I finally got to the gym today - it's been a while. While there was snow, I skied rather than go to the gym. And some of you know, ski season ended with a bit of knee trouble for me. Aside from being a little side-lined with the knee, I always find it a hard to get back into a gym routine after ski, windsurfing, climbing season ends. So today, motivation or no, I forced myself to go. And I'm happier for it.
There were a couple of men exercising today - father and son. The son looks to be around 65 to 70, his father, well into his 90's. They spend 15-20 minutes on the stationary bikes, side-by-side, father pedaling very slowly. Then they hit the track. They walk for a while, son slightly in the lead, holding his father's hand. They go slowly, a comfortable pace for the father, but they go. They're mostly silent. And then they leave.
Clearly the father would not be getting to the gym on his own. But regular exercise is good for his body, his mind, and his spirit. So the son brings his father and exercises along side him, providing not just the transportation, but the motivation.
I love seeing them! I don't often see too many more beautiful acts.
We all can use a little help and motivation sometimes - whether we're dealing with illness, age, tension, or just life. When it comes to exercise, I've always been pretty self-motivated. But there have been times when a word or a simple thumbs up from someone has made all the difference for me. Be that motivation for someone else if you can; it might be as simple as offering a ride or a word of encouragement. And if you can use some encouragement, ask. Speak up. The people who care about you may not realize that you're struggling some days. They're probably happy to help.
Julie
Monday, March 29, 2010
Saturday, March 27, 2010
The Health Of Our Care - Promises, Promises
I said in the first post of this series that there aren't too many simple, good stories of healthcare in America. Who's the good guy? Who's the bad guy? Sometimes it's hard to tell the difference.
B. (as in B hopeful) is a part-time teacher at a private school. She was thrilled a couple of years ago when her school offered benefits to everyone who qualified by making the hourly requirement. It was a much better deal than she was able to get as an individual.
There are millions of people who are paid hourly wages rather than a salary, and therefore are not eligible for the company's group insurance plans. Often, the hourly people work almost the same hours as their salaried counterparts. The person at the next desk or in the next classroom may be working just as hard as you (or maybe harder), but is getting paid by the hour with no benefits (saving the company money). And because we know that getting insurance through the individual market is expensive (or completely unaffordable), being offered the company plan is the holy grail of hourly and freelance workers.
So B. was happy to be offered the group plan at her school. In the past, B. had changed plans many times in an effort to find something affordable. One result of that is that she didn't always have continuity with her doctors because they might not be a part of whatever her new plan was. Now she would have consistency and it was affordable. B. was happy.
In the middle of last year, B.'s doctor discussed the benign, yet expanding growth in the lining of her uterus that would require a D&C and endometrial ablation. B. dutifully checked to make sure everything was fine with her insurance, that everything was in order and would be covered. She talked with three different people at her school (people who were supposed to be in charge of such things), to double check that her insurance policy ran until January. They all assured her that her policy did in fact run until January, and there was no problem with her coverage even though, as an hourly teacher, it was possible her work load might drop below the minimum hourly requirement. The agreement was by the year, not the fluctuating hourly changes per quarter.
So B. had all the necessary tests, and with her doctor, decided to wait to schedule her surgery for October or November.
On August 12, B. received notice from her school that her policy was being dropped, effective September 1.
It would be easy to say that's not fair, can't be legal, and she should fight. But fighting takes time, and fighting raises the specter of losing the job. With the debilitating symptoms caused by the rapidly expanding fibroid growth, B. did not feel like she could put off her surgery. She got a COBRA continuation plan that would cover her surgery. The problem was the COBRA plan was double the cost of her employee plan, an increase she could not afford. She was now paying around $800 a month. But it would cover her procedure, so she scraped by for a few months.
In November, B. had her surgery and one follow-up visit at which everything looked fine. December 1, B. dropped her COBRA coverage. Because this is real life and not a spreadsheet, there were also unexpected expenses of apartment damage, repairs, and theft. It was simply not possible to continue paying $800 every month.
B. is now among the uninsured. She has spent the last four months hoping that nothing serious happens. She's been lucky so far.
She has not been sitting idly by, though. She has searched around and found a plan that is marginally affordable, although it does have a deductible. The new plan goes into effect April 1.
So in these last days of March, B. is feeling a little nervous about something going wrong. But at she counts down the final five days of her uninsuredness (yes, I made up that word) she is looking forward to being covered once again.
I am wishing B. a very safe end to March. I hope she looks both ways when she crosses the street, and is careful in the kitchen with knives or pots of boiling water. B well, B.
Julie
B. (as in B hopeful) is a part-time teacher at a private school. She was thrilled a couple of years ago when her school offered benefits to everyone who qualified by making the hourly requirement. It was a much better deal than she was able to get as an individual.
There are millions of people who are paid hourly wages rather than a salary, and therefore are not eligible for the company's group insurance plans. Often, the hourly people work almost the same hours as their salaried counterparts. The person at the next desk or in the next classroom may be working just as hard as you (or maybe harder), but is getting paid by the hour with no benefits (saving the company money). And because we know that getting insurance through the individual market is expensive (or completely unaffordable), being offered the company plan is the holy grail of hourly and freelance workers.
So B. was happy to be offered the group plan at her school. In the past, B. had changed plans many times in an effort to find something affordable. One result of that is that she didn't always have continuity with her doctors because they might not be a part of whatever her new plan was. Now she would have consistency and it was affordable. B. was happy.
In the middle of last year, B.'s doctor discussed the benign, yet expanding growth in the lining of her uterus that would require a D&C and endometrial ablation. B. dutifully checked to make sure everything was fine with her insurance, that everything was in order and would be covered. She talked with three different people at her school (people who were supposed to be in charge of such things), to double check that her insurance policy ran until January. They all assured her that her policy did in fact run until January, and there was no problem with her coverage even though, as an hourly teacher, it was possible her work load might drop below the minimum hourly requirement. The agreement was by the year, not the fluctuating hourly changes per quarter.
So B. had all the necessary tests, and with her doctor, decided to wait to schedule her surgery for October or November.
On August 12, B. received notice from her school that her policy was being dropped, effective September 1.
It would be easy to say that's not fair, can't be legal, and she should fight. But fighting takes time, and fighting raises the specter of losing the job. With the debilitating symptoms caused by the rapidly expanding fibroid growth, B. did not feel like she could put off her surgery. She got a COBRA continuation plan that would cover her surgery. The problem was the COBRA plan was double the cost of her employee plan, an increase she could not afford. She was now paying around $800 a month. But it would cover her procedure, so she scraped by for a few months.
In November, B. had her surgery and one follow-up visit at which everything looked fine. December 1, B. dropped her COBRA coverage. Because this is real life and not a spreadsheet, there were also unexpected expenses of apartment damage, repairs, and theft. It was simply not possible to continue paying $800 every month.
B. is now among the uninsured. She has spent the last four months hoping that nothing serious happens. She's been lucky so far.
She has not been sitting idly by, though. She has searched around and found a plan that is marginally affordable, although it does have a deductible. The new plan goes into effect April 1.
So in these last days of March, B. is feeling a little nervous about something going wrong. But at she counts down the final five days of her uninsuredness (yes, I made up that word) she is looking forward to being covered once again.
I am wishing B. a very safe end to March. I hope she looks both ways when she crosses the street, and is careful in the kitchen with knives or pots of boiling water. B well, B.
Julie
Thursday, March 25, 2010
More Exercise To Weigh Less - But How To Work In Those 60 Minutes?
Women may need more exercise to stave off weight gain as they age. A new study published in the Journal of the American Medical Association found that middle-aged women need an hour a day of moderate exercise to maintain their weight with a normal diet.
The study looked at more than 34,000 women, who's average age at the start of the study was 54. Researchers followed the women for 15 years. The women ate a normal diet and self-reported their physical activity and weight at various times during the study.
The average weight gain during the study was 5.7 pounds, but the women who were more active gained less weight than the women who were less active. The women who maintained their healthy weight exercised an average of 60 minutes per day.
What bothers me about most of the coverage I've seen of this story is that the emphasis is on how much time that is, and how hard that is for people to manage. The stories quote people saying they can't possibly spend an hour at the gym every day - it's just impossible. Many of the women interviewed just sound discouraged.
Unfortunately, many people hear these recommendations, can't imagine how they could actually manage it, and simply give up. But getting 60 minutes of exercise does not necessarily mean spending an hour on the treadmill or going to the gym every day. I wish more of the coverage focused on useful ideas for increasing the amount of exercise you get every day. It's not really that hard to get 60 minutes of moderate exercise in a day.
A month ago, I wrote a post with several ideas for building some exercise into your day. The important thing to remember is that exercise is cumulative - you don't have to do it all at once for it to be effective. So, take a little walk at lunch time, park further from the store so you have to walk, make more trips up & down the stairs (instead of carrying everything at once), walk your dog a little faster or further, rake the leaves instead of blowing them into your neighbor's yard (that will be better for the air in your neighborhood, too), take the stairs, dance while you're dusting....You get the idea.
Julie
The study looked at more than 34,000 women, who's average age at the start of the study was 54. Researchers followed the women for 15 years. The women ate a normal diet and self-reported their physical activity and weight at various times during the study.
The average weight gain during the study was 5.7 pounds, but the women who were more active gained less weight than the women who were less active. The women who maintained their healthy weight exercised an average of 60 minutes per day.
What bothers me about most of the coverage I've seen of this story is that the emphasis is on how much time that is, and how hard that is for people to manage. The stories quote people saying they can't possibly spend an hour at the gym every day - it's just impossible. Many of the women interviewed just sound discouraged.
Unfortunately, many people hear these recommendations, can't imagine how they could actually manage it, and simply give up. But getting 60 minutes of exercise does not necessarily mean spending an hour on the treadmill or going to the gym every day. I wish more of the coverage focused on useful ideas for increasing the amount of exercise you get every day. It's not really that hard to get 60 minutes of moderate exercise in a day.
A month ago, I wrote a post with several ideas for building some exercise into your day. The important thing to remember is that exercise is cumulative - you don't have to do it all at once for it to be effective. So, take a little walk at lunch time, park further from the store so you have to walk, make more trips up & down the stairs (instead of carrying everything at once), walk your dog a little faster or further, rake the leaves instead of blowing them into your neighbor's yard (that will be better for the air in your neighborhood, too), take the stairs, dance while you're dusting....You get the idea.
Julie
Saturday, March 20, 2010
Body Image After Breast Cancer - A Story Of Time, Acceptance, And A Little Exercise
The first time I wrote about body image was for GALTime. I had suggested the topic to my friend Charlene without really thinking too much about it. It ended up being a really difficult article to write - so very personal. Strange for me, since I've always been so open about all aspects of my cancer experience. And every time I write or speak about the topic, I'm surprised at how difficult it still is....
I was young, healthy, and very fit when I was diagnosed with breast cancer. Then, it turned out one of my breasts would kill me. Because the cancer had already spread throughout most of my breast, I would need a mastectomy. Initially, I thought I would not have any reconstruction. I would be a modern day Amazon - a warrior, cutting off my right breast to more easily wield my bow. In defiance, I wanted to shout to the world, “I am not my breasts!”
I was young, healthy, and very fit when I was diagnosed with breast cancer. Then, it turned out one of my breasts would kill me. Because the cancer had already spread throughout most of my breast, I would need a mastectomy. Initially, I thought I would not have any reconstruction. I would be a modern day Amazon - a warrior, cutting off my right breast to more easily wield my bow. In defiance, I wanted to shout to the world, “I am not my breasts!”
That’s a tough statement since we live in a culture that is sometimes bizarrely obsessed with breasts. I grew up with Ginger and Maryanne, Rachel Welch, and later, Baywatch. We pore over magazines showing us every star’s body-hugging, plunging-neckline fashions, debate Real or Fake? We begin learning from our teenage years that many men don’t understand basic anatomy – our eyes are in our heads. And yet a wardrobe malfunction generates horrified complaints and fines because someone might have caught a split-second glimpse of part of an exposed breast - oh my!
In the end, I chose reconstruction. It occurred to me that in the future I might not always feel so defiant; I might have days when I just wanted to get dressed and not be noticed. I had a free tram reconstruction, in which my belly fat and a small piece of muscle is removed and used to build a new “breast”. But since I was thin, I didn’t have enough belly to equal my other breast. To achieve relative symmetry I had a reduction on the other side.
So, in one day, I went from a full 34D to a smallish 34C. OK, it’s just one cup size. It’s not like I was suddenly horribly disfigured. But, besides all the issues that go with cancer, my profile was suddenly different. I had an image of my body: long, lean, athletic, and a 34D. Now it was different. I was still lean and athletic, but my chest was just average.
I don’t mean to sound like I’m complaining. My beautiful breasts would have killed me; I was quite pleased to change that!
But it’s definitely strange to suddenly be faced with a profile that doesn’t match your self-image. I was frequently surprised when I would catch a glimpse of my reflection in a window or see my shadow on the sidewalk. This was not the body I knew.
And it was equally strange to see friends and colleagues look with surprise at my new body.
For women going through cancer treatments, there are lots of programs aimed at improving self-image. There are free makeovers to help women feel good in their wigs, or with their new hair as it comes in curly, or perk up with some new makeup. I did them all. These programs are great, especially learning how to minimize the look of no eyelashes or eyebrows after they fall out. Let’s face it, looking like a frog is never a fashion statement one wants to make.
But no makeup or haircut could really change how I felt about my body. I decided the best way to feel good about my new body was to stand up straight and get strong enough to get back to all the things I love to do: playing music, rock climbing, windsurfing, skiing….
So I began the long process of stretching out scar tissue and strengthening weakened muscles. Even if I wasn’t sure just how I felt about my new profile, I stood tall and at least looked like I was proud. As I grew strong and returned to climbing and windsurfing, I did indeed begin to feel pride in my body again.
Our surgeries can cause tightness across the chest, stiffness of the shoulder, and a tendency for the shoulder to roll forward, as though to protect the area. Left unaddressed, this can result in serious problems over time, including poor posture, lack of mobility, weakness and pain.
The process of regaining good range of motion is a process of incremental, barely noticeable change. It takes patience - something I'm not always so good at - and diligence - something I'm much better at.
Only after I regained good range of motion did I begin strengthening exercises. Stretching is vital to recovering from breast surgery, but strengthening is equally important, especially the muscles of the shoulder and upper back.
A couple of exercises I did at the beginning for the upper back are the wing pinch and Superman lifts. These simple movements were great for helping me stand up straight with my shoulders back. For the wing pinch, hold your arms at your side and bend your elbows to 90 degrees. Hold your hands, palms up, slightly wider than your body, keeping your elbows at your sides. Draw your elbows back and squeeze your shoulder blades together. An easy version of the Superman lifts can be done sitting in a chair, good for beginning strengthening after surgery, when lowering yourself down onto the floor might be difficult. Sit up tall. Raise your right arm up overhead. At the same time, raise your left knee. Hold, and lower. Repeat on the opposite side.
In some ways, adjusting to our new bodies after breast cancer surgery is not that different than learning to accept and love our bodies in the first place. We all have flaws, certain things about our bodies we would prefer were different; I certainly do! But part of the process of being a happy adult is learning to accept ourselves, and that’s a process that can take years.
The trouble with image after breast cancer is that it’s all so sudden. Overnight our bodies are different. We’ve had some number of decades to get to know our bodies, and in a few hours they change, sometimes dramatically.
What we need most is time. It took us years as adults to be comfortable with who we are; it will take time to adjust to our new bodies.
But in the mean time, exercise. You’ll feel better and be a little healthier. Stand tall and proud. Even if you don’t feel that way yet, look like you do. And you might just find that, in fact, you are.
Julie
Julie
Thursday, March 18, 2010
Core Strength Even With Limited Mobility
Core strength - great, right? It's important for everyone, but, as I said in the last post, it's especially good preparation if you're facing an upcoming surgery. But what about people with limited mobility? If you are confined to bed or chair, or are very unsteady on your feet, doing a standing plank is not going to be so possible for you.
Don't worry - it's still possible to get a good core workout. It's always possible to work muscles, you just have to find a modification that works for you. There's no one way to work a muscle!
A great exercise to work your core from a seated position is the Seated Tummy Tuck with Rotation: Strengthens abdominal muscles (rectus abdominis, transverse abdominis, and obliques)Sit on a flat-seated chair. Place your hands on your hips. Draw your navel in toward your spine. While keeping your tummy tucked, slowly rotate your torso 45o to one side, then the other. Return to front.
And you can even work you abs while lying in bed. The Tummy Tuck gently strengthens your abdominal muscles. Lie on your back. Bend your knees, keeping your feet flat on the floor (or bed), about hip-width apart. Focus on your abdomen, draw in your navel toward your spine. Continue breathing while you hold this position for a few seconds. Release. Repeat.
These are two simply but effective exercises that can be done no matter what your mobility level is.
And the Seated Tummy Tuck is a great way for all you too-busy-for-exercise-people to add a little exercise into your day. Do it at your desk; do it in your car (while you're stopped!); do it on the subway.
Julie
Don't worry - it's still possible to get a good core workout. It's always possible to work muscles, you just have to find a modification that works for you. There's no one way to work a muscle!
A great exercise to work your core from a seated position is the Seated Tummy Tuck with Rotation: Strengthens abdominal muscles (rectus abdominis, transverse abdominis, and obliques)Sit on a flat-seated chair. Place your hands on your hips. Draw your navel in toward your spine. While keeping your tummy tucked, slowly rotate your torso 45o to one side, then the other. Return to front.
And you can even work you abs while lying in bed. The Tummy Tuck gently strengthens your abdominal muscles. Lie on your back. Bend your knees, keeping your feet flat on the floor (or bed), about hip-width apart. Focus on your abdomen, draw in your navel toward your spine. Continue breathing while you hold this position for a few seconds. Release. Repeat.
These are two simply but effective exercises that can be done no matter what your mobility level is.
And the Seated Tummy Tuck is a great way for all you too-busy-for-exercise-people to add a little exercise into your day. Do it at your desk; do it in your car (while you're stopped!); do it on the subway.
Julie
Saturday, March 13, 2010
Improving Core Strength - A Good Strategy Before Surgery
Core strength is important for everything we do. Our core, or trunk, is the link between our upper and lower bodies. It encompasses our abdominal muscles as well as our backs. A strong core can improve our stability and functionality - our ability to do normal, every day activities.
If you have surgery in your future, working to improve your core strength is a smart strategy. After surgery even routine things like just getting out of a chair can be difficult. Any improvements you make in your core fitness before surgery will pay off after in better stability and mobility.
The plank is one of my favorite core exercises. It strengthens your abs, the muscles of your back, shoulders, gluteals, and legs - pretty much everything. Lie face-down on the floor. Raise yourself up onto your elbows and toes, keeping your torso straight (like a plank, hence the name). Don't stick your butt up in the air or let your hips sag. Hold - for 30 seconds, or as long as you can if that's too much.
The plank is tough, though. If you haven't been working your core muscles, the plank may be too difficult to start. It may not be the right exercise for you. Or if you have difficulty getting down onto the floor, or have shoulder problems, the plank could be a problem. But there are alternatives; you can still effectively work your core.
The plank can be done as a standing exercise. For standing plank, face the wall about arm's distance away. Lean against the wall on your elbows and forearms. Like the floor plank, keep your body straight, like a plank. Pull in your abs and squeeze your buttocks - make your body as rigid as you can. Hold for as long as you can while keeping good form. If you're just starting out, 5-10 seconds may be enough. Repeat.
The plank, in either form, is a highly effective exercise for building up core strength. It's a great exercise for anyone. But if you are facing surgery, this exercise can really help you. It can help you feel more solid on your feet after surgery, potentially increasing your mobility and reducing falls. Spend a little time with the plank; you'll be glad you did.
Julie
If you have surgery in your future, working to improve your core strength is a smart strategy. After surgery even routine things like just getting out of a chair can be difficult. Any improvements you make in your core fitness before surgery will pay off after in better stability and mobility.
The plank is one of my favorite core exercises. It strengthens your abs, the muscles of your back, shoulders, gluteals, and legs - pretty much everything. Lie face-down on the floor. Raise yourself up onto your elbows and toes, keeping your torso straight (like a plank, hence the name). Don't stick your butt up in the air or let your hips sag. Hold - for 30 seconds, or as long as you can if that's too much.
The plank is tough, though. If you haven't been working your core muscles, the plank may be too difficult to start. It may not be the right exercise for you. Or if you have difficulty getting down onto the floor, or have shoulder problems, the plank could be a problem. But there are alternatives; you can still effectively work your core.
The plank can be done as a standing exercise. For standing plank, face the wall about arm's distance away. Lean against the wall on your elbows and forearms. Like the floor plank, keep your body straight, like a plank. Pull in your abs and squeeze your buttocks - make your body as rigid as you can. Hold for as long as you can while keeping good form. If you're just starting out, 5-10 seconds may be enough. Repeat.
The plank, in either form, is a highly effective exercise for building up core strength. It's a great exercise for anyone. But if you are facing surgery, this exercise can really help you. It can help you feel more solid on your feet after surgery, potentially increasing your mobility and reducing falls. Spend a little time with the plank; you'll be glad you did.
Julie
Sunday, March 7, 2010
The Health Of Our Care - me, part 2
Ronald Williams, Chairmen & CEO, Aetna, in an interview with Nightly Business Report Correspondent Darren Gersh on PBS (Thursday, March 4, 2010):
Gersh - Are you charging people up to 40% more for their individual insurance?
Williams - The answer is by and large no, we don't see those kinds of increases.
Well, I guess I'm one of the exceptions. Or, in Mr. Williams' mind, does an increase of 35% not count as large?
I had planned on introducing someone else's story today, but instead I'm updating my story. I was just notified that my individual health insurance premiums will increase to $1204 per month, beginning April 1.
Now, I know I said in the last post that this is not the place for my political opinions. I plan to stick with that, but I admit at the outset that I'm not sure I can manage that today. I am too filled with justifiable, righteous anger. I plan to write the facts as I have found them, but I AM FILLED WITH JUSTIFIABLE, RIGHTEOUS ANGER! And I'm struggling to understand.
I am a lucky person. I've been able to afford very good insurance with a company that has actually paid for the care they promised me. I was one of the good stories of healthcare in America.
But now, I am stunned. I am angry. I am typing with tears streaming down my face. How does a person deal with this kind of increase? Every solution I come up with is just temporary, cannot be sustained over the long term, or is simply not enough. It's $314 more a month - every single month. That's $3,768 more a year, for a total of $14,448 for one year of health insurance.
I'm really a frightfully boring and responsible kind of person. I pay my bills on time, don't buy things I can't afford, always contribute to my retirement account, and put any extra money into savings. Isn't that what we're supposed to do? That may change very soon.
I've spent the morning reading reports, trying to understand. The men who run Aetna are not inherently evil; they have reasons for their rate increases; they have reasons for every action the company takes. So I'm trying to figure it out. I understand that healthcare costs continue to rise. According to the US Department of Labor's Consumer Price Index for urban areas, medical care increased 3.5% over the last year. Hospital and related services increased 6.8%. Last month, Aetna announced that fourth quarter earnings fell 15%, reflecting lower earnings in their Group Insurance business.
How do we get from a 15% loss in earnings and 6.8 & 3.5% increase in medical care costs to 35% increase in premiums? And the largest increases appear to fall to individual plans like mine.
Ron Williams, Chairman & CEO of Aetna flatly denies in his interview on the Nightly Business Report that Aetna is shifting costs from the big guys (large group plans) to the little guys (individuals with no negotiating power). But if Aetna's earnings fell because of lower earnings in Group Insurance, and my individual plan has just gone up 35%, how is that statement true?
While rummaging around the internet searching for answers, I found some other interesting numbers. Related to my increase, or not? I don't know.
Aetna Inc. has spent well over $11 million in the last 5 years on lobbying in Washington (that does not include donations to individual candidates or industry organizations), according to the Center for Responsive Politics. In 2009, while Aetna was losing money, they increased lobbying spending to $2,824,955 (that's equal to 8,997 months of my increase).
2008 was the most recent year I could find compensation records for Aetna Inc. Mr. Williams' total compensation was $24.3 million (that's $2,025,000 a month, or $467,307 a week, or $66,575 per day). That compensation package was up 5.6% over his 2007 earnings. And that was 16% higher than 2006, which was 187% up from 2005 (just $6.9 million). Joseph Zubretsky, CFO & Executive VP earned $5.6 million in 2008, up 41% over his compensation for 2007. And Mark Bertolini, President, made $7.9 million in 2008, a 54% increase from the year before. (source: Morningstar)
Just curious: how many of you had increases like those? I didn't. But my income is derived from music, fitness, and a little real estate, so I've seen only cuts. One orchestra I play for is trying to convince me that my colleagues and I should work for less than our 2005 wages... if only I could pay Mr. Williams my premium rate from 2005.
I know that total compensation is complex, including all sorts of stock options and "other compensation" in addition to salary. And I can't say whether these salaries are justified or not. I assume these guys work very hard at a very complex job for that compensation. I do wonder though, if the company is losing money, do they give back any of that compensation? I mean, seems like they're kind of failing at their job, doesn't it? - But that's for the shareholders to decide.
I really am not trying to beat up on Aetna or Mr. Williams. I said in the last post that the company has treated me fairly and always honored it's contractual obligations. I am just trying to understand a 35% increase in my premiums in light of the numbers I've found. Maybe I'm looking at the wrong numbers. I am not an economist. I'm sure I'm missing very important pieces of this puzzle - but I'm not understanding how all this makes sense. I'm just not understanding how it adds up.
What I do know is that, like me, very many people in this country are seeing their individual premiums go up in astounding amounts. And I do know that many will not be able to absorb the cost. Should they start selling off assets? Take out another mortgage on the house? Use their savings to pay the bills (how long will that last)? Tell their kid he can't stay in college? Run up credit card debt? Or drop their insurance and hope they don't get sick? But what if they're already sick?
Insurance executives are fond of saying that the American people don't really understand the cost of healthcare - we don't have enough "skin in the game." I assure you that those of us who are spending 30, 40, 50% and more of our earnings on healthcare have plenty of skin in the game! Mr Williams, I suggest to you that until you are spending in excess of $10 million every year for your own personal healthcare, or until you are deciding whether to default on your mortgage or pay for healthcare, you have far less skin in this game!
To you, the shareholders of Aetna and other insurance companies, what's your plan? Are you thinking of shorting your insurance stock? How good a long-term investment do you think this really is? If your company is bankrupting the people of this country, how sustainable is this business model, long-term?
And to you in Washington, spend some time in my life, or the lives of your constituents, spend a few months putting over 50% of your income toward your insurance. Make the choices so many of us are, and then tell me that this is not a crisis! (and remember, researchers at Harvard found that 62% of all personal bankruptcies filed in 2007 were caused by healthcare costs - undoubtedly, that number has gone up significantly since then.) Reasonable people can disagree on details, but the status quo is bankrupting the people of this nation. It cannot be sustained. Work out your differences and do your job!
It seems I have failed utterly at keeping my opinions out of this. It was my intention to simply tell some stories and leave politics and ranting for other realms. But I am angry and I am worried. I worry about my own health and my economic health. And I worry about the heath and economic wellness of the people of this country - not the executives, not the politicians - but the people who work and pay taxes, who make this country run, who buy and sell things, who want to educate their children and have a roof over their heads - I worry about all the rest of us.
Julie
(I'm curious what kinds of increases others are seeing around the country. Send me an email: julie@Life-Cise.com)
Gersh - Are you charging people up to 40% more for their individual insurance?
Williams - The answer is by and large no, we don't see those kinds of increases.
Well, I guess I'm one of the exceptions. Or, in Mr. Williams' mind, does an increase of 35% not count as large?
I had planned on introducing someone else's story today, but instead I'm updating my story. I was just notified that my individual health insurance premiums will increase to $1204 per month, beginning April 1.
Now, I know I said in the last post that this is not the place for my political opinions. I plan to stick with that, but I admit at the outset that I'm not sure I can manage that today. I am too filled with justifiable, righteous anger. I plan to write the facts as I have found them, but I AM FILLED WITH JUSTIFIABLE, RIGHTEOUS ANGER! And I'm struggling to understand.
I am a lucky person. I've been able to afford very good insurance with a company that has actually paid for the care they promised me. I was one of the good stories of healthcare in America.
But now, I am stunned. I am angry. I am typing with tears streaming down my face. How does a person deal with this kind of increase? Every solution I come up with is just temporary, cannot be sustained over the long term, or is simply not enough. It's $314 more a month - every single month. That's $3,768 more a year, for a total of $14,448 for one year of health insurance.
I'm really a frightfully boring and responsible kind of person. I pay my bills on time, don't buy things I can't afford, always contribute to my retirement account, and put any extra money into savings. Isn't that what we're supposed to do? That may change very soon.
I've spent the morning reading reports, trying to understand. The men who run Aetna are not inherently evil; they have reasons for their rate increases; they have reasons for every action the company takes. So I'm trying to figure it out. I understand that healthcare costs continue to rise. According to the US Department of Labor's Consumer Price Index for urban areas, medical care increased 3.5% over the last year. Hospital and related services increased 6.8%. Last month, Aetna announced that fourth quarter earnings fell 15%, reflecting lower earnings in their Group Insurance business.
How do we get from a 15% loss in earnings and 6.8 & 3.5% increase in medical care costs to 35% increase in premiums? And the largest increases appear to fall to individual plans like mine.
Ron Williams, Chairman & CEO of Aetna flatly denies in his interview on the Nightly Business Report that Aetna is shifting costs from the big guys (large group plans) to the little guys (individuals with no negotiating power). But if Aetna's earnings fell because of lower earnings in Group Insurance, and my individual plan has just gone up 35%, how is that statement true?
While rummaging around the internet searching for answers, I found some other interesting numbers. Related to my increase, or not? I don't know.
Aetna Inc. has spent well over $11 million in the last 5 years on lobbying in Washington (that does not include donations to individual candidates or industry organizations), according to the Center for Responsive Politics. In 2009, while Aetna was losing money, they increased lobbying spending to $2,824,955 (that's equal to 8,997 months of my increase).
2008 was the most recent year I could find compensation records for Aetna Inc. Mr. Williams' total compensation was $24.3 million (that's $2,025,000 a month, or $467,307 a week, or $66,575 per day). That compensation package was up 5.6% over his 2007 earnings. And that was 16% higher than 2006, which was 187% up from 2005 (just $6.9 million). Joseph Zubretsky, CFO & Executive VP earned $5.6 million in 2008, up 41% over his compensation for 2007. And Mark Bertolini, President, made $7.9 million in 2008, a 54% increase from the year before. (source: Morningstar)
Just curious: how many of you had increases like those? I didn't. But my income is derived from music, fitness, and a little real estate, so I've seen only cuts. One orchestra I play for is trying to convince me that my colleagues and I should work for less than our 2005 wages... if only I could pay Mr. Williams my premium rate from 2005.
I know that total compensation is complex, including all sorts of stock options and "other compensation" in addition to salary. And I can't say whether these salaries are justified or not. I assume these guys work very hard at a very complex job for that compensation. I do wonder though, if the company is losing money, do they give back any of that compensation? I mean, seems like they're kind of failing at their job, doesn't it? - But that's for the shareholders to decide.
I really am not trying to beat up on Aetna or Mr. Williams. I said in the last post that the company has treated me fairly and always honored it's contractual obligations. I am just trying to understand a 35% increase in my premiums in light of the numbers I've found. Maybe I'm looking at the wrong numbers. I am not an economist. I'm sure I'm missing very important pieces of this puzzle - but I'm not understanding how all this makes sense. I'm just not understanding how it adds up.
What I do know is that, like me, very many people in this country are seeing their individual premiums go up in astounding amounts. And I do know that many will not be able to absorb the cost. Should they start selling off assets? Take out another mortgage on the house? Use their savings to pay the bills (how long will that last)? Tell their kid he can't stay in college? Run up credit card debt? Or drop their insurance and hope they don't get sick? But what if they're already sick?
Insurance executives are fond of saying that the American people don't really understand the cost of healthcare - we don't have enough "skin in the game." I assure you that those of us who are spending 30, 40, 50% and more of our earnings on healthcare have plenty of skin in the game! Mr Williams, I suggest to you that until you are spending in excess of $10 million every year for your own personal healthcare, or until you are deciding whether to default on your mortgage or pay for healthcare, you have far less skin in this game!
To you, the shareholders of Aetna and other insurance companies, what's your plan? Are you thinking of shorting your insurance stock? How good a long-term investment do you think this really is? If your company is bankrupting the people of this country, how sustainable is this business model, long-term?
And to you in Washington, spend some time in my life, or the lives of your constituents, spend a few months putting over 50% of your income toward your insurance. Make the choices so many of us are, and then tell me that this is not a crisis! (and remember, researchers at Harvard found that 62% of all personal bankruptcies filed in 2007 were caused by healthcare costs - undoubtedly, that number has gone up significantly since then.) Reasonable people can disagree on details, but the status quo is bankrupting the people of this nation. It cannot be sustained. Work out your differences and do your job!
It seems I have failed utterly at keeping my opinions out of this. It was my intention to simply tell some stories and leave politics and ranting for other realms. But I am angry and I am worried. I worry about my own health and my economic health. And I worry about the heath and economic wellness of the people of this country - not the executives, not the politicians - but the people who work and pay taxes, who make this country run, who buy and sell things, who want to educate their children and have a roof over their heads - I worry about all the rest of us.
Julie
(I'm curious what kinds of increases others are seeing around the country. Send me an email: julie@Life-Cise.com)
Thursday, March 4, 2010
Oops...Ow!! Another Reason To Be Strong
Any of you who visit here very often, know me through Life-Cise, or know me personally, know that I emphasize strength training - a lot! Strong is good! Strong is healthy! Strong is sexy!
It's important to help slow the bone loss that is sometimes caused by so many of our life-saving drugs. It helps us maintain our mobility and range of motion. And it's been shown in studies to improve our self esteem, irregardless of how much strength we actually gain.
But there's another benefit - preventing injury (or more serious injury).
Last week we saw another HUGE snowstorm here in the Northeast. We had close to 2 feet of snow at my house! It was really wet, heavy snow, but it was almost 2 feet! Since pretty much everything was shut down, including very many of our roads, I went skiing in the woods by my house. (Of course, what else would I do?)
It was gorgeous and tons of fun, although I wasn't skiing my best. I think it started off badly when I climbed up on a ridge and chose the most direct line from the highest point I could find for my very first run. There is a word for that: hubris. And hubris often leads to a downfall (as politicians and golf players know). I hit a tree. Not hard, no serious damage, other than to my ego.
But that shook me up, so I felt a little off all day.
After 5 hours, we decided it was last run. To make the last run "worthwhile", I once again headed up to the top. Apparently, I had learned nothing earlier in the day. It was a great run...until it wasn't. I fell. No trees were hurt this time, but I was. My knee, my ankle. I couldn't really tell which was more of a problem. I slowly and gingerly made my way off the ridge and down to my house, took an epsom salts bath, and followed that with ice.
It is tweaked. I'm still nursing it, but it's not anything very serious. I did go skiing (quite cautiously) yesterday, and will go tomorrow. - Come on, we don't often get snow like this here - I have to take advantage of it!
What does this story of my lack of skill have to do with strength? Protection. Limiting injury. You have to understand, I really twisted my knee and ankle with a lot of force. I'm quite sure that had I not been in such good shape, I would have done some very serious damage. I had a lot of strong muscles protecting my joints and ligaments.
Now, you might point out that if I weren't in such good shape I might not have been out skiing, putting myself in potential danger. True.
But back before I had cancer, I was run down by a taxi as I crossed the street. I was in the cross walk, crossing with the light (which is kind of unusual for a New Yorker). The only danger I was putting myself in was going to work. I was tossed several feet through the air. I had a neck injury that eventually required surgery (totally successful).
I had just come back from ice climbing and skiing in the Adirondacks, and a month before was climbing large mountains in Ecuador. I was in the best shape of my life up to that point. Many of my doctors told me that had I not been in such good shape, with such strong muscles protecting my frame, I probably would have been much worse off - possibly paralyzed or dead.
When you are strong, you have some protection when accidents happen. You've got a layer of muscles holding your joints in place, protecting your tendons and ligaments. If the accident is bad enough, strong muscles may not save you, but they might at least limit some of the damage. Strong muscles will certainly save you from a lot of the ordinary day-to-day accidents. You might be able to catch yourself if you trip. You might be able to pick up that box of records without hurting your back. You might even be able to play basketball with your kid without hurting your shoulder.
So, work some strength training into your week so you're not so weak. You may save yourself a lot of trouble if you do.
Julie
It's important to help slow the bone loss that is sometimes caused by so many of our life-saving drugs. It helps us maintain our mobility and range of motion. And it's been shown in studies to improve our self esteem, irregardless of how much strength we actually gain.
But there's another benefit - preventing injury (or more serious injury).
Last week we saw another HUGE snowstorm here in the Northeast. We had close to 2 feet of snow at my house! It was really wet, heavy snow, but it was almost 2 feet! Since pretty much everything was shut down, including very many of our roads, I went skiing in the woods by my house. (Of course, what else would I do?)It was gorgeous and tons of fun, although I wasn't skiing my best. I think it started off badly when I climbed up on a ridge and chose the most direct line from the highest point I could find for my very first run. There is a word for that: hubris. And hubris often leads to a downfall (as politicians and golf players know). I hit a tree. Not hard, no serious damage, other than to my ego.
But that shook me up, so I felt a little off all day.
After 5 hours, we decided it was last run. To make the last run "worthwhile", I once again headed up to the top. Apparently, I had learned nothing earlier in the day. It was a great run...until it wasn't. I fell. No trees were hurt this time, but I was. My knee, my ankle. I couldn't really tell which was more of a problem. I slowly and gingerly made my way off the ridge and down to my house, took an epsom salts bath, and followed that with ice.It is tweaked. I'm still nursing it, but it's not anything very serious. I did go skiing (quite cautiously) yesterday, and will go tomorrow. - Come on, we don't often get snow like this here - I have to take advantage of it!
What does this story of my lack of skill have to do with strength? Protection. Limiting injury. You have to understand, I really twisted my knee and ankle with a lot of force. I'm quite sure that had I not been in such good shape, I would have done some very serious damage. I had a lot of strong muscles protecting my joints and ligaments.
Now, you might point out that if I weren't in such good shape I might not have been out skiing, putting myself in potential danger. True.
But back before I had cancer, I was run down by a taxi as I crossed the street. I was in the cross walk, crossing with the light (which is kind of unusual for a New Yorker). The only danger I was putting myself in was going to work. I was tossed several feet through the air. I had a neck injury that eventually required surgery (totally successful).
I had just come back from ice climbing and skiing in the Adirondacks, and a month before was climbing large mountains in Ecuador. I was in the best shape of my life up to that point. Many of my doctors told me that had I not been in such good shape, with such strong muscles protecting my frame, I probably would have been much worse off - possibly paralyzed or dead.
When you are strong, you have some protection when accidents happen. You've got a layer of muscles holding your joints in place, protecting your tendons and ligaments. If the accident is bad enough, strong muscles may not save you, but they might at least limit some of the damage. Strong muscles will certainly save you from a lot of the ordinary day-to-day accidents. You might be able to catch yourself if you trip. You might be able to pick up that box of records without hurting your back. You might even be able to play basketball with your kid without hurting your shoulder.
So, work some strength training into your week so you're not so weak. You may save yourself a lot of trouble if you do.
Julie
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