It's Not the Years, It's the Milage

Indiana Jones mentioned that "It's not the years, it's the mileage" early in the fourth installment of his adventures. MY car recently turned over 100,000 miles. MY Durango is 10 years old this July. It has been a good car. It has driven carpools to school, Young Women to camp, family to vacations, stuff to the dump, stuff to Goodwill and DI, kids to their grandparents' place, children to doctors', dentists' orthodontist's speech therapist's offices, Trek kids to go sledding, friends to birthday parties. You get the idea.

Lots of good memories have gone into those 100,000 miles. Let's hope the old Durango has another 100,000 to offer us. After all, it's not the years, it's the mileage.

Won't You Be My Neighbor?

Sometimes you just have to say what you think. I wish a little that Mr. Rogers was my neighbor.

Always A Promise

I had the chance this week to do some meditation and I focused primarily on the creation, the beauties that surround us. Now this week, I have had to look long and hard for things that make me feel happy or inspired in nature, since the sunshine has been playing tricks on me--coming out only to hide away for a few days again. I know I am ready for spring, and that thought led me to ponder the beauties of the earth.

I have tulip leaves poking out of the dirt in my front yard flower bed. I have columbine leaves mounding up and preparing for their blooms later in the season. The Girl planted a bag of seeds on the back raised bed where I can see it from the kitchen window that was marked "butterfly garden". She is hopeful that there will be many flowers with butterflies all summer long to look at while she or her brother does the dishes at the sink.

Even the lawn is slowly turning an under layer green while the thatchy yellowed winter grass is slowly shedding away. Everything is getting for Spring to really take hold.

I guess that is really beauty of the seasons. Even one a long, isolating, discouraging and cold as this winter was for me there is that ever present promise of spring. And some days--especially lately--the promise is all I have. But I'll take that and look forward to the day when the sun will shine brightly and the flowers will be in bloom and the grass will be warm and green and soft. I will soak it all in and enjoy each day because I know that in six or eight months, the wintry hibernation will begin again.

Garbage Gripe

Today was garbage day. The garbage truck stopped at our can and even seemingly dumped the trash into the truck's compactor. Sadly, all the trash was not dumped out of our can. Now I have half a can of trash and it was just garbage day this morning. I hate it when that happens.

Confusion Timeline

As if I didn't quite understand the Health care legislation that was passed Sunday night, now I still don't understand the bill as it was signed this morning. This article, published in one of Salt Lake City's daily paper, was the first step in understanding for me. Maybe it will help you too. It is long, but so is the reach of this new law.

Health overhaul: Immediate change, long term steps
By Ricardo Alonso-Zaldivar
Associated Press

Published: Monday, March 22, 2010 11:52 a.m. MDT
WASHINGTON — When President Lyndon Johnson signed the Medicare law in 1965, seniors got their health insurance cards less than a year later.

When President Barack Obama finally gets to hold a signing ceremony for his health care overhaul, the major expansion of coverage for uninsured workers and their families won't come until 2014 — after the next presidential election.

Parts of the plan won't be fully phased in for a decade, but ultimately 94 percent of eligible Americans would have coverage.

Here's a timeline of some changes:

THIS YEAR

• Sets up a high-risk health insurance pool to provide affordable coverage for uninsured people with medical problems.

• Starting six months after enactment, requires all health insurance plans to maintain dependent coverage for children until they turn 26; prohibits insurers from denying coverage to children because of pre-existing health problems.

• Bars insurance companies from putting lifetime dollar limits on coverage, and canceling policies except for fraud.

• Provides tax credits to help small businesses with up to 25 employees get and keep coverage for their employees.

• Begins narrowing the Medicare prescription coverage gap by providing a $250 rebate to seniors in the gap, which starts this year once they have spent $2,830. It would be fully closed by 2020.

• Reduces projected Medicare payments to hospitals, home health agencies, nursing homes, hospices and other providers.

• Imposes 10 percent sales tax on indoor tanning.

2011

• Creates a voluntary long-term care insurance program to provide a modest cash benefit helping disabled people stay in their homes, or cover nursing home costs. Benefits can begin five years after people start paying a fee for the coverage.

• Provides Medicare recipients in the prescription coverage gap with a 50 percent discount on brand name drugs; begins phasing in additional drug discounts to close the gap by 2020.

• Provides 10 percent Medicare bonus to primary care doctors and general surgeons practicing in underserved areas, such as inner cities and rural communities; improves preventive coverage.

• Freezes payments to Medicare Advantage plans, the first step in reducing payments to the private insurers who serve about one-fourth of seniors. The reductions would be phased in over three to seven years.

• Boosts funding for community health centers, which provide basic care for many low-income and uninsured people.

• Requires employers to report the value of health care benefits on employees' W-2 tax statements.

• Imposes $2.3 billion annual fee on drug makers, increasing over time.

2012

• Sets up program to create nonprofit insurance co-ops that would compete with commercial insurers.

• Initiates Medicare payment reforms by encouraging hospitals and doctors to band together in quality-driven "accountable care organizations" along the lines of the Mayo Clinic. Sets up a pilot program to test more efficient ways of paying hospitals, doctors, nursing homes and other providers who care for Medicare patients from admission through discharge. Successful experiments would be widely adopted.

• Penalizes hospitals with high rates of preventable readmissions by reducing Medicare payments.

2013

• Standardizes insurance company paperwork, first in a series of steps to reduce administrative costs.

• Limits medical expense contributions to tax-sheltered flexible spending accounts (FSAs) to $2,500 a year, indexed for inflation. Raises threshold for claiming itemized tax deduction for medical expenses from 7.5 percent of income to 10 percent. People over 65 can still deduct medical expenses above 7.5 percent of income through 2016.

• Increases Medicare payroll tax on couples making more than $250,000 and individuals making more than $200,000. The tax rate on wages above those thresholds would rise to 2.35 percent from the current 1.45 percent. Also adds a new tax of 3.8 percent on income from investments.

• Imposes a 2.3 percent sales tax on medical devices. Eyeglasses, contact lenses, hearing aids and many everyday items bought at the drug store are exempt.

2014

• Prohibits insurers from denying coverage to people with medical problems, or refusing to renew their policy. Health plans cannot limit coverage based on pre-existing conditions, or charge higher rates to those in poor health. Premiums can only vary by age (no more than 3-to-1), place of residence, family size and tobacco use.

• Coverage expansion goes into high gear as states create new health insurance exchanges — supermarkets for individuals and small businesses to buy coverage. People who already have employer coverage won't see any changes.

• Provides income-based tax credits for most consumers in the exchanges, substantially reducing costs for many. Sliding scale credits phase out completely for households above four times the federal poverty level, about $88,000 for a family of four.

• Medicaid expanded to cover low-income people up to 133 percent of the federal poverty line, about $28,300 for a family of four. Low-income childless adults covered for the first time.

• Requires citizens and legal residents to have health insurance, except in cases of financial hardship, or pay a fine to the IRS. Penalty starts at $95 per person in 2014, rising to $695 in 2016. Family penalty capped at $2,250. Penalties indexed for inflation after 2016.

• Penalizes employers with more than 50 workers if any of their workers get coverage through the exchange and receive a tax credit. The penalty is $2,000 times the total number of workers employed at the company. However, employers get to deduct the first 30 workers.

2018

• Imposes a tax on employer-sponsored health insurance worth more than $10,200 for individual coverage, $27,500 for a family plan. The tax is 40 percent of the value of the plan above the thresholds, indexed for inflation.

2020

• Doughnut hole coverage gap in Medicare prescription benefit is phased out. Seniors continue to pay the standard 25 percent of their drug costs until they reach the threshold for Medicare catastrophic coverage, when their copayments drop to 5 percent.

Sources: House Energy and Commerce Committee; Kaiser Family Foundation.

Teeter-Tottering

The health care reform vote passed last night. I have uncertain feelings about this whole issue. Do I think the systems needs an overhaul? YES. Do I think the pre-existing condition problem is troublesome? YES. Do I think insurance companies are lining their pockets while providing less and less actual coverage to their customers? YES. Do I think it is government's place to run a health care system? No, not really. Do I think the government, and congress specifically, is capable of real bipartisan compromise and cooperation? NO.

I finally, just this week, got the two insurance companies we had coverage with last June to both agree that I was covered during the "bad boob month". Meanwhile I have had to put the office, doctor and billing department that actually performed the bad boob MRI at bay over and over again because while I was covered by two insurances neither one would claim that they were the primary carrier, and therefore refused to pay until the other denied the claim. It has made me sick to my stomach for months.

Ay the moment, I think I am happy something is being done, but this is not the thing I would have had them do. I feel like Charlie Brown, in the cartoon above, who knows that at any moment Linus could just jump off the teeter-totter and I'd drop like a stone to the hard ground below.

And who would pay for the medical care I would need then?!

Video Sunday

Yesterday was a little like this...too much ordinary stuff happened and I didn't ever get back on the computer to blog about it. It reminds me a little of Ferris Bueller's advice: "Life moves pretty fast. You don't stop and look around once in a while, you could miss it."