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February 1, 2003 ...

In case you haven't yet heard

Seven astronauts dead, and may their souls rest in peace, but that's not why I'm crying. (I work at a newspaper and report death day in and day out; I've been trained not to cry at bodies.)

I'm crying because the space program is one of our best and most concrete hopes for broadening our horizons past this little dirtball. It's our gateway to a frontier we've only just started to realize is there for the exploring.

And, like Challenger before it, this is going to be another nail in the coffin of manned space missions.

Seven astronauts are already dead, but I fear our dreams are dying in front of our eyes.

Rick Husband, Willie McCool, Dave Brown, Laurel Clark, Kalpana Chawla, Mike Anderson, and Ilan Ramon: Thank you for your bravery. I honor your ultimate sacrifice. May it not have been in vain.


February 3, 2003 ...

In Saturday's entry, I have realized, I was wrong about one thing: I did cry over the astronauts' deaths.

They were professional dream-chasers. They were fellow explorers, lost during an ongoing effort to push back the boundaries of humanity. That hits where it hurts, you know? I may not explore the same frontiers that they did -- I may go inward, to the far reaches of the heart of the soul rather than the skin of the sky -- but I feel a kinship to them as fellow frontiersmen.

The loss was the more tragic because space, far more so than any of the world's inner or outer frontiers, is a dangerous and isolated place. Americans don't like to see American lives lost in dangerous pursuits. A space shuttle explosion is the sort of event that leaves scars in people's minds; and if there are too many, people start asking whether we should send space shuttles up at all, or whether it would be safer to just abandon the space program.

This idea of kowtowing to "safety" scares me. I don't think it's a healthy thing to close off our frontiers; and I especially don't think it's healthy to close off our frontiers because of fear of danger. But when I first heard we'd lost the shuttle, I almost braced myself for that as an inevitability.

From looking at our zealous laws, our abundant class-action lawsuits, our foreign policy, our ubiquitous warning labels, and the wide-eyed, innocent shock with which the news media reports tragedies, I think that any reasonable person would conclude that the average American lives in a fantasy world in which life is clean and predictable and nothing ever goes wrong unless it's the fault of some malevolent corporate scum out to sell the proletariat shoddy or dangerous goods for the basest of profit motives. (Note to skeptics: Yes, I realize the irony of someone who is a dragon in spirit talking about "normal" people living in a fantasy world, thank you very much. Can we stick to the point?) Think about it. What is the last major tragedy in the media spotlight to which the general reaction has not been, "Somebody should have done more to prevent it"?

Insofar as this gets us thinking about long-term planning and disaster preparedness, this is a healthy attitude. But the current feeling seems more pathological: "That could have been me! I want someone to fix it so it doesn't happen again, no matter the cost!"

The problem is that there are situations in this world that are inherently risky. Building houses on a floodplain, or on the top of an eroding ocean cliff. Inhaling searing, chemical-laden smoke for a quick pick-me-up. Escaping Earth's gravity on top of a long, controlled explosion.

Sometimes people do these things anyway, and then try to pin the responsibility on someone else when the house inevitably collapses. Sometimes people get self-righteous and say, "We ought not to let people do these things, because smoking kills and people are too stupid to understand the risks they're taking!" Which category does space exploration fit into? Time will tell. I hope it's the former, though it would be small consolation.

In the meantime, the feeling of having been punched in the gut that the loss of Columbia gave me has been slowly receding. Work on Saturday (I had to lay out the Sunday newspaper, including exhaustive details on the incident) was something of a catharsis; while it was an emotional roller-coaster not being able to escape the images of debris and shock and pain, I'd basically recovered by the end of the night, and have been spending my weekend readjusting and getting back into the normal patterns of life.

Incidentally: It's interesting, in hindsight, to compare my reaction with what I felt after 9/11. I reflected there that all tragedies, essentially, are personal; and argued that it was okay not to mourn if one didn't have a personal connection. I went through a whole range of emotions, but I didn't mourn. Five thousand dead and I couldn't find a tear to shed.

Now seven, none of whom I had ever heard the name of before a few weeks ago (my newspaper did report briefly on the first-Israeli-in-space angle), are gone, and I was openly weeping for most of the day of the disaster. Several of my friends on Livejournal said, with varying degrees of defensiveness, that the event had very little emotional impact on them. I got to see the pain from the other side.

What was most interesting was my reaction to people's apathy, which is probably best summed up by quoting LJ user cathouse_blues: "I don't ask or expect anyone else to grieve; what does bother me are those who insist we shouldn't because it's just not big enough in the grand scheme of things." I alternated that evening between telling people that, no, they weren't a monster for not crying; and fiercely defending the worth of the space program to a few skeptics, trying to explain what about these deaths in particular was hitting me so hard.

But now we've all had a chance to catch our collective breaths; the 24-hour coverage has stopped (at least I hope so); and George W. Bush has stated (and, oh, how I wish I could believe a single word that came out of his mouth) that our journey into space will continue. The one thing that remains to be seen is: How long?

After Challenger, it was two and a half years before any more manned projects launched. Let's hope that our world's final frontier doesn't remain closed for so long this time.


February 5, 2003 ...

Hello, audience.

You're the reason there's no journal entry today.

I am suffering from a particularly virulent form of writer's block known as "self-censorship." I've got three posts dancing around in my head that demand to be written; but I don't want to share them, I don't want to take the effort to write them if nobody else is going to read them (since I know what's going on whether they're written or not); and I don't want to abandon them. Inertia or momentum will push me to one of those choices shortly, but until then I can't give word to thoughts of any significance.

In the meantime, in order to start exorcising these ghosts, I have a public, private message to someone who I strongly suspect is reading this page. Unless you think it's you, it probably isn't.

You pride yourself on making a difference in the world. You've said as much, not just to me. You have a cause that drives you. You won't let anything stand in your way. You are, in the words of George Bernard Shaw if not necessarily your own, an "unreasonable man."

I'm not. I've spent entirely too much time being reasonable lately, wallowing in paralysis because I'm trying to remake myself instead of standing fast and bending the earth to my whim. More's the pity, I guess, because you feel I'm failing in my responsibility to shape the world for the better, and I think that I agree. (I suppose I could dedicate my new year's resolution to you, if I didn't think you'd take it the wrong way.)

Yeah, I can be a coward when it comes right down to it; maybe it's my tragic flaw. But if I've wasted myself by dropping that ball ... how much more tragic the waste must be for you.

What the hell are you patting yourself on the back for? For a man who finds himself driven to a cause, for a man who does feel that fire ... you certainly have little to recommend the courage of your convictions.

You may think what I believe is crazy, and you may think that I can't find the strength to do what I know to be right ... but, dammit, at least I have the courage to be myself, and to accept the consequences of my life choices. I am public about my draconity because it is important to me -- and because I feel (rightly or wrongly, that's not the point) I'm doing the world a service by sharing my 'cause' with others, hoping I can spark fires that will give other people the determination you say you feel. Don't you agree it would be better -- and easier -- for me to remove the relevant webpages if I changed my mind on either of those issues? Yes, I should be doing more, and I have known this for a while ... but at least I will stand by what I have done.

And you. For someone so passionate about the things they care about, how can you be so craven as to criticize me behind my back, saying you hope I get the message someday but remaining unwilling to be its bearer? I hope you show more enthusiasm for your "cause," whatever that may be -- for all you bragged about your dedication, you never saw fit to mention what it is you're driven to. If you care about me in the slightest, if you care about changing me in the slightest, you should at least have the balls to say so to my face! And if you don't care about actually changing my behavior, what's the point of acting catty? I hope that your comments made you feel better -- superior to the poor old dragon who's wallowing in his own inaction. At least that way I'll know they served some useful purpose, instead of being the typed equivalent of inane spit-dribbles on the corner of one's five-paragraph essay.

Me, I don't actually care about you. I have your e-mail address; I write this knowing full well that I have the option of taking the moral high ground and leveling my criticisms at you personally. I don't do this, not because I'm a hypocrite, but because I don't care if you change, and, yes, because writing this is making me feel better. I suppose I should thank you for being a Shaw "unreasonable"; that frees me of any lingering guilt I might have felt over the matter.

"I don't have enough time for all the cool people I know," Aahz Maruch has famously quipped, "let alone all the cool people *they* know." Every moment I waste on someone who is un-cool -- or on inoculating myself against the venom of their words -- is time I can't spend hanging out with people who are changing the world for the better. People whose fires I can catch, and perhaps run with briefly when they tire; people whose fires I enjoy, and want to spread; people being passionate about causes antithetical in spirit to my own, but who are nonetheless reasonable and enjoyable in conversation, and from whom I can learn and perhaps modify my own ideas. (Postvixen is as staunchly socialist as I have been Libertarian, and for months it seemed like disagreeing about politics was our only interaction; and despite that, I still think she's one of the coolest people I'm acquainted with, and in fact I have started drifting into market agnosticism.)

Anyway, in short: Find a backbone. I'm looking for a good one, too, but at least I know I'm looking.


February 9, 2003 ...

Due to my altered schedule from working at a newspaper, my work weekend is Sunday and Monday. For some reason, that seems to make a lot more sense than the way people normally take weekends.

Sunday, in the embedded Christian ethos of my native culture, is a Day of Rest. I did some things I'd been meaning to do -- talked for 90 minutes on the phone with an East Coast dragon; uploaded a bunch of new icons to my Livejournal; and worked out some minor financial matters. But the day was basically full of me slacking off. I played some video games and actually watched TV (mostly because it was in use and I was too lazy to ask if I could play video games). I did some pleasure reading. I sat around the house and let myself do nothing and didn't feel guilty in the slightest. Day of rest. The last few weeks have been filled with a number of stresses from various sources, and it felt good to recharge my batteries.

And now I've even got an entire day of "weekend" left over to do chores with!

I would have been pretty miserable on Saturday if I'd been running around all day trying to play catch-up on my personal life, knowing that even though I was done with work for the week I still had to stay on task for another 24 hours. This way, though, I get to go into Monday morning with a clear head -- heck, even sleep in a little if I feel like it; it is a weekend day for me. Not only that, but because of the way my schedule intersects with the mundane world's, I can even get things done on my day off that usually need to be accomplished during business hours! If I'd taken a Saturday to slack off and a Sunday to be productive ... well, let's just say "Good luck finding an open bank or post office."

So I'm very happy with my "reverse weekend." Sort of a pity that so few people get the opportunity to do it the right way around.


February 11, 2003 ... Ah, the simple joys of moral high ground.

On Monday, Chinese dissident Wang Bingzhang was convicted of "organizing and leading a terrorist group" by the Chinese government and sentenced to life in prison. Wang is a pro-democracy activist who lived in New York for most of the past two decades after defecting to the U.S. in 1982.

Naturally, the U.S. government expressed its outrage. "We are particularly concerned by the charge of terrorism in this case, given the apparent lack of evidence and due process," said State Dept. spokesman Richard Boucher.

Meanwhile, just out of earshot, U.S. Attorney John McKay defended the indefinite detention of approximately 650 foreigners (more of whom continue to arrive) at Guantanamo Bay. The world's greatest bastion of democracy has asserted these "enemy combatants" are terrorists, but can't even work up the enthusiasm to convict them in a closed-door kangaroo court as China did with its single activist. Instead, they are held without trials, formal charges, or legal representation, in a legal limbo mirroring their almost total isolation in high-security cells (which, at least, is loosening up for the 'cooperative ones'). Doing otherwise "would critically undermine our national security and frustrate the military's effort to collect vital intelligence information," McKay said.

If these people are terrorists, or if they've aided terrorists, or if they have a brother who is best friends with a guy who has the same last name as a terrorist -- why won't our government take steps to prove it, and weed out the innocent from the guilty? Even a classified military tribunal would force the white-hats to get their shit together enough to make sure they grabbed the right suspects -- or, at least, more so than now, where basically all we have to go on is the ardent promise of the government that gave us Watergate, Iran-Contra, Monica Lewinsky, and Enron.

But, ya know, we're the good guys. We shouldn't have to worry about standards like "innocent until proven guilty," because we're trying to make the world safe for people to be innocent until proven guilty.

Let's just lean on communist China until they realize that.


February 13, 2003 ... On political realities, predictions, and revolution

Trend 1. Americans are steadily becoming less educated. (Not necessarily stupider, though that would explain a lot.) Grade inflation, an increasing lack of consequences for failure (such as the increasing trend of students being promoted even if they haven't mastered a grade), pressure to perform only on standardized tests at the expense of less easily measured skills, etc., are decreasing the value of a high school education. In my parents' time, for a child to go to college and not know trigonometry was aberrant; now colleges offer remedial courses in algebra and an increasing number have to take them. Our high schools are increasingly turning out adults unprepared for any sort of skilled labor.

Meanwhile, the cost of a college education continues to rise at a pace faster than inflation. In California, where the state's budget crisis is accelerating the process, cheaper community colleges are facing a doubling in per-unit charges while more expensive four-year institutions are only projected to rise about ten percent. In other words, those who can't already afford to educate themselves are being slowly locked out of the ability to work at much more than minimum wage. The class divide is growing and the poor are getting the shaft.

Trend 2. Historically, revolutions have come about not when the peasants are getting shafted (that always occurs to some degree), but when their quality of life drops so far that they stop being able to avoid noticing. The Romans had bread and circuses, and the Romans had their empire.

As technology increases, the ability to placate the masses increases with it. Television is the most immediate example, but nearly every first-world innovation is a warranty against revolt, right down to indoor plumbing and microwave burritos. The American masses have an impossibly high quality of life, historically speaking. There may be widespread discontent, but a revolution would disrupt so many of the things we take for granted (water, garbage, supermarkets, electricity, cable, etc., etc.) that it is basically unthinkable to the average individual. Things would have to get really bad to foment any sort of uprising -- these comforts would have to be disrupted and the populace would have to lose faith that the government was providing a service valuable enough to justify their sudden decline in quality of life.

Observation. This is unlikely to happen, because with the United States running around being unilaterally, erratically aggressive as the world's "sole superpower," and with its economic oppression of the rest of the world (whatever our motives may be, it's undeniable that our quality of life would vastly degrade if we were to pay overseas for labor and goods what they're worth here), most of the rest of the world -- especially less-developed countries -- is becoming increasingly pissed off at us. Sooner or later, someone will decide to take out their frustrations on us, and American politicians will seize the excuse to unite the U.S. under the banner of self-defense, making people feel that the external threat is more pressing than any domestic degradation. After all, who wants to overthrow a government that is the only thing standing between them and horrible certain death?

I predict, in fact, that this will happen soon. Perhaps starting as early as September of two years ago.

All jokes aside, keep this in mind: I don't know just how quickly the gap between the classes is going to grow, or how quickly the middle class is going to disintegrate as rich become richer and poor become poorer. But if that class gap is widening too fast, the "War on Terrorism" may be the only thing standing between us and an internal revolt.

If that is the case, then it would be unthinkable to end it; and it is equally unthinkable to continue to escalate our external conflicts, because sooner or later we're going to either end up occupying the remainder of the world, or provoking someone who actually has the ability to strike back in a formal, large-scale way.

I'm not at all certain that things are going to get better after they get worse.


February 14, 2003 ... Happy Valentine's Day, everyone. :) Thea here. It's been longer than I thought, almost two years, since Bax has dragged me out in front of a keyboard to go on the record in his journal with my thoughts. I haven't been completely gone; I spent some very special time with a friend of ours (you know who you are :)). But I haven't been writing.

Bax has been giving some thought to the idea of "Thea's Story Hour," giving me more front time to write a weekly feature or some such. It sounds cool -- and boy, could I embarrass him (sure, we can look back on the milkstones NOW and laugh!) -- but that's not what I'm here to talk about.

It has come to my attention that today was, of course, Valentine's Day. I'll make certain to jump Bax later tonight and properly celebrate it, but in the meantime I get to "talk about love, talk about love," as the Judds sang. I recall Bax writing about us earlier -- hmm, the memory must be this -- and I don't have much to add there, beyond how grateful I am back at him for being the person he is. He has this crazy idea that I'm the one who made all the sacrifices to get us back together. But he needed to change almost as much as I did, in order to open up and see what we could have; and he did, and he didn't have to in the slightest, and that he came out of his shell and did so is a gift I can't take for granted. Huh, guess I did have something to add. ;)

I realize how sacred what we've got is; I don't want to turn this into some sort of public sap-fest to rub into the faces of people out there who are single. What I came to the keyboard intending to write was a reflection of what got us to where we are today -- and a sort of belated Thanksgiving for the things and people that made it possible. I think Valentine's Day and Thanksgiving are a lot more related than people think. Or at least they should be. :) Real love means giving so much of yourself to another person, and being willing to do it whether they return it or not; and taking happiness from the fact that they are doing the same right back to you. Love is always something to be thankful for.

Beyond Baxil, whose place in my heart should be obvious, I'm thankful for Raja. I've been thinking for five minutes now how to describe our relationship, and the best thing that comes up is "comrade-in-arms." Except that doesn't really cover the depth of it. It's like we're mates, up to and including sex, except neither of us thinks of each other that way. Functionally, I guess we are. I've known him longer than I have Bax, and Raja's supported me the entire time I've been on the hunt, and I don't think there's anything I wouldn't share if he asked -- not that there's much left. :) But, well, I guess we're so comfortable with each other that we don't need to. We fit together around the edges so well that we don't need to be any closer. Bax and I, on the other hand, well, it seems like we fill in missing parts of each other. I know he's noticed a difference in himself since we Joined, and I'd be lying if I said any different about myself.

*Makes a mental note to file some Raja stories for Thea's Story Hour*

Oh, well, this is getting sappy anyway; I guess I couldn't expect to talk about my closest beloveds and avoid it. ;)

But I was going somewhere with all that, I promise. I wanted to offer some words of inspiration to those facing empty arms or an empty bed tonight, and feeling the peculiar wrenching pain of loneliness I'm all too glad to leave behind.

There's someone out there for you. You'll know it when you see them. You may have to weed it out from a million false alarms, and I don't think you should fall in love expecting that This Is The One, but we are all pieces of the same, single, universe-sized jigsaw puzzle, and there are people out there who will fit against you as if mandated by fate. I don't know, maybe that's the case. :)

In the meantime, while you're still looking, don't get caught up in the romance that They (tm) try to sell you on Valentine's Day. I completely agree with Bax; the commercialization of love (um, link, there we go) is a perverse and disturbing and quite frankly nauseating thing. It's not just that they try to convince you that money can buy love, which is bad enough in itself. But the commercialization cheapens love by focusing solely on the whole romantic/soul-mate angle.

Bax reminds me that the Greeks had three different words for love, different sorts of love entirely. Philios, brotherly love; eros, erotic or romantic love; agape, spiritual, selfless love. What they sell you on Valentine's Day is eros. Philios doesn't deserve chocolates and balloons; agape doesn't need them.

And you don't need "a soulmate" to use Valentine's Day as an excuse to reflect (positively! :P) on the people you love. Think of your friends -- some people who have made great sacrifices for you, who have stood by your side when you've done something stupid and forgiven you afterward. Think of an officemate who brought you cookies just because. Think of someone who gave you an unsolicited smile today.

This isn't the love that corporations want to sell you, because it's not the love that makes them money. But it is love nonetheless. While it is no substitute for a soulmate, I guarantee you that the reverse is also true: to get through life from day to day, we all have to have friends and small kindnesses as well as the lovers we crave.

If you're alone today, make a list of friends, acquaintances, and strangers who made your day a little brighter. Call everyone you can, and tell them, "Thank you." (Or "I love you," although I am given to understand that such things can be misunderstood in spoken language. ;)) Feel those connections, their strength, their brightness; stop a moment and let yourself take in the universe and see just how un-alone you are.

It won't find you a soulmate, but it'll make you a lot happier until you do.

Thank you, Raja, for helping me remember that over my centuries of uncertainty and despair. I love you too.


February 19, 2003 ... Hopefully -- hopefully -- the saga of the broken arm is over.

Well, I mean, it's not really over until I finish paying off the bills; but now, barring any more crazy plot twists, it will at least produce no further drama.

This is going to be a long story, and I'll serialize it over the next several days. Today's entry will mostly be backstory, to catch everyone up on the background of the problems I've been dealing with behind the scenes for the past ten months.

What it boils down to is that when the arm got broken in the first place, way back in April 2002, I was in the unenviable position of having no medical insurance. And, to top things off, no source of income. Keep this in mind as you read the following.

The break occurred when I got a little too enthusiastic while running downhill on a wet, slick slope. The universe seemed to decide that I needed some sort of karmic punishment rather than just a polite lesson in physics, and I discovered once the initial shock had worn off and the X-rays had been developed that the broken bone in question would need surgery in order to set properly and give me back use of my arm. (It was a very clean break. It was a very simple break. It was also, unfortunately, right at the elbow joint; and the muscles of my upper and lower arm were pulling the bone and the bone fragment in different directions.)

The arm came out of the cast in June, 2002 and finished healing by July. In October, the wire that they'd stapled my ulna back together with poked around where it shouldn't have been, and burst a blood vessel, causing some persistent internal bruising (details here); but there have been no other physical complications since. By any metric, it has been problem-free for four months; and if one ignores the delayed problem, for over half a year.

However, my pocketbook doesn't seem to agree.

The sum total of my medical bills -- while I was unemployed, mind you -- came to $11,811.49 from a total of 12 different service providers. In the grand scheme of things, most of these were nickel-and-dime deals; what's $47 for an X-ray when you owe $8,198 for the surgery? The bills that were sufficiently large that I didn't just grit my teeth and pay them -- such as $700 from the anaesthesiologist -- showed an admirable willingness to work with me; of those twelve providers, only two (both radiologists to whom I owed less than $50) ended up settling with me for the full amount on the bill. In both of those cases, it was because it wasn't worth my time to go through their charity program application process for the piddling amount it would save me.

In most cases, simply a phone call explaining that I was an uninsured patient was enough to save me 20 to 25 percent of the tab. On the rare occasions that I had to provide supporting documentation for a charity waiver, or write a formal request letter, I typically saved more. (The anaesthesiologist ended up knocking 50 percent off.)

I very nearly got the best deal for the largest bill, in fact. The hospital at which I got the surgery done was willing to knock off 55 percent of the $8,198 bill -- that's $4,500 off -- if I would just pay the balance due in a lump sum (which I could have done on a credit card if necessary, or by financing through my parents). Notice that this wasn't even a charity waiver. This was what they termed a "self-pay discount," and didn't even require a promise that I was poor and needy, simply the fact that I was uninsured. So what kept me from taking advantage of this incredible offer? I'll tell you: The belief that government could help me with my problems better than private charity.

The state of Washington (in which I lived at the time), as it turns out, has an emergency medical care program. Sort of like Medicare, except that any uninsured and sufficiently poor resident is eligible, with no age, disability or family restrictions. It's designed to help deal with catastrophic injury or illness, and pays for all but the first $2,000 of medical expenses relating to that incident.

That did give me pause. Applying meant a great deal of paperwork, bureaucracy, and a blow to my lofty Libertarian ideals, but after some careful consideration and discussion with the parental units, I filled out the forms. After all, situations like mine were exactly what the program was there for; I was (still) unemployed; and the difference between $11,000 and $2,000 was a lot bigger than the difference between $8,200 and $3,700.

So, with slight misgivings but strong hope, I turned everything in to the local Department of Social and Health Services office. About a week later, I received an acceptance letter in the mail, followed shortly thereafter by my coverage card.

It was a very innocent beginning to a ten-month nightmare journey that brought me to within days of declaring bankruptcy.

Tomorrow: Labyrinths and loopholes.


February 22, 2003 ... (Continued from previous entry on my broken arm tribulations.)

The coverage card arrived in a plain manila envelope from the State Department of Social and Health Services. Return service requested.

I opened the package, skimmed the disclaimer included with the card (in eight languages and six alphabets), picked up the card, and read it while I tried to track down the phone numbers for all of the medical providers who were eagerly awaiting my payment.

And then my eye caught on a notice on the front of the card, right above where it provided a space for my signature: "NO OUT OF STATE CARE."

This would not ordinarily be a problem; I lived in the middle of Seattle, and had no desire to drive out to some Idaho clinic while within walking range of an excellent hospital and bus distance of five others. But there was nevertheless an issue with this. See, I had my surgery in California, because I broke my arm in California about a week before my return trip -- and my choices were either to hit the operating table in Santa Barbara, Calif., or leave the bone unset and in a temporary splint for a distressingly long period of time. Nobody bothered telling me that the state of Washington might have issues with my desire to address my broken bone promptly. Heck, nobody bothered telling me that even after I returned to Washington and applied for medical care; the disclaimer on the card was the first that I'd heard.

So it was back to DSHS -- or at least a phone call to the local office. To make a long story short, after talking with three separate representatives and two supervisors, I discovered (and confirmed to a reasonable degree) that "NO OUT OF STATE CARE" really meant "No hospitals that are not signed up with the state as Washington State Health Care Providers." Armed with that, and with the phone number that institutions could call for the free application package (just in case), I set out to call the medical institutions to which I owed money.

I figured I would take care of the easy ones first. I had gone to a local clinic for follow-up care in Seattle, to get my cast changed, and subsequently to get it removed. There was no possible way that a large provider in the middle of Washington's largest city could fail to be a Washington State Provider, I figured, and there at least I was right.

But even with the easy ones, it was surprisingly difficult to get anywhere with public-sector aid.

I called Swedish Medical Center, at which the clinic was located (they sent me a bill for facility services). To my pleasant surprise, I discovered that I was already on their Poor People list after having applied for (private) aid during an earlier visit for an unrelated health issue; they had already charged off my bill as a charity case.

I called PacMed and gave them my medical assistance information. There, at least, it seemed to work. A follow-up call in December confirmed that the accounts had been "paid off" (presumably through the state).

I called Seattle Radiologists, who had X-rayed my arm three times. They accepted my card for the first two visits but not the third -- my cast came off on July 1, and my state coverage conveniently expired June 30. I paid for that last X-ray out of pocket. Later on, in August, I called them back to check on the status of the DSHS claim; they said they hadn't heard anything back. A final follow-up call in December revealed that their claim to DSHS, for no reason I can determine, had been denied on Nov. 16, and that they had decided to write off my $54.00 account rather than hound me through credit agencies over such an inconsequential sum. Thank goodness for small favors.

Of my six in-state bills, state assistance ended up covering only two.

The majority of my bills, and the vast majority of the money I owed, lay with medical institutions in California. I had a feeling that as the saga progressed, that average would only drop.

Tomorrow: Competing bureaucracies.


February 24, 2003 ... (Part three of a series on my broken arm tribulations.)

Over nine thousand dollars of medical debt lay in front of me, spread out over six providers in California. My assets? A few hundred dollars in rent money, supportive parents, and a medical card from Washington State specifying "No out-of-state care," which meant in practice that non-Washington hospitals had to fill out a mess of paperwork and wait to get entered into the system before being able to bill them.

The calls were predictable. Anaesthesia Medical Group; Pueblo Radiology; Santa Barbara Radiology; South Coast Medical Group. Are you Washington state providers, I asked them rhetorically. Of course not. Would you be interested in becoming one in order to get my bills resolved? Thanks anyway. So, do you have any sort of charity program or self-pay discount?

Most did. With help from my parents, I paid off the emergency room bill and the radiologists in short order -- not quite $500 of the remaining ten-thousand-plus. The anaesthesiologist wanted a formal written charity request; the $700 tab made it worthwhile to put on my to-do list. Then I turned to Cottage Hospital, which was billing me for the surgery.

With $9,343 on the line, I wasn't going to take no for an answer without a fight.

No, they weren't Washington State providers, naturally. I asked the representative on the other end of the phone line who I would have to talk to in order to get that set up so that we could settle the bill. That would be Greg, the department director. I somehow managed to get his direct line and started the long process of phone tag. We spoke the first week of July.

I explained my situation yet again. He took a look at the numbers and advised me that, for over nine thousand dollars, they'd be willing to go through the forms for a one-time billing. I gave him the number that Washington DSHS had provided me for account setup. He promised he'd call and get the paperwork sent down and filled out.

I continued to check in with the hospital over the course of the next several months. Bureaucracy continued to grind its slow wheels. I moved back to California, which undoubtedly made things more complex, but there wasn't much I could do about it besides update my address with all the providers I was still keeping tabs on.

Washington's forms were sent to Cottage; Greg filled out the forms; Greg sent them on to the hospital's corporate financial officer for a signature. I called the hospital's main billing office back in mid-August after receiving a nastygram reminding me that I still owed them money; after explaining the situation from scratch to one of the customer service representatives while she read the fifteen pages of notes on my account's file, she promised me that a hold would be placed on the account while the Washington state situation was resolved. (The accounts, technically. I had three different bills with the same hospital system. I got separate paperwork for each of the three, and had to give them three account numbers when I called. It ended up making little difference, though.)

After weeks of phone tag, Greg and I talked again at the end of August. He had lost track of the paperwork after it had been sent on to the CFO, and promised he'd check in to see whether it had been signed and delivered. In the meantime, I gave him the account numbers, and asked him to check and make certain they'd been placed on hold as the representative had assured me. I was still getting increasingly ominous-sounding bills mailed to me, and figured they were computer-generated, but wanted to hedge my bets.

Meanwhile, I sent in my charity application to the anaesthesiologist. That was the first week of September, around which time I also heard confirmation from Greg that the paperwork had been mailed off to Washington and that they were waiting to be set up as a provider.

The fall swept in; I found employment at a local newspaper. The anaesthesiologist called me back in October after having read my letter. "You say that you actually have coverage for this incident?" the sympathetic lady asked. (I had explained the Washington state fiasco in the letter.) "We'd be interested in signing up with them to get the bill taken care of." A bit surprised at their turnaround, I gave them the phone number. A few days later, they called me back to inform me that they'd spoken with Washington state, and had discovered that they probably wouldn't be able to take care of all the paperwork before the claim deadline expired on my April incident; and would I be okay with a 50 percent charity waiver instead? Suddenly finding myself $350 less in debt, I readily agreed, and worked out a payment plan to give them the remaining amount over the next few months.

Meanwhile, October passed. Greg and I twiddled our thumbs and waited on Washington state.

November passed.

The last week of November, I finally got ahold of Greg again, in a long-distance call that seemed like it was becoming a weekly ritual. "We just got all the paperwork back," he told me. "So now we're set up as providers. Go ahead and call the billing office and we'll get everything settled."

My sense of elation was short-lived.

I hung up, dialed the hospital back, gave the phone rep my account numbers, and waited five minutes while they read the thirty pages of notes on the accounts. "I'm sorry," they told me. "The account's been sent to collections. We can't bill your insurance. There's nothing more we can do for you. You're going to have to call FCN."

Tomorrow: The showdown.


February 26, 2003 ... (Part four of a series on my broken arm tribulations.)

"Wha?" I asked cogently, but I knew no amount of stalling would disguise the fact: The accounts had been sent to a collection agency. After I'd twice confirmed with a billing representative and a financial department director that they were placing those accounts on hold. After six months of calls, waiting, and wrangling were finally about to pay off now that the hospital had been cleared to bill Washington state's medical coverage program.

"Can't you call back the accounts from collections now that we've got the billing issues straightened out?" I asked.

"No, at this point it's in their hands," the rep said.

I've worked telephone customer service before; I knew that tone of voice. It's what you use when you're staring an enormous problem in the face and have suddenly discovered in a grand, shining epiphany that it isn't your problem, your supervisor will tell the customer the exact same thing, and you don't have to feel guilty that you can't assist the voice on the other end of the line.

There was nothing to be done but to give Financial Credit Network a call.

Monica answered the phone there after I got through the automated system. I explained the situation -- a quick synopsis from the broken arm to the bureaucratic error that had me speaking with her. "Look, can't you guys just send the bills back over to the hospital so I can get my insurance to cover this?" I pleaded.

"We don't have any control over that," I was told. "It's up to the hospital if they want to cancel the contract. We can't back out."

Armed with the knowledge that several of my roommates had, in their dealings with collection agencies, negotiated deals to settle their debts for dimes on the dollar just to get it paid off -- and armed with the knowledge that the hospital itself was willing to settle for less than half of what was on the bills -- I tried a different tack: I asked about the amounts in question. Somewhere along the line, the $9,343 I had been billed by the hospital had turned into $9,879. The rest, Monica explained, was interest. She helpfully provided that the interest rate was 10 percent, which meant that they had also in their infinite generosity allowed me to retroactively be charged interest back to the date of the original surgery.

"So," I said, perhaps a little desperately, "the hospital was quite willing to settle this for about $4,000 back before the whole Washington state mess blew up. Will you honor that?"

"No," she said, "but I'll talk to my supervisor and see what we can do."

I called the hospital back. "Look," I pleaded (perhaps to a supervisor; I don't remember). "Can't you guys call off the dogs? The big note in bold letters saying 'PLACE A HOLD ON THIS ACCOUNT' is right there on your screen. You can talk to Greg to verify everything that's been going on for the last half-year. All you have to do is get the accounts back from collections and I can give you the billing information right now over the phone, and you can get the whole bill covered instead of settling for the self-pay amount or the pittance you'll get from the collectors, and I can be less achingly poor, and we all win."

"Actually, I think there is something I can do to help."

"Really?"

"Yeah. Here's a dollar. Go buy a lottery ticket and cross your fingers."

Actually, I lie. The hospital representative never said anything of the sort. But for a good approximation of the substance of the real reply, say it in a very nice voice, and don't mention the dollar.

So I was feeling increasingly backed into a corner when I got a call back from Monica a few days later. "I've spoken with my supervisor, and I shared the details of your problem with her, and I've got some good news," she said.

"Really?"

"Yeah. We've agreed to only charge you 5 percent interest instead of 10 percent."

Actually, I lie. Monica never said anything of the sort. I don't remember what term she used to describe their, quote, "concession," end quote, but I'm fairly certain she didn't add insult to injury by calling it "good news."

On top of this, I had to basically get the entire amount paid off within three weeks or they were going to start reporting my debt to credit agencies and my previously-spotless credit history was going to start going down the tubes.

I called up my parents, who had promised to finance a private loan for whatever medical bills landed on my head after the state covered what it could, and filled them in on the situation. "Look," I said. "At this point I'm beginning to think it's not even worth the hassle to try to bargain them down. I don't have any leverage except refusing to pay, at which point my credit rating gets shredded, and this eight-month ordeal turns into a several-year ordeal while I dig myself out from that hole and field increasingly hassling calls. I've dealt with enough stress from this incident and I just want it over with."

"Ten thousand dollars is a lot of money," my dad pointed out. "Especially when you only should have paid four in the first place."

"It seems like I end up owing more every time I try to make things simpler instead of just gritting my teeth and putting it behind me. Remember, the only reason I DIDN'T pay four is because I thought by working with the state they'd cover all but two."

"Still, ten thousand dollars is a lot of money."

Ultimately, I reluctantly allowed my parents to talk me into speaking with a lawyer to see if anything could be done. If his professional opinion was that trying to prolong the issue any further would cause me insufferable hassle, we agreed, then we'd collectively sigh and pay the damn bill. If he thought there was something that could be done, we'd pursue it.

So it was, in the fading weeks of November 2002, that I found myself searching through the local Yellow Pages. I went through the "Bankruptcy Lawyers" section, because I figured they would be the ones with the most experience in dealing with collection agencies. I picked out a moderately-sized, not-too-fancy advertisement at random, one that had everything properly spelled.

After a short phone call, a few days of waiting, and half an hour of discussion, I had regained enough hope to give the whole mess one final chance at cheap resolution. I made out a check to Mr. Gruner, and walked out of his office having retained legal counsel to deal with the problem.

Tomorrow: Staring into the abyss.


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