Friday, December 20, 2013

Reason #307: I Actually Signed Up For Obamacare

People keep asking me questions about this, so I figured I'd just start from the beginning.

A year ago, I was on the best employer health insurance plan I'd ever had. That's not saying too much, as I've never made enough money to have a really good plan, but I happen to have certain specific ongoing medical needs that cost a not-insignificant amount of money, so for me, the difference between a "good" plan and a "bad" plan is either paying UPMC upwards of $100 per month just to keep my debt to them leveled off...or paying a $50 copay once or twice a year. And the plan I was on a year ago was the first ever to land me in the latter situation.

Then the re-enrollment period came up last July, and my employer was dumped from the plan. We're a pretty big company, but still small enough that if a handful of people get really sick in a short period of time--which is apparently what happened--it can tilt the entire company's insurance situation from profitable to not profitable. So there I was, fresh out of a $1500 medical procedure that had only cost me $50, learning that that would no longer be an option.

The two options I had going forward were thus: a roughly equivalent plan to the good one with a 70% increase in my premium, or a worse plan...with a 30% increase in my premium. Said premium was already on the high side, but it was virtually eliminating my medical expenses, so I was okay with it--but 70% more wasn't happening. So onward I went into the second half of 2013, with less medical coverage and a smaller paycheck to show for it.

Suffice it to say, I was happy to give Obamacare a shot. It's ironic that insurance companies rejiggering their rates in anticipation of the health care exchange might have had a hand in my employer costs going up, because if everything had stayed the same I'd have been happy to keep my employer plan.

I started an account on within the first couple weeks of October--even before all the website nonsense started, I wasn't in a big hurry, because I know enough about the tech industry to expect problems with any big launch. Buying an iPod the day it comes out is stupid, and trying to get health care on day one of the exchange would have been equally stupid. So by the time I got around to making the account, I was well aware of the problems and was just expecting to dip my toes in. I started the account itself, entered most of my personal info with no problems, and eventually they wanted some information on my employer coverage that I wanted to confirm with HR first, so I stopped there. I had the info within a couple days, but I figured I might as well leave it be until things seemed to be going better with the site.

Cut to the beginning of December. Word was they'd mostly met their deadline of making the site usable by the end of November, but there were still problems with the "back end"--meaning people would sign up for a plan but the information wasn't being passed along to the insurers correctly--so my thinking was, better to get signed up soon enough that I would have time to make sure everything went through properly before the end of the year. On December 12th, I logged back in, finished off my profile stuff, and started looking at plans. The website wasn't perfect; not all the navigation options were as intuitive and/or reliable as they could have been, but nothing that really hurt my ability to use it--I've been a Chrome user since the beta, so I'm used to having the occasional hiccup on certain websites. No big deal.

Meanwhile, without too much digging, I found a plan that was pretty close to that old one I had liked, for just about the same amount of money (which, remember, meant it would be cheaper than what I'm paying right now). The exchange gave me an "eligibility notice" based on my personal financial information that told me I might qualify for a tax subsidy, but weirdly, the cost for the plan included a listing for my subsidy, but listed said subsidy as zero dollars. Checking the fine print of my eligibility notice, I saw a message that basically said they'd need more time to look into my situation and determine what kind of tax break I could have--but the base cost of my plan was still acceptable to me, and in the interest of getting this over with I decided I'd go ahead and enroll either way. I clicked the button to do just that, and it went through okay, but then it gave me a link to make a payment on the insurer's website. I didn't want to go quite that far until I was sure about the subsidy thing--and sure that the paperwork for the plan had actually gone through correctly--so rather than actually make a payment, I called the exchange's hotline and was talking to someone within five minutes. She was very friendly, but admittedly didn't have much specific information for me. She told me that I would be hearing from the insurer shortly to finalize things, and that when that happened I could go ahead and pay them without losing my chance at a subsidy in the event that I was ultimately able to get one.

A week goes by. My plan status is still listed on my exchange account as "initial enrollment", but I haven't gotten any mail or phone calls from the insurer yet. The hotline lady gave me a direct number for the insurer that I could call if I wanted to follow up myself, so I called it this morning and, well, it was a useless number. I couldn't get through their menu options without a plan ID number that I didn't have yet, and every time I tried to get an operator it hung up on me. I was not optimistic.

So I tried Googling the name of my plan, and I found a PDF "summary of benefits" document on the insurer's website that had the company's general customer service number on it--that seemed like a safe bet. So I called that one, and got a human being almost immediately. Normally I'm one of the few people that prefers talking to robots on the phone, but given that I wasn't even sure I existed in their system at all it was a relief to be able to just tell someone what my situation was. To my even greater relief, she found my records right away and confirmed that everything the exchange had told me was correct and my first bill was en route. It'll probably show up sometime next week, but since I'm leaving town for Christmas I decided to just get the first payment taken care of over the phone, so she transferred me to billing and 5-10 minutes later I was done--and officially Obamacare's newest success.

I still haven't heard anything new about my tax subsidy, of course, and I'm not optimistic; I do know that I make well under the $44 thousand per year or so that's supposed to be the line for one-person households to qualify, but it's possible there's some other extenuating circumstance I don't know about. Maybe I'll hear something, maybe not--even if I'm stuck at this price for 2014, maybe sometime next year I'll call the exchange again and investigate further, but frankly, I'm already perfectly content with what I'll be paying; it's not dirt cheap, but at least I had dozens of plans to choose from instead of two.

My sense of the new system overall is that it's not likely to be immensely cheaper unless you really do manage to qualify for some huge tax subsidy, but even if the price difference is a wash, it's infinitely preferable to have the option to browse through a bunch of different plans and pick the one with the best details, rather than just have to take whatever my job happened to offer, or research a million different private insurance plan on my own. Having available as the Orbitz or Travelocity of health insurance is definitely a great thing, even if the value element is hard to predict.

Friday, December 13, 2013

Interlude VII - Final Essay

While it's tempting to simply say that yes, the process of globalization is by definition a process of homogenization, I think a more accurate term would be universalization--the process does not make our life experiences interchangeable, but it does make them more broadly translatable.

For example, if you look at the island of Great Britain, with a landlocked population that has been remained largely isolated for the bulk of its thousands of years of human occupation, you will still find an enormous degree of cultural variation from region to region; not just in separate nations like Ireland and Scotland, but even within England itself, there are worlds of difference between the metropolitan Londoners and the countryfolk, between the farmers and the fishermen. Culturally, of course, one only needs to look at the violent struggles surrounding the Catholic Church in Great Britain to see that people will find things to argue about no matter how similar they are.

Great Britain's longevity makes it a particularly useful example, but you can see the same pattern play out to varying degrees all over the world: less so on the island of Japan, which is both landlocked and has a long history of atypical cultural purity and imperialism--but which still exhibits striking divisions between modern and traditional values, and the United States, which is far younger than the nations of Eurasia, and across its three-thousand-mile expanse demonstrates enormous variations in culture, modernity, and lifestyle.

So, then, if even populations such as Great Britain's and Japan's don't really demonstrate all that much homogenization, it seems unlikely that the age of globalization will somehow be the thing that changes that--much less increasing their homogeneity with other nations entirely.

Universalization, on the other hand, can be understood as the mainstreaming of certain societal or cultural infrastructure--cinema being one example, or fast food, or on the more negative end of the spectrum, offshoring and deregulation. Processes and paradigms that were once unique to specific nations are indeed becoming commonplace all over the world, but they do so according to open-market logic--the most useful and popular methods tend to win out, even if they're not always the most fair--and often take on a local flavor specific to the needs and mores of each individual population.

Looking through our course material, more specific examples come to mind. Locomotives, now a ubiquitous system of transportation for both freight and passenger travel, were first developed in England for their convenience and efficiency. The technology proved uniquely useful in the United States, however, whose landmass dwarfs that of England--the intercontinental railroad was what made safe and reliable travel to and from the west coast of the US a reality. What was largely a convenience in Europe became an existential necessity for the US. Moving into the present, high-speed rail has found particular success in Japan, where the enormous metropolitan area of Tokyo renders automobile travel a unique challenge. The Japanese took the western model of locomotive travel and greatly developed its commuter aspect to suit their own needs. Globalization allowed each of these far-flung cultures access to the same revolutionary technology, but left them free to adapt it to greatly different ends.

Of course, those who are wary of globalization tend to be less concerned about technological advancement than the slow creep of a perceived "cultural imperialism". The example of Cosmopolitan magazine, however, suggests that the only way for a cultural product to truly take root around the world is to offer a universal message in the first place. Cosmo, as the course outlines, has been very successful in isolating core universal principles--female empowerment and coming of age--and translating them into numerous different cultures, without causing riots in the more repressive cultures of the Middle East, or boring the daylights out of ultra-progressive Sweden. This requires not just identifying those aspects of their product that have universal appeal, but also giving regional editors the freedom to envelop those aspects in the best parts of their own cultures, and bring to bear their own understanding of where the line is--and precisely how far the magazine may dare to cross it.

This is not to say that the process of globalization is always positive, of course. Filtering the world of globalization through a local lens doesn't always remove the bad elements, and in fact can give them new opportunities to flourish. Dubai's entrance onto the world stage, for all the grandeur and regality of its enormous skyscrapers and resorts, left plenty of room for the subjugation of the country's natives into an invisible, lower class of construction workers and service industry wage slaves and indentured servants. The danger inherent in globalization's advent is not inherent to the process, but in its potential to blind us to injustices by normalizing them--the more widespread acceptance they garner, the less problematic they may seem, or at least, the less fixable. But it's easy to overlook the wealth of different cultures this planet continues to be home to--homogeneous only in their having equal capacities for both good and evil.