The Breakroom
Speedbumps and Rackets
Welcome to the Water Cooler
After our Friday episode, many of you asked for Sarah’s Speed Bumps that helped her break up with her phone
One Sec (this is a paid app that sets up automations to make you wait one second before opening social media apps on your phone)
Dumb Phone Turns off many of the “smart features” to make your phone less interesting to look at
Sets the phone to automatically switch to grayscale after 3 pm for reference: How to Turn your Phone Scree to Grayscale (The Verge)
Habits: don’t carry the phone around your house with you. Leave it on a desk or other designated place (this was Beth’s idea that Sarah tried and enthusiastically adopted)
She also turned her landline back on, so that if someone really needs to get her attention, they can call.
This week on Pantsuit Politics, we’re reflecting on what we’ve learned in 2024 and what we expect and look forward to in 2025. We’re looking forward to your thoughts on this year too!
Pantsuit Politics Bulletin Board
Reminder: We’re adjusting our calendar in December. Our Tuesday episode of Pantsuit Politics will be in your feeds later this afternoon.
More to Say: Beth started us off this week with a conversation about Violence.
Good Morning: Yesterday on the Good Morning News Brief, Sarah explained what’s going on with the drone in New Jersey. She’ll be back tomorrow with another update and we’re closing out the year on Friday with a Good News Blow Out!
Book Club: If you love a Book Club, Sarah (as part of her move away from social media) has moved her travel itineraries and book reviews to Substack. She is also starting 2025 with a First Books Book Club with our friend Lisa at The Bookshelf Irvington. Check out By Plane or By Page to see what she’s up to.
If you’d like to send the Pantsuit Politics fan in your life a Cameo (custom video message) from Sarah and Beth, this week is the last week we can record those and guarantee we’ll get them back to you before Christmas.
Pantsuit Politics will take a holiday break during Christmas and New Year’s. You’ll hear some new and revisit some old episodes of Pantsuit Politics in our main podcast feed (including our final episode in our Democracy in America Slow Read!), but we’re going to take a rest in our premium space and come back with new episodes on January 6th.
From the Spice Cabinet
Last Week on More to Say, Beth concluded her series about the price of prescription drugs.
One proposed solution to our healthcare cost crisis is Medicare for All. One of our listeners let us share their perspective on why even this isn’t a quick fix.
Beth,
Thank you so much for the deep dive into the healthcare costs topic. I'm sure you're flooded with stories of listeners' experiences, but I'm going to share mine too from 15 years ago. Because of this experience, I flinch whenever I hear the "Medicare for All" war cry.
We were small business owners, neck-deep in debt and the busyness of three small children. My 2, 4, and 6-year-olds qualified for Medicaid, and we took it. It was the first time in my life that I'd been on any type of public assistance, and wow, did I feel the unspoken stigma from the healthcare industry in terms of rationed healthcare. One in particular involved the drug formulary.
My 2-year-old son's asthma was controlled by a preventative inhaler. We had worked with his allergist to get the right prescription, and all was well. Then, when picking up a monthly refill, our small-town pharmacist told me that Medicaid had changed the formulary without warning, and my prescription was denied. I didn't even know what a formulary was at the time, but I soon found myself going down the path of a physician's proof of previous medications tried, yada yada. While that was in process, they DID approve a different inhaler: Symbicort. Symbicort is a very strong medicine with side effect warnings of death. It had not been tested, nor was it approved for children under 12. Medicaid was doing everything they could to stop us from using the safe, effective medicine that my son had already been using and was going off-label, pushing a possibly dangerous medicine onto him. Cool.
I appealed their decision (magic words: "What are my options?"-- they never OFFER an appeals process) and was soon assigned a case manager who acted like my best friend. He was not my best friend-- when I eventually found myself at the end of the appeals process, a phone hearing in front of a panel of Medicaid physicians, he made it sound like this big scary ordeal. He notified me less than 24-hours before the hearing that it was scheduled. Little did he know that I was raised by a nurse who was not afraid to stand up to doctors and taught me how to navigate the medical system.
A couple of hours before the hearing, the case manager called and said that he'd discussed the case with our physician, and the Medicaid panel was very reluctantly granting the prescription on a "trial basis." He acted like he was doing me some big favor.
It's all a racket.
Since that time, we've put health insurance at the top of our priority list and have worked for employers that offer gold-standard plans.
I don't think that government-run healthcare is the solution that some think it is because I experienced the same shady practices with Medicaid as others with private health insurance.
One final note: when I was a child in the 80's, my parents only had major medical health insurance. They paid cash for doctor's appointments and prescriptions, and I watched doctors lower the price of their visits for us because of it. It was difficult because we were the exception rather than the rule, but I often wonder if everyone was on the same playing field and medical insurance was more like car insurance, would it make the racket a little less tempting?
Thanks for everything you do.
Copyright (C) 2024 Pantsuit Politics. All rights reserved.
My perspecitve as a pediatrician who switched from 10 years of private practice with privately insured patients to now working at a clinic with primarily Medicaid patients is that the story described about the inhaler is much more common with private insurance than with Medicaid. From the physician perspective, with Medicaid, we can at least know what the formulary is and work with it (and go through approval processes when needed). For private insurance, it is really hard to determine what medicines are on formulary for which patients (and believe me, insurance companies have very strict formularies too). Patients can all have a Blue Cross / Blue Shield plan, but it will depend if they have "HMO Blue" or "PPO Blue" or "my Blue", etc. Private insurances send me something in the paper mail telling me that I have 72 hours from the time the letter was sent to protest their decision (which I rarely receive within the window) and then deny the medication and blame me to the patient. It is a hot mess.
Please give us Medicare for All. Please.
My family has been “self-insured” (i.e. no insurance bc we’re small business owners who can’t access group insurance, make too much household income for meaningful ACA subsidies but not enough to pay over $1000/month for a Bronze plan) for a few years and it’s been mostly fine except for the weight of knowing at any moment we could have an accident or a diagnosis that would completely ruin us financially. But this year I couldn’t take that weight anymore so I signed up for a plan during ACA open enrollment that has a huge deductible, high premiums, and covers nothing but the mandated care until we meet our huge deductible. Oh and none of our current providers are in-network. So that’s my experience with private insurance. Can you tell I’m in my feelings about this topic?
Also last year I had a procedure done and the office told me the cash price was higher than if I’d had insurance. So no. Self-insurance isn’t the answer to this.