succumbing to peer pressure

Saturday, January 26, 2008


A belated post on this new-fangled medical credit score idea. Thanks to Sid for the assignment heads up. Somewhat remarkably, this thing has somehow escaped most major news outlets. A google search turns up mostly just other blog posts. South Carolina's The State has a news story up, from which we learn that the medFICO will be a type of credit score used by the health industry to predict your ability to pay medical bills. The score will be based on your medical bill payment history, and allegedly won't be checked until after you've been discharged from the hospital (to ensure that it has no influence on the care you receive). Uh-huh. Yeah, I'll sleep securely at night with those assurances.

The chairman and CEO of Healthcare Analytics, the company developing the score, says, "We just help figure out what sort of relief a hospital should grant the patient." Something more specific than a general credit score, which your hospital can obtain without your permission, is needed because, as the article so helpfully points out, "Health care debt is largely involuntary."

Supporters of the idea claim it will be used to identify bills that are, essentially, lost causes, and conserve resources that would otherwise be spent trying to collect that bill. Additionally, the score could be used to better help hospitals plan budgets, with some idea of which bills are likely to be paid and which are not.

Which sort of sounds reasonable, except when you start digging around in the reliability of existing credit score data - "...the Consumer Federation of America says it found that 29 percent were 50 points lower than they should have been."

So with the medFICO you've got hospitals, insurance companies, and third parties collecting data that a) is likely to violate privacy laws by including too-detailed medical information, b) is rife for identity theft, c) could trivially be abused to reduce care provided to those unable to pay and d) is moderately likely to be just plain inaccurate. Wow, seems like a swell idea to me!

(the blog post linked earlier has a nice breakdown of the economic side of things, and some pretty cogent arguments as to why the company's claims about the timing and implementation of the score are likely bogus)

"Heath Ledger passed away this week and in all the years we've been doing this show we've never had cause to mention him. So stop digging through the dirt weasels. A talented, decent guy is gone and our thoughts go to those who knew him."
(I heart Joel McHale)

Heath Ledger is sort of like my Kurt Cobain/River Phoenix. Not that his particular talent helped me through an emotional adolescence or anything like that, but he's one of the few pop culture icons who I can claim to have appreciated from nearly the beginning. Yes, I actually watched Roar back when it was on network tv. Although I've also long been a fan of Matt Damon, it was sort of fun to watch Ledger act circles around the boy in The Brothers Grimm. And his small role in Lords of Dogtown was a direct (and impressive) channeling of Val Kilmer. He not only held his own, but downright stole scenes from the likes of Billy Bob Thornton in Monster's Ball. Even in mediocre-to-crappy movies (The Order, First Knight, etc.) it was always a pleasure to watch him work. I was really looking forward to watching him further his craft, and his absence is a real loss to the profession. Obviously, his loved ones miss him personally too, but not having known the guy, it feels disingenuous to speak about anything other than the ways in which I personally appreciated his presence.

Wednesday, January 23, 2008

A somewhat sappy mental health entry

As Kathy and I were shouting and giggling in celebration over the phone last night she mentioned one of the best things about good news - the sort of forgetting and re-remembering and being excited all over again that happens as good news keeps sinking in. I was thinking about that this morning as I was lying in bed - first I thought about how soft and comfortable my bed was, then how adorable the cat looked rolling around in the shaft of sunlight leaking through the curtains, then I remembered that I got the fellowship and started grinning like an idiot. I spent a few minutes just lying there, being happy and warm and comfortable.

Things are going particularly well right now, so it's easy to revel in moments like that. But that's also just a part of who I am - even without my stupendously good news, I probably would have indulged in a few minutes in bed this morning, grooving to the radio, curled up with the cat, appreciating how lovely that moment was.

But I can also appreciate that that is not how things always work. Right now I can really take in how fortunate I am and how good my life is - I have the kinds of friends who virtually hold my hand all day while I wait for news, who spread the good news even faster than I can to make sure I get lots of messages of congratulations. But I know there are places where those facts don't reach. Where no matter what the tangible evidence of your life is, none of it makes a dent in how you're feeling. I've never been depressed, but I do get anxious, and at the worst of times it feels a lot like how Mark (over at Good Math, Bad Math) describes his depression:

What happens if I don't take my medication? I turn into a zombie. Everything turns flat, it seems almost as if things lose their color, like all the colors fade. I feel like my body weighs so much that I can't even hold my shoulders up. I don't feel sad; I feel nothing. Empty, blank, flat. Great things can happen, but they don't make me happy. Awful things can happen, but they don't make me sad.

I spent a lot of the summer two years ago in a state like that - remembering how much I used to enjoy the sheer number of stars you can see at night in WV, how the wind whipping in through the windows of the car used to make me feel good, on and on and on. And yet that summer, pretty much everything made me feel nothing. And the thing is, when you're in those moments, even if you can remember times when you luxuriated in tiny moments, those seem impossibly far away, and like they'll never happen again. I can remember getting into my car to drive over to a friend's house, realizing I would need to stop and get gas on the way over, and almost getting back out of the car and staying home. It wasn't that stopping to get gas was too scary or overwhelming specifically, it was just too much to have one more tiny thing to do. I had mustered up the energy to drive somewhere, to be around people, and I just knew that if I was delayed on that mission I wouldn't get there. Existing just took too much energy, not because it was so awful, but because it stretched out in this unending, unbearable vacancy of absolutely anything. Nothing was bad because nothing was good.

I have no idea how mental health problems feel for other people, but that's how mine feel for me. And I can only really be articulate about them when I'm in a good place. And we don't talk about them enough. So that's my story.

Tuesday, January 22, 2008

Happiness, only slightly tempered

Although I am shocked and saddened that we lost Heath Ledger today, I have to confess that my giddiness over my own news outweighs that. I just found out that I got the fellowship! This just makes so many things in my life easier. I am funded through May '09, with that being my new planned graduation date. In a perfect world, I'll wrap up my dissertation by the end of '08, then spend the spring really seriously job hunting, without the added pressure of defending and house hunting simultaneously. In exchange for the funding I'll teach one introductory class this fall and a seminar based on my dissertation work in the spring. I can sign my lease for one more full year, and hunt for one more roommate this summer. And now I'll consider pushing ahead with hip surgery in the spring. There's never going to be a good time for it, but now there is at least the possibility that I could schedule it over spring break, take a good solid week off, and then only have one day a week of teaching to worry about, which I could clearly do from a seated position. It's probably the best timing that could be available to me for a while. Life is good.

I'm busy neurotically checking my e-mail and obsessing over my own petty concerns, so meanwhile, head over to Lawyers, Guns and Money where Bean does an excellent job blogging for choice and celebrating the 35th anniversary of Roe v. Wade.