Trying to get back to work – day is mostly consumed by health care

I need to make something clear to everyone out there.  I have been coping with Obamacare since October – I was *very pissed* when I learned that my insurance wasn’t the right kind – I’d developed a health care solution for my family, it was appropriate and cost effective.  In the confusion and aftermath I continue to be embroiled in bureaucratic hell.  This means that often, when I try to do my day job, my subconscious will keep hammering away at trying to get me to deal with the intrusion into my life and the squelching of my rights of individual sovereignty, and my ability to provide health insurance to my family in a manner that is appropriate to our unique situation.  More than that, it has been the exceptional, gross, and unforgivable incompetence and deception – and just plane ignorance – of our government agencies, legislators, and executives – that has raked me through the coals.

When I drive down the street, I see a nightmare of a society poised to get me – I just came back from my trip downtown, to drop my daughter off so I could help her break the law and see an R rated movie with my blessing, but not my participation (she’s a non-american 14, which means that her maturity level is far beyond the age-equivalent).  Driving back, out of the downtown, on this sunny Portland day, was an exercise in fear and hell.

Imagine hellish hallucinations – a sort of Steadman style – the escape from the downtown was it’s usual fear of persecution.  I drove by a police car and winced – was he following me?  Did I do something wrong?  I know I probably am, but does *he* know that.  Will I make a mistake because I’m concentrating on the traffic and pedestrians and not noticing some complex markings on the roadway?  How can I be sure – it’s an anxiety attack, driven by one and only one fear – engagement with the overbearing ogre of america, ticking off the wardens and guards of my prison.

I climb out of the downtown onto the network of asphalt strips, overly trimmed and landscaped gardens giving a nod to the faux-forest aesthetic of this region.  These people don’t know shit about living with nature, but they certainly believe they do.  I drive the arterials out to a strip mall nestled amidst the gardens and outrageous homes and park my car.  My heart is beating fast, my blood pressure skyrocketed, my sense of raw, untempered psychological fear – it is a trauma, to me – to drive down these roads.

The hallucinations are not perceptual, they are cognitive and drive into my affect.  I do not literally see the leering essence of the buildings, the bus stops, the signage, the traffic control, the routing of life, the separation of individuals – rather, I feel it as the remnants of a sort of divide and conquer, the people a pulsing mass devoid of individuality – they are americans, fused by a collective and re-enforced delusion about their freedom, governed effectively by a system of laws with self-replicating complexity.  They are human-animals taken over by a giant tumor of thought, a very clean version of a zombie horror – one where the decaying flesh takes on the style of an alec baldwin haircut and the infrastructure destruction is replaced by a hyper-landscaping fetish.

To me, it is the cognitive, affective background that creates the hell.  It drives rants – and if I am distracted by something like driving, my subconscious will start playing and developing those rants – and it will be fueled by the omnipresent fear of ‘breaking a law’, and the knowledge that the law, once engaged, is devoid of humanity and common sense.  That is why the law is terrifying, and it looms at you from every corner.  Driving down the street I see laws and more laws, and complex laws, and a cognitive load that is way beyond what is reasonable.  I see the effects being to distract and delude the populace into supporting and sustaining the illusion that they are better off than they were 50 years ago, or 100 years ago, or 140,000 years ago.

In some ways, this is obviously true – but I am no longer willing to believe that we are better off as a species.  I have lived free, and life in modern america is nothing like freedom – it is quite the opposite.  It is a collective, tacit minimum security prison, a tyranny of lifestyle and pragmatics.  I can not think of a problem I have had in the last 3 years that was not driven by the western world, the basis of greed, the capitalism of it all – capitalism is not a panacea, it is like anything, sensible in moderation and in doses and places it is good.  Regulation of capitalist markets is not the answer, but there is a role of regulation – creating a framework for negotiation, transaction, and reconciliation of differences for example.  What is not acceptable is the american version of capitalism, where moral decisions are enshrined in a complex web of regulation.

Another place where capitalism does not belong is health care.  It just does not belong there.  I have a deep moral opposition to insurance driven health care – no no no no no no, that is wrong, and deeply so.  We have the shittiest health care in the developed world, and it costs by far the most – the reason is over regulation of capitalism.  There are other motivating factors than greed – we’ve just forgotten that in our collective delusion.

I could, and would, go on and on about this – but I’ve got to go do work to support the capitalism into which I am enshrined.  Soulless, unsatisfying work to pay for my daughter to attend a university, because our high schools suck donkey balls and we would rather spend trillions invading countries or bailing out banks than funding education.  That’s the kind of stuff that just makes me say “fuck you – fuck you all”.

It was okay when I had to just live with you, but now that you’ve shoved your Obamacare fist up my ass, made it illegal for me to pay for health care for my wife, stolen hundreds of hours of my life, and really pushed me over the fucking edge – that’s when it went too far.  Fuck you Barak – just fuck you, you could have allowed freedom to be retained, but you did not – there is no way for me to comply with this law by demonstrating minimal essential coverage – the only way is to show where my money goes, and it must go to one of your approved agencies.  Just come clean and say it that way, you lying, deceitful fuck.

 

 

 

 

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My god, I’m turning republican because that fuck in the whitehouse stole my health care

It is memorial day and, thanks to bureaucracy, it is still technically illegal for me to take my wife to a doctor here in this country.  Thanks to the incompetence of my government – idiot shitwipes like Jeff Merkley who is one of my senators and who supported the ACA.  Fuck that idiot.

I find myself, for the first time in my life, reading and agreeing with shit from Forbes:  Here is something I agree with (from: http://www.forbes.com/sites/billfrezza/2013/07/09/can-post-constitutional-america-recover-its-freedom-and-prosperity/ )

What brought us to this point? Our failing public education system? The erosion of non-governmental social institutions? A media-induced national stupor? How about all of the above?

We publicly celebrate the birth of a nation uniquely founded on individual liberty and limited government, yet we keep returning professional politicians to office that not only mock these ideals but portray them as dangerous lunacy, characterizing advocates as potential terrorists.

We demand an ever expanding array of entitlements that we expect someone else to pay for, distributed by a corrupt and bankrupt bureaucracy we openly hold in contempt.

We’ve become so easily distracted by “culture war” sideshows that we’ve forgotten how to hold elected officials to minimal standards of competence.

We have descended into such an abject state of ungovernable dysfunction that the best we can do when a floundering president starts ruling by decree is stand back and gawk.

Yep – basic, minimal standards of competence.

I voted for you Obama – I supported you – I once had hope.  I was sitting in a consulate when your victory over that massive idiot cheneybush when they made the announcement 0f your victory.  There was a standing ovation, I stood with everyone – even the state department employees who called my wife a whore and threatened us, quite illegally, if we didn’t engage in illegal actions (yep, the state department).

So I did support you – i even supported Obamacare until I got fucked by it.

And now – your INCOMPETENCE at legislation has made it illegal for my to take my wife to a doctor.  Thank you – you miserable shit.

 

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From a letter to a friend, just an aside about the latest facet of the Obamacarenightmare

Excerpt:

BTW – you’ll get a kick out of this – I had to call HHS as part of this health care nightmare and the feds botched their wire tap in what I later described as a ‘Leslie Nielsen Moment’ – i got to listen to doofus and dicknut while they tried to fix the tap and get it back in recording mode.  And I have to shell out a few thousand dollars in June to renew my health insurance – the health insurance that is not recognized by the government of the united states, for reasons they themselves do not understand (we actually got in contact with the Director of Market Rules and Enforcement for Health and Human Services – he doesn’t understand that law either, that is ‘above his pay grade’).  Regardless, the interplay of OHP’s CAWEM program and OAR 410 120-1280 make it illegal for my wife to receive non emergency-room care here in the states, until she has been legally present in oregon for >= 5.0 years – prior to that time, if she wants the state-managed, non-compliant medicaid then it is illegal for her to use any facility *other than* the emergency room.  This program saves me $30/mo over what I had before (which the government told me I could not longer keep) and is not worth it – her part of our CoverOregon application from 7 months ago finally got processed and this is what happened.  The government is, once again, helping me to death against my will – too bad they just can’t stay the fuck out of it.

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Here we go – this is the sort of discussion I have with *reasonable* elements of our government – not those fucknuts in washington!

On May 21, 2014, at 5:10 PM, <ADDRESS HIDDEN> wrote:

E…,

Yes, you are a prime example of issues that the state faces with this roll out. Or more like roll back. I simply don’t have an answer. I consider myself very lucky to juts have coverage through my employer. Its my hope that eventually things will get corrected. It is really hard to forecast how long that would take at this point.

That is an incredible cost for a flight to anywhere in Asia. Is that round trip or each way? Hope the best for you, and thanks for keeping me up to date. I continue to archive your messages in case anything comes up where they are required. Good luck!

 

And I respond…..

I wish it was simply an example of ‘issues the state faces’ – there is a fundamental problem with the complexity of it all.  We are over-lawyered and common sense is no longer an option.

Federal health care law should stop at a hundred or so words of constitutional amendment charging the states with the responsibility of implementing access to health care.  Could have done the whole thing for 100 words of prime text.  1000+ pages attempting to coordinate literally hundreds of thousands of pages of legislation is not an effective way to manage a society – it just doesn’t work – the attempt at uniformity robs us of the diversity the states could have brought to it.
100 word constitution amendment, federal programs to support the states without dictating implementation – that would have been an elegant, cost effective solution – instead we have the least effective congress in history (there’s some NPR story about that) run by a bunch of entrenched dumbfucks purchased as little puppets of the rich and powerful…. that’s the Europe that we fled, not the america we could be – and that’s who we’ve entrusted to rebuild our health care…. just look at CoverOregon – that’s our future.
BTW, say hello to the feds…. they goofed the other day and i heard some of them trying to get a recording in place when I called back to HHS to clarify something in my earlier discussion with the nice (but not too bright) “ACA Specialist” I’m dealing with.  Seriously – hilarious little technical oops that belonged in a movie staring Leslie Nielsen, I didn’t have the heart to make any jokes about it – poor little ACA specialist was audibly sweating.
And still, it pisses me off that every single problem I have could be solved simply by, for example, letting me keep my existing insurance or at least giving me the ability to take some control over my health care.  How about accepting my offer to pay Tax Penalty – Insurance Premiums instead of Tax Penalty + Insurance Premiums?  Lot’s of options – except that the incompetent legislators and executives of the 2014 government are too un-dextrous and anti-agile to manage that.
They literally can no longer find a way to enable local judgement or common sense – there is this sense, almost Stalinist or Chinese, that only the central government can coordinate any social policy effectively.  It’s so authoritarian and backasswards that it is tragic – half the damn government is involved trying to figure out how non-compliant medicare programs interact with existing legislation to make it effectively illegal for me to pay a doctor for a consultation.  I want the fist of the state removed from my anus and I want the freedom to pay cash to see a doctor – we’ll deal with overhauling health care and establishing reasonable rates later – first and foremost they have to pull their bureaucratic fist from my ass.
In July I’m taking my daughter to a $20 dermatologist consutation overseas.  I’m getting my teeth cleaned, excellently, by the dental faculty at a solid school for $40.  I’m going to get a preventative EKG and cardio screen – maybe $120.  And all that is *before* insurance!  And you know what, it is *exactly* as good as you get here in terms of quality.  Just gotta escape all the protections being jammed down our throats by incompetent legislators like Obama and Merkley.
ah….. i want a break from this place.
and speaking of that flight – it is one way – I need to get some trees in the ground as it will take 3 years before they will fruit and we just decided wife will stay through daughter’s graduation from high school (sadly, not long enough to qualify for 1st class-immigrant status – my wife will *never* receive the *wonders* of obamacare – she’s just a little 2nd class brown girl).  so that means I need to get over and get the orchard started ASAP – and, I need a break.
I need to spend a little time feeling free, and taking advantage of the high quality, affordable health care before returning to this over-regulated minimum-security-prison nightmare that is modern america.
seriously though – you are fortunate with your health care.
wishing good health to you and yours,
cheers,
 -e
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I’m still pissed today – my wife is at home under a blanket, and I’m taking tranquilizers to try to deal with the fucking government so she can see a doctor

Fucking thank you Obama!  Fucking thank you Merkley!

This is the state of that shit you did to me, against my wishes, and sold to us on a plate of lies.  Smoke and fucking mirrors and you two are bastards for it.  Everyone who voted for and supports the ACA is a motherfucking useless, dishonest piece of human shit – you sold it to us on a bed of lies, and, what makes this unforgivable – no one in your organization, the federal government, understands this bill enough to navigate it – and I mean no one, even the people in charge of it, can navigate this complexity.  You shoved that level of shit down our throats and plugged up our assess with wads of legislation – and you have the *gall* to demand that we treat you with civility?  Fuck you.

So wife is home – she took some ibuprofen for the soreness in her legs and has a bit of a cold.  She slept late today and had a hard time waking up.  She’s sniffling a lot.  We suspect that there are significant allergens in our new bedroom (we swapped with our daughter), which is putting our immune systems under stress.  Gonna get a rug-shampooer because we suspect it’s the result of dirt built up in the carpet from daughter spilling stuff and not cleaning it up properly.  In the meantime we both have a bit of bronchial irritation in the mornings, after we’ve spent several hours in our bedroom.  We feel better if we sleep on the sofa downstairs.

But wife also has had a pain moving around her legs over the last few weeks.  If we were at our other home, we’d have any of the dozens of local massage therapists or other similar healers take a stab at it.  There are dozens within walking distance, or a quick jump on a 100cc motorbike, away.  There is no “going online” and “trying to track down a provider” and “negotiating insurance and payment terms” – there is only community knowledge, friendships, reputation and recommendation – something like $5-$20 an hour or so, and different folks have better reputations for taking on different ailments.  Today, I would walk across the street to the trio of women – two generations of family and a few friends – who run a laundry shop.

I would walk up to this trio and I’d ask “my wife’s leg is hurting – but the pain is moving around, sometimes here, here, or here like this” (and with that here, here, or here like this I am gesturing around my leg).  I describe the sort of pain, but that the muscle always feels loose, not seized up.  Then I’d ask for suggestions and probably later I’d take my wife over to one – if it is far maybe it will be a minute or so ride on a 100cc scooter,  and the healer would either make another referral, or would help out.  It would be $5-$20 for a treatment ($20 would be way high, usually $10, often less) – the healer would thumb around, putting years of experience to the test and their reputation on the line, and suggest something “I could do this, we could try that” and you make a decision and see if helps you feel better.  These are trained, experienced massage therapists, often folks who have engaged in lifelong practices of professional improvement.  There’s nothing quite like a 58 year old woman working the kink out of your shoulder using massage techniques passed down for thousand or more years – it’s not candles and magic, it’s not kids trying to make you feel better or give you happy endings – this is a woman or man, who has, for several decades, demonstrated a reliable competence in helping cope with the muscular stresses and strains of daily life.  They are quite good and you do feel better – at least enough for you to stand and shell shrimps at the cannery for 8 hours so that the fine customers at a Zupan’s 15 time zones away will never go without.

No – here, here it takes several hours to try to figure out how OAR 410-120-1280 and CAWEM interact – because, if you read the damn law, non-critical care is not covered by CAWEM – CAWEM is not an ACA compliant medicaid program – it is the only one, but it is clearly documented that it is not ACA-compliant.  My wife will have to pay the Tax Penalty, no matter what, for 3.5 more years or provide her own MEC-compliant health insurance *in addition to* her existing health insurance, which is also non MEC-compliant.  Got it so far?  Good – let’s say it again (I have repeated this well over 1000 times – but it is beyond the capacity of our legislators and administrators to even understand this): wife has non MEC compliant primary health insurance, and had a non MEC compliant catastrophic policy – after months of working with CoverOregon, the non compliant policy was replaced by CAWEM, a catastrophic-only OHP program providing lesser coverage but activating OAR 410 120-1280, the state law that makes it illegal for a provider to accept money from patients receiving OHP medicaid benefits.

The effect is clear:

(a) had Obama kept is promise we would have kept our original insurance and it would cost me $85 to see a doctor.

(b) Obamacare, in conjunction with state laws, effectively blocks access to health care for non-critical cases

Thanks a fucking lot, you fucking fucks.  Give me my god damn health care back – just get the fuck out of my business, stop protecting me to death.  I do *not* want your fucking protections, because you fuck up every fucking thing you touch you motherfucking incompetent federal fucknuts!

 

 

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This is the kind of letter I write to the police who are monitoring my navigation of the Obamacare Hell

Detective,
 
My wife came home sick from work today.  That, of course, sets off another battle with the damn state.
 
As per the request of those cowards at the USCP, I have agreed to no longer contact anyone I’d been contacting before.  I have allowed one exception, an ACA Specialist at the HHS which called me back a few times afterwards.  While she is thick as a brick, we only speak on the phone, and it is a recorded conversation, we keep it civil even though she, in now over a month of effort, can not find anyone in the HHS who understands the law.  The best she’s been able to do is that, since the situation is complex, I should know by late 2015 or 2016, if I managed to be in compliance with the law in 2014.  That lag time makes planning impossible, and this is something that HHS and the IRS just couldn’t give a damn about.
 
Calling “OHA Client Services” leads, on average, to wait times of 59 minutes – that’s 59 minutes with your phone on hold – waiting to get through to someone, just to figure out the pathway to seeing a doctor.
 
There is no intermediary agency governing CAWEM – this program does not appear to have been outsourced to a suite of implementing coordinated care management agencies.
 
Anyhow – I am now pissed as shit, and just wrote some letter off to dhs.info@state.or.us – then I realized that it was the start of another healthcare battle, so I took a bunch of tranquilizers and am going to try to sedate myself while we overcome the health-care-access obstacle described below.  Again, since I will no longer initiate non-followup contact with administrators, I will confine myself to the physical 1-800-* client service pathway, or the publicly available general purpose info emails.  Futhermore, I will only contact the agencies involved with the administration of the programs to which we have been assigned, and whose obtuse and incomprehensible rule, and poor implementations lead directly to these problems – all problems which could be solved by ensuring and simplifying access to health care – something our government just screwed up.  But I feel it is prudent to keep you in the loop when the DHS picks another fight with me, which they do each time someone in my family gets ill and forces us to face some obtuse legal obstacle between us and our doctor.
 
 
Here is the situation and the question I am asking them (and I’m damn tired of repeating this to them – since this is the situation *they* created): does CAWEM require treatment waivers for non-critical care due to OAR 410 120-1280?
 
Here’s why it applies….
 
The DHS assigned my wife to CAWEM in our attempt to replace our existing insurance with MEC-compliant health care solutions using the expanded medicaid and the health care exchange system.  CAWEM (This is not, we think, CAWEM-Plus, which we know nothing about) is a non MEC-compliant health care program administered via the expanded medicaid program which is run the DHS/OHA.  CAWEM does not cover non-emergency services – it is less than, but similar to, the policy we carried previously – a catastrophic only, afforable, fixed-cap policy with a high deductible.
 
CAWEM is an OHP program and thus activates OAR 410 120-1280, which limits the abilities of providers to receive payment in exchange for services, because it embodies a bunch of protections that I do not want, but which I must receive by virtue of the fact that I am judged unreasonable by the state unless I value and want said level of intrusive over-protection.  OAR 410 120-1280 protects me from an unscrupulous provider by assuming that I (a) can not so protect myself, and (b) even if I could, I desire to be so protected by the state in a known, uniform level of protection.  There is an escape clause utilizing a waiver and re-establishment of limited rights process.
 
I ran into OAR 410 120-1280 and discovered the waiver process when I tried to book an appointment for my daughter to talk with a skin care specialist about some zits and pitting on her back.  This is what I consider a $20 walk-in appointment at the hospital in my health care home.  In Oregon it is a nightmare of bureaucratic obstacles. CAWEM specifically does not cover someone who is basically home with bhronchitis, but has a developed an odd, chronic muscle pain in her legs because she works a full 7 days a week, on her feet, walking, and has pre-existing joint problems because she has so worked for over 30 years.  Treatment for such a condition, or even a consultation, wherein I pay money to see a provider, is not immediately legal due to OAR 410 120-1280, which, we think, requires the location of a provider willing to spontaneously re-negotiate our treatment and payment terms and who is suitable to the sort of injury and issues we’re seeking to cope with.
 
Since this is a legal question, it is not appropriate for me to bother my primary care physician about this – my PCP is for medical, not legal advice, and it is incorrect for the state to require our physicians to be legal experts – doing so directly damages the integrity of the doctor-patient relationship, wherein I want to make sure that my doctor is not distracted by obtuse bureaucracy, byzantine billing process, and intrusive, yet irrelevant, rules.
 
In addition, I know for a fact that my preferred provider is migrating away from insurance driven practice, following one of the new developments in provider remuneration – one that is based on a monthly subscription fee paid as a sort of health-care retainer.  That being the case, distracting her and the clinic support staff with an obtuse question about a situation created by the failed bureaucracy of Oregon Health Care, well….. I just don’t see that my physician should be the first point of contact.  I want the legal department who is responsible for Oregon Health Care to document the process by which I correctly obtain medical services for non-critical care for a legal permanent resident covered by CAWEM.  Since we were assigned to CAWEM because of the mess of CoverOregon and Obamacare, I feel it is the government’s responsibility to answer this question.
 
So here I am – my wife comes home sick from work, losing a day of work, and I wonder what to do.  At our other domicile we have access to high quality, affordable, accessible, patient driven health care at around 1/30th-1/50th the cost.  We would walk into a doctor’s office and take care of it.  Here, thanks to Obamacare, and thanks to the obtuseness of our laws, it is actually illegal for my wife to seek health care for non-critical conditions, – after she has been lawfully present in Oregon for 3.5 more years, however, she will graduate from CAWEM to MEC-compliant medicaid.
 
 
I would like to state one more thing – before my email, I tried calling the DHS directly.  The receptionist who answered the phone had never heard of the OAR – she referred to it as “whatever it is you’re reading from” and indicated that she didn’t know what this OAR was.  Imagine that – the person you talk to at the DHS is so competent, so brilliant, so wonderful, that they are *above* knowing what the OAR is.  Wow….  i think i kinda lost it at that point.
 
sigh – i’m so sick of this shit, i just want to be able to see a physician that I trust, using my insurance with a $5000 deductible.
I’m also DAMN SICK AND TIRED of having to repeat this situation over and over and over – I have been working for months trying to get answers, and we have yet to find a single god damn person in the fucking federal fucking government, or the god damn state bureaucracy, who understands jack shit about this law.  I am SICK and TIRED and I want the damn government to get the fuck out of my health care.  Merkely’s office didn’t know jack shit about the law, wyden is a useless suck-up to money, and some ass from USCP told me that it was unreasonable to expect legislators to understand the law’s they work on.  Really?  So here the government walks into my life, tells me about some new health care laws, made me change a bunch of shit, changes the laws, changes them again, drops us in some government program, then shuts down operations and cuts town.  What has changed?  I can’t go to see a doctor – 100% unacceptable, and those useless motherfuckers in Salem owe me a direct apology – hell, they should pay for a platinum policy for my family for the next 10 years just because of their screwup.  Treat them with respect starting with 59 minutes on hold – fuck them and everyone in the fucking OHA.
 
anyhow – you’re now in the loop – new fight – question: does CAWEM require the negotiation of treatment waivers for non-critical consultations?
 
BTW – i’m likely going overseas in a few weeks – I found a $585 flight to Chiangmai on a new promotional China Eastern route, and one that takes me through Kunming, the northern edge of Tai culture – at $585 I can’t miss the chance to fly over to visit family, oversee the planting, and meet the horses – just got two new colts – bringing the total to 6.  Once over there, I’ll be able to walk into a doctor’s office, get a consultation, pay cash or arrange to use insurance if the bill is over, say $100. I will likely get my teeth cleaned by a competent dentist for $40 too – happy with my catastrophic-only dental insurance.  The country is in the middle of the third coup in a dozen years, and it still has better health care than the u.s.
 
hope all is well and healthy with you and yours,
 
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Argh! Two hours this morning – wife needs to see a doctor, but is that legal?

My wife is on the CAWEM program with the OHP – this is the only non-ACA, non-MEC compliant program associated with the expanded medicaid.  (You would be amazed how few people, even higher ups in the HHS, don’t understand that Medicaid has non-compliant programs – those idiotic federal jackasses still believe the lie that “medicaid is ACA” compliant – that is *NOT TRUE* – the CAWEM program is *NOT COMPLIANT* – but very few people, very few of the people who run medicaid, understand this)

CAWEM provided less coverage than the private catastrophic health insurance that we had before, except that it is run by the government and is slow, inefficient, difficult to work with, and, we suspect, triggers OAR 410-120-1280, which makes it illegal for us to seek health care for issues not listed as CAWEM covered.  In other words, thanks to fucking Obamacare, and jackoff as swipes like Merkley and Kitzhaber, their “good intentions” have made it actually fucking illegal to see a damn doctor.

I have no choice but to call the OHA client services line – last time I did that I was on hold for 59 minutes before the first person answered my call.  I just want to know if it is legal for my wife to see a doctor – still trying to figure that out – but mostly I’m explaining the damn law to the damn people who wrote and administer the damn law.  Seriously – no one at the state or federal level even fucking understands their own fucking health care laws.

FUCK YOU OBAMA – YOU DID THIS TO ME.  FUCK YOU MERKLEY – YOU SUPPORTED THIS.  FUCK YOU KITZHABER – YOU FUCKED UP THE STATE HEALTH CARE.  FUCK YOU ALL – it should *never* be illegal for someone to seek health care in the united states – yet that’s what you managed to do.  Fuck you.

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The Air Force called today – this is not directly ACA related, but is Fed related

Because of the ACA I did not sleep until about 5:30 in the morning – the sun was coming up the last time I went downstairs to get a drink of water, and before I finally made it to sleep.  So, whether I want to or not, I fretted and tried to understand how in the world I can live in a country where a simple human right like seeing a doctor could be so inefficiently, incoherently, and inaccessibly overgoverned.  How could I have come to live in a country where legal and economic concerns dominate common sense and basic human rights – and how could I have come to live in a country where most of the citizens bought in to this social architecture like it made any kind of sense, and where discussion or efforts to change were met with singsong indoctrination about the glory of capitalism and the simple fact that we were the best-est, free-est, kick-assyist country in the world.

I explored the mental universe around these ideas, fueled by the imposition of an absolutely incoherent legalistic overhaul of the medical economy.  No – that’s not how you it – that’s the engineering, and engineering has to be local – the role of the legislature, the proper role of the legislature in the context of health care overhaul is not to produce a thousand pages, but a good 100 word amendment to the constitution stating the relationship between the federal government, the state government, the fundamental human rights and responsibilities that we, as a people, by virtue of a common constitution, do collectively ordain as essential.  Maybe sumthing like this – lifted directly from the Locke quotes on the wikipedia page about Self-Ownership:

Every citizen has the right to individual sovereignty, wherein every Citizen has a Property in their own Person and the right to decide what would become of themselves and what they would do, and as having a right to reap the benefits of what they did, insofar as they do not transgress the Boundary of another Citizen without establishing consent.  Neither the States nor the United States have a right to intrude within the Boundary of a Citizen, except as punishment for a crime, whereof the party shall have been duly convicted. 

 

Access to health care shall be universal and offered without regard to citizenship and without direct cost to the disadvantaged.  This right incurs the responsibility of States to provide such institutions as are required to ensure the common health of all Citizens, to legislate the minimum standard of health standard, to determine compliance and penalties, and to collect such revenues as are required to support the health of the Citizens.  

 

Congress shall have power to enforce this article by appropriate legislation of the following nature: the sharing of resources, including facilities, access, and monies between states so as to raise the united health to the highest possible standard, the arbitration of conflicts between States, the restitution for services rendered between Nations.  Congress shall not dictate, in any way, any further restriction upon the States, but may provide facilities and require the sharing and distribution of information required to assess the common sense.  The government will maintain this information without regard of individual identity, in such a manner so as to deny correlation between any other state or federal record describing the individual, and will provide common and uniform access to this information.

It’s a bit wordy, but it is a first draft – this, to me is Life, Liberty and the Pursuit of Happiness linked to the fundamental rights of Self-Ownership – it is my body, damn it, and I want the Fucking Federal Fucking Government to get the Fuck out of my Fucking Business!  1000 pages of ACA legislation, creating situations wherein one might find the health care bureaucracy itself a traumatic, evil, life threatening obstacle is just not the way to do it.  You really fucked this up Washington – this was just a massive fuckup, trying to over legislate health care – I am exceptionally disappointed in you Barry – I mean cheneybush was a frankenstein of idiocy and cunning evil, but you – i had hope in you.  Bush was a cowardly little pussycat – likely a retarded pussycat, but you Barry, I fucking had hope in you – you shit on that hope with this ACA – so, to quote myself “Fuck You”

Let’s look at my proposed amendment in detail:

Section 1: The Right of Individual Sovereignty – Government rights end at my skin, but leaves room for the death penalty and prison doctors to experiment wildly on the incarcerated.  I used the 13th Amendment as a model, which establishes the proper conditions of State sponsored slavery.  I presume that the same legal machinery which allows the death penalty, but avoids death camps would come into play here – but you know, I honestly don’t know where that line is anymore – I had a god damn federal fucking employee threaten to “disappear my ass to guantanemo” and that was before we started to learn what happens there.  Do you fucking trust the government – they fucking lie and deceive and can not be trusted – they lost my trust, and I suspect they’ve lost the trust of most of america.

Section 2: Right of Access and Delegation to the States – the states are both required and empowered to provide health care.  This is a state matter, and the federal government’s role is to resolve interstate disputes according to our machinery of negotiation and due process.  Health care is not a matter of cost to the patient – ever, and it is offered to all people, regardless of race, sex, disposition, or citizenship – we the people do hereby offer the fruits of our excellence in health care to all upon our doorstep and within our borders.  One would hope that we the people would be so grand and great as to offer the same level of leadership in health care that we do running around trying to be the world’s thug and enforcer – but that is really just a hope for a hope, i do not have faith in we the people much, especially since the government of the people, by the people, continues to lie to me, deceive me, and just took a giant shit on my fucking health care.

Section 3: Limitation of Federal Power and Liability – I want the nation out.  This is critical.  We desperately need the diversity to affect positive change in our country.  Without diversity, we will not have a rich health care ecosystem, we will have an increasingly bloated, inefficient, and ineffective bureaucratically paralyzed health care system – meaning, what the fucking government did with the ACA was effectively amplify the core problems with health care.  And it is not about cost, you fucking jammed up the mechanism good and you shitcanned diversity.  I want true diversity – i want the right of people decide for them fucking selves, in groups that are smaller than the whole nation.  It could be that we mighty disagree – maybe in California you can get an abortion or have the state pay to turn your dick into a pussy, but maybe in the District of Columbia that will be frowned upon.  Point is, there is at least a way to navigate this as a society.  The battle for moral consensus can continue to be fought locally, and not by some distant, centralized, authority – americans are not known for their love of distant, centralized, universal and obtuse authorities – we call that Tyranny and we have given ourselves an obligation to get rid of it.  The ham fist of fucking Obamacare is a giant tyrant’s fist up my ass, and I am pissed to fucking hell about that.  I want my freedom of and access to health care back!

 

but yeah – i talked to the Air Force ROTC representative at Embry-Riddle today – cause, like I said, my daughter wants to be a pilot, and I’m suggesting to her that a decade in the Air Force, as an officer, might be a great way to get there, and teach her an enormous amount along the way.  Keep that in mind when I fucking talk to you motherfuckers in washington – for some fucking reason i still have some sense of obligation to my country, even though I feel that you – you motherfuckers in the current government can and should just get the fuck out – you are not competent to govern and it is time to start over.  I’m tired of your fucking lies and I will fight for my access to health care until you kill me.  Fuck you washington – i’m fucking claiming my right to manage my own fucking health care, so fuck you.

 

 

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Argh – still frustrated, can’t sleep, dreading the ACA-week

So my daughter began taking antibiotics, prescribed by the primary care physician that we were forced to see because (to quote the Public Benefits Attorney I spoke with about the matter of OAR 410-120=1280) “she has more resources available than you know about”.  Turns out she didn’t, we only got about 30% of our questions answered, and we agreed to start a therapy that was on the state-allowed list of therapies.  Her menses was late a week and she hasn’t been able to eat well for several days due to some sort of constant stomach pain – now, this is only the 2nd time in a 18 months that my daughter has seen a u.s. doctor – once for a court mandated physical that cost me $150 (state wouldn’t accept the physicals we got for our visas which we got at a hospital 3 months before), and once because of the inability to see a doctor in the united states, now that we are on “Obamacare” (Fuck you obama – just fuck you)

In July we’re going back to our health care home, and we will spend the $20 to just walk into our local hospital, walk up to reception, show our id card (not our insurance card), and then walk over to see a dermatologist.  We will not involve insurance at all, and it will cost about $20.

Thanks to the Obamacare fist up my ass, here in the united states, with our shitty health care system, it took 2 days of negotiating with lawyers, administrators, legislators, and dozens of others including the USCP,  just trying to find a pathway by which one can pay a doctor for services, once they have been assigned, against their wishes, to Medicaid.  And that pathway involves a ream of forms and the establishment of a minimum of a few hundred dollars of retainer fees to safeguard the consultation.  We’re talking about $20 worth of medical care – and it cost me an opportunity cost upwards of $1200, and established tense, hate filled relationship with those little FLETC trained jackasses over at USCP – who tried to argue that it was completely sensible that our health care law should make it so complicated.  The USCP actually suggested that I should hire an attorney to negotiate my participation in Medicaid, which I am assigned to against my will by the incompetent failure that was CoverOregon!

Fuck you CoverOregon – fuck you Oregon – fuck you Merkley – fuck you Obama – it should just not be that fucking complicated to see a doctor.  I do *not* want your fucking protections any more – i do not want what you call rights.  Look at those rights – that’s a load of bullshit too – the MEC compliance process only makes cursory and imprecise reference to the general sense of “better insurance” where that is defined in Title I of the ACA.  Rights…. shit, it’s so complicated that you might have a right, but it may take years to figure out whether any given case does or does not qualify.  Having rights in theory is of little value when it is practically impossible to see a doctor, get a consultation, and pay them money!

And I *have* insurance – i just have the wrong kind and no one can tell me why.  I can not maintain the appropriate and effective insurance for my family, and the fucking ACA has created an exceptional bureaucratic distance between my family and health care.

I am so damn tired of having the conversation and effort reset.  I tried going through my senators and representative, but jesus they were useless, idiots with no understanding of the damn law.  I mean, I had to educate them about how the law works.  They literally did not know about the MEC compliance process – that’s not surprising, half the people in the HHS do not understand the MEC compliance process.  The one thing that the senator’s assistant did for me that was in any way useful, was find a Baker & MacKenzie document which verified my understanding of MEC-compliance.  I felt vindicated to read that my research had taken me exactly to the right spot – except I didn’t get paid shitloads of money.

In fact, I think I should bill the damn government for the time I spent doing that research, and I should charge them the standard Baker and MacKenzie rate.  We can take it as an advance tax credit.

It is 4:30 in the morning, I have no been able to sleep – every time I try to sleep i start thinking of the fact that my daughter is feeling ill because of the medication we had to get, and that the doors to fixing the problem are effectively shut down.  What Obamacare means to me is that it is effectively unrealistic to see a doctor for anything other than a life threatening condition.

We’re stopping the medication and giving up on the united states health care system for this issue.  We’ll go back to our health care home, spend $20, and deal with the issue at a competence level that is as good or better than the united states.  But who knows, maybe it is illegal for me to see doctors outside of Oregon – I would not be surprised if there was a law that stupid here.  Who knows what is in the law, the legislators certainly do not, and the police are ready to kill us to defend the right of legislators not to understand what they are doing.

This is a severely broken america – it’s not right/left, it’s just fucking broken.  Thank you for fucking up my health care Kitzhaber, Merkley, Obama and every other jackass behind that shitpile of legislation that is the ACA.  Fuck you all – your incompetence has convinced me that the united states model of government does not work as currently implemented.  Needs some serious fixing – and in the meantime, I figuratively spit on Kitzhaber, Merkley, and Obama in disgust.

 

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Light few days…. not a full hour of ACA pain in two whole days, time to look at a few pages of the crap OHP sent me

Well, it’s Sunday night and I’m probably heading out of the country.  Daughter did her homework, finished the laundry, wife studied for one of her government required tests (despite over 30 years experience in a restaurant/bar environment, she needs to get licensed to hand people beer here in OLCC), I did the vacuuming, clipped the weeks coupons, and sat down to clean up my desk in the corner of the living room.  I routinely shove health care related shit under my cat’s sleeping pad, then pull it out from time to time.  Earlier in this blog we talked about 20+ pages of crap.

The first page introduced us to the CAWEM – the non ACA compliant medicaid program which is equivalent to the private insurance that I am no longer allowed to have (if I also wish to avoid the Tax Penalty) – seriously, I had insurance that worked almost just fine, but now, now I spend hours every week trying to locate someone, anyone, in the fucking federal government who understands how this pile of ignorant bullshit works.  I say “almost” because pre-ACA the state of Oregon had a law indicating that I could not hold this sort of insurance for more than 12 months without a 2 month break.  What the fuck.  And this was pre-ACA.  Thankfully the insurance oversight staff was familiar enough with the loopholes that they were able to help me find a “questionable, but probably not a problem” work-around that bypassed the law (which makes you wonder, why the hell have that damn law in the first place! )  After the hours I spent on hold with the OHA, to find out why my wife qualified for only the non-ACA compliant medicaid program I couldn’t take any more.  I’m returning now to see what else was in that stack.

Three pieces of paper are about the appeals process if we did not like the judgement.  So 1 piece of paper, front and pack, describing that we did not meet the immigration/alien status requirements, and listing 17 laws in the OAR, one of which hid a rule indicating that the condition we did not meet was being a legal permanent resident for more than 5 years within Oregon.  Seriously, after the costs, humiliation, and degradation of the IR visa acquisition process we still can not get effective medicaid until we stay in one place for 5 years?  That seems pretty fucked up – so once again, fuck you Oregon, fuck you Oregonians, and fuck you, you cowardly USCIS/Homeland Security fucking fuckers – you’re so fucking afraid of everything that you nearly shit yourself with effort trying to make it difficult for me and my wife and daughter to relocate to the united states to participate in my mother’s death.  You, americans, homeland security, uscis – are suck fucking cowards that you can not even respect the integrity of a family attending to a beloved’s end of life.  Fuck you America, fuck you USCIS – you are fucking cowards.

So where was I – ok – first page was fucking annoying, then the next six sides were just what to do if we wanted to try to “upgrade” our status and appeal it.  I don’t fucking want to appeal it, I wan’t my freedom back so I can purchase the *identical* fucking insurance and get away from the government.  I do not *want* Obamacare Medicaid that requires that we also pay the Tax Penalty.  I do not want to be forced to interact with this inefficient and fucked up waste of a government, just to regain my family’s rights to their individual sovereignty – we are not property of anyone or anything, we are each individually sovereign (as in Locke’s concept, you are your own property – see this: http://en.wikipedia.org/wiki/Self-ownership – not the ‘sovereign citizen’ stuff, and I need to make this case why?  because using the sovereign citizen term in conversations that are being monitored by the national government is risky – it is literally risky to discuss politics in the united states these days – seriously.  what the fuck happened to the constitution!)

But – now that I have recycled these 8 pages of information, none of which are welcome in my life I see what’s next.  The page is yellow… it is a list of benefits covered by….. OHP Plus, OHP with Limited Drug, and CAWEM Plus.  What the fuck.  are we CAWEM plus?  I grab the paper I’ve just recycled to check – and then I see at the bottom of the page a statement for “Other benefits packages” of which CAWEM is one.  I check on the recycled paper and it says only CAWEM, not CAWEM plus – so I think the only line on publication DMAP 1418 that is relevant is the after note at the bottom of the page.

Great – took a while to figure this out from this impressive list of benefits that are not available to us.  Can’t someone just make sense of this?  Why is the government forcing me to try to reverse engineer this asinine health care system they’ve created.  Fuck you Oregon, Fuck you Washington, Fuck you Kitzhaber – you’re a shitnugget if I ever saw one (and i’m triple pissed at you today because I had to see your fucking offensive name on a political candidacy ad!  Fuck you, you mustachioed fuck)

I turn the yellow paper over and am asked “Are you enrolled in a CCO or are you an open card member?” – is this yet another thing they do not understand?  Is there no fucking coordination in this government?  What the fuck is a CCO?  Again, I’m an idiot, I’ve had access to affordable, high quality health care – I see doctors and utilize hospitals, I have no fucking idea what a CCO is.

There is an example of a page and some instructions at how to look at some chart that it seems like I should see somewhere.  There is a pair of examples of overly complicated acronym soup – something about DCO and CCO – maybe DCO is a dental care organization, so a CCO is a “C” care organization.  What the fuck is the C for and why is it important?  There is a highlighted bubble and some circles and arrows – the page instructs me that “These letters relate to the letters on page 3”.  Jesus – this is a User Interface Fail – what the fuck am I trying to figure out.  Shit – if the information can not be presented sensibly, it probably doesn’t apply – so I recycle the yellow page.  It appears to contain no information of relevance.

Next page is something about Oregon Health Plan – that may be the same as CAWEM, maybe not.  I don’t know – and we are enrolled in this against our wishes, and only because of the confusion internal to the government about how to apply the ACA to our lives.  So we’re stuck on OHP, non-compliant plan, out of confusion on behalf of the government on to how we can be compliant.  Fucking frustrating – it would have been so simple if “if you have insurance, you can keep it” worked – I have insurance, still do, and we have OHP because they couldn’t account for my plan on the MEC-compliance list operated by James Mayhew.

I scan this – this is talking about providers and I see that CCO is a “coordinated care organization” – jesus, it was so simple overseas – if you’re sick, go to your doctor.  That’s it.  If you want medical advice, go to your doctor.  Try different doctors until you find one you get on with.  It’s that simple.  Here is some shit about care coordination organizations and provider registries, and options that I have that may or may not be in alignment with my current choice of doctor, who is ceasing to take insurance.  Fuck – I think I just had my Dr. yanked out from under me by this OHP.  Do I need to select a new doctor?  Who the fuck understands this shit – and you know what, I have a bi-weekly call with a Director of the OHA, who has been absolutely unable to provide any information of value to me – nice gal, but ultimately useless.  I just want the freedom to fucking see a god damn doctor that I get along well with and figure out how to pay for it sensibly without resorting to this fucked up OHP or any government program.  Argh!

I see on the reverse of this page that there are more conditions and sub conditions about the agencies involved in the different aspects of running this behemoth of inefficiency – good lord.  I have my damn Dr’s number, why can’t I just use that…. I scan further down the list of phone numbers and legal bullshit – i see that the number that I dialed (59 minutes on hold before the first answer) is listed for questions about eligibility.  Golly me – I figured that out before.  Still waited for 59 minutes, and then a bit longer, to learn that my wife is a 2nd class immigrant, liable for the Tax Penalty, who can access only non-compliant health care via Medicaid but who, like me, has perfectly fucking fine insurance that is not on James Mayhew’s MEC-compliant policy list in the Enforcement Division of the CCIIO of the CMS of the HHS – damn it – i just want to see my damn doctor.

Returning to the united states after 10 years abroad and it is beyond pathetic how fucked up our government has made our health care.  You’re damn right I don’t want the ACA – the government has a sort of anti-midas finger, everything it touches turns to shit – and I do not want it to fully destroy the pathetic united states health care system it has already partially shitified.

The next piece of paper is my “explanation of benefits” – this appears to be the welcome letter that says that we are on a plan, and explains a bunch of other stuff.  It’s strange, no one in the government can simply come out and say something – this is the announcement that I will soon know what plans my family has.  At the bottom I see that my wife supposedly applied for her health care three times back in April and was then assigned a short while later.  Why three times?  Why April?  This is insane – we applied over a dozen times, as a family, in October through January, then 2/3rds of the family got on OHP (because the state could not answer the question – how do we document our existing insurance) – then, only later – as part of my battle, did we find out that my wife’s records had gotten all screwed up.

I turn the page over and I see a chart like that yellow explanation of benefits.  There is no data in the final column, so the examples on that yellow paper do not really apply.  I am vindicated in thinking that the yellow paper was useless.  I laugh, because this lists “everyone in my household” and only my wife is on it.  I laugh because I had to fight the government so hard to document my family, because the united states so vehemently attacks families, because they are greedy little over-regulated cowards hiding in their little nanny-state and I had to work through half a dozen agencies over the span of two years, just to get the right to be documented as a family – and it means nothing when the ACA is involved.   Fuck you ACA – fuck you Kitzhaber, Obama, Merkley, Wyden, Bonamicci – fuck you oregon, and fuck you america – get the fuck out of my fucking health care – all of you, out, out, out – you did not help the situation, you fucked me and then, in a twist of irony, you refer to me as a success and being ‘helped by’ the ACA – fuck you all.

Last page is a sheet of what look like cards.  This i’ve seen before – the state isn’t very bright when it comes to software – look at how much they blew on Cover Oregon – so it doesn’t surprise me that they can’t handle distributing a piece of shit paper card in a user friendly way.  I’ve read several times that the card does not guarantee benefits – so I scrape all the paper into the recycle bin.

Not bad – just an hour of reading papers that turned out to be more confusing than anything.  Why they couldn’t process our family as a family I’ll never know – but then nothing that comes out of OHA or CoverOregon makes much sense.  I just wish I didn’t have assholes with guns forcing me to pay for this level of shitty service.

Fuck you America – you are not the country I was born in, you are no longer a country worthy of honor – you’re a bunch of cowardly, greedy, fucks with a dysfunctional government and an economy that’s trashing the planet to keep you fat.  You can’t even see a doctor in the united states – what a fucking shitty place to live – I can not wait to get out again.

Fuck you ACA.

 

 

 

 

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