Monday, May 19, 2014

Something that bugs me about net neutrality

(If you don't know anything about Net Neutrality (NN) find yourself a good primer on Net Neutrality.  The Wikipedia article is pretty decent as is this Medium article.)

If you read anything about net neutrality you will undoubtedly include references to "fast lanes" or how Netflix will have to pay more to get good service for video or other tiered service concerns.  Tiering is NOT the problem...  No one would complain about a tiered service model that drives prices down like the tiered/bulk pricing models for online services like AWSMailChimp, Dropbox, or myriad others.

The problem is that there isn't enough competition among internet service providers and in the absence of more competition and/or regulatory power the consumer (innovative start-up OR end user) will lose.

Monday, February 24, 2014

My name is Andy. I'm an an ACA policy-holder.

There is a vocal contingent of people that sees the Affordable Care Act as a train wreck and people like me as dependent on a government hand-out.  So I wanted to air some facts.
  1. If you can I cannot agree on the high-level goals of the first 17 pages (the table of contents) of the Affordable Care Act then we should probably just part ways now.  The goals, to me, seem like things that we should all be able to agree on.  If you agree on the goals but have a better solution then talk about *that*.
  2. My family selected Optima's Vantage Foursight 3500/80% silver level plan. Here are the important terms:
    • $1,140/mo. premium (we'll talk subsidies below)
    • $3,500 deductible per person, $7000 for the family
    • $6,250 maximum out of pocket per person, $12500 for the family
    • $25 co-pay on 4 doctor visits per person per year and 20% co-pay there after
    • $150 drug deductible
    • Tiered drug co-insurance... $15 co-pay/generics and the greater of $30 co-pay/40% co-insurance OR $50/50% depending on the "tier")
    • 20% co-insurance on almost anything else
  3. We forecasted income at $56,000 (as an entrepreneur starting something new and with only intermittent income it may be lower but we wanted to avoid dealing with another set of rules and regulations that we would've qualified for under Medicaid as a family of 5 with 3 kids).  This qualified us for $633/mo. of premium subsidies.
  4. In the worst case (multiple big expenses and non-generic drugs charged at 50% co-pay for multiple family members) assuming we qualify for the subsidy for the whole year (i.e. we don't make more than $56k for the year) we would pay: $18,584 total for the year.
  5. If we ceased to qualify for the subsidy that total increases to $26,180
Undoubtedly you will look at those numbers and think "$%@*% that is really expensive!  The median US income in 2013 was $51,000.  How is nearly 50% of your income AFFORDABLE health care?"  consider few more things:
  1. This is the worst case.  Best case where we had no medical expenses at all would be $6,084/$13,680 (with and without subsidy)
  2. There are actually two types of subsidies/tax credits; premium subsidies and cost-sharing subsidies.  I have not investigated the cost-sharing subsidies which could limit my out of pocket expenses beyond premiums.
  3. Take a minute and review my pre-ACA analysis of Anthem Health Insurance plans.  The best and worst case of the common "Anthem Premiere" plan is within 10-15% of the ACA plan above.  So it's not as if the existing options for my family were hands down better before the ACA.
  4. The point of insurance is to hedge against costs that are financially ruining.  The worst case under this policy would not be financially ruining to almost anyone.  On the other hand the cost of even "routine" hospital visits can quickly rack-up bills that are ruinous much less things that are not "routine."
  5. ACA-compliant policies have broader coverage, no pre-existing condition exclusions, and no lifetime limits.
Yeah, but is it really worth it?  Let me leave you with a few more facts.
  • We use a couple of drugs that don't have effect generic equivalents that cost almost $500/mo each.  That alone could add up to near $12,000 (you don't get a "cash" discount from pharmacies and even Canadian online pharmacies were only 10-20% cheaper).
  • We had several "routine" procedures that used hospital or other special facilities, anesthesia, etc.  The total of those was around $20,000.
You do the math.

Wednesday, January 8, 2014

Let go of who you think you should be to be who you are

It's an odd thing that we single out "mid-life crises" and talk about them as a moment; an event suspended in time.

Nothing happens in a moment as if it were plucked out of nowhere and dropped onto the timeline of your life.  And everyone, not just those who are middle-aged, experiences profound changes throughout their life; vocationally, spiritually, personally.  Perhaps most of us just develop the capacity for, or appreciation of, self-reflection during middle-age.  And upon honest reflection of vocation, family, spirituality, possessions, etc. an impulse to change is not a surprising result.

My "mid-life crisis" began in 2010.  That year for my annual performance evaluation, after pouring myself into my team and project and working 80-100 hours per week for almost an entire year, I was given a rating of "developing" (only one step above "needs improvement").  Starting in 2011 my spiritual community split over issues of human sexuality, attempted transformation among those remaining, lost our vicar, and ultimately closed.  In the fall of 2012, at work I got a new boss.  He presided over intense and dramatic changes.  In March of 2013 I had the crushing responsibility of laying off 10 people (from a 20+ person team).  In June I found myself and rest of the team in the same cross-hairs of a layoff.  It may have been luck, intuition, or God but my angst at work had me exploring start-up ideas in April and May.  So when I heard the words "your position is no longer needed" at least I had something to pour myself into while I sought to make sense of "what I want to be when I grow up."

One summer when we lived in Seattle a family friend and sea plane pilot invited us to "get a slice of pizza in Poulsbo."  Poulsbo, is at least an hour and a half driving distance and involves a ferry so when I said "a slice of pizza?"our friend responded without skipping a beat "yeah, we'll be flying."  We boarded the plane, took in beautiful sights, did a loop around the Space Needle, landed in the middle of a carnival, had a slice of pizza, and returned home.  Back on the dock at home I stumbled to express my gratitude saying, "George.  You have ruined me for fun.  I may never enjoy myself again."

The past three years have "ruined" me for many things.  I'm ruined for "church"; at least the church that primarily concerns itself with buildings and "services" and bulletins, Sunday school, potluck dinners, small groups, and undemanding relationships.  I'm ruined for "jobs"; at least the sort of jobs where shareholder value is primary and it's people are secondary.  I'm ruined for "capitalism"; at least the capitalism that isn't deeply troubled by the impact of widening economic inequality and environmental degradation.  I'm ruined for "politics"; at least the politics that finds no compromise, even on goals, if not means, and is corrupted by money and powerful interests.

I recently re-watched a TED talk by Brene Brown about vulnerability.  She describes a group of people from her research whom she calls the "whole-hearted." They are people who have embraced vulnerability.  They have the courage to be imperfect, compassion towards themselves and others, and have relationships based on authenticity.  Brown says they have:
"let go of who they think they should be in order to be who they are."
 I may be "ruined" for church, jobs, or politics.  But I am NOT ruined in faith, enterprising ideas, or political convictions.  Quite the opposite...  I find myself pondering who I thought I should be, who I really am, and whether I've been fooled.  I haven't found the answers yet but I'm certain I intend to live "whole-heartedly."