If you didn't know, I am not the person in my family with the most health issues. That distinction belongs to my daughter. My daughter was born the same year I was officially diagnosed (my son was born the year my symptoms began). When she was born, we were expecting a healthy baby girl (we found out she was a girl beforehand) and I was not taking any medications at that time. Needless to say, the moment she was born, we knew we were in for it. However, we actually had no clue.
My daughter was born with a cleft lip. While immediately noticeable, it ended up being one of the smallest issues we've dealt with over the past six years. She had heart surgery at 10 days old to fix a PDA, had surgery again at one month old to get a mic-key feeding tube and fundoplication, had two surgeries at 5-6 months old to redo the fundoplication and get a tracheotomy inserted due to a laryngomalacia and tracheomalacia, and surgery at 8 months old to fix her cleft lip. The trach and feeding tubes were removed when she was four years old. She is also deaf in her left ear, hard of hearing in her right ear (aided to normal with a hearing aid), has coloboma's in both eyes and is missing her semi-circular canals in both ears. Besides this, she broke her neck last month, again due to a congenital issue. Needless to say, my daughter deals with a LOT. Yet, she is in a mainstream Kindergarten and is doing work appropriate to her grade level.
My wife is a stay at home mom, who has not only taken care of our daughter, but has ensured that she has thrived. My daughter is a very special girl with an amazing attitude. If you doubt me, you can ask any of her therapists and teachers who not only are amazed by the progress she shows every year, but her work attitude and desire to succeed. But, I will say, if not for the mama bear of a mother she would not be doing as well as she is. Also, in the past six years, my wife has started a foundation at my children's elementary school which has raised over $50k in its first two years, run a multitude of half marathons, finished a half-ironman, became a great cook and pushed my ass to workout countless times.
This week, my daughter's halo came off at the doctor after wearing it for eight weeks. She will now be in a neck brace for an additional 7 weeks and then will probably wear a neck collar for a little while after that. She should make a great recovery. The night it came off, my wife commented that our daughter is her hero. I would venture my wife is my daughter's hero.
In my opinion, they're both incredible and I'm lucky to have them both in my life.
Thursday, December 13, 2012
Tuesday, December 4, 2012
Jon Stewart nails Fox on the "War on Christmas"
As a Jew in the US, the idea of a War on Christmas just seems ridiculous to me. The fact is, I had to tell my kids to lie to their friends and just keep their mouths shut when they mention Santa Claus. I don't like having to tell my kids to lie for you, but it's the right thing to do for other reasons.
However, Jon Stewart nailed it this year in the annual mocking of Fox News' War on Christmas. Two of my favorite parts of the show:
However, Jon Stewart nailed it this year in the annual mocking of Fox News' War on Christmas. Two of my favorite parts of the show:
- On the proliferance of Christmas specials, there's even a Flinstone's Christmas special, Stewart pointed out, meaning "there’s a Christmas special celebrating Jesus’ birth thousands of years before the birth of Jesus."
- On Bill O'Reilly's argument that Christianity is not a religion, but a philosophy, Stewart replied, "While I can get an A in Jesus' philosophy class, I don't get to go to the after party
How OptumRX legally screwed me out of $150
I take a number of drugs for Parkinson's. One of those drugs is Requip XL (Ropinerole ER). This drug is the same as the drug Requip (Ropinerole), except it has a time release capability which means the drug company that created it, could keep it from going generic, longer. The advantage of taking the time release version is that you get a little bit of the drug over the whole day as opposed to large doses that taper off. The good news is that the drug just went generic. The bad news is that my prescription plan through UHC has not yet approved it for generic pricing.
Nevertheless, my pharmacy, OptumRX, in their infinite wisdom as a generic pharmacy sent me the generic version of the drug. They also charged me the same rate as it would have cost if I they had sent me the brand name of the drug. I called them and asked since I was paying brand name prices, I wanted the brand name drug. They basically said, tough. They sent it out and there was no indication on the prescription to fill as ordered instead of using a generic version of the drug.
Now understand this, I would prefer to have the generic version of the drug, but for generic prices. The fact that I called them immediately upon receiving the medication and they did not call me back is indicative that they knew what they were doing. I called back a few weeks later, and after discussing with a customer service representative and her supervisor, I asked to talk to the pharmacist who was in charge of making the decision. I was told by the supervisor that the pharmacist would not speak to me and the decision was final.
The problem is, I have no recourse and the pharmacy knows this. They are the only mail order prescription service that my health plan uses and they are on the whole much less expensive then going to the local drug store. Nevertheless, I will probably be transferring this prescription to a local drug store, because then I will be able to see what I am receiving and quickly be able to determine whether the generic brand has been accepted by my health plan and the price will go down.
For reference, my plan offers Tier III drugs such as Requip XL for $170 for a three month supply, while a generic brand will cost $20.
Nevertheless, my pharmacy, OptumRX, in their infinite wisdom as a generic pharmacy sent me the generic version of the drug. They also charged me the same rate as it would have cost if I they had sent me the brand name of the drug. I called them and asked since I was paying brand name prices, I wanted the brand name drug. They basically said, tough. They sent it out and there was no indication on the prescription to fill as ordered instead of using a generic version of the drug.
Now understand this, I would prefer to have the generic version of the drug, but for generic prices. The fact that I called them immediately upon receiving the medication and they did not call me back is indicative that they knew what they were doing. I called back a few weeks later, and after discussing with a customer service representative and her supervisor, I asked to talk to the pharmacist who was in charge of making the decision. I was told by the supervisor that the pharmacist would not speak to me and the decision was final.
The problem is, I have no recourse and the pharmacy knows this. They are the only mail order prescription service that my health plan uses and they are on the whole much less expensive then going to the local drug store. Nevertheless, I will probably be transferring this prescription to a local drug store, because then I will be able to see what I am receiving and quickly be able to determine whether the generic brand has been accepted by my health plan and the price will go down.
For reference, my plan offers Tier III drugs such as Requip XL for $170 for a three month supply, while a generic brand will cost $20.
Monday, December 3, 2012
Pledge to get Active
And now for something, somewhat different....
I mentioned in my last post, my wife wants me to sign up for a swim race/event. After the post and the positive response I got from a number of people, I decided that I thought the idea of doing a race is a great one. However, the more I thought about it, the more I thought that this would also be a great way to challenge others. So, I'm putting my legs and arms where my mouth is and challenging everyone in the Parkinson's community to sign up for a race.
I don't care if it's a 5K, a marathon, a bicycle ride, a long swim or something completely different like a dance marathon. The only condition, is that it has to be a distance/length/time that you have either never done before and/or that you have to keep up your training level to be able to finish. If you've never done a 5k, sign up for one. If you feel you cannot run one, walk one. It doesn't have to be a Parkinson's related race and you don't have to raise money for Parkinson's as part of your training. This is something for you and your health, because everything I've seen is that the best thing you can do for yourself in order to slow the progression is get active.
I'm not even swimming a mile yet, so I have not yet decided on whether to swim the full 2.4 mile race or just the 1.2 mile race. However, I am pledging that I will be swimming at the Oceanside Tiki swim in September of 2013. Currently, the website does not have next year's registration and/or event information for next year.
Nevertheless, considering we are coming up on a New Year, this is the perfect opportunity to make a New Year's resolution to get active. Do it and I'm sure you will feel better. Active means getting up and moving. Just pledge to do something more and something measurable (can you tell I'm an engineer).
Leave a comment if you plan to sign up for something or have already pledged to do an activity. Remember, this is in your own best interest. So be selfish and get active.
I mentioned in my last post, my wife wants me to sign up for a swim race/event. After the post and the positive response I got from a number of people, I decided that I thought the idea of doing a race is a great one. However, the more I thought about it, the more I thought that this would also be a great way to challenge others. So, I'm putting my legs and arms where my mouth is and challenging everyone in the Parkinson's community to sign up for a race.
I don't care if it's a 5K, a marathon, a bicycle ride, a long swim or something completely different like a dance marathon. The only condition, is that it has to be a distance/length/time that you have either never done before and/or that you have to keep up your training level to be able to finish. If you've never done a 5k, sign up for one. If you feel you cannot run one, walk one. It doesn't have to be a Parkinson's related race and you don't have to raise money for Parkinson's as part of your training. This is something for you and your health, because everything I've seen is that the best thing you can do for yourself in order to slow the progression is get active.
I'm not even swimming a mile yet, so I have not yet decided on whether to swim the full 2.4 mile race or just the 1.2 mile race. However, I am pledging that I will be swimming at the Oceanside Tiki swim in September of 2013. Currently, the website does not have next year's registration and/or event information for next year.
Nevertheless, considering we are coming up on a New Year, this is the perfect opportunity to make a New Year's resolution to get active. Do it and I'm sure you will feel better. Active means getting up and moving. Just pledge to do something more and something measurable (can you tell I'm an engineer).
Leave a comment if you plan to sign up for something or have already pledged to do an activity. Remember, this is in your own best interest. So be selfish and get active.
Friday, November 30, 2012
Swimming, my new/old exercise
I'm hesitant to even write this, because every time I start writing about exercising, I seem to soon find some excuse to stop. However, I have started swimming a few times in the week and unlike running, I'm actually enjoying it. My wife love's running, I on the other hand, abhor it. I feel slow and weak and especially in the morning when I was doing it this summer, I just felt uncoordinated. I have never really enjoyed running, but with Parkinson's, I actually am moving toward dislike and possibly hatred.
However, swimming in the morning when I've been getting up around 5:00 am and am in the pool at my gym by 5:30 or earlier is amazing. There are a couple of reasons for this.
However, swimming in the morning when I've been getting up around 5:00 am and am in the pool at my gym by 5:30 or earlier is amazing. There are a couple of reasons for this.
- Peace and tranquility - If you have never swum in a pool in the morning when it is still dark outside and the stars are out and you can only hear the strokes and kicks of the other people in the pool, you have never felt a more relaxing workout environment. I will admit helps that I live in San Diego and I can swim outside year-round.
- The feeling of weightlessness - As someone who struggles in the morning to just walk to the bathroom without shuffling, when I get in the pool, even if my meds haven't fully taken effect, I don't feel the PD. It is freeing and my body just feels easier to manipulate.
- I am actually not a bad swimmer. I am definitely not in shape, but one of the sports I did well at as a kid was swimming. The fact that my stroke form is pretty good and when I start a swim, I don't feel slow, helps me enjoy it more. I'll admit it, one of the reasons I don't like running is because I'm slow. I've always been a slow runner and I don't see that changing anytime soon; but, I am not a slow swimmer and in the past week, I've already seen progress.
Because of all this, I'm hoping it sticks. My wife is already on me to sign up for a race that she'll be doing in the fall (a 2.4 mile swim), but she uses races to motivate her. She paid the money and is damn well going to finish it. That is not my motivator. I'm actually still searching for it (other than the obvious family, health, slowing of progression, etc). However, I'm hoping these enjoyable parts of swimming will point me to my motivation faster or will in themselves be it.
What motivates you and what are you doing to get moving?
Wednesday, October 24, 2012
The Wealthy Pay the Exact Same in Federal Income Taxes as Everyone Else
I'd like to propose a change in an argument I've seen online a great deal. I've been seeing this argument in one form or another for the past 15 years (at least since Steve Forbes ran for President in 2000). The idea is that a flat tax would be a fairer system of taxation because currently the rich pay a higher percentage of their income than the poor or middle class.
What this argument totally ignores is the fact that the rich actually pay a higher marginal tax rate. However, they pay exactly the same rate as a poor or middle class person for the same income. For example, a single person with no dependents, up to the first $8700 in income has a tax rate of 10%, no matter how much subsequent income they earn, for income between $8700 and $35k everyone has an income tax rate of 15%, and so on, until you reach the top tax bracket and currently pay a 35% federal income tax rate. One of the big issues is that most citizens truly do not understand marginal tax rates. They believe, incorrectly, that if you are in the top tax bracket you pay 35% on all of your income.
Also, I'd argue that the lower income is more important to the taxpayer, that it makes sense the rates go up. One way to look at this is to calculate the opposite of one's Return on Investment for these different groups of individuals or families. A rich family will clearly save more and spend a lower percentage of their income than a poor one (note: there are always exceptions). Therefore, the money at higher income levels is not as valued as the money at lower levels, and to match the value, should be taxed at a higher rate. BTW, yes, I know I'm reaching here; but that's the beauty of having one's own blog to write down your thoughts.
Caveat: This totally ignores looking at standard deductions as well as other deductions for which people are eligible. This will be a big issue if Romney is elected, because he has stated publicly that he will eliminate many of these deductions in order to reduce overall rates; however, I did not include deductions for simplicity. However, since the deductions are taken off the top level income, if you have enough you can drop your marginal tax rate below the $85k pretty easily depending on your income.
The other point that is missed in whether the rich are overtaxed, is the fact that we are currently near historical lows for the rich in terms of their marginal tax rates. In fact, this guy ran the numbers and determined that:
So, when someone tells you that the rich already pay their fare share of taxes, you can tell them, they paid the exact same amount as everyone else.
What this argument totally ignores is the fact that the rich actually pay a higher marginal tax rate. However, they pay exactly the same rate as a poor or middle class person for the same income. For example, a single person with no dependents, up to the first $8700 in income has a tax rate of 10%, no matter how much subsequent income they earn, for income between $8700 and $35k everyone has an income tax rate of 15%, and so on, until you reach the top tax bracket and currently pay a 35% federal income tax rate. One of the big issues is that most citizens truly do not understand marginal tax rates. They believe, incorrectly, that if you are in the top tax bracket you pay 35% on all of your income.
Also, I'd argue that the lower income is more important to the taxpayer, that it makes sense the rates go up. One way to look at this is to calculate the opposite of one's Return on Investment for these different groups of individuals or families. A rich family will clearly save more and spend a lower percentage of their income than a poor one (note: there are always exceptions). Therefore, the money at higher income levels is not as valued as the money at lower levels, and to match the value, should be taxed at a higher rate. BTW, yes, I know I'm reaching here; but that's the beauty of having one's own blog to write down your thoughts.
Caveat: This totally ignores looking at standard deductions as well as other deductions for which people are eligible. This will be a big issue if Romney is elected, because he has stated publicly that he will eliminate many of these deductions in order to reduce overall rates; however, I did not include deductions for simplicity. However, since the deductions are taken off the top level income, if you have enough you can drop your marginal tax rate below the $85k pretty easily depending on your income.
The other point that is missed in whether the rich are overtaxed, is the fact that we are currently near historical lows for the rich in terms of their marginal tax rates. In fact, this guy ran the numbers and determined that:
if you want to maximize growth, the top rate should be raised to about 64% and the tax burden on folks at the lower end of the income scale should be lowered.Now before you say, but 50% of people pay no income taxes, the lower end rates in the analysis also included other taxes like Social Security and Medicare which are regressive taxes taken out of your paychecks as FICA. Why is this important, because one of the main taxes the GOP has tried to raise is the FICA tax rate which was reduced as part of the stimulus package that Obama in the beginning of his first term.
So, when someone tells you that the rich already pay their fare share of taxes, you can tell them, they paid the exact same amount as everyone else.
Sunday, October 21, 2012
Open Letter to my Family
I was thinking of sending this letter to members of my family that have said they will not vote for Obama. I know it probably will not convince any of them; however, I'd like to know what others think.
I know election time is coming up and it is not a big surprise that I am voting for Obama. However, I am writing this letter to ask you to vote for him as well. I know that some of you did not vote for him in 2008 and some of you who did are switching over to Romney because you don't like how he implemented his policies over the last four years. I do have one argument to make and if that does not convince you fine; but, I'd like you to consider one thing when you do vote for Romney.
My daughter.
Now I know many of you have or continue to have health issues. And the fact that you don't see how "Obamacare" is most likely the reason you will have healthcare in your old age is beyond me. If Romney and Ryan are voted in with a majority in Congress and the Senate (definite possibilities) and you have any pre-existing condition and buy your insurance on the open market, you will not be able to buy an affordable plan. If you reach an out-of-pocket maximum which will become legal again if Obamacare is repealed, an expensive monthly treatment will soon eat into that lifetime maximum along with any hospital stays you may have. If you are out of work or lose your insurance for 90 days, you will automatically not be eligible for an individual policy that excludes pre-existing conditions.
Oh, and if you say, I'm already over 65 and receive medicare, they won't change mine. Yeah, right. Once everyone else sees that they have no chance to receive healthcare like the baby-boomer generation does, I'm pretty sure the rest of us will make sure that discrepancy goes away. Also, I know the baby-boomers are considered the me generation, but "F.U., I've got mine", is no way to treat your children and grandchildren.
However, getting back to my daughter. Do you really think there is a chance in hell that she will be able to get any form of health insurance after I stop working? The only reason we are able to cover her is because I am on my large employer's group policy. What do you think is one of the reasons I've worked there for over 19 years is? Also, you say she receives some medi-cal to help offset many of her other medical expenses (copay and deductibles) we've faced over the past six years. However, they have already stated that most states will receive 30% less in medicaid dollars if "Obamacare" is repealed. Who do you think will be one of the first to be kicked off the medi-cal rolls, someone who uses medi-cal as supplemental insurance or someone who uses it for everything?
And if you think this is 20 years down the road, you are kidding yourself even more. Yes, my Parkinson's is under control, but it is a deteriorating neurological disease. While I hope for better treatments and possibly a cure in the next 20 years, I really have no clue how long I will be able to work. My doctor gives me ranges of 10-20 years. What happens to the rest of my (our) family after that? Many of you know I have already begun discussing DBS with my neurologist. Thank goodness I have insurance that will probably be willing to pay for this. See my length of employment for reasons why.
As for another example, Romney's plan calls for making the Individuals with Disabilities Education Act, or IDEA, into a national voucher program. Part of this program helps fund all the therapists and aides that are required by the school to meet the needs of children with disabilities. Please, relatives who worked in education their entire lives, explain how a voucher program will assist my daughter in receiving the OT, PT, Speech Therapy, DHH and other therapies and assistance that she receives from the school district. She currently receives a larger percentage than most children and with a broken neck, may require even more for the next few months. Do you really believe any voucher program would allow for different monetary values per child and do you believe she'd continue to get these services in school. Since we'd get vouchers, the school districts wouldn't need to hire anyone because they could then tell us to use outside providers.
Thanks for taking the time to read this. If you're still going to vote for Romney fine. But I hope you can come up with a better answer than I just don't trust Obama, Because if you trust Romney more, we are at an impossible impasse.
I know election time is coming up and it is not a big surprise that I am voting for Obama. However, I am writing this letter to ask you to vote for him as well. I know that some of you did not vote for him in 2008 and some of you who did are switching over to Romney because you don't like how he implemented his policies over the last four years. I do have one argument to make and if that does not convince you fine; but, I'd like you to consider one thing when you do vote for Romney.
My daughter.
Now I know many of you have or continue to have health issues. And the fact that you don't see how "Obamacare" is most likely the reason you will have healthcare in your old age is beyond me. If Romney and Ryan are voted in with a majority in Congress and the Senate (definite possibilities) and you have any pre-existing condition and buy your insurance on the open market, you will not be able to buy an affordable plan. If you reach an out-of-pocket maximum which will become legal again if Obamacare is repealed, an expensive monthly treatment will soon eat into that lifetime maximum along with any hospital stays you may have. If you are out of work or lose your insurance for 90 days, you will automatically not be eligible for an individual policy that excludes pre-existing conditions.
Oh, and if you say, I'm already over 65 and receive medicare, they won't change mine. Yeah, right. Once everyone else sees that they have no chance to receive healthcare like the baby-boomer generation does, I'm pretty sure the rest of us will make sure that discrepancy goes away. Also, I know the baby-boomers are considered the me generation, but "F.U., I've got mine", is no way to treat your children and grandchildren.
However, getting back to my daughter. Do you really think there is a chance in hell that she will be able to get any form of health insurance after I stop working? The only reason we are able to cover her is because I am on my large employer's group policy. What do you think is one of the reasons I've worked there for over 19 years is? Also, you say she receives some medi-cal to help offset many of her other medical expenses (copay and deductibles) we've faced over the past six years. However, they have already stated that most states will receive 30% less in medicaid dollars if "Obamacare" is repealed. Who do you think will be one of the first to be kicked off the medi-cal rolls, someone who uses medi-cal as supplemental insurance or someone who uses it for everything?
And if you think this is 20 years down the road, you are kidding yourself even more. Yes, my Parkinson's is under control, but it is a deteriorating neurological disease. While I hope for better treatments and possibly a cure in the next 20 years, I really have no clue how long I will be able to work. My doctor gives me ranges of 10-20 years. What happens to the rest of my (our) family after that? Many of you know I have already begun discussing DBS with my neurologist. Thank goodness I have insurance that will probably be willing to pay for this. See my length of employment for reasons why.
As for another example, Romney's plan calls for making the Individuals with Disabilities Education Act, or IDEA, into a national voucher program. Part of this program helps fund all the therapists and aides that are required by the school to meet the needs of children with disabilities. Please, relatives who worked in education their entire lives, explain how a voucher program will assist my daughter in receiving the OT, PT, Speech Therapy, DHH and other therapies and assistance that she receives from the school district. She currently receives a larger percentage than most children and with a broken neck, may require even more for the next few months. Do you really believe any voucher program would allow for different monetary values per child and do you believe she'd continue to get these services in school. Since we'd get vouchers, the school districts wouldn't need to hire anyone because they could then tell us to use outside providers.
Thanks for taking the time to read this. If you're still going to vote for Romney fine. But I hope you can come up with a better answer than I just don't trust Obama, Because if you trust Romney more, we are at an impossible impasse.
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