I have read more occult books...well...I was counting up and realizing that I have self-identified as a Witch for 32 years now...and I am a librarian. I have read a lot of occult books. They warn you about all sorts of eldritch dangers...but the one I have never seen as a warning is that if you become even a half-serious practitioner, your life is in danger of being taken over by MAGICAL CLUTTER!!! Now THAT is a serious bane. I'm not entirely sure what Japanese Organization Lady would advise me to do since, "does this sealed arcane spell binding the power of a serial rapist bring you joy?" is not a sentence that should ever be uttered. Or typed. TOO LATE! Because I am a witch and I say shit that certainly wouldn't be said in polite company and maybe shouldn't be said at all.
This post is coming from a Facebook post that I wrote, and I am memorializing it so it can serve as a reminder and cautionary tale for me in the future.
As an urban witch who lives in a one-bedroom apartment, I am incredibly fortunate to have a special nook just for my altars and magick. Now...of course, I have altars and other stuff ALL OVER the apartment, but I also have a dedicated little personal temple space. GLORY! So superior to the years spent in the 400 square foot studio! But it really, really needed to get straightened up. But the STUFF. How do I have this much stuff? What is this stuff? The occult books are very clear that one should not have a cluttered magical working environment. Both, TRUE and HAH! I mean, I live in a one bedroom apartment and have 9 altars, 3 of which get daily use and the other 6 get used over once a season. Minimalism is just not the witchy way...no matter how much we romanticize our ancestors and their "simpler" ways. And I consciously TRY not to do this. Try and fail. Try again.
Anyway, I needed to clean up my supplies. So, I decided to clean house. It went something like this:
What are these stones? Why are they together? There must be a reason...is that bark? Is this the molybdenite? Why did I buy this much selenite? I must have been planning to do something with it. What the hell was it? Is it disrespectful to throw this out? It was an offering at one point. I know I'm supposed to bury or burn it...but I think my apartment manager would be mad at me if I did that and I'm not in the mood to get caught digging in the park. Oh bloody hell...what is this? I know it's not one of the McCormick spices...I just used the bottle. And here are bottles of oils that the labels are no longer readable or that fell off. And save me from the collection of feathers and special bits of string and other ritual detritus. I really should have labeled my rocks better. The sacred waters are reasonably labeled at least. Note to self...I DO NOT NEED HYSSOP OIL!!! I HAVE PLENTY. Make a bloody inventory already! Why did I ever think it was a good idea to create a spell that leaves me having to keep a physical item until the end of time? That's just bad planning. Etc. etc. etc.
I know that part of this is because we feel like we need to be prepared for all sorts of unknown circumstances...so we collect all sorts of things with the "just in case" mentality. My personal favorite, for me, was an early morning phone call from my sweetie (who is a magnificent Darren).
I answered the phone and he excitedly burst out with a "Good morning, sweetie! Do you need a snake in a bottle?"
I couldn't even fully parse what he was saying and was like, "Wha....?"
"Do you need a snake in a bottle?"
At this point, I was trying to think through whether or not this could be some really weird double entendre that was sailing over my head, or something. Then he decided to explain."My friend at work gave me a dead snake preserved in a bottle of alcohol and I don't know what to do with it. Do you need a snake in a bottle."
"OH! You mean do I need a SNAKE in a bottle." And you know, for a witch, the answer to that question, taken literally, is "Yes...Yes I do. I do need a snake in a bottle."
I have a magnificent Darren. He gave me a snake in a bottle. Now, should there ever be an emergency in which we were thinking, "I could save the world with my wild edge-walking magicks if only I but had...a snake in a bottle..." The struggle, it is real.
But seriously...I am still not done organizing the clutter. I did create an inventory. I am thinking maybe I should capture and release some rocks back into the wild. But I do think we need to be thinking about our magical detritus problem. If I never, ever, ever get another random piece of special string or a candle I'm not supposed to finish burning or whatever in a ritual...this would be good. And I am going to be much more conscious about what I saddle people with at the rituals I run.In the meantime, if I'm ever caught burying shit in the park...I promise you a weird trial.
Monday, May 8, 2017
Some thoughts on healthcare
I am rethinking how I am going to talk about healthcare with people. I think that it is important that we fight what is, essentially, a repeal of the ACA, but recognize that the ACA is a woefully imperfect bill. I think we need to force the discourse to move in a different direction and be careful about how we do it.
One thing that is dangerous is debating pieces of Trumpcare - although we can point some of it out. I'd really rather have us just start talking very differently about our entire healthcare system. Take the debate where we want it to go rather than being on the defensive.
To me, the real question--and it is a moral question--is, should profit-making motives have anything to do with healthcare? Do we really want a system of healthcare that is designed to generate profit for corporations?
The reason that we have governments is that there are times in which "the market" is the wrong instrument for social organization. There are many reasons why this might be the case. Sometimes they are social "goods" that are just never going to make a profit, but that we recognize as contributing to society in important ways, so want to support them. Sometimes it is because if the services were run like a business, it would be dangerous for society - imagine if the military was not a government entity, but was loyal to companies and shareholders - we would be back in the days of warring petite fiefdoms. I believe that healthcare is one of these instances in which the market is just the absolute wrong instrument for healthcare. The goal of healthcare is to prevent illness, heal the sick and the injured, ease the suffering of the dying, and to help the members of the society thrive. As such, there needs to be enough money in the system to fairly compensate all those who work in healthcare, to ensure that facilities are top notch, and to encourage continued research and development into new treatments, but they should not be about profit. And I'm going to point out that I know A LOT of people who work in the medical professions, and not a one of them got into healthcare with profit as their main motive. They got into healthcare because they wanted to serve humanity as healers....because they care about people.
The ACA was an attempt to move the needle, but it was a compromise, and not a very good one. What we really need is to get medical care free of the insurance companies by moving to single payer - to Medicare for all. This would cut way down on the administrative burden. A huge amount of the business that doctor's offices have to deal with is trying to get claims paid. Medicare for all would dramatically simplify that. With all the population in the pool - it would balance out the younger and healthier balancing the older and sicker. Rather than returning to the horror-show of pre-existing conditions exclusions, Medicare for all would eliminate the terrible risks to people who have employer paid insurance if they lose or change jobs. The government could negotiate for actually reasonable drug prices. We could kill the UCR tables where every bill I ever get from a doctor says things like "Hospital services, amount charged $39,541.60, Allowed amount $4,466.50, Amount paid, $4,466.50." (This was from my surgery). So, what this says to me is that my surgery costs around $4500, but in order to get that amount, they jacked up the price by almost $35,000 and if I didn't have insurance...I'd be paying almost $40,000 for the surgery I just had...which means I wouldn't be having that surgery because I don't have $40,000. I mean, who does? What reality are we living in? I guess I'd just continue to go through life with sinus troubles and not being able to breathe. I suspect that if we had single payer, they could negotiate what they are going to pay and there would be no more of this crazy math. And before anyone says, "But wait! SOCIALIZED MEDICINE!!!" That is a red-herring. Nobody says in hysterical tones, "SOCIALIZED STOPLIGHTS!!!" There are things that it makes more sense if they are run through the government rather than the market. Medical care is one of them.
So now, I want to wind the clock back to before the ACA and talk about what I DO NOT want to go back to...and what I believe Trumpcare could re-create.
Obviously, there were a lot of uninsured people who would go to emergency rooms for everything because they didn't have care and you can't get turned away from an emergency room. We will have a lot of people who will lose their insurance. But, at the moment, I'm going to speak from the position of someone who works as a manager in an organization that has employer-provided healthcare because I want to point out several ways that tying employment to healthcare makes NO SENSE.
Without laws making it illegal to exclude pre-existing conditions, depending on how large and aggressive your company is in negotiations, you may or may not have a plan that has pre-existing conditions exclusions. Now, this doesn't necessarily keep you from getting "care," it just means that the plan is not going to cover conditions that you had prior to being covered by that plan. So, let's say you are in the job and you have something that you are concerned might be serious or chronic. If you knew that no matter what you would be covered, you would go get the diagnostic tests as soon as you were worried about it...possibly catching a situation early, when it is easier to treat. But instead, you think..."well...I may want to change jobs in a couple of years and if it is something chronic, then if I switched insurers, they might not cover me and I think in the long-run, I'm not likely to be at this job in ten years. Maybe I should just wait and see if it goes away."
This kind of thinking is really common. It keeps people from getting checked out when things can often be dealt with more safely and cheaply and then they finally end up in the doctor's office when it is really bad and much more expensive to treat. This is one of the reasons why our healthcare costs were so ungodly high.
Another scenario goes like this. You know you have a chronic condition that needs to be managed and that if you left your job, would be uncovered. Maybe you need a drug that costs $200 a month for the rest of your life, a liver test that costs $1500 annually, and if anything ever went wrong with it, it could be quite expensive. You hate your job and you feel trapped, but you don't dare leave. On the other hand, you are a good twenty years from retirement. Every day, you get up, feeling trapped and resentful. You carry that into the workplace where you are angry, ready to take offense, frustrated in general and are a morale dark hole. You are totally toxic in your workplace, but are not going anywhere. You do your job well enough to not get fired, but negatively affect everyone around you. Another variant is that instead of being angry, you are a hyper-anxious mess about the possibility of getting fired and losing your coverage...which is also a seriously negative hit on productivity and morale. These were really common and are devastatingly bad to an organization.
Maybe you have an entrepreneurial spirit and would really like to try starting your own business. Or you are an artist and can support yourself, living frugally, on your art and a part-time job. Except you can't, because you can't get health insurance that would actually cover anything at a price you can afford. So, instead, you never strike out and, instead, stay at a full-time job that does not allow you to take a chance on your innovation. Is this good for our country? I don't think so.
Finally, you have employer-related insurance for your children. You have a teen that is showing some signs of a potentially chronic condition. They are going to be off your coverage soon...do you wait on seeking a diagnosis and medical care in the hope that they can make it until they get a job that they will then be tied to? Do you get them the care and then hope that they will be able to get into a job that is both large enough and has been able to negotiate strongly enough that they don't have pre-existing conditions exclusions...but what if they don't? What do you do? If it's a mental illness, you only have until they are eighteen where you can force them to get help, but then you set them up to be potentially without care the rest of their lives. Yay. This totally sucks and there is no good conclusion without pre-existing conditions being illegal.
We need, we absolutely need, the requirement that companies must cover pre-existing conditions and that those with pre-existing conditions should not be isolated into their own "high risk" pool. What will happen if they are isolated is that they will be given an "opportunity" to buy health insurance that will be so cost prohibitive that no one who is not wealthy will be able to afford it. That isn't "access" to health care. That is a "bare opportunity."
Again, I think we need to step back and ask ourselves why we have for-profit health insurance companies. Unlike, say, fire insurance - health problems happen to all of us. It is part of the human condition. There isn't anyone who is not going to get sick, get hurt, get old, and eventually die. So, it isn't like the statistical odds of various forms of accident or fire insurance where you are paying a bit into the kitty on the off-chance that you are the one who will need it...but you may never. You WILL need healthcare. You will probably need health care at some point this year. You SHOULD probably at least get screenings for something so that you can stay healthy. Insurance is not the way to deal with this.
The clear solution is Medicare for All.
One thing that is dangerous is debating pieces of Trumpcare - although we can point some of it out. I'd really rather have us just start talking very differently about our entire healthcare system. Take the debate where we want it to go rather than being on the defensive.
To me, the real question--and it is a moral question--is, should profit-making motives have anything to do with healthcare? Do we really want a system of healthcare that is designed to generate profit for corporations?
The reason that we have governments is that there are times in which "the market" is the wrong instrument for social organization. There are many reasons why this might be the case. Sometimes they are social "goods" that are just never going to make a profit, but that we recognize as contributing to society in important ways, so want to support them. Sometimes it is because if the services were run like a business, it would be dangerous for society - imagine if the military was not a government entity, but was loyal to companies and shareholders - we would be back in the days of warring petite fiefdoms. I believe that healthcare is one of these instances in which the market is just the absolute wrong instrument for healthcare. The goal of healthcare is to prevent illness, heal the sick and the injured, ease the suffering of the dying, and to help the members of the society thrive. As such, there needs to be enough money in the system to fairly compensate all those who work in healthcare, to ensure that facilities are top notch, and to encourage continued research and development into new treatments, but they should not be about profit. And I'm going to point out that I know A LOT of people who work in the medical professions, and not a one of them got into healthcare with profit as their main motive. They got into healthcare because they wanted to serve humanity as healers....because they care about people.
The ACA was an attempt to move the needle, but it was a compromise, and not a very good one. What we really need is to get medical care free of the insurance companies by moving to single payer - to Medicare for all. This would cut way down on the administrative burden. A huge amount of the business that doctor's offices have to deal with is trying to get claims paid. Medicare for all would dramatically simplify that. With all the population in the pool - it would balance out the younger and healthier balancing the older and sicker. Rather than returning to the horror-show of pre-existing conditions exclusions, Medicare for all would eliminate the terrible risks to people who have employer paid insurance if they lose or change jobs. The government could negotiate for actually reasonable drug prices. We could kill the UCR tables where every bill I ever get from a doctor says things like "Hospital services, amount charged $39,541.60, Allowed amount $4,466.50, Amount paid, $4,466.50." (This was from my surgery). So, what this says to me is that my surgery costs around $4500, but in order to get that amount, they jacked up the price by almost $35,000 and if I didn't have insurance...I'd be paying almost $40,000 for the surgery I just had...which means I wouldn't be having that surgery because I don't have $40,000. I mean, who does? What reality are we living in? I guess I'd just continue to go through life with sinus troubles and not being able to breathe. I suspect that if we had single payer, they could negotiate what they are going to pay and there would be no more of this crazy math. And before anyone says, "But wait! SOCIALIZED MEDICINE!!!" That is a red-herring. Nobody says in hysterical tones, "SOCIALIZED STOPLIGHTS!!!" There are things that it makes more sense if they are run through the government rather than the market. Medical care is one of them.
So now, I want to wind the clock back to before the ACA and talk about what I DO NOT want to go back to...and what I believe Trumpcare could re-create.
Obviously, there were a lot of uninsured people who would go to emergency rooms for everything because they didn't have care and you can't get turned away from an emergency room. We will have a lot of people who will lose their insurance. But, at the moment, I'm going to speak from the position of someone who works as a manager in an organization that has employer-provided healthcare because I want to point out several ways that tying employment to healthcare makes NO SENSE.
Without laws making it illegal to exclude pre-existing conditions, depending on how large and aggressive your company is in negotiations, you may or may not have a plan that has pre-existing conditions exclusions. Now, this doesn't necessarily keep you from getting "care," it just means that the plan is not going to cover conditions that you had prior to being covered by that plan. So, let's say you are in the job and you have something that you are concerned might be serious or chronic. If you knew that no matter what you would be covered, you would go get the diagnostic tests as soon as you were worried about it...possibly catching a situation early, when it is easier to treat. But instead, you think..."well...I may want to change jobs in a couple of years and if it is something chronic, then if I switched insurers, they might not cover me and I think in the long-run, I'm not likely to be at this job in ten years. Maybe I should just wait and see if it goes away."
This kind of thinking is really common. It keeps people from getting checked out when things can often be dealt with more safely and cheaply and then they finally end up in the doctor's office when it is really bad and much more expensive to treat. This is one of the reasons why our healthcare costs were so ungodly high.
Another scenario goes like this. You know you have a chronic condition that needs to be managed and that if you left your job, would be uncovered. Maybe you need a drug that costs $200 a month for the rest of your life, a liver test that costs $1500 annually, and if anything ever went wrong with it, it could be quite expensive. You hate your job and you feel trapped, but you don't dare leave. On the other hand, you are a good twenty years from retirement. Every day, you get up, feeling trapped and resentful. You carry that into the workplace where you are angry, ready to take offense, frustrated in general and are a morale dark hole. You are totally toxic in your workplace, but are not going anywhere. You do your job well enough to not get fired, but negatively affect everyone around you. Another variant is that instead of being angry, you are a hyper-anxious mess about the possibility of getting fired and losing your coverage...which is also a seriously negative hit on productivity and morale. These were really common and are devastatingly bad to an organization.
Maybe you have an entrepreneurial spirit and would really like to try starting your own business. Or you are an artist and can support yourself, living frugally, on your art and a part-time job. Except you can't, because you can't get health insurance that would actually cover anything at a price you can afford. So, instead, you never strike out and, instead, stay at a full-time job that does not allow you to take a chance on your innovation. Is this good for our country? I don't think so.
Finally, you have employer-related insurance for your children. You have a teen that is showing some signs of a potentially chronic condition. They are going to be off your coverage soon...do you wait on seeking a diagnosis and medical care in the hope that they can make it until they get a job that they will then be tied to? Do you get them the care and then hope that they will be able to get into a job that is both large enough and has been able to negotiate strongly enough that they don't have pre-existing conditions exclusions...but what if they don't? What do you do? If it's a mental illness, you only have until they are eighteen where you can force them to get help, but then you set them up to be potentially without care the rest of their lives. Yay. This totally sucks and there is no good conclusion without pre-existing conditions being illegal.
We need, we absolutely need, the requirement that companies must cover pre-existing conditions and that those with pre-existing conditions should not be isolated into their own "high risk" pool. What will happen if they are isolated is that they will be given an "opportunity" to buy health insurance that will be so cost prohibitive that no one who is not wealthy will be able to afford it. That isn't "access" to health care. That is a "bare opportunity."
Again, I think we need to step back and ask ourselves why we have for-profit health insurance companies. Unlike, say, fire insurance - health problems happen to all of us. It is part of the human condition. There isn't anyone who is not going to get sick, get hurt, get old, and eventually die. So, it isn't like the statistical odds of various forms of accident or fire insurance where you are paying a bit into the kitty on the off-chance that you are the one who will need it...but you may never. You WILL need healthcare. You will probably need health care at some point this year. You SHOULD probably at least get screenings for something so that you can stay healthy. Insurance is not the way to deal with this.
The clear solution is Medicare for All.
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