≈ Comments Off on Inflation continues to bite; Lyft rides.
A month ago, my car developed some problems and the dreaded engine light went on. Since I had moved to a new neighborhood, my old mechanic was now, further away. Being enterprising, I thought, ‘Let’s try someone new. Those prices are too high anyway!’ I got on Yelp and found a local shop with good reviews. I set an appointment and took it in. After discussion, it was agreed the mechanic would work on the fuel line. A day later I had 4 new spark plugs, rotated coils and a flushed fuel line. I picked up the car. It worked great. For five days. Then the light went on again. Called back to the shop. Had to bring it back in. What now? Well, could be the ignition coils. How much? $200 per coil. Wow!
So, since I had just paid a small fortune to move into my one-bed apartment ($1,600), I was strapped for cash. I had paid $421 for the first repair job and didn’t have the addition $400 for a second repair. Me: “Can I drive this car?” “Oh, no, Ma’am, don’t drive it with the engine light on.” Got it. Can’t drive the car and can’t afford to fix it. Will have to wait for my next payday.
So, for the rest of the month I have a) walked b) ridden the bus and c) taken Lyft here and there. The cost of gas in this area has now risen to $4.25 per gallon. Lyft sends me a message after each ride to tell me the cost (linked to my checking account) and that includes the miles. My father, who was big into math, used to always talk about algorithms. I wish I had paid closer attention.
The Lyft program follows a algorithm (Uber too) and it calculates the prices of the ride based on a) distance b) time to get there and c) the time of day. Therefore, the ride prices can vary wildly and seem to be particularly high in the evenings going to movie and entertainment events. My rides have swung from a very reasonalbe $1.94 per mile ride (DMV) to a whopping $5.73 per mile coming home from the theater. All in all, in one month, I have paid well over $200 for Lyft rides and usually, I am going less that 10 miles in one direction.
Back to the mechanic. Live and learn. After chaatting up a number of Lyft drivers, I found out (!!!!) that by going to O”Reilly Parts or Autoworld, I could get a free diagnosis on the meaning of the engine light. I drove the mechanical beast to the parts shop. In less than 10 minutes, the man had pulled out a little handheld device, attached to the panel on my dash and diagnosed ‘failure of coil #1’. Viola! Job done. In thinking back to my encounter with the shop, I remembered the words ‘diagnosis’ were never mentioned. We were just pulling out parts and sticking in parts and seeing what worked. Sigh.
So, today I am back to the old shop. The mechanic told me up front that ‘diagnosis’ was $200. Before I start screaming, I guess I need to review the last month and see what the whole mess has already cost me.
The last little bit, and this will be a blog for another day, I was able to experience first hand how very less than perfect our city’s bus system in. However, also, before I start bashing them too much, I was able to hear (overhear) a conversation between a driver and a passenger. Apparently, no less than four female bus drivers had been sexually assualted by passengers in the recent days. It is a sign of our times and one that needs to be addressed. cew
≈ Comments Off on The Death of the Manly Man in America
The Death of the Manly Man in America
Recently, I was at my favorite soup and sandwich place, enjoying lunch outside with the warm sunshine and light breezes. The patio area is popular with patrons and many people sit there. As I was downing my tomato basil and bread, perusing my I-Phone, I could not help but overhear the conversation of the white-haired couple one table over. It looked like a man and his wife; however, it could have been sister and brother. Since she did all the talking, it was difficult to tell.
The conversation had started before I sat and went on for some time as I was there. The subject seems to have been a young man (son?) and the rendition of a very long laundry list of items concerning his job. The items were the distance, the cost of gas, the repairs on his car, situations with co-workers, etc. etc. (her voice dropped). However, the list continued and continued. There was a final wrap up where she concluded that ‘he quit the job and now is working part time here and there and that gives him more freedom to ….’ I lost the last bit. The man during this monologue said not so much as two words. They finally concluded lunch and left. I sat in thought for a few minutes thinking about what I had just heard. This was probably a son or grandson she had been talking about. In retrospect, it was the biggest pile of BS concerning why someone didn’t want a full-time job I had heard in sometime. The sad part is that the woman appeared to accept these long-winded explanations completely and the man didn’t bother to disagree with her. (Does he?)
One week earlier, I had been at a favorite coffee spot having an early coffee. I was again checking messages on my phone while sipping. Another couple was off to the side. A young man, early 30’s with a older male companion. The conversation between the two of them went on and on; with, mind you, the younger man doing most of the talking. Again, proximity made it difficult to not hear. The young man is apparently involved in developing computer game designs. The dialogue about his efforts to be ‘successful’ and get ‘established’ went on for three-quarters of an hour. The game design was peppered with many stories of moving from place to place. Sleeping on his sister’s sofa; moving back down here, etc. etc. I was getting tired of hearing him ramble and the older man finally interjected a few encouraging words, which, like jet fuel, set the young man off again. It was still going on when I had to run out and go take care of some of my work business.
There appears to be a kind of unspoken consensus among people my age, that young people (a lot younger than us!) need to have a lot of ‘space’ in order to be ‘creative.’ The idea of having a plain regular job doesn’t seem to appeal. Somehow, ‘regular’ work kills all creative flame. God forbid you consider getting married and having children. Yikes! Those thoughts in mind, I would like to touch lightly upon the careers of some of my favorite guys and how they handled things in their day. Let’s see if ordinary ‘conventions’ killed the spark.
Charles John Huffam Dickens, 1812-1878 (58)
Married to Catherine Hogarth in 1836 and had 9 surviving children.
Married in his twenties to the mother of his children, Dickens had his problems with the marriage.
“This comes from the correspondence with Forster in 1854–55, which contains the first admissions of his marital unhappiness; by 1856 he was writing, “I find the skeleton in my domestic closet is becoming a pretty big one”; by 1857–58, as Forster remarked, an “unsettled feeling” had become almost habitual with him, “and the satisfactions which home should have supplied, and which indeed were essential requirements of his nature, he had failed to find…”
Regardless of this, Dickens was one of the most prolificate, creative and influential writers of our age. He wrote for newspapers, journals; did essays, novels, short stories and poetry. He was in life and of life for the whole of his career. He was popular with the public and had good earnings.
He was one of the most creative and respected writers of his and our time. All the while, as indicated, being married, having a large family and supporting them (and some relatives.)
Of course, in those days, large families were common. Today, couples and individuals have many more options. A blessing or a curse?
Doyle went to school at Edinburgh University and graduated with a degree in medicine and became a practicing physician. In 1885 he married Louisa Hawkins and they had two children. After her death, he remarried Jean Lecke and they had three children.
Doyle started off as a doctor but started to write his famous detective stories for The Strand and became famous in a short period of time. He continued to be a prolific writer for the rest of his life. He wrote short stories, novels, and essays on political subjects. He was knighted for service in South Africa during the Boer War.
Twain was married to Olivia Langdon in 1870; they had four children. Twain was famous during his own lifetime for short stories (The Celebrated Jumping Frog of Calaveras County.) His novels, Adventures of Tom Sawyer and Adventures of Huckleberry Finn, for some. He was a celebrated essayist and speaker. He was invited to do world tours and was famous for his wit and political satire.
……………………
It would appear that these extremely famous and prolific writers/speakers were able to be married, have children, work at their craft and support their families. So, what has happened to change all that? Is it just our ‘modern’ attitudes? We have clearly had a revolution with modern birth control methods that drastically alter the choices couples have about having children or not. Is this real freedom or the freedom to remain children forever and never grow up?
≈ Comments Off on No, do not let your Two-Year use your cell phone!
More and more when I am in restaurants and other places, I am seeing young mothers, with very small children, allowing the child to ‘use’ the cell phone or else, buying them electronic devices of their own to use. Seems great, right? The kid is entertained, you are free to a) eat b) talk to your friends c) be on your cell phone. Great? Not great. Remember the days when every restaurant had coloring placemats and crayons? Your kids would spend a lot of time coloring the cows and cowboys all kinda wierd colors. Remember how proud they were of that. You worked hard to smile and said “Beautiful, darling!”
FYI parents; the purple cows and pink cowboys will eventually become pink and purple butterflys, with brown houses in greeen lawns. Those with become cats, dogs and horses and those will become…..wait for it…people. This process, and it is a process, is called creativity and yes, surprise, surprise, it does have to be ‘developed.’ When your kid is watching a cartoon, playing a computer game, watching movies and TV shows, they are watching something created by someone else. Not them. This is a very passive activity that doesn’t do much for them except fill time.
Social skills: as a teacher, I see in the classroom a growing lack of basic social skills between students. A lot of this was extremely aggravated by Covid, but the constant presence of cell-phones and their addiction is not helping.
The never-ending, unreal world of not only TV but Facebook: In case you have not seen the movie Barbie, I would recommend it. Barbie starts off very happy in a very fantasy world. It’s not real and neither is she. Facebook pages are filled to the brim with wonderfully happy people living wonderfully happy lives in a kind of never, never, land. As an adult, with pretty good self-esteem and judgment, I can get jealous and envious of others and start feeling bad about myself. Kids and teens don’t stand a chance as they have little life experience to compare to these perfect vignettes to. So, no, don’t let small children use cell phones and other electronic devices. Also, pay close attention to how much ‘total time’ your older children are spending on the same devices.
Yes, your smartphone habit is affecting your kid—here’s how
We’ve all spent countless hours lost in emails or Instagram, but experts are worried that when we’re connecting online, we’re connecting less with our kids.
“Well, when can we go?” My three kids, ages six, nine and 12, stood before me with frustrated faces, as though they’d been waiting a long time for an answer.
“Go where?” I asked. My eyes fought to look up from my tiny phone screen and then struggled to refocus on their faces.
“To the pool! Mom, you were looking for the pool hours.”
I’m not sure how long it had been since I picked up my phone for the search. My various apps and notifications had led me deep down digital rabbit holes. Dozens of times a day, as I walk, eat and parent, my phone distracts me and, embarrassingly, the kids are starting to notice.
Child psychologists are also noticing, and they’re concerned—not for me, but for my kids.
Our tech tools have become essential for our work, play and comfort. My phone is my research assistant, as well as my yoga teacher. It gets me to meetings on time, reminds me to call the dentist, deposits cheques, encourages me to take deep breaths—it even tracks my hormone cycles so that I only have to experience them, not be attuned to them.
But these devices aren’t as benign as we all thought when we opened their stiff boxes and gloried in the shiny glass screens in which we could check our lipstick. They have been designed to capture our attention and keep us coming back to monitor the popularity of our status, read our most recent notifications and find out the latest trending stories. We pick up our phones as many as 150 times per day, creating short interruptions in our real-world relationships. This has experts wondering: Are smartphones impeding the critical human connections that for millennia have been the primary way parents have transferred rules, skills and social norms to the next generation?
Devices are interfering with development
Humans learn best through person-to-person, in-the-flesh interactions. Jeanne Williams, a child psychologist and play therapist based in Edmonton, explains that this interaction-based learning begins long before a child is verbal. At birth, a baby’s brain has a hundred billion neurons, most of which are not connected. The neurons begin to form connections with one another when the child engages with their parents and others around them—for instance, when a baby smiles and their parent smiles back, or a baby cries and a parent responds with a hug.
These types of reciprocal exchanges are known as “serve and return” interactions, because they work like a game in which a ball is volleyed back and forth. The child sends a signal, and the parent responds. Serve and return helps connect neurons in the brain to support language and communication skills, and as a child grows, these interactions help them learn emotional control, as well as important non-verbal emotional cues (for instance, what anger and happiness look like). The more responsive we are to their elemental attempts at communication, Williams says, “the more they learn the world is a pretty safe place.”
But for all of this learning to happen, the “served” communication must be promptly “returned.” While I’m no sports fan, even I know there is no game if one team stops bumping back. And that’s exactly what happens when our devices interrupt our interactions with our kids. Researchers at Boston University School of Medicine observed that when parents were distracted by a device at dinner, they had 20 percent less conversation with their kid and 39 percent fewer non-verbal interactions.
The tech interruptions start early on in our relationships with our kids, disrupting even little things like eye contact. And the consequences are real. University of Cambridge researchers have found that when mom and baby lock eyes, their brainwave patterns sync up so that scans of their brain activity look very similar. Researchers concluded that gaze powerfully signals to the baby that mom is available and interested in communicating, and the baby in turn will make more vocalizations and greater attempts to interact.
So when breastfeeding moms use devices to pass the time, lactation consultants are worried they’re missing those critical bonding opportunities that come from looking their babies in the eye. It’s true that texting or social scrolling can connect us to friends and family at a time when we’re isolated and feeding on the couch, but by getting lost in notifications and never-ending pictures of other people’s super cute babies, we miss out on the connection our babies may be trying to have with us.
Missed opportunities continue as our children begin to process emotion through conversation. “Often, the effect of looking down at a screen can eliminate the opportunity and space kids need to say what’s on their mind,” warns Williams. That’s why, when I drive the kids to school and activities, and have no distractions, they become exponentially more open to sharing stories about their day.
As kids grow, being available and responsive also helps them learn emotional regulation. “When a kid is distressed and you completely ignore them, their distress is going to grow,” Williams says. “They won’t build neural pathways that teach them how to soothe themselves.”
The inconsistent and unpredictable responses that often evolve from tech distraction (sometimes I ignore you; sometimes I don’t) can be especially harmful to kids. Tracy Dennis-Tiwary, professor of psychology at Hunter College and the Graduate Center of the City University of New York, decided to measure the effect. She had parents self-report their normal technology use and their child’s temperament. The children whose parents used their phones more had a harder time reconnecting with their parents and displayed fewer signs of happiness and curiosity overall. What this means for kids’ emotional health later in life is of concern to Dennis-Tiwary: “If we disrupt our one-on-one time by disappearing into our smartphones, then they will learn to disconnect in similar ways.” She fears that parents’ cellphone use is teaching kids that technological distraction is the way to handle boredom and negative feelings. “If our children learn to navigate these challenging moments with devices, they may have fewer and less flexible strategies at their disposal to cope with day-to-day social ups and downs.”
And if this weren’t enough to jolt me from my scrolling-induced reverie, there are also the physical consequences of distracted parenting. One study matched hospital data against the slow rollout of 3G cell networks in the US. When cell service became available, local hospitals reported a 10 percent spike in emergency room visits for kids under six. The study’s author argued that it wasn’t because kids were involved in riskier activities; it was because parents were distracted.
Competing for attention
It’s not like distracted parenting is new. From constantly watching for predators in our early cave-dwelling days to dealing with gruelling work weeks during the Industrial Revolution, parents have always had activities that pulled their focus from their kids. Tech-induced distraction is also not new—parents of previous generations had car radios and sports on TV. However, today’s technology is designed to draw us in and follow us wherever we go. Vast amounts of money and science go into playing on our vulnerabilities in order to attract and keep our attention. Unfortunately, it seems to have a detrimental effect on our ability to focus on anything else. In fact, according to one study, my goldfish now has a longer attention span than I do.
With such a well-funded and successful campaign to capture our attention, how can our kids compete? They try. Brandon McDaniel, assistant professor in Human Development and Family Science at Illinois State University, has studied “technoference,” as he has dubbed it, since 2012. In a recent study published in Pediatric Research, he observed that the more parents were distracted by tech, the more kids acted out. But it didn’t stop there; it became a cycle. As kids acted out, parents became stressed, and when parents were stressed, they turned to technology, which, of course, only led to more acting out. He empathizes with parents who are just responding to pressure in our hyper-connected world, but he feels it is important to sound the alarm: “We are allowing tech to interfere with our relationships, and that feeds back into how our children are doing.” Don’t I know it: My kids get louder, get closer, grab my chin and suddenly, I pay attention—but usually it is only to ask them to settle down.
Scaling back screen time
While I can’t give up my phone, I want to manage my distraction. McDaniel suggests I start with analyzing my phone use. By downloading a few apps (I tried Moment, Mute and RealizD, but Apple’s iOS 12 also has a Screen Time feature), I’ve been able to track my usageand the number of times I pick it up. The analytics tell a story about my emotional, social and professional reliance on my phone. I’m most vulnerable to being distracted by my phone after I post on social media or in the late afternoon when I’m tired from the day (and, unfortunately, just when my kids return from school).
McDaniel says we have to take the time to create strategies to better manage our tech use. I decided to set a tech-free zone at the dinner table and in my bedroom, but McDaniel discourages a one-size-fits-all approach to managing the distractions: “Tech-free zones work differently for every family.” He encourages families to consider when and where tech-free times would work best for them.
Most phone-use tracking apps come with goal-setting tools, and when I ask Williams about what goals she recommends, she says, “Try to have some regular time that you are 100 percent focused on your kid.” Start with scheduling one or two playtimes every week. That might mean 20 minutes of playing catch in the front yard or swimming at the pool, but whatever it is, commit to no distractions. By being really present, she says, “you’re primed to hear if your kids have something to talk about, or see a scowl and have the availability to ask, ‘What’s up?’”
Williams also urges me to limit my unnecessary screen time, like surfing social media after the kids get home from school. “It’s OK to use our phones to chill out, but try to keep it to when kids are in school or in bed. Ask yourself, Do I really need to be on here?”
But what about all those times when looking up an address, turning on music or finding a recipe is necessary? Although I need to do these things, to my kids, it all appears like distraction. Without the visual and audio cues I had as a child—when I could see my parents looking at a map or going to the post office—my kids are often left in the dark as to what I’m doing or planning.
To combat this, I say out loud what I’m up to so they know I’m arranging their summer camp registration or finding the perfect birthday cake recipe. This way, they know when they can interrupt. When appropriate, I’ll mirror my screen on the TV, so we can meditate together on Headspace or edit pictures collaboratively. Williams says kids love being included when we’re trying to solve problems and often have ideas of their own. “Talking with your kids about the struggle you are having to achieve balance with your technology is a huge opportunity to learn together with your kids what balance looks like for your family.”
McDaniel’s final piece of advice is simple: Look up. “If your child walks in to get your attention, look in their eyes instead of looking at your device.” Adults understand that a person focused on their phone is distracted or attending to another task, but McDaniel says young children can’t comprehend that their parent still values them over technology. By looking your child in the eye, he says, “You’ve shown them that you are listening, and they are learning that the device doesn’t have more value than them.”
The other day, McDaniel’s advice came to mind when I found selfies of my 11-year-old daughter on my phone. They were blurry photos in very close range of her eye. It was as if she were saying, “Look at me.”
I took it as a reminder to look up. There’s no app for that.
This article was originally published online in December 2018.
≈ Comments Off on Wellness exams or Disqualifying exams?
As a medical insured with United Health, I have been very happy with my coverage for the last year. Basically, I have had no problems with them and I love the coverage with multiple gyms for workouts.
After about one year, I have received repeat phone calls from the company requesting time for a ‘wellness exam.” At first I told them I already had a regular doctor and got this exam from her each year. Not to be deterred, the phone calls kept coming and coming. Finally, I agreed to have a nurse come to my place for a wellness exam.
The date of the exam, I made sure to be there on time and have cold water in the fridge in case someone needed some. The nurse showed up with a sidekick, another nurse in training. The exam took an hour and included my weight, bloodpressure and heart. In addition, was a cognitive test for my memory. All of these items were stock in trade and usual for all exams I get at the clinic. The disturbing part came with the long, long list of deep and probing questions about my entire health history to include information about mother, father, brothers and sisters. I answered the questions. The question went on about drugs and alcohol for myself and all family members. I had to answer questions about all surgeries and injuries that I had had in the last year. I discussed two recent surgeries that were for arthritis. The nurse got practically excited when I admitted to smoking cigarettes 30 years ago. She wanted me to tell her how many cigarettes I smoked per day. I laughed at this point and said I couldn’t remember that far back but it was only ‘occasional, social smoking.’ More questions followed, I had my temperature taken and got measured for height and my BMI was calculated. I had to have a pressure test to the bottoms of my feet to check for nerve damage. The digging kept on about depression, mental illness, treatment for psychological problems. The nurse was very nervous when she showed up.
After giving her negative answers to most of these questions and we found that my BMI was low enought, blood pressure low enough and heart ok, the nurse seemed to relax. By the time the pair left I realized that I had been subjected not to a wellness exam, it was a disqualifing exam. This was an intensive investigation to see if the company had a basis for cancelling my coverage. I was shocked when it all sank in. I await the results of my exam. Hopefully I passed. However, next year, my response will be that they can get copies of my records from my GP. What an invasive and demeaning experience. And, how many people have to go through this.? God forbid I had anything serious wrong with me, short of age, of course. Wow! I can’t talk to family members about this as they are all military and have life long coverage. Review the next.
U.S. Federal Court Finds UnitedHealthcare Affiliate Illegally Denied Mental Health and Substance Use Coverage in Nationwide Class Action
BY INC., PSYCH-APPEALPublished 10:47 AM MST, March 5, 2019Share
— Landmark Case Challenges the Nation’s Largest Mental Health Insurance Company for Unlawful, Systematic Claims Denials – and Wins — Groundbreaking Ruling Affects Certified Classes of Tens of Thousands of Patients, Including Thousands of Children and Teenagers — Judge Rules, “At every level of care that is at issue in this case, there is an excessive emphasis on addressing acute symptoms and stabilizing crises while ignoring the effective treatment of members’ underlying conditions.”
LOS ANGELES, March 05, 2019 (GLOBE NEWSWIRE) — In a landmark mental health ruling, a federal court held today that health insurance giant United Behavioral Health (UBH), which serves over 60 million members and is owned by UnitedHealth Group, used flawed internal guidelines to unlawfully deny mental health and substance use treatment for its insureds across the United States. The historic class action was filed by Psych-Appeal, Inc. and Zuckerman Spaeder LLP, and litigated in the U.S. District Court for the Northern District of California.
The federal court found that, to promote its own bottom line, UBH denied claims based on internally developed medical necessity criteria that were far more restrictive than generally accepted standards for behavioral health care. Specifically, the court found that UBH’s criteria were skewed to cover “acute” treatment, which is short-term or crisis-focused, and disregarded chronic or complex mental health conditions that often require ongoing care.
The court was particularly troubled by UBH’s lack of coverage criteria for children and adolescents, estimated to number in the thousands in the certified classes.
“For far too long, patients and their families have been stretched to the breaking point, both financially and emotionally, as they battle with insurers for the mental health coverage promised by their health plans,” said Meiram Bendat of Psych-Appeal, Inc. and co-counsel for the plaintiffs who uncovered the guideline flaws. “Now a court has ruled that denying coverage based on defective medical necessity criteria is illegal.”
In its decision, the court also held that UBH misled regulators about its guidelines being consistent with the American Society of Addiction Medicine (ASAM) criteria, which insurers must use in Connecticut, Illinois and Rhode Island. Additionally, the court found that UBH failed to apply Texas-mandated substance use criteria for at least a portion of the class period.
While the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 requires parity for mental health and substance use benefits, insurers are permitted to evaluate claims for medical necessity. However, by using flawed medical necessity criteria, insurers can circumvent parity in favor of financial considerations and prevent patients from receiving the type and amount of care they actually require.
In his decision, Chief Magistrate Judge Joseph Spero concluded that “the record is replete with evidence that UBH’s Guidelines were viewed as an important tool for meeting utilization management targets, ‘mitigating’ the impact of the 2008 Parity Act, and keeping ‘benex’ [benefit expense] down.”
Psych-Appeal, Inc. and Zuckerman Spaeder LLP were appointed class counsel by the federal court and represent plaintiffs in several class actions against other insurers.
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