Friday, August 28, 2009

To Your Health

I've hesitated to dip my toes into the wide-ranging and increasingly rancorous debate over health care reform in America for several reasons. One, I'm not so desperate for mail that I want to start getting hate mail. Two, while I have a master's in public policy, I didn't focus on health policy and am hardly an expert. Three, I've been a little busy.

But with the passing this week of Senator Edward Kennedy, one of health care reform's most ardent supporters, I could no longer resist jumping into the fray. Besides, it gave me something else to blog about this week .

As stated above, I am by no means an authority on health care or the detailed minutiae of government regulations. However, I have a pretty good idea of what I believe are basic human rights that a nation such as ours should endow to all its citizens. I know that totally outs me as a bleeding-heart liberal and I am completely comfortable with that label. Yes dear readers, I give a shit about my fellow citizens. Let the AK-47s fire!

Plus, I have entirely too many family members who have battled chronic illnesses and I know the incredible importance of quality health care. It is beyond my imagination how anyone deals with health problems in the absence of comprehensive coverage. So here is my essentially unresearched, deeply personal vision for what health care should look like in our country. President Obama, if you're reading this - hi there - I'm still available for a new job.


PART ONE - The Working (not-yet) Stiffs
If your employer offers a health care plan that fits your needs and is affordable, take it. I know HMOs aren't perfect, but they are a huge piece of the puzzle and it would probably cost so much to dismantle them, that we'd piss away all the allocations right from the start.

Within the employer-provided plans, I do have one new policy in which I strongly believe. If you're like me and you're reasonably healthy, you should have the option at the end of each year to reinvest a portion of your unused (but paid for) premiums into a personal health savings account. That way when your health goes through an inevitable rough spot, you will have some cash in the bank to cover your ass, or your pancreas, or your lungs. Whichever goes first.

If you use up all your premiums and have cash leftover, then you can designate some for a special health savings account too. Or you can take some of that cash and donate it to me.

PART TWO - The Old Folks
If you're already on Medicare, just stay there. You're old and probably resistant to change and like in Part One, it would cost too much to make all the modifications so you might as well stay where you're at.

For those on Medicaid, it's a little different. It would be best if you could just get a job that offers full coverage, but if that isn't in the cards, then I suggest you stay tuned for Part Three.

PART THREE - The 47 Million
If you fall into that egregious statistic of the 47 million uninsured Americans, this is for you. Clearly, you've been stuck between a rock and a hard place for a while. You either are self-employed and not wealthy enough to buy insurance for yourself, or you work for a small company that isn't mandated to provide coverage, or you have some freakish illness that makes you like the kid who pees in the pool and no insurance company wants to take you.

Luckily, there's a ton of you in this category, so all your health shit more or less balances out so that we can average the costs to the "system" and call it even. One year, Mr. Gonzalez will cost a lot because he has diabetes and in the next year Ms. Wilson will cost a lot because she needs a hysterectomy. You get the idea.

By creating a government-backed, perhaps independently-run (or gov't-run) insurance company, all these folks will have the option to sign up and get the same level of coverage as those lucky bastards in Part One and Two. Yeah, it's the PUBLIC OPTION and it's a good fucking idea so stop bitching about it.

Is it going to cost a lot? More than likely, it will. Is it socialism? No, it's simply ethically right. And Medicall (my new name for the program), will also allow everyone in Part Three to get the same preventative care as those in the other categories that will ultimately prevent them from needed obscenely expensive care when their illnesses and conditions become acute. Like a hybrid car, it will cost more on the front end but will save our nation money in the long run with healthier citizens and fewer unnecessary procedures.

Besides, Howard Dean had some good stuff to say about it in the New York Times last week, “There are too many people who understand, including the president himself, the public option is absolutely linked to reform,” he said. “You can’t have reform without a public option. If you really want to fix the health-care system, you’ve got to give the public the choice of having such an option.”

Just like in Part One, people choosing to get their health insurance through Medicall would have the ability to invest their unused premiums into a savings account.

PART FOUR - Peanut Butter Jelly-Time

PART FIVE - Medicall versus the HMO
Over on the Republican side of the aisle, legislators are freaking out that a government-backed insurance company would easily trounce the private sector since profit would not be their bottom line. And on the surface, I can understand their fears. Capitalism is certainly the American way and allowing the free market to solve various societal problems has often proven to be the best solution.

However, there are people's lives at stake and we all pay for ridiculous deadweight losses when we consider what it costs to provide emergency coverage for those 47 million people in Part Three.

Also, since both liberals and conservatives will play a role in drafting the legislation for the new program (or whatever reform passes), the policies can be drafted in a way that forces Medicall to be competitively priced, subject to market changes and ostensibly similar to employer-backed offerings. It can also require people to first go through their employers' insurance companies.

Sure, people may still choose Medicall over their job-based coverage and HMOs may still be at risk unless they take this opportunity to re-examine their own offerings and to make them better. Here's just a few ideas I have to make private-insurance companies better enough that people would choose them over government-sponsored Medicall.
Better doctor choices
Discounts for gym memberships & yoga
No referral requirements
Holistic care
Coverage of vitamins & supplements
Full mental health, dental and vision care
Non-ER emergency help
Better preventative care

There you have it. Senator Kennedy can rest in peace if only the powers that be will listen to the wisdom of the Shtetl. And let the comments begin!

Tuesday, August 25, 2009

Managing Expectations

For the convenience of those lazy readers out there, I will begin at the end. Last week, after nearly four months of tireless searching, I accepted a new job. The specifics of the position will allow me to have a manager-level position on my resume, will offer me a chance to learn new, marketable skills and will only occupy my time four days a week, thereby allowing me to keep up my concierge service business. It's also only a few miles from my apartment which means I don't have to move.

Since being laid off on May 1, I wrote 27 different versions of my resume, submitted nearly 100 cover letters, interviewed with 17 organizations, spent entirely too much money on NJ Transit, made umpteen phone calls and sent a litany of emails to friends, colleagues, classmates, advisers and sometimes even total strangers. I made a thorough accounting of my unique skills, did several self-assessment tests and humbly reached out to my contacts for informational meetings whenever possible.

As I wrote on Facebook, I absolutely could not have gotten through this test in my life without the amazing friends who called me to check in, who bought me a drink, who sent me job listings and who generally encouraged me along the way.

Yet, I've titled this post "Managing Expectations" for a very specific reason. I'm not taking my dream job. What I am taking is a 15% pay cut from my old job and the risk of working within the same community, albeit under the auspices of a different agency. I'm not working in the cutting-edge, innovative environment I had imagined, but rather am working for an organization that goes back almost 150 years and provides some of the most basic human services one can imagine.

Most critically, I'm not relocating which means I do get to keep my aforementioned awesome group of friends, but I also keep the challenges of living an involved Jewish life as a single girl in suburban New Jersey. Hopefully, my 4 day/week schedule will allow me some extra time to create new opportunities for Jewish young adults in my area to mingle and with Fridays off, I can travel a bit more too.

And I suppose this mental act of making vodka-spiked lemonade out of life's lemons is the biggest lesson that I have learned in this latest episode of my life. Many people of my generation were taught hard work guaranteed delivery of your heart's desire and that having it all was inherently possible.

I absolutely feel that I have identified myself (and my friends) based on the bags we carry, the vacations we take and the cocktails we drink. After two master's degrees and three years of post-grad work, I expected a certain earning power that simply has not translated in our society's new reality.

Now with this economic crisis particularly crippling the mid-level/pre-executive labor market, those of us on the Generation X/Y cusp have had to re-evaluate and learn serious new skills. We garden, trade food, cook for each other or eat in cheaper restaurants rather than dining in the newest hot spot. We barter and enlist each others' sweat equity. We give smaller gifts and give our time more than our money. We may not fear the label of "thrifty," the way we would have in college or lusher days. We go on walking dates instead of happy hours.

I cannot begin to wonder what the next several months will bring and I have also learned that long-term planning is an exercise best executed in terms of generalities. The next few weeks will be a true gift as I have until after Yom Kippur to start my new job. I am hoping to take a few cultural and culinary staycations around New York and New Jersey so please send your suggestions for your favorite ethnic neighborhood so I can get additional stamps in my virtual passport.

And yes, doing a better job keeping up with this blog will be on the agenda as well.

Tuesday, August 18, 2009

Pura Vida


Pura Vida is a motto in Costa Rica that captures the national zeitgeist in a way similar to that of Aloha in Hawaii and Hakuna Matata in singing/dancing duos of meerkats and warthogs. Literally translating to "pure life," Ticos (as Costa Ricans are familiarly called) dole out well-wishes of pura vida on all occasions. In practice, pura vida can be used to say "thank you," "you're welcome," "have a nice day," "I like drugs/anonymous sex," you name it. The only other word that comes to mind with such versatility is "fuck," which I rarely heard during my recent week in Costa Rica.

I did hear a lot of Spanish and I had much occasion to practice the language, allowing me to feel comfortable in checking #29 off my list. And aside from the frequest pura vidas sprinkling their speech, I didn't notice too many other lingual nuances of Tico Spanish the way that Cuban, Mexican or Castillian versions of the language instantly set themselves apart. And that blending into the surrounding Central American Latino culture characterized much more than the language.

Unlike so many of their neighbors, Costa Rica is a peaceful country with less political upheaval and no standing army. Here the tourist is king and the natural world is his kingdom. Within a few hours' drive of the airport, you can experience beaches (in August 2009, Jaco Beach hosted the World Surfing Championships), mountains, volcanoes, rain forests, cities and more. While you won't experience much high culture in the form of museums, symphonies or theaters, your camera will go crazy with all the amazing vistas and unusual animals.

More to come soon... heading out for the night. Check back early next week for a full report on my Costa Rican adventure!

OK, so it's taken me four days but I'm going to make my best effort to finish this post. In between contemplating my future, drinking with friends, embarking on a new exercise mission and lord knows what else - I put a bit more thought into what I got out of my Costa Rican adventure.

Normally, I find these travelogues easy to write. I love going to a new place, making various observations (or judgments) and then bringing those hopefully witty insights to you, dear readers.

However, I have had a tough time coming up with a way to frame my experience. At first, I thought it might be because my previously blogged journeys to Cancun and Portland were largely solo enterprises where I had plenty of time to opine, journal and explore. In contrast, I took this trip with three friends and had to make a real effort to carve out "me time," a commodity I value much more after three months of unemployment.

More than that, I think having trouble writing more than just a "If it's Monday then we must be open ocean kayaking," type record of this trip stems from there being minimal meat beyond the observations. Costa Rica is an absurdly beautiful country. The scenery is breathtaking - whether it's the beach, the mountains or even the synagogue sanctuary. The people are nice, they are patient with your middling Spanish and they generally go out of their way for tourists. The food is tasty and I ate my weight in black beans and rice and plantains (often in the same breakfast).

If you're looking for a relaxing vacation in a great natural setting that is generally affordable and safer than many other developing nations, go to Costa Rica. Hell, even take the kids. Plenty of other people did.

If you're looking for inspiration for anything literary or juicy, you might have to dig a little deeper and mingle with locals on topics other than the negative side effects of the rainy season or the tasty queso palmito. Or maybe that's all there is to it. Like that super-sweet cheerleader who is fun to be around but lousy when you want to dissect The Unbearable Lightness of Being, Costa Rica entices you with its looks but can disappoint when you want something a tad more real.

And in the end that may not be an entirely bad thing. After months of deep self-reflection and ridiculously laborious job hunting, a vacation with less effort and investigation may have been precisely what the Department of Labor bureaucrat ordered.

For those who do want to know about my first attempt at snorkeling, being stuck at the San Jose Chabad kids' Shabbos dinner table or how I managed to make 5 new Facebook friends while traveling in a foreign country, I'm happy to oblige. In the meantime, accept this humble reporting, hasta luego and of course, Pura Vida!

Tuesday, August 4, 2009

Adios Amigos

When I was first laid off, I pondered the idea of taking a month to travel around the world. Preferably mooching off of friends in Israel for a while, then maybe jetting over to Macedonia to hobnob with my cousin the ambassador. Then reality and the exhaustion of professionally job hunting set in and I scaled back my plans.

A friend sent me links for cheap flights to Ireland and another talked up skiing in South America. But since I've already visited the British Isles and I'm utterly useless on snow-bound modes of transportation.

Then one day, I decided to search for flights in Central America whilst sipping a latte at my favorite local coffee shop. I spotted a great deal to Costa Rica and posted the sensational find to my status. Instantly, my friend Jannah who I've known since our Hebrew School days back in Arizona, voiced her interest. Then my friend Florence who represents Brooklyn alerted me to her status of the previous day where she espoused interest in a similar jungle-bound vacation.

Another friend joined the pack and thus a girls' tropical adventure was born. Hard to believe that just a few weeks later, I've got a packed bag, a boarding pass, some quality beach reads and a lot of sunscreen. Befitting of my slightly-less controlling between-employment self, I have relinquished much of the planning to my travel buddies and wherever the winds take me.

I cannot express the full extent of my excitement in a week that involves kayaking, fresh off the tree pineapples, exploring volcanoes, swimming in hot springs/pools/the Pacific Ocean and lord knows what else in lieu of managing spreadsheets and reciting my resume for total strangers.

Though I cannot guarantee a travelogue as detailed as my trip to Cancun two years ago, I would hate to break a streak of summer vacation blog posts (last year was Portland) so be sure to check in later next week for a full accounting of all the awkward tan lines, the communication challenges and the exquisite scenery. And for all you Facebook fans of Shtetl Fab, there will be pictures to boot! Hasta luego everyone!