Monday, May 31, 2010

A "one payer plan" would have been nice!

As a working woman with great benefits I had the extreme privilege (since 1971) of never having to think about doctor visits, paying for tests, health related bills, or doing anything more than plunking down my co-pay and leaving a physician's office. Magically everything happened as planned by the Empire Health Care Plan that New York State provided as a choice for teaching employees. I paid no annual deductible, no paper work to file, no screw-ups and over 30 years of great coverage. When I went for my retirement consultation and spoke with the people in the benefits office at Buffalo State College, I learned that my accumulated sick days would continue to cover the annual cost of my health care, minus a 375.00 yearly deductible which I would now pay out of pocket until I become eligible for Medicare at 65. That's reasonable. I could continue to use any of the physicians listed on the website for Empire Plan. But what I found out when consulting the web list for physicians subscribing to the Empire Plan in CA, specifically my county, is there are none! New York is the Empire state and the Empire Plan works really well in New York. OK, if I had a substance abuse or mental health issues(which I probably will have after trying to figure out the paperwork for my health care) I can choose from a reasonable number of physicians or approved counselors in Davis. But medical/surgical needs? Nadda One! Turns out the closest Empire Plan providers are in Walnut Creek, easily over a one hour drive from Davis. What I have learned after choosing a very nice family practice doctor in Davis, who is "out of network", as is everyone in Davis,is my health insurance will cover 80% of incurred expenses and, once I have paid my deductible and 1,033 the plan then picks up 100%.
None of this would be an issue except shortly after moving I discovered I needed outpatient surgery for what turned out to be a double hernia repair (too much lifting, pushing, shoving, rearranging furniture, and overdoing it during the move). Long story short I'm learning the ropes of navigating a cumbersome, multilayered, mega-papered, health care system and I clearly understand how confusing and frustrating it becomes for an average person. Here is just one example of what I learned through trial and error in my latest endeavor. Certain tests, like an MRI or PETSCAN require prenotification. I must call the "care core unit" at a certain number. How was I supposed to know that? OK, maybe by reading the 156 page book given to me when I retired? I admit I skimmed it....lightly. I didn't find the answer in the book but managed to talk to a real person. After several calls to various numbers I finally got this bit of advice: Once the cheerful automated message voice answers (and after having to call numerous times to get it right I wanted to slam my fist right down it's cheerful throat) I must press #8, after the 2nd automated message, press #1 after the 3rd press #3, and after the 4th, press #5. Then I can speak to someone about what test is being required. "Oh it's really easy to zip through that menu", said the real person I finally managed to speak with after numerous lost-leader calls. "Really easy once you are in control of the secret code I suggested politely".
Another day after an hour of phoning, downloading forms, and faxing documentation to united health care (for the 3rd time because it was "lost") my stomach was completely in a knot and I began to feel really sick. Get a grip I thought. You have a minor issue here to deal with and the process of dealing with the out-of-control health care systems is "sickening" you! I don't know exactly what snapped that day but since then I had an attitude adjustment and started riding the paper wave, joking with the occasional person I could get on the line to answer my questions, and in general started to have some fun when I absolutely had to deal with stuff. I'm happy to report it all seems to be working! The checks are starting to roll in for the blood work, tests, the surgery, doctor visits etc. One cautionary note. I'm not out of the woods yet. I've yet to get a bill!

Wednesday, May 5, 2010

"Moving" to Find Me -

When I was working full time exercise as a daily habit waxed and waned. I'd start very enthusiastically to do "the latest" form of keeping fit, join an athletic club, take a few yoga classes, sign on with a personal trainer for a few sessions, write out a daily schedule and stick to it approximately 2 weeks before POOF! - it all disappeared from my life, once again! I was pathetic....or was I? In composting the topic for this blog I really did some memory searching and have come up with some solid reasons for being pathetic.
As a kid, moving and being out of doors was my passion. I roller skated, in winter built snow houses, sledded and played endlessly in the snow, rode bikes and scooters with neighborhood friends, and hated to come inside and be still. I was punished for "not hearing" my mother call me in for lunch, and more than once stayed out past the magic time of coming in when the street lights came on. Gym classes in elementary school were torture in the 50's and high school athletics in the 60's placated women with one team sport called Intramurals. This was a combination of sports played by any the girls who admitted to liking sports and being physically active and didn't want to be cheerleaders. It was pretty much designed to kill any hopes of becoming proficient in one sport or help you fulfill your passion for any one particular game. Six weeks on basketball, six weeks on field hockey....I think you get the picture. In the end, at least in my high school, it was wishy washy whimpish "girl games" played lightly and politely.
What I do remember from my childhood was an intense love of the water. This resulted in going to the city park pool daily in the summer and challenging myself on the 7 and 9 foot diving boards to fly through the air and enter the water in all sorts of positions. I swam the hours away every afternoon and stayed from opening hour to closing hour most days. I adored the ocean where my family vacationed each year for one week. I rode the waves, went into water when it was brutally cold, and never came out unless forced by the adults. In was in junior high luckily we had a young, right out of college, physical education teacher named Gail Ship who empowered the girls by forming a swim team and participating in the elementary school swim meets. It was in the pool where I transformed all the energy of my childhood and channeled it into becoming the team overarm sidestroke queen for the relay race. It involved daily practice, discipline, listening to your coach, working hard, getting strong and taking criticism. These were all by products of the team effort at an age when my body was changing and hormones were screwing with everyone's brain functioning. The pool became a wonderful place of solace after my mother passed away quite suddenly. I could enter the water, swim as hard as I could for lap work, mute all my senses, and work out some of the pain in a very positive way. In high school the option for swimming (for women) was synchronized swimming. This was athletic but not something I remember gravitating toward. Music became my passion and throughout college in the late 60's and early 70's (a time when physical fitness hadn't quite grabbed the nation's attention), I continued to be twenty pounds overweight, carrying that through most of my life. Walking and hiking were always naturals for me but when I remember back to a feeling of being totally absolutely spent, it only happened for me after hours in water.
After retiring I determined I must make physical fitness the top priority of my day. If I didn't have easy mobility, good health, and a positive attitude in life I would be left without the ability to enjoy a time in my life that should be filled with the things I want to do for me! Since my track record for staying with physical exercise ranked pathetic, I knew I needed, like Stella, to get my Groove Back! A woman I met at a dinner in the neighborhood invited me to accompany her to the athletic club for a yoga class. Okay, I thought, here I go again dabbling in the world of clubs and classes. The yoga class was very nice but on my way out the door I picked up a blue sheet listing the Lap Pool (always 80 degrees and open year round...it said at the top of the flyer) Schedule for something called Aqua Classes. There were classes with names like: Aqua Aerobics, Dynamic Deep, Making Waves, Early Morning Aqua, Cardio and Tone, Rebound and Suspend, Aqua Power. That was a Monday, I joined the club on Tuesday and was at my first water class Wednesday morning.
For those of you who don't know about water aerobics (and I really didn't) I'll describe it the way it feels to me. Imagine wearing a flotation device that keeps your head above water but your body is totally submerged and you are in the deepest part of the pool. The instructor calls out familiar aerobic and swimming moves, and you perform them with the sweet embrace of water cushioning and yet challenging your every move. You feel weightless, yet you are working so hard to do the simplest of moves. Then, once you get the moves down, you are really shaking your flab (and you can feel it moving every which way under water) BUT NO ONE CAN SEE IT JIGGLE!!!) Your heart is pumping, toning all the muscles, and yet you are moving fluidly through space in the water with no stress or weight on your joints. I thought I had found nirvana and returned to in utero!
I go to water aerobics 4 to 5 times a week for an hour class. At the end of each session I emerge from the pool and feel like a new born baby. My midsection feels sleek, my fingers, arms, and legs all toned, my limbs move effortless through the air instead of the water, and I feel light, free, and renewed! I feel spent in the way I felt spent in that junior high pool with Miss Ship yelling directions and demonstrating strokes, and getting in our faces when we were slackers or swimming like "girlie girls"! I feel so good, so spent, so ME! I feel that junior high girl emerging under the waves and have found a portal to a time in my youth when I was doing something that was establishing me, something that carved into my soul the essence of what I would need to cherish and honor and sing and dance to every day of the rest of my life. And so it was that Marionette Got her Moves Back!