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Marissa Lingen

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Tomatoes and health care [Sep. 29th, 2010|11:00 am]
Marissa Lingen
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It is a sad, sad week at our house. It is the week of the first grocery store tomatoes.

It's not that our tomato plants have stopped producing, and it looks like we'll have enough sun this week that some of the tomatoes may even ripen outdoors on the vine and actually taste better than the grocery tomatoes. They are not like the green beans and cucumbers, which are as dead as Marley. They're just not producing tomatoes reliably. And so the grocery tomatoes had to happen as a fallback. Because lack of tomatoes was not an option.

(Really not. Earlier this year, sources close to the mrissa had a shorthand for talking to me about my daily life that was "what you're reading and what was in your salad." And I had to laugh, because it was all too accurate. There are days when I don't have a salad. I mean, I think there are. I just can't think of one. But we're out of the part of the year when the basis of the salad is "what's ripe and needs using up from the garden" and into the part of the year when the basis of the salad is brassicas from the grocery.)

But! The tomatillos are in fall craziness mode, to the point where I am willing to spare some of them for experiments and not save all of them in frozen goop form for chili verde base all winter. So there will be some cedar-planked fish with roasted garlic tomatillo sauce. I think it sounds wondrous. I think it sounds amazing. I think it sounds like something I will totally make someone else work the grill for.

In other news, I have been working on paperwork for our health care savings account. There are people who are touting these things as though they will cure cancer and halitosis, and now that I have folders and spreadsheets set up, they'll be a lot easier. But truthfully it seems to me that this thing is a lot of work for people who are seriously ill or disabled, and they're really best suited for people who are healthy and already have plenty of money. See if you can spot the flaw in this system! Seriously, there are a lot of things that work that way: they're set up supposedly to help people who are ill or disabled, but they are really only helpful if you have the time and energy of an able-bodied person. This summer and early fall has been particularly frustrating, since we have a household with three adults in it, and the able-bodied one has only been at home half-time. And then this month he's been sick the whole month. A lot of stuff kind of goes kaput when that happens. In our circumstance, we have resources to throw at the situation. We can throw money at it, and we can throw family and friends at it, and we have been, sometimes. But things will fall through the cracks, which is why I have lost a big chunk of my very limited work time to sorting out this stuff and setting up the system for it to work longer-term.

And my work is flexible, and we have these resources. I can do that. A lot of people would just be lost and permanently behind and would just have to drop that particular ball. Would just have to drop a lot of balls. And it frustrates me to know that something is being proposed as a solution by people who don't have any concept of what the problem is even like. Over and over again I run into people who seem to be saying that something works as long as nothing goes wrong. And I know that that's exactly the same as saying that it doesn't work.

[User Picture]From: redbird
2010-09-29 04:53 pm (UTC)
You are a kinder person than I am. I do not for a minute believe that the people who invent these things know or care that the system doesn't work for the people who need it. They want the disabled, and especially the poor and working-class disabled, to go away and leave them alone. (Dying is optional. I think.)

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[User Picture]From: alecaustin
2010-09-29 08:50 pm (UTC)
In fact, a lot of those people seem to think their lives would be just peachy if the poor and working classes just went away entirely. As long as they could still import sub-minimum-wage help from Mexico or Bolivia.

And there are definitely others for whom the dying is not optional, sad to say.
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[User Picture]From: mrissa
2010-09-30 12:22 pm (UTC)
I see why you're frustrated, and I agree that there certainly are people who don't care about the disabled and particularly the poor and working-class disabled.

But unfortunately I think the problem is larger than that. I think there are people who do care and do not fundamentally understand very well what it can be like to be coping with a long-term illness or disability. The people who honestly feel the way you describe or the way alecaustin describes are a tougher nut to crack. The people who are just not very clueful can perhaps be reached by talking more openly about how much extra work it puts on someone to be ill or disabled in the first place, how much time it takes just to get to a baseline, and pointing out that some of the solutions proposed don't go very well with that necessity. It seems worth trying for the low-hanging fruit to me rather than writing it all off as rotten.
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[User Picture]From: caoilfhionn
2010-09-29 05:07 pm (UTC)
I was basically forced into an HSA when I became self-employed, and I am not happy with it at all. Add to the list the fact that if you are not comfortable with computers and the Internet, managing the account becomes exponentially harder...and more expensive. My HSA charges you extra for pretty much any transaction other than electronic deposits and debit-card point-of-service payments, especially anything requiring paper copies. They add layers of bureaucracy and service charges to push people into using the Internet to manage the account. I can only imagine the added frustration to the many people who are not comfortable with computers and who are used to traditional banking services.
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[User Picture]From: mrissa
2010-09-30 12:25 pm (UTC)
So yours is an HSA that works well as long as you're not ill or disabled or...older or have cognitive difficulties? Oh, good! Nobody with health problems is older or has cognitive difficulties! (I mean, there are other reasons to feel uncomfortable with the internet, and lots of older folks and people with cognitive difficulties manage just fine, but those are two big ones, statistically.)
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[User Picture]From: moiread
2010-09-29 06:00 pm (UTC)
The Ontario Disability Savings Plans here work the same way. They say, congrats! You're disabled! If you put money into this savings account, the government will match it. And then you need to put it into a locked GIC or some other type of locked investment, because we did it through banks and they want to make money off it too, and we'll make all the terms and conditions so complicated that nobody will understand it without their investment agent explaining it, and we'll fuck all of them up to start with so people don't know what's happened with their money and are confused and upset and have to run around pushing for the corrections themselves even though we've already established that the only people who can understand the plans are the bank people, and then even once it's all sorted out, it requires poor people to contribute about $5000 a year to be really effective, and also you can't take it out until you're sixty without the government taking back anything they put in. So what it really is is a complicated RETIREMENT savings plan, only nobody's saying so upfront and you need to dig through the fine print to discover this.

I'm grateful to everyone who pays their taxes, because they're paying my rent every month, and I'm grateful to the government for setting up the program that allows this to happen. I know I'm essentially getting money for nothing, because I am too broken to support myself. (Though, as you know, I work when I can, and in fact should hopefully be working again by October, now that school's back in. I have been chomping at the bit about this but they keep pushing the starting date back and grrrr.) I am equally grateful that programs like the savings plan exist at all, because chances are good my ability to save for supporting myself in my old age will be kind of crap, considering the circumstances. But fuck. In what world do I reliably have the energy to deal with all that? Especially when just getting to the bank requires finding someone who can give me a ride, because the location is awkward for bussing and I've spent the last six months being unable to walk half the time? It's better now, but now is way after the savings plan stuff needed to be dealt with. And I did deal with it, but I needed help on multiple fronts, and it was extremely frustrating.

Edited at 2010-09-29 06:03 pm (UTC)
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[User Picture]From: mrissa
2010-09-30 12:36 pm (UTC)
Yah, it's yet another situation where something not really being optional to deal with does not actually confer the resources to deal with it. Yay universe. Sigh. I'm glad it's dealt with, and I'm glad it's better now.
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[User Picture]From: oursin
2010-09-29 07:47 pm (UTC)
they are really only helpful if you have the time and energy of an able-bodied person

Am reminded of reading those pieces of advice about making your life more organised and efficient, which basically involve having an entire week, or possibly a fortnight, clear in order to get the pieces in place first. Huh. What one wants is how to cope when already running well behind and without stacking up yet more hassle.
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[User Picture]From: mrissa
2010-09-30 12:32 pm (UTC)
"Are you just out of college and having a hiatus of a month before starting your first job? No. Oh, never mind then, this article won't be any good to you."

And sometimes one really does have to either use one's vacation time or take unpaid vacation time to deal with things that have stacked up, if one has an illness or disability or family crisis or any of a number of other things that happen in people's lives; sometimes those fortnights make themselves non-optional. It's just that the chirpy magazine articles never recognize that. "So your parent has just died and you are a complete wreck and have to deal with the estate in the absolute minimum amount of time so you don't have to live on cat food because your boss is a jerk and you took unpaid time off and the will isn't through probate yet and won't be for months," is just not a very snappy title for women's magazines, somehow.
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[User Picture]From: mkille
2010-09-30 03:10 pm (UTC)
The other downright evil thing about high-deductible HSA plans is that they have often been marketed as ways to keep premiums down. So, for example, at MPOW the monthly family employee contribution dropped from ~600 to ~450 while the deductible rose from ~1500 to ~3000. With an automatic monthly HSA deduction (that one has to be In Orderly Fashion to set up and monitor), it came out more or less a wash. The next year? Employee contribution rose to ~750, and the high deductible stayed high. Hijinks ensued.

(The HSA itself, as a financial instrument, I have no complaints about. It's run through a local credit union. I now do all my banking with them.)

The theory behind high-deductible HSA plans is "consumer-driven health costs." That is, the more people see their own money going to doctors and nurses and hospitals and such, the more cautious they'll be about seeking care and the more price-shopping they'll do for the care they can't avoid. Because, you know, one's kidneys, say, are *exactly* the same kind of product as one's car or brand of cheese. I'm sure when I have that inexplicable recurring pain in my chest, I'll haggle the doctor down on the power windows, I mean, the various lab tests.

Which also supports the "only works if you actually have the resources" criticism quite well.
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[User Picture]From: reveritas
2010-09-30 06:04 pm (UTC)


Do you like salsa? Tomatillo salsa is one of my top like ... 15 favorite things these days. (You know me and my ranked preferences.) ;)
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[User Picture]From: mrissa
2010-09-30 06:14 pm (UTC)

Re: Tomatillos

I do like salsa, but I don't like canning, so stuff I can either use immediately or freeze is hitting the priority list higher. Fresh salsa might end up being a thing. We'll see how many I have when I go out with the big colander to harvest next time.
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[User Picture]From: careswen
2010-10-03 12:07 am (UTC)
If I had more braining now, I'd have more brain for this HSA topic, which interests me, as a soapboxy thing. Migraine. Hmm.

I may have just unintentionally illustrated your point. Hmm.
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[User Picture]From: mrissa
2010-10-03 03:18 am (UTC)
How frustrating that you should have to.
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