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In September of 2009 I blogged here about a letter I wrote to the President and my Senators about prescription drug costs. That post, called My Big Fat $7,575.00 Annual Prescription Bill, received a good amount of traffic, so I thought I would do a follow up.

When Congress passed the Affordable Care Act in March of 2010, it provided some relief for my immediate problem, which was the cost of my prescriptions. This post will look at how the act addressed my problem from a practical perspective, rather than a political perspective. There are many articles that address the politics of the Affordable Care Act, if you want to read about that. I'm focusing on practical issues because, as a patient who depends on drugs every day, that was what I needed to deal with regardless of whether I agreed with the politics behind the act.

As background, my situation as a patient in March 2010 was this: I was self-employed, had two pre-existing conditions that required daily medication, and I could not buy private health insurance at any price. I was paying full price for prescriptions inside the U.S. at an annual cost of $7,575.00 (for more detail on this, see my previous blog post). In addition to my prescriptions, I was paying whatever rate I could get for office visits to see my physicians (I usually received a 10% discount as an uninsured patient).

The Affordable Care Act established the Pre-existing Condition Insurance Plan (PCIP), a for-pay program that provides insurance to people like myself who have been refused individual private health insurance. The PCIP program is administered either at the state or federal level; it varies by state. California missed the established deadline for implementation of its PCIP program and several months passed before it was up and running. When California finally announced that applications to the program were available, I downloaded the paperwork and filed my application on the first day they were being accepted. Within a month, I had PCIP insurance.

Once my insurance card arrived, I used the information packet that came with it to add up how much I might expect to spend in the coming year on prescription drugs and health care services. Refreshingly, it was a simple matter to tally my drug costs under the PCIP program. There was a $100.00 deductible for brand name drugs, which I would breeze through in the first month with just one prescription. After meeting the deductible, brand drugs had a co-pay of $5.00. All generic drugs also had a co-pay of $5.00.

I was glad the PCIP program offered flat fee co-pays instead of percentage-of-price co-pays for drugs. It is much easier to budget with a flat fee co-pay. It means I don't have to keep track of the retail price of all my drugs, which may increase in price more than once over the course of a year. It also means I don't have to call pharmacies to track down the lowest price available for multiple drugs. Although PCIP does have a $100.00 deductible for brand drugs, I was pleased to see they did not create a higher co-pay for brand drugs.

To find the true cost of my prescriptions, I also had to add the cost of the insurance premiums that bought me that discount. The California PCIP program's insurance rates are based on age and locale. I found my age and location in the rate table and discovered my premium was $371.00 a month. Then I guessed at the services I would need in a year: two specialist visits, a physical, a pap smear, a mammogram and a flu shot. Plus I added in an extra doctor's visit and drug co-pay in case I came down with an infection. Most visits had flat fee co-pays and several fell under the category of preventative care, so there would be no co-pay.

When I added up the year's costs for prescriptions, co-pays on office visits, and premiums, the total was roughly $20.00 less than my previous year's drug costs. Comparing my previous year prescription costs to current year prescription costs plus premiums, my costs were a few hundred dollars lower under the PCIP program.

The bad news was that, overall, my health care costs were going to remain extremely high. The good news was that I was getting a lot more for my money. I now had insurance coverage and could take care of basic medical visits, get recommended preventative care and fill my prescriptions for the cost of what I paid during the previous year for drugs alone.

I worry a lot less now because I have insurance coverage. With insurance, I feel free to attempt to change or lessen my use of a specific medication under a doctor's care. Before, when I had no insurance, I was fearful of trying to switch to a less expensive or different drug in case a bad reaction put me into the emergency room, with costs I would have to bear myself. Less worry and less stress equals more health.

On August 1, the California PCIP implemented a premium rate reduction. My premiums went down from $371 a month to $306 a month. I am very happy the program has been made more affordable, because affordability is a continuing problem with health care, as is the overall fragility of the health care system. But as long as I am still eligible and have the money for premiums, I expect to continue with PCIP.

The Missing Were-Women

Bare-chested werewolf under a full moonI was perusing the t-shirt offerings over at The Mountain awhile back when I ran across an image that made me pause. It was an image of a werewolf in a typical pose, at the moment of turning. The creature's head was that of a wolf, while the body remained a man's body--though a hairy one. The creature's shirt was in tatters, a sign that the animal self was ascendent.

I wanted a shirt with that image on it, but I wanted the creature to be female. And I realized I'd never seen a female werewolf posed like that, so I did the obvious thing: an image search. The results didn't provide me with exactly what I wanted. The images I found tended to look too much like a woman or too much like a wolf. I was looking for the hybrid state.

While I was clicking around the web, I ran across an article on female werewolves on the website Jezebel. The article mentions an issue I'd considered myself: why weren't there any female Lycans in the Underworld movies? Apparently the female star of the Underworld series, Kate Beckinsale, had answered this question during an interview with MTV.

"Because that could be really horrifying," Beckinsale explained. "Hairy, thuggish women." Well, yes, that's exactly the point. That's why I want to see them.

The Jezebel article also turned me on to Elizabeth M. Clark's college thesis, Hairy, Thuggish Women: Female Werewolves, Gender, and the Hoped-for Monster, a large part of which I read online. Clark analyses monster films with female werewolves, which she calls examples of "the masculine-female-grotesque."

The thesis contains many photos from the films discussed, along with Clark's analysis of those physical aspects of the female werewolf shown on screen. For the most part, the films avoid showing "hairy, thuggish women" either through their shot choices or by showing only creatures that have been fully transformed into wolves. The exceptions Clark notes are worth reading about, though.

A bare-breasted woman and a wolfWerewolves came to mind again recently while I was reading Wayne Koestenbaum's new book, Humiliation. The book has received mixed reviews but I bought it on the stength of an endorsement from John Waters, which goes a long way in my book. I just started reading it but based on how frequently Liza Minnelli's name has come up in the first chapter I'm prepared to say I like the book.

Koestenbaum writes, "Humiliation--as experience--resembles a fold.[...] The self-abased soul undergoes an inner contortion.[...] Through the action of folding, the outer and inner realms change places.[...] This fold (the self become a seam) is the structure of revulsion."

This description of humiliation as a fold, a contortion, a pulling of the inside outside, made me think of the werewolf's transformation. What Koestenbaum calls "the self become a seam" is that hybrid state where human turns into wolf. This scene of humiliation is also the scene of horror and revulsion we know from so many movies.

In some recent werewolf stories, lycanthropy is equated with disgrace or humilation. In the Harry Potter series for instance, Professor Lupin, a werewolf, feels shame regarding his condition. And in the Underworld series, the Vampires keep the Lycans enslaved for centuries.

How interesting that women, the sex so intimately connected with the state of humiliation, should be held back from being seen as lycanthropes. It would be, I suppose, "really horrifying," to use Beckinsale's words, to see this most debased creature.


I'm Back in the Latest Ready-to-Wear

If you come to this blog to read my entries rather than follow my RSS feed, you may notice that In Sequence looks different than it used to. Some time ago the blogging system I was using, Movable Type 3.*, demonstrated a glitchiness that prompted me to upgrade to the latest version. The upgrade path turned out to be much more complicated than I would have liked. My blog is now wearing an off-the-rack Movable Type 5 template style, mostly because it's too much of a pain to change it to something different. Still, I've finally got things working again, and more frequent blogging should commence shortly.

Joe, Five-Oh

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The wave from Hawaii Five-OhMy friend Joe recently turned 50, and he called me on Gizmo to discuss reaching this milestone. Our conversation is the basis for his most recent Bored Beyond Belief podcast, which he calls A Disgruntled 50 and a T. The T is me.

I think this is my favorite podcast that Joe and I have done together. You can't deny that we have a certain chemistry. If we weren't such flaming queers we would be good candidates for opposite-sex marriage. Joe and I cover a variety of topics, including Miss California and the Golden State's budget crisis. Since Joe is older now, I try to listen respectfully while he reminisces about living in California. I didn't have the heart to remind him that L.A. is Logan's Run territory and if he tried to celebrate his 50th birthday out here he'd be likely to disappear.

In between our discussion, Joe has edited in several appropriate musical interludes. You should listen just to hear Lorne Greene's rendition of "Ringo." You'll find the podcast here.

I'm to Be Queen of the May

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The Cute Little Red Headed Girlfriend and I dine out often, and in the latter part of this year we saw the cost of restaurant dining out go up significantly. As restaurants struggled with the climb in food prices, we saw portions shrink, substitutions made, and menus change frequently. More than anything, we saw the price of alcoholic drinks go up.

A few months ago, in part hoping to save money, I started making mixed drinks at home. It turns out to have been a good decision, since one of our favorite watering-holes has gone out of business as a result of the economic downturn. Supposedly people all over the country are drinking more as a result of the recession. I also read in a profile piece that lesbian "it" girl Rachel Maddow mixes cocktails for a hobby. So I feel like my new bartending habits have put me in the midst of a trend.

Because the Cute Little Red Headed Girlfriend likes drinks that ideally include a maraschino cherry and a parasol, I have concentrated on learning recipes for sweeter-tasting alcoholic beverages. I've found some that I like at cocktail blogs such as Science of Drink.

I was reading P.G. Wodehouse's novel Uncle Fred in the Springtime when I ran across a reference to an intriguing drink called May Queen. This is actually it's abbreviated name, as the character Uncle Fred (also known as Lord Ickenham) recounts in the novel:

Do we by any chance know a beverage called May Queen? It's full name is 'To-morrow'll be of all the year the maddest, merriest day, for I'm to be Queen of the May, mother, I'm to be Queen of the May.' A clumsy title, generally shortened for purposes of ordinary conversation.

Lord Ickenham is here recommending May Queen to his nephew, Pongo Twistleton, assuring that it will "alleviate the deepest despondency." It's hard to argue with that sort of recommendation, so I decided to locate a recipe. The ingredients were listed in the Wodehouse book but the proportions were vague:

Its foundation is any good, dry champagne, to which is added liqueur brandy, armagnac, kummel, yellow chartreuse and old stout, to taste.

Despite its legendary position within the Wodehouse universe, a good recipe for May Queen is difficult to track down. The best I could find was "2 or 3 parts champagne to 1 part of everything else, and lots of ice" courtesy of another Wodehouse fan.

Further investigation led me to believe that the May Queen may have fallen out of favor with the public due to the priciness of its ingredients. As I tracked them down, one by one, I was much taken with their esoteric origins.

Take, for example, Yellow Chartreuse. This herbal flavored liqueur is made by the Carthusian monks of the Grand Chartreuse monastery in France. Wikipedia tells me that the recipe for Yellow Chartreuse--which some have attempted to steal--has been kept secret for hundreds of years and that no single monk is allowed to know the full recipe at any time.

Three monks, each possessing knowledge of no more than one-third of the herbal ingredients, prepare the liqueur. That's exactly the kind of convoluted, arcane story that you can only get from the Catholic Church and I must say it appeals to me. And yes, you can expect to pay through the nose for that kind of exclusivity. I found Yellow Chartreuse available locally for $54.99 a bottle.

I had to make due without the May Queen this New Year's Eve. But eventually, I will have the necessary ingredients to happily sing, "I'm to be Queen of the May, mother, I'm to be Queen of the May."

Hear from the Birthday Girl

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Frau Tottenkinder looks menacingMy old buddy Joe called me on my recent birthday (October 12, if you're wondering) and recorded our conversation for his podcast, Bored Beyond Belief.

For reasons that escape me, Joe decided to edit out all of his portion of the conversation, so the podcast is almost all me chattering, even though Joe prompted me with questions he planned for the podcast. Those questions included:
"Are you really going through menopause or are you just having sympathetic menopause with your girlfriend?" and "Have you pushed any children in public lately?"

If you don't have time to listen to the podcast, Joe did a fairly good job of summarizing my thoughts on his blog. Although we started talking about menopause, somehow the conversation drifted towards feminism and politics. We end with a discussion that reveals my secret identification with one of the witches featured in the comic book Fables, Frau Tottenkinder, pictured here.

Also, thanks to all those who sent me birthday wishes via Twitter or Facebook.

Disgraceful Newsweek coverEveryone knows the mainstream press is beyond reprehensible, and for that reason I try to avoid it as much as possible. But while at the grocery store the other day with the Cute Little Red-Headed Girlfriend, I couldn't help but notice the cover of Newsweek magazine. On it, Abraham Lincoln stands back to back with Charles Darwin, under the headline, "Lincoln versus Darwin: Who Matters More?"

This ridiculous question was displayed under a banner labeling the issue "The (Mostly) Big Thoughts Edition." Astounded by this boneheaded display, I opened the magazine to see if there was more. Indeed, on the Contents page, a teaser for the "Lincoln versus Darwin" article boldly declared, "What You Need to Know." I wondered how they would deliver on this promise. Perhaps a chart of Lincoln's and Darwin's major achievements, with each entry judged "hot" or "not"?

I don't know who writes the cover or contents copy at Newsweek, but I assume that they and the editors who approved this copy all went to accredited institutions of higher learning. May those institutions revoke your degrees, you shameless, condescending asshats. Is this really how members of the "responsible" press (not bloggers) inform the public about the legacies of Lincoln and Darwin? With debasing questions, cutesy comparisons and flip editorial judgements?

Things Past

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Yves Saint Laurent wearing bulky glassesI was sad to hear about Yves Saint Laurent's passing last week. He was a fashion icon for me back in the day. I'm not talking about his women's wear, but rather his own personal style. He had a proto-nerdcore look going on that I really liked. I copied it by purchasing a pair of eyeglasses just like his.

The obituary in the L.A. Times reminded me of why I was so drawn to Saint Laurent's person in the first place. There's a quote from his former partner, Pierre Berge, on Saint Laurent's personality: he was "born with a nervous breakdown." That is a description of someone I could spend time with. And then there's Saint Laurent's own testimony that he had "known those fair-weather friends we call tranquilizers and drugs." By a strange coincidence, I have known those fair-weather friends, too.

I used to lust like crazy after Saint Laurent's homes--all of them, but especially his Paris pad. Some thoughtful soul has gone ahead and scanned in some pictures so you can see for yourself how lovely the interiors were.

My Old Kentucky Gnome

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NCAA Garden GnomeOne reads a lot today about the pressures of "information overload." I spend a lot of time trying to stay informed in various ways, through rss feeds, podcasts, blogs, some radio and print media. Yet I discovered a gaping whole in my knowledge management system while I was browsing at Amazon several weeks ago. There, on the front page, I was greeted with the question, "Did you know that Amazon carries NCAA gnomes?"

Despite my best efforts to stay abreast of the popular, I had to admit: no, I did not know. So I clicked on the link and discovered a huge array of merry NCAA garden gnomes as well as companion NCAA cheerleader garden gnomes. My excitement was intense as I browsed for the Duke Blue Devils garden gnome, only to realize after a few searches and several page refreshes that some schools seem to have gotten quite a big head.

Apparently some schools have won a few too many back-to-back basketball championships and think they're a bit too good for the NCAA Gnome Collection. And this despite being situated smack dab in the middle of yard ornament territory. I guess that's what happens when you go around calling yourself the Harvard of the South. So I've put up an image of Kentucky's team gnome instead, in honor of the improbably large number of bloggers and other people I know in that state.

If the slipper fits

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You may recall reading about the loss of my bedroom slippers recently. Having come to terms with this loss, I decided to go to one of my favorite stores on the web, Zappo's, to see if I could find a new pair for myself.

Fuzzy bootieMy search was immediately rewarded when I stumbled across a cozy looking pair with the improbable name "Teresa." That is the name of the slipper, which you see pictured here in lavender, although it also comes in cheetah. It seemed like a true victory for one-to-one-marketing; I mean, the slipper actually had my name on it!

Slipper decorated with brocadeI browsed the slippers at Zappo's some more and I came across yet another winner: "Carmen." As you can see from the image shown here, "Carmen" projects a different image than "Teresa." If I had to chose a single word to describe that image, I think it would be "pretentious." It's generally not a good quality in humans but I think it's alright in footwear.

Sexy black slipperI was pondering whether my personality is more like the comfy and cute "Teresa" or the somewhat masculine but fruity "Carmen" when I came across "Xena." Naturally, part of me wanted to get "Xena," seen in the image shown here as a svelte black model with faux fur trim. Yet as I reflected on how well the sexy "Xena" suited me compared to frumpy "Teresa" and uptight "Carmen," I found my conclusions did not please me.

"Xena" was just a little too attractive for its own good. "Xena" was forcing me to come face to face with my own inadequacies, my own inability to live up to the larger-than-life image of Xena as represented in this moderately priced bedroom slipper. Who needs that much grief from a slipper? So I browsed some more, hoping I might find a comforting "Gabrielle" slipper to cheer me up. Sadly, I found nothing.

Since I did my first browsing, the "Xena" slipper has sold out. I'm still trying to choose between "Teresa" and "Carmen." If you have a preference as to which one you think I should get, please let me know in the comments section.

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