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 healthcare.gov 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 healthcare.gov available as the Orbitz or Travelocity of health insurance is definitely a great thing, even if the value element is hard to predict.

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.

Interlude VI - Competition for Everyone

According to Richard B. Freeman (2008), "almost all at once in the 1990s, China, India, and the former Soviet bloc joined the global economy, and the entire world came together into a single economic world based on capitalism and markets." Describe two (2) important effects this development has had on the global labor market.

After the collapse of the Soviet Union, the joining of that area's workers, along with those of India and China, into the global work force had the immediate effect of increasing competition around the world for many of the simplest and most portable jobs. Market capitalism had been great for the West, in particular the United States, in the years after World War II. Before the war, no middle class existed in the US and so much money was concentrated in so few hands that the entire economy was susceptible to the disaster of the Great Depression--what was a bad turn of events for the wealthy meant unmitigated devastation for the poor, who depended upon the upper class for their employment, and upon the banks for their savings. After the war, new industries existed that served to boost more people up to genuine self-sufficiency than had ever before been the case, which combined with all-time-high taxes on the highest incomes to create the most equal society (at least financially) the US had ever experienced. Once the global labor market opened up in the nineties, however, the finite number of jobs offered by those new industries faced a vastly-increased pool of workers. The United States had pioneered a lot of the technology of globalization, and now that technology was making it harder and harder to justify leaving a basic, low-to-moderate-skill job in the same city as a company's headquarters when there were people on the other side of the planet willing to do it for far less, because a generation ago they were picking rice for a living. Market competition was the thing that created the United States' successful economy in the first place, so it made sense that if Company A only hired middle-class Americans and Company B hired destitute Indians and Chinese, Company B would be the winner of that competition, and thus you'd start seeing more of that in the future.

The second effect of this increased competition was the lowering of wages for those jobs that did remain in the United States. Even companies that preferred at first not to outsource their jobs overseas felt economic pressure from those that did, and whose operating costs were therefore lower) and were motivated to lower their wages nevertheless. Also, more unemployed American workers means higher competition for those few jobs, and once again, lower wages. Of course, this was only a problem in the West; while these new workers in the East were theoretically open to all sorts of exploitative business practices due to their desperation, the immediate effect of their sudden employment was indeed higher levels of income, and a large boost to those countries' urban areas as more and more people moved away from their farms. Time will tell, but in my opinion, workers in the East are going through a process similar to what happened in the United States after the Great Depression; now that work is available, they will become higher-skilled and better-educated, leading to yet higher wages until they eventually catch up with the West, thereby eliminating the impetus for outsourcing as a cost-saving venture and leading to a "genuinely integrated world economy", as Professor Hoberman describes it.

Interlude V - The Marriage of East and West

Why are certain cultural products globally popular while others are not? What are some of the SPECIFIC QUALITIES or CHARACTERISTICS that make cultural products (books, music, films, sports) most accessible to global audiences?

While the United States happened to be uniquely positioned at the dawn of globalization to produce cultural products like films, television, and music that could reach cultures all around the world, the last couple decades of experience have been excellently instructive as far as which products are truly global in their appeal, and which are limited to the West, or even the US in particular, in their scope.

In the example of Avatar, one of the two highest-grossing feature films of all time, the movie was the quintessential merging of numerous global sensibilities into a universal product that would be familiar to many cultures without being too specific to any one. Set in the far future, it embodied the promise of technology—a theme that also has universal appeal in the present due to the internet and popular music—in both the high-tech universe of its story and in the groundbreaking-yet-real technology that brought its universe to the big screen (and in three dimensions, no less).

But tempering that promise was, as Professor Hoberman noted, a very anti-imperialist, philosophically-Eastern narrative and moral message. The worldwide success of American cinema demonstrated that global audiences were happy to embrace Western-style storytelling from the get-to, so adding a layer of non-Western themes only upped the ante and enhanced the film’s palatability to far-flung cultures. The lesson to take from this going forward is that even the most universal experiences and messages—love, honor, autonomy—can benefit from being filtered through the proficient delivery system that is American cinema.

A different sort of success has been found by Cosmopolitan magazine, but one no less worldwide in its reach. What Cosmo, as it is known colloquially, has done is to distill its own essence down to a core message—that of feminine pride, independence, and self-assurance—and tailor that to the individual boundaries of a wealth of different nations and cultures. An article about having great sex, for example, could be seen as passé in Sweden yet appalling in Saudi Arabia—but it would be right at home in America. As such, each nation’s editors have been able to translate the same core principles according to their own respective mores in a way that retains the same positive, forward-leaning position in each respective culture; without inciting riots, of course.

From these examples, one may conclude that there are multiple avenues through which the producers of cultural product can appeal to global audiences. While the United States remains in an exceptional position thanks to the length and breadth, and generations-long experience, of its creative industries, the force-multiplier that is universal experience (not to mention diverse casts of characters) cannot be underestimated. Not only will a marriage of both Eastern and Western storytelling strengths produce more globally-appealing commodities, but it serves to further universalize their messages, as well—something that cloistered Western audiences can benefit from as much as the East can benefit from the West’s technology.

Interlude IV - America's Example Trumps Its Flaws

Imagine that the content of the Internet were controlled by a powerful global agency comparable to the United Nations. Explain the possible ADVANTAGES and/or DISADVANTAGES of such a system.

Ironically, the primary advantage of assigning all power over the regulation of the internet to one giant agency like the United Nations would be the decentralization of said power--by taking it out of America's hands. While the existence of one authoritative international body in the place of, for example, ICANN, would mean decisions regarding content control, censorship, naming conventions, and so on would still be in as few hands as always, those hands would then be from a much wider variety of cultures and international powers. This would also mean that said body would be in a better position to adapt to the sudden and unexpected challenges that so often characterize the internet, whereas right now it's much harder for anyone to get anything done if they're not in a position of power in the American system. It would also produce the intangible benefits that come with improved perception--regardless of its actual effectiveness as a regulatory body, the myriad nations of the world would likely be more patient in dealing with it given that they'd have at least nominal say in the decisions it makes.

Of course, without the military and financial might of the United States to back it up, other nations also might be less inclined to pay it much heed to begin with--as the United Nations in its current form can tell you already. Furthermore, modeling the disbursement of power over the internet after the powers of the UN would also mean dealing with the UN's extensive procedural and bureaucratic problems, making it harder to settle on effective regulatory policies and platforms in the first place.

Where censorship is concerned, while the United States pursuing free speech in China at the same time as it's pursuing Edward Snowden and Julian Assange means that we maybe don't have the strongest position from which to criticize China's censorship of the internet, one disadvantage of having a global agency manage the internet would mean detaching it from free speech in even a rhetorical sense--without powerful American corporations like Google loudly championing free speech in the popular culture, censorship would become a matter of popular opinion. One of the biggest procedural problems in the United Nations is overcoming vetoes from China and Russia, two countries who clearly aren't overly concerned about free speech, so if they were given equal footing in a theoretical internet management entity they could simply use their weight in the international community to prevent the enactment of any anti-censorship policies they disagree with.

In conclusion, I think that the best thing about the current system is that it highlights the problems of Chinese censorship by throwing them into harsh relief. While the Unites States should not, and cannot, lead the world forever on this or any other matter, I believe that the example our Bill of Rights sets for the rest of the world (a tainted example though it may be) is a strong motivator to drag more totalitarian countries into a more tolerant, Western mindset, where divorcing the internet from the American example, while philosophically appealing, would just mean a more tepid set of policies all around. Ultimately, I believe the most American thing about the internet is its free-market values; if the rest of the world comes up with a better system, I believe it will supplant ours whether we want it to or not.