is not actually how good the congregation is at probability. The difference is how the irregulars feel about being the 12th or 14th adult at the service. You need to feel really good about that in order to typically have enough of a cushion that when the usual variation in attendance happens (due to weather, illness, vacations, or key sporting events on television) you don’t often drop below 10.

There are probably ways to affect this by building in escalating rewards. With 10 adults we get to have the service. With 12 adults we get to have dessert afterwards. With 14 adults we get to have a beer afterwards, or we all get party yarmulkes. Or we could skip the party yarmulkes and just act as excited about the 14th person showing up as we do about the 10th person showing up. After all, that 14th person showing up today is what makes it far more likely that the 10th person will show up next week.

My shul gave up on daily weekday services some years ago. Now there’s just a Wednesday evening service each week, with a Thursday evening service added once a month when there’s a board meeting on Thursday evening. Most of the regulars who want a weekday service just come on Wednesdays now. Not enough board members want to go to a service before the board meeting to reliably make a minyan, so as board members we were recently asked whether we want to continue having a service before board meetings. To encourage honest answers, we were told that all answers were ok. Some people said no, some people said they already show up and are frustrated that there isn’t a minyan, some people said yes but they would not personally show up for it, and not enough people said that they had not been showing up and would start showing up regularly. After reading the responses, I thought the conclusion would be that we should stop having the Thursday evening service. Instead we were scolded over email for our wrong answers, and we heard extensive lectures at the next board meeting about the importance of worship services, the importance of community, and the obligation of supporting synagogue functions that we are not interested in so that other people will support the functions that we are interested in.

Aside from the inanity of a group of volunteers being subjected to self-righteous scolding, there was no attempt to examine how far this logic would go. If I am interested in 5 synagogue functions a month and there are 50 to choose from, how many am I obligated to show up at? 10? 30? All 50? Is there any limit to how many daily services we should hold despite a sufficient lack of interest in actually showing up? When I go to a function I’m not interested in, how clear do I need to make it that I’m not interested in being there in order to satisfy the people who need to know that other people are making sacrifices so that more functions can happen? If I go to 10 functions that I don’t want to go to each month, and then I start enjoying 3 of those functions, do they no longer count?

I can see going to a service out of religious obligation or community obligation. I can see a lot of valid reasons to go that do not require me to be delighted to be there. But what I heard at the board meeting is that my attendance at the service will be valued only if my heart clearly is not in it. That seems like a terrible paradigm for a religious service and a destructive model to create for the next generation. I’d rather go back to the party yarmulkes idea.

Monday, March 21, 2016

Speaking up

This is me speaking up, right here and right now.

I grew up being told that people, you and me and every single one of us, have an obligation to speak up in the face of a new Hitler.

Being on guard in a country that perpetually denies its own history is difficult. America displays not just the typical national exceptionalism which refuses examples from the history of other nations, but an exceptionalism that divorces discussion of our present and future from our own past. “It could never happen here,” the decades-long rallying cry of the American chattering classes, is an evidence-free optimism that has no rational justification and unfortunately forestalls reasoned discussion of how to safeguard our country from a future some of us now see ourselves hurtling towards.

We must not wait for mass graves and concentration camps with gas chambers. We must be watchful for public figures who seek to create and exploit divisions, who advocate hatred and violence based on those divisions, and who do not welcome limits on their individual power or on governmental power. We must treat those public figures warily, we must look askance at their followers and cheerleaders, and we must work to make sure that they do not achieve political power because a political movement based on those premises is dangerous.

Trump and his followers have formed precisely that movement.

This is me, speaking up, while I can.

The members of my extended family who ultimately escaped Hitler’s Germany recalled how he started out seeming ridiculous to the educated classes even in Germany, whether liberal or conservative. He was an object of derision, a clown, a shouting lunatic who could never achieve power.

But millions of bodies, among them many who knew that “it could never happen here,” were ground into dust beneath the boots of the Third Reich. So inevitably was the national conscience of what had been an enlightened country.

We are not so enlightened a country. We do not have as far to fall, and it will not necessarily take us as long.

Trump and his supporters do not regret the increasing violence at his rallies; they rejoice in it. That should be enough to remove them from serious consideration as a political force, because we are supposed to have limits on free speech precisely to stop demagogues from inciting immediate violence. Our press has chosen to promote spectacle, however, and we are all suffering for it. We are watching a hateful politics rise to power on the promise of a violently-enforced Christian white supremacy, and our electorate is rewarding every increase in extremist rhetoric.

I have been glad to live in a country where I can often worship freely, where I am often free to hold minority political views, where I can often freely associate with anyone I choose, where I can say and write and publish many things that I choose to say and write and publish. And I have been glad to live in a country where those who have different faiths and different opinions and different friends also enjoy those freedoms. Trump and his supporters do not value that diversity. In fact, the only unifying principle of Trump’s movement is a forceful rejection of that diversity. Trump’s domestic and foreign policy choices, when expressed coherently, change with a frequency that is usually only possible in dream sequences. But even if those choices congeal into a semi-solid state—even if his followers all adopt those choices as their own—the founding principle of Trump’s movement is hatred and violence, and the mechanisms of violence and hatred are how they will seek to enforce those choices.

Perhaps we will not elect Trump. But he has poisoned our national well of discourse deeply, his followers have drunk far too deeply, and remediation will take a generational change.

I hope for better than our present for my child and yours.

This is me, speaking up. I encourage you to speak up as well.

Saturday, March 19, 2016

So hard to keep track of who Edgepark hates

We have employer-sponsored commercial health insurance for our family, which is lovely. Cigna is a kind and benevolent group of control freaks who tell us exactly what sorts of medical care we are allowed to receive (benefits limitations, prior authorizations, medical reviews, etc.) and who we can use as providers (network limitations).

So when we need medical supplies or medical equipment, Cigna gives us a very short list of companies we are allowed to order from. One of those companies is Edgepark.

Edgepark refuses to sell to customers in a number of states when those customers have Medicaid as secondary insurance. Medicaid helps a lot of people with lower incomes, and Edgepark’s billing department was quite clear that they don’t want customers like that. “People like that are often on fixed incomes,” Edgepark’s billing department supervisor says, and expects me to understand that people like that are undesirable.

My son is 4. His fixed income is $0, as is the case for many 4-year-olds. Despite that, I don’t actually understand why he is undesirable. I think he’s quite cute. More importantly, he is insured.

There are a lot of levels of insanity and frustration here:

(1) We have already hit our son’s out-of-pocket maximum for the year with Cigna, so Cigna would pay Edgepark at 100%. Cigna can confirm this to Edgepark. There would not be any remainder to bill to any secondary insurance or to the customer. Yet Edgepark is very concerned about not being able to collect the $0 balance after Cigna pays them 100% of the contracted amount.

(2) We should be able to decline to use our secondary insurance, and I tried that. I offered to provide full payment for anything that Cigna does not cover. Edgepark says that’s not possible. Why exactly am I not allowed to decline a benefit? The offer of a handout from the state suddenly comes with handcuffs that are not removed even if I decline the handout.

(3) Medicaid as secondary insurance will only cover providers that are in network with our primary insurance, even if there are no such providers. They add no provider options. Instead they remove provider options, even when they are not involved in the financial transaction at all.

(4) Cigna offers no network adequacy exceptions for medical supplies. If there is no cardiologist within 50 miles who is in network, Cigna will let you see an out-of-network cardiologist. That isn’t true with medical supplies, for which Cigna does not recognize any obligation to have any providers in network. But even if they did, they say that Edgepark is technically an option for us to use even if Edgepark refuses to accept our orders.

(5) Edgepark will not bill our insurance and ship the order after they have been paid in full by our primary insurance, or even by us. It is so important to refuse to do business with people who have Medicaid as secondary insurance that even receiving full payment up front would not be enough to overcome Edgepark’s moral objections to poor people and disabled people.

(6) Medicaid is such a persistent stigma for Edgepark that if they get even a hint of Medicaid on a potential customer, they put a block on the account and refuse to remove the Medicaid information.

(7) Edgepark is so concerned about someone with secondary Medicaid possibly concealing that fact and paying on their own that Edgepark hides its own policy about this when signing up potential customers. Remember, it’s not about the money. It’s about not contaminating your customer pool with the wrong sort of people.

What would be different if Edgepark were refusing to do business with black people? It might help to know that 22% of people covered by Medicaid are black, while only 13% of the US population is black. But that’s ok with Cigna (the folks who decide what providers we have to choose from at all); black Medicaid customers can always shop at Byram instead of Edgepark. It doesn’t matter that Byram randomly cancels orders, is frequently back-ordered, doesn’t offer samples, and has fewer product choices. After all, the problem with “separate but equal” was probably the equal part, right?

I’m sure this is fixable. Edgepark could develop a corporate conscience. Cigna could decide to pressure their providers to accept all of their customers, even if they might be poor. We could change the law to say that providers who are willing to be “in network” for a plan must accept all customers who have that plan. We could change the law to say that providers who are willing to be “in network” for any plan must accept Medicare and Medicaid. We could improve societal attitudes towards poor people.

I don’t see any of that happening. Do you?