at war with my own magical thinking

So here's the thought, on some level I believe I have an almost supernatural tendency to run into people I know when I travel. I know, this happens to everyone but I feel like it happens much more to me than to others.

Last year, in New York, I was speaking about this to my friend, about how I run into people I know everywhere or meet people I don't know with odd connections to myself or people I know. Not a few hours later, on the subway, I see a sloppy drunk talking to some random other drunk. "I know that blond guy," I whispered to my friend. "You do not!" she replied. Maybe I'm just mistaken, looking for connections everywhere, as any good paranoiac does, I thought. The drunk was grossly eating a shawerma and, after spilling it on himself and the floor and scarfing down the rest, he stood up, walked to the other end of the car, opened the door, and threw his wrapper out of the moving train. Disgusting I thought, glad I don't know him. But on his way back to his seat I caught a good look at his face, and yes, I know him, hopefully he won't recognize me. A few seconds after sitting down, his arm shoots out at me, "YOU, I KNOW YOU! Cafe Express, Right?" He comes and sits next to me, spraying his shawerma saliva on me as he talks. We exchange a little information, he expresses his hatred of his job and obvious disdain for mine and my plan to study economics. I believe his exact words were "all economists I know are glorified accountants." Which happens to be my current profession, accounting. When I tell him I'm just in New York to help my friend move he gives her a pretty vile undressing with his eyes, best as he can while sitting on the other side of me. We get off at the same station and, unable to cut the interaction short for some reason, I follow him outside where he's catching his bus. Thankfully, we're able to leave him here to the rest of his drunken path home.

Then, this year, I went to New York again. Again I stayed with that friend who didn't believe me. Walking from the train to her place I cross paths with another friend, luckily someone I wanted to see this time, someone I forgot was in New York. In a neighborhood she said she generally avoids. We decided to have lunch the following day, which was nice. Not as much of a story as the other but 2 for 2.

Then, at most four weeks later, I'm in Portland, drunk, smoking, sitting on a low wall on my way back to the youth hostel. In something of a depressed mood. three women are walking towards me and not wanting to stare like the drunk I was, I looked away, past them. "Dylan?!" one of them says. Not just a friend, but someone else I missed while in New York, visiting Portland. Three for three.

So I try to avoid thinking that the world has some inscrutable plan, or my chi or whatever draws people I know to myself, or any one of the other magical thoughts I've had regarding my life, regarding this most stupid of "super powers." I can tell myself this just happens but it repeats and repeats and repeats. When I think somewhat rationally about this, I figure the fact that I still look almost exactly the same as I did in high school has a lot to do with it, or at least being recognizable doesn't hurt. But how often do any of us really think rationally?


HSA "Insurance": the scam

My employer has Health Savings Account insurance. This means that I have a high annual deductible (what I pay before they start to pay) and a savings account that I can add to and that my employer does add to each month with non-taxed dollars to pay for expenses before I've met my deductible.

I have Hepatitis C. I probably received it from a blood transfusion in 1983, before before they knew of Hep C and before they were testing the blood supply for HIV, so I actually feel lucky. I didn't find out about that until around 1996 when I tried to give blood for the first time. I saw a hepatologist when I found out and since the genotype of the virus I have was the resistant kind, I figured a 30% success rate for putting up with a treatment that was almost as bad as Chemotherapy wasn't good enough for me to actually do anything about it at the time.

So fast forward 10 years, to the next time I saw a doctor for this issue. I did see a doctor for an unrelated sickness 8 years before that but that was the last time I saw a doctor at all. I had to fight my insurance company to pay for the doctor's visit but that wasn't very hard and it was my money from the HSA that paid anyway. Their excuse was that it was a "preexisting condition," which I'll give them but legally it's only a preexisting condition if I'd seen a doctor for this in the previous two years. They did pay for those visits but only after angry calls and threats of getting a lawyer. At that visit, my doctor seemed to be steering me towards this same treatment, though the results have gotten better (~50% for the resistant strain) and they know sooner if it's not working and can stop the treatment. Before I got the treatment I started to feel seriously depressed and since suicidal depression is a possible side effect I wanted to make sure it was necessary before I started. So my doctor mentioned that I could get a liver biopsy to see what the effect on my liver had been. I went in, had the biopsy, the results said there was no damage to my liver. Confirmation that the treatment is not an emergency. All told, that brought home a bill of around $2500. I knew this would be an expense so I had put money into my HSA to cover it. My insurance statements, there were 3 of them for this one event, showed up and they covered the doctor's time (1st statement), refused both the lab work (2nd statement) and all the extra hospital expenses like needles and the local anesthetic (3rd statement). What they refused was, again, on the grounds that it was a "preexisting condition." So here I am, 8 mos. later, fighting them to pay these bills that probably won't go above my deductible. This wouldn't feel like such a slap in the face if I was fighting them to cover it with their own money, but it's my money they're refusing to spend. Money I set aside for this purpose.

So this is what I learned, markets are the wrong mechanism for insurance. Markets provide incentives for insurance companies to a) push their responsibility onto the consumer, b) to refuse paying for treatment whenever possible (even, as in my case, the biopsy was cheaper than the treatment likely would have been), and c) refusing or pricing out of the market many "high risk" individuals from coverage altogether. Obviously they also hurt hospitals too because we need to spend much higher percentages of our health care dollars on overhead such as billing departments that don't actually improve health care. And they are paid for this service. A job well done. Too bad that job is creating bankruptcy and making it more difficult for hospitals to provide the care we need.