Monday, April 29, 2013

The Sublime Art of Being Offensive

Recently I was told that a post I put on Facebook was offensive. Let's be honest, it was adolescent. I was asked by someone I respect to delete it so I did. No problem, no offense taken at the suggestion. I won't even post it here to show just how offensive it was. Don't bother trying to judge for yourself, just know it was in poor taste. I admit it, I have bad taste sometimes, especially when others make it possible for me to exercise my bad taste.

Of course, that's why my Facebook privacy settings are "friends only." For what that's worth in the land of internet privacy, but that's for another day. There was nothing sublime about how offensive my comment was. But I do like to look for the sublime of what's offensive.

By the way, what my post was a comment on the poor quality of mass advertising of church/worship in America. The picture associated with my caption was a part of a vast marketing (church marketing ~~SHUDDER~~) campaign and it was ripe for lampooning.

I believe the most sublime of offenses is found in our health care system. Recently, someone from the Board of Pensions, the PC(USA) insurance and pension group, came to Grace Presbytery to get the grassroots response from plan participants about their multiple plans to make Presbyterian insurance more financially solvent.

Before I had my say, I told the representative that I respect what he was doing trying to fix our little corner of a system that's broken. I dare say that the PC(USA) part of the system is less broken than our society as a whole, but there are some big problems.

The one he spoke about was financing. He noted that with increased expenses there a bulge in the pipeline and when it comes to a weak spot there would be trouble. He noted that two things needed to happen. There would have to be more revenue and less expenses.

He said that not everybody can have the "new" drug that was advertised on the television when the old drugs would work. He said that not everybody needed the state of the art orthopedic device when others would work. That's fine with me, but for one major problem.

The Board currently employs two different management companies to operate the plan. They employ one to handle medicines and another to handle doctors and hospitals. This is actually a problem for the consumer. Each company has incentives to reduce what they pay out. This is the best possible system to care for the bottom line of these company and the Board working to pay no claims at all.

In my family, my wife is on an expensive medicine for migraines which the medicine component of our insurance will not pick up unless she uses others first. Problem one: She has used those other medicines, but they were provided by doctor samples so the insurance company does not have a record. No prescription  no copay, it doesn't really exist so they don't want to help with the one that does work. Problem two: If she doesn't take it she ends up in the Emergency Room with a headache that registers 10 on a scale of 10. They take care of her, but at a cost.

Do you see the issue? The medicine company doesn't care if she uses the ER because it's not on their bottom line. When she uses the med, the medical service folks are glad they aren't paying for ER treatment  Our system has effectively pitted one component of itself against the other. Our insurance is literally at war with itself to get the other guy to pay.

So how do we save money, by refusing any and all claims. We save money by increasing pain because we can't get meds that do work. Tests that can find damage can be deferred because others weren't taken first, who cares if that deferred test can save a life. Oh, and yes, this happened to us to when my wife's surgeon actually watched her bowel perforate during a test.

Good times.

So if this is how they reduce expenses, how do they plan to increase income? I'm glad you asked.

One way, probably the most painful and equitable is to raise everyone's relative expense from 21% to 23%. Not cheap is it.

Another way is just to cover the pastor and nobody else in the family. They have two different options under this provision, but they have the similarity that the Pastor getting coverage alone is where they start. Don't get me wrong, I love Jesus, but I suspect Jesus wants me to take care of my family. So if we went this way, the extra would come out of the pastor's, our of my pocket directly.

This is where the board has lost track of something fundamental. The source of my salary and the source of the money to pay the Board comes out of the same pockets, or more accurately, the same plate. It is the congregation that sends money to the Board and pays my salary. It's all one source!

Hooray to the families where there is more than one breadwinner. They can afford it, or they can finagle another way of getting health insurance between the two employers. That isn't so in my family. Disease has made it impossible for my wife to work. So the Board has given me two choices, find a better paying call or get another job.

Leave the small church that can't really afford all the bells and whistles of the plan on its own or find a job in that same small town... probably a town that is still recovering from the Great Recession and isn't firmly on its feet yet. If these are our choices then that is the church of the future. Singles who can be covered alone, the independently wealthy, dual career folks who can both find work, and tent-makers.

I'll say it again, it's the whole American health care system that's broken. The Board's plan has its merits and I thank God everyday I have insurance, and since I'm at the pharmacy almost everyday I'm not exaggerating. Complaining that the Board isn't doing enough is like saying the little Dutch boy isn't doing enough during a tsunami. But that's the problem-Our health care system isn't facing a bulge in the pipeline, it's a tsunami and all we have are Dutch boys. That's offensive.

My picture and caption, sure it was offensive. The kind of offensive that gets deleted. Life and death, sickness and health, what we're doing with that is a whole new kind of offensive. Deleting life is offensive too.

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