Wednesday, September 20, 2006

new year, new plan?

As Rosh Hashana approaches, the newness is wearing off things.

The Eldest is now happily ensconced in his new classroom, and he has had the first bleed for which I was called...and the first bleed for which I was (appropriately) not called. All is right in his world, especially as there is a woodworking corner in the classroom! As far as I can tell, he spends most of his time there, working on a mysterious project that he tells me is a ship. Apparently, it involves a lot of hammering.

The babes is getting to know Mary Poppins Jr., who is splendid, and far better at her job than I deserve. Did I hope for someone who will love my child? Yes. Did I expect someone who will celebrate him? No, nor did I hope for all of that energy, that delight, that willingness to get dirty with him, and yes - to bake for him. For Mary Jr. is also a baker, working at one of the crunchy granola stores. She makes beautiful bread (I've seen it), and cupcakes with icing that looks like frogs. Yowza.

She promised to show me the frog trick...

And I had my big presentation to the I.V. nurses association, complete with my very first experience with PowerPoint. Somehow, nothing went wrong, and yes, I made them laugh, and yes, they cried (I still don't know why they do that, but the last time I talked to a group of nurses they also cried. Ya got me.). But most importantly, there were a couple of points during the talk when they went dead silent, focussed absolutely on what I was saying. Now that was high praise.

And the man is getting through the annual tough work-patch, and is motoring through well. He keeps getting swamped in work and calling to say, desperately, 'I just don't know when I can get home.' And coming home by 7pm. Sweets, it's just too easy to support you...or seem to, anyway.

But, as I said, it's a new year coming, and a new plan - health care, that is. This time, the company singled out hemophilia as a driving cause in the rising healthcare costs for the company. Um, yup - that'd be our fault, because I seriously doubt there's anyone else with this in your huge, ginormous company. Sorry, all.

As expected, the huge ginormous company is trying to cut costs - by making us switch our provider of the ridiculously expensive clotting stuff from a hemophilia-specializing homecare company to GIANT pharmaceutical supply company. BTW, GIANT p.s.c. charges 50% more than tiny hemophilia-specializing company, and very well may charge for the ancillary medical supplies that we get comped by the tiny hemophilia-specializing folks. WTF?

The answer is that our company probably made a deal with the GIANT p.s.c., whereby they switch everybody over, save money overall, even if we expensive folks cost more, individually. This is a classic move, increasingly common among companies trying to manage costs with expensive folks like us hiding in the crowd. Which is fine by me, except: a. our factor may now start counting against a lifetime cap (see me on caps here) of a piddling million or so dollars (at 2,000.00 a week, that's nothing, not to mention that the doses rise as the kid grows). and b. with this change came lots of 'we're not calling them co-pays' co-pays with no maxiumum out-of-pocket costs on them...like $100 a pop for ER visits. And c. we could end up trying to get factor, ancillary supplies, home care nursing from people who just wanted to fill a 'script. Oy. I do hear tales of factor improperly stored, poorly shipped, and will I lose my beloved 24 hour emergency courier service? Yes, I am that organized, so yes, i could manage without, but I like to prepare in advance under the pretense that I'm not actually that organized. That way, I actually am...following me here?

This is going to suck. It will suck eggs. nasty, allergenic eggs...sigh. It will trash our budget just as we start moving into the slightly improbable situation of paying for two kids to have childcare/tuition. Sigh some more, gustily. I can mentally review a long, long list of things this is going to affect, and I like none of them.

What irks me most of all is that even the HR people, who supposedly negotiated this plan, don't know the details. We stand or fall based on the details of it, and nobody can give us solid information. We get a nugget of information, rejoice or shriek over it, then discover that it is incomplete, incorrect, is retracted, and ride the emotional rollercoasted all over again. Year after year, I've watched us try to find more and more money to pay our insurance costs. The partner man feels that it's just what comes with having our kids. He's a good guy, a sweet guy. Love that man. But a leetle too turn the other cheek, I think. Me, I feel like there's something a little wrong here, something a little personally offensive. Me, I'm thinking of breaking out the shotgun and politely leaning it against a wall while I have earnest, in person discussions with folks about all of this.

What, that? Oh - I use that as a plant holder. Now, let's talk about ambulances: are they in-service or out-of-service?

But of course, I can't be sure where this will leave us. The ending to this year's drama may very well be a crowd pleaser, but at this time we can neither confirm nor deny the possibility...thank you for calling, we appreciate your business and will be with you as soon as possible...Blue mooooon, yoooouu saw me standing aloooonne, withouuutt a dreammm in my heaarrrrrrrt, without...blech.

If I don't post again before Rosh Hashana, for those of you who observe it, I hope it is an introspective and healing experience, that it prepares you for the coming year with strength and self-awareness.

G'mar chatima tova*, all.



* may you be sealed for a good fate/year to come.

4 comments:

magid said...

Oh, dang.

Which is to say, it sounds like things were getting onto a nice even keel just before the holidays hit when this insurance kerfuffle started. Which sounds like, whatever happens, it will take lots of time and attention and such, not to mention the money side.

I'm glad Mary Jr. is such a great fit (I should get in touch with her (/them); I'd love to have some baked things I could make for you, plus there's that cooking from other-language cookbook).

And I'm glad that the boy's school is dealing so well with bleeds.

And of course I'm glad that the babes is doing so well, glorious as he is :-).

mama o' the matrices said...

Yup. Great bit PIA, this. But with any luck, it will only be a PIA, and not a 'now we must sell the house and move somewhere else' pain.

Personally, I refuse to be shoved around by things that aren't life-threatening. I'll change my life for diagnoses, but I'll make someone else's life miserable over beauracracy.

Lois Grebowski said...

see if they can pass the factor through your pharmacy plan so it doesn't count toward your max. also make sure big psc matches dose to assay as closely as possible to avoid waste/more $ toward lifetime max. Evey bit helps.

lois grebowski

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