Giving and Getting

Invited “Anne” over last night for a glass of wine and a movie. I can not tell you exactly why I did it. This is not a friendly place- Tequesta Hills Condominium”- and no one even expects a smile when passing in the street, let alone an invitation for the evening. But she and I had begun a dog-walking relationship over the past few weeks and I thought she might appreciate a little company. I went over to her apartment and she invited me in. She showed me her paintings and her drawings. They were very good. I could learn a lot from her. Her dog Ollie came over to me and let me pet him. She said that it was rare for him to be so trusting. ( I didn’t tell her I am the “Dog Man” and have a secret key that unlocks the hearts of all dogs!) I told her to come on by at about 7:30 and we would watch a movie from the library and have a glass of wine, etc... I told her to bring Ollie too. Gurler wouldn’t mind the company.



She came on time and we sat, she, Elisabeth and I in our place and I turned on the TV. Lizzy poured them some white wine while I que’d up the DVD. We talked a while and the DVD player went into sleep mode which meant it played a slide show of my photographs on the TV screen. Anne seemed interested in the pictures and we ended up talking about the photos for the better part of an hour. It was fun but I was self-conscious of being a bore and making her view and talk about our camper and our sons and our lives in general. I got over it when I realized she was genuinely interested.



We watched the movie (What the Deaf Man Heard-about a boy who is abandoned and who plays deaf for twenty years. Dickens-esque story that was sweet and innocent. Perfect for the evening ) and Lizzy made popcorn and tea. It was a strange coincidence that Anne has an adopted son who is deaf. She told us a little bit about him while we watched the film. Her insights about the handicap were heartfelt and informative. And then she said something that made me feel wonderful. She said “You two are so easy to be around...” I could tell she was enjoying the evening and the company and if she didn’t enjoy the family photos then she was a brilliant actress. How lovely our lives really seem when viewed through the eyes of another person. Elisabeth and I are so lucky and creative and happy. But we lose sight of our good fortune and it takes another perspective to see that sometimes. In the end what seemed like an act of kindness inviting a stranger into our home turned into a reaffirmation of ourselves. We got, from the evening, so much more than we gave, which, I guess is what friendship is all about.



Gurler and I walked Anne home after. The weather was starting to threaten and the coming rain was foreshadowed by the humidity that hung in the wind. The orange colored street lights lit our way. Gurler was happy to be out. We dropped Anne off by her gate and went home cutting across the lawn and the parking areas, just before the rain blew into Tequesta.

Enter The Maze of American Health Care-bring a shovel!

Health care in America is a maze of poor information and inefficiency.

AARP United Health Care- Medicare Solutions Adds to the Confusion

When you want medical help you don’t want to spend hours looking for a doctor.  If you are enrolled in a Medicare “Advantage Plan" underwritten by a major health care management corporation you might assume that a doctor is easy to find.  You just pick up the provider directory (the telephone book sized reference sent you in the mail) and call one of the physicians close to your home and make an appointment.  Even if it isn’t an emergency, no one wants to spend hours on the phone trying to locate a doctor who will see them.  I am here to say that finding a doctor in the provider network of the AARP United Health Care- Medicare Solutions Plan is a torturous process that will have you sitting on the phone, pecking away at the computer, and having painful and repetitive conversations with strangers for hours on end. 

Let me say that I do not go to doctors frequently. In my experience in the labyrinth of the American medical system I have always been lucky to have had a decent health plan attached to my employment package.   I saw the same doctors for decades.  I knew them and they knew me.  I thought Medicare would be a continuation of that sort of care.  Not so!  Medicare is a maze unto itself.  Layered upon the maze of Medicare regulations, price structures, donut holes and a thousand and one frustrating dates and deadlines is the “Advantage Plan”, a sort of Medicare privatization that is supposed to reduce costs for participants and provide good care within a network of providers.  I do not pretend to be an expert in the workings of either Medicare or the “Advantage Plan” but I relate one experience for the reader to consider.

I have a pain.  I live with it until I see it is not going away by itself.  I take out my United Health Care plastic wallet card and call the primary care physician given me by the “plan”.  When I signed up for the “plan” and saw that my own doctor was not a participant I should have known that the “plan” was not for me.  But I signed up anyway.  I assumed I could easily get used to another doctor and the plan seemed to have dozens in my area.  There was no answer at the office/doctor listed on my card so I took out the provider directory and began, what turned out to be, a two and a half hour juggernaut of phone calls and dead-ended conversations.  I found many of the listed providers put me through a vetting process, extracting mass quantities of personal and contact info only to find out afterward that they didn’t accept the UHC insurance.   After the first few calls I began each conversation telling the receptionist exactly what my insurance was so there would not be a lot of wasted time.  It did not matter.  Though I’d warned them upfront and even scheduled appointments a final reminder at the end of the process turned up that the insurance was unacceptable and my time was wasted.  Once I was sent on a “goose chase” calling the accounting department of a large doctor’s group only to find that they did not accept AARP United Health Care- Medicare Solutions Plan! 

Remember-all of these doctors are listed in the 2014 list of providers given me by the plan when I signed up!

Out of the twenty providers I called, half refused to accept the insurance at all.  Of the balance, many were not answering the phone and there was no message machine or any way to know if they were even in business.  I left messages on a half dozen machines but have received no return call in twenty-four hours.  The only place that would give me an appointment was a community clinic and the appointment was for a week in the future.  I was informed that they do accept the “benefits” but the doctor who participates in the plan only comes to the clinic for four hours, one day a week.

I was frustrated and shocked with this experience.  So I called the provider.  I spoke to a woman who gave me the phone listings a half dozen more providers in my area and I kept her waiting while I cross checked them.  Half of them I’d already called and didn’t accept the plan, and the rest of them were either too far away to be of any use to me or were in the same clinic where I’d gotten my appointment.  I asked to talk to a supervisor.

This is where I entered the “Twilight Zone”.  I told her about my experiences in the pages of the provider directory.  She apologized and, according to the supervisor, the plan had recently been “cleaning up” and they were “updating” the directory.  In fact, she said, United Health Care turned away many, many providers who wanted to participate in the plan.  Why, I asked, would you want to limit the number of providers, and if so many wanted to participate why couldn’t I find any in a metropolitan area like Westchester county, New York?  Her answer was not intelligible.  I asked her if I used the on-line directory would I find more doctors who actually accepted the plan.  She said “Yes!”

Today I went to the provider directory (PDF on-line) and it was for 2013!  Even more out of date than the 2014 directory I’d been using.  It was 2393 pages of useless information! To wit- I quote from page 3:  

This directory is current as of

September 1, 2012. Some plan providers may have been added or removed from

our network after this directory was printed. We do not guarantee that each provider is still accepting new

members.

To get the most up-to-date information about the Plan’s network providers in your area, please call the phone

number listed below or visit our website at

www.UHCRetiree.com

.

Call Customer Service toll-free at

1-800-457-8506

Now I know what it takes to be a supervisor at United Health Care-You need to know how to get people like me off the phone. 

Health care in America is a maze of poor information and inefficiency. 

Sixty-Five

Sixty-five.  Hoodathunkit?  In two more days I’m gonna be 65.  It is an important mile-marker, I think, though age is, in some respects, just a state of mind.  I don’t feel 65.  That is something I have heard a lot of people say-that they don’t feel their age.  When I look in the mirror I expect to see a pup of 20 or so looking back at me but I see an old man instead.  Sometimes it is a shock.  Mostly I am used to it now.   My beard is fully gray and my hair is turning too.  My muscles have lost a good bit of the tone that they had all my life.  I am reconciling myself to the ‘things I can not change vs the things that I can change’ and the things I can still do easily and those that I cannot.  It is more a function of what my body can do as opposed to what my mind can do because my mind is aging more slowly than my body.  At least that is my feeling. 

Things I cannot do easily any longer:

-drive for long periods of time.

-tackle large, labor intensive projects.

-jump off of scaffolds higher than 3 feet off the ground.

-stay awake for the eleven o’clock news.

-put up with stupid people.

Things I can still do well:

-drive to my job in the Bronx (though I wish I had an automatic transmission for when I get caught in traffic jams on the Taconic.)

-work in my garden until I get tired then take a nap.

-climb up scaffolds

-sleep until 3:35am at which time I can sleep no longer.

-keep my mouth shut when confronted with stupid people.

I look forward to whatever is coming.  I used to think I knew what was coming but now I know that I know nothing about what is coming.  I love my wife and I am glad I never cheated on her.  I love my children though I know they are more important to me than I could ever be to them.  I love my dog more than my own life-and she deserves it.