Maybe We Can't

You cannot apply basic economic theory and free market principles to health care. Health care is fundamentally different and should be considered a public good.

First, health care is completely self-regulated and controlled. A person does not have free choice when choosing a provider. Due to an unholy alliance of provider networks, insurance underwriters, pharmaceutical conglomerates and private for profit hospital corporations such as HCA.

By negotiating with providers and developing one-size-fits-all prescription formularies and treatment protocols, we remove the ability for the consumer to make independent informed decisions about the value of various treatment options.

We rely upon one the ratings of physicians who have a self-interest in controlling access and information to accurate information through their reliance upon Certification and Licensing Boards. By limiting access into the profession, health care costs are inflated and it is near impossible for the consumer to determine the fair value of a health care service.

Second, the consumer is far removed from the negotiating process, so we do not have a good sense of the fair, free market value of one particular service in comparison to another. All you need to do is look at any EOB (explanation of benefits) report for your last trip to the hospital. 

Billing codes are used and assigned through various service departments and the insurance carrier then decides which services are covered and at what rate. They use the terms like "Reasonable and Customary Rates" and then choose to pay 80% of that. So by definition, that 20% must be built in to the billing rates to adjust for the actual (and expected) rate of reimbursement.

Such complicated billing procedures and methods are so complicated and technical that the end recipient of services (the consumer) really has no idea if an X-ray costs $90 or $73. Add into that a separate fee for the radiologist, and sometimes a charge just to use the facility, and even smart people find it difficult to understand.

The bills are then processed by an insurance adjuster who must determine primary and secondary (supplemental) plans and determine who is responsible for what, the end cost and intricate design is truly "priceless."

A false sense of security is unfair and unjust. I would rather have nothing than false expectations and disappointment.Writing Through Dark

Without regulation, intervention and enforcement, many people will continue to believe they are prepared and protected from that ultimate for "just in case" scenario that results in major, catastrophic medical loss.

Yeah, right. The administrative cost alone on the part of the "Responsible Party" is probably more costly than the initial service they received at whatever hospital for whatever condition.

The bottom line is this, we can pass laws, we can file injunctive, pass symbolic legislation, and spew feel good if oration about public programs that fall short if their promise to assist those in crisis. However, unless we demand accountability from state and federal agencies (1) demanding a timely response; (2) create and external entity to do an independent audit to ensure compliance, (3) enforce those laws through whatever means necessary; we have no recourse.

As more and more people continue to lose their benefits, and their unemployment benefits run out... the state will continue to be overburdened, and people in crisis can only go so long without before it is too late. Social Security and DHS MUST be held accountable, and we must pressure our legislators to create a separate entity to conduct external reviews IMMEDIATELY.

I would write more, but I have some forms that MUST be filed out and faxed immediately to appeal the termination of my benefits. Since the Dept of Human Services only have 20 days to appeal, they should be required to respond in a timely fashion.

It is on us to see that this happens. Regardless of whether we chose a public or private option, without regulation, accountability and strict enforcement... we have no recourse. Please fix it. I can't do this alone!

CLICK HERE TO CALL CONGRESS: YOU'RE CALL WILL AUTOMATICALLY BE RECORDED AND COUNTED
 SO STFU ALREADY YOU STUPID, SELF-SERVING, POLITICAL WANNA-BE, SELL-OUT! OF ALL THE THINGS IN MY ARSENAL: THAT LETTER YOU SENT FROM YOUR BOSSES E-MAIL? NO WONDER THE DEMS  RE GOING TO SHIT IN TENNESSEE-- AND YOU PRETEND TO SPEAK FOR ALL OF THEM!)  I ALMOST GET GIDDY THINKING OF THE DVD THT WAS MADE ABOUT COMMUNITY APATHY...  WHICH IN LL PROBILITY, WILL, IN FACT  GO "VIRAL" 

BECAUSE THERE AINT NOTHING LIKE YOUR OWN WORDS TO DIGG A GRAVE!




TRANSPARENCY? YES. PRICELESS!



Elyssa Durant, Ed.M.
Nashville, Tennessee

MODIFIED 366 DAYS LTER.... [EDD/eds 11.07.09]

I have a serious problem with the most recent health reform effort. Asking or expecting the health industry to reduce costs through self-regulation without accountability is simply ridiculous.

Health care is already completely self-regulated and controlled. A person does not have free choice when choosing a provider. Due to an unholy alliance of provider networks, insurance underwriters, pharmaceutical conglomerates and private for profit hospital corporations such as HCA.

By negotiating with providers and developing one-size-fits-all prescription formularies and treatment protocols, we remove the ability for the consumer to make independent informed decisions about the value of various treatment options.

We rely upon one the ratings of physicians who have self-interest in controlling access and information to accurate information through their reliance upon Certification and Licensing Boards. By limiting access into the profession, health care costs are inflated and it is near impossible for the consumer to determine the fair value of a health care service.

Second, the consumer is far removed from the negotiating process, so we do not have a good sense of the fair, free market value of one particular service in comparison to another. All you need to do is look at any EOB (explanation of benefits) report for your last trip to the hospital.

Billing codes are used and assigned through various service departments and the insurance carrier then decides which services are covered and at what rate. They use the terms like “Reasonable and Customary Rates” and then choose to pay 80% of that. Therefore, by definition, that 20% must be built in to the billing rates to adjust for the actual (and expected) rate of reimbursement.

Such complicated billing procedures and methods are so complicated and technical that the end recipient of services (the consumer) really has no idea if an X-ray costs $90 or $73. Add into that a separate fee for the radiologist, and sometimes a charge just to use the facility, and even smart people find it difficult to understand.

The bills are then processed by an insurance adjuster who must determine primary and secondary (supplemental) plans and determine who is responsible for what, the end cost and intricate design is truly “priceless.”

Good luck to those people who actually purchased supplemental plans they saw advertised on TV, you have been duped. Giving people (especially the poor, the elderly, and other high risk populations) a false sense of security is unfair and unjust.

Without regulation, intervention and enforcement, many people will continue to believe they are prepared and protected from that ultimate catastrophic medical loss.

The administrative cost alone on the part of the “Responsible Party” is probably more costly than the initial service they received at whatever hospital for whatever condition.

You cannot apply basic economic theory and free market principles to health care. Health care is fundamentally different and until I am convinced that the poor pathetic people of this nation are competent enough to understand the complexities innvolved in the healthcare industry, I say we all need to stfu. As a "certified health insurance information broker" [a bullshit title, but it does give the right to comment, and my that gives me the right to say "I don't know," then surely America can admit, just a little, that you really don't know nearly as much as FaceBook status would have us believe.

Yes I am angry as hell, but after seeing the ignorant, vile, completely innapropriate, irrelevant, and in... in... in... OMG! You've finally done it... I am speechless. WOW!

discussion that hurts every single one of us, I hope you think twice before you ask me to log my calls. Trust me, I have. Every single one!

That's all. I have nothing more to say. I watch you make asses out of yourselves fighting over values, religion, ethics... Anyone who knows anything about healthcare can see through your ridiculous facade. Because values, SES, education, elitism, LIBERALS, CONSERVATIVES, oh and lets forget the evil "SOCIALISTS" "atheists" whore mongering welfare recipients like myself (who are going going to hell anyway!)

RICH, POOR, STUPID, SMART, IDGAF anymore... none of these things will lay the groundwork for sound policy and effective reform. America has shown the world our true colors, and the rest of the world is laughing as we fall like dominoes into the depths of the depression.

When you start a real converation, let me know. But until then... I can't participate in this massive effort to completely self destruct.

On the brightside, for dear friends like @Potus, @badjerry @dwbjr69 @donnette @amazingflora @rocketman528 @almostvisible  @PortCityPisces @badwebsites @elvisofdallas dont worry, I got this one.... As usual I will continue to take names, laugh out loud, scream and shout for justice, but for those who know me best, my silence speaks so much louder than my words.

So when I find the words, maybe I'll rejoin the conversation. Until I am convinced that people are informed and prepared for the mess you are creating, I want no part of of it. Healthcare is public good. Without it, we have nothing.

 

Elyssa Durant, Ed.M.

Nashville, Tennessee

Health Economics 101: What Most Don't Know

You cannot apply basic economic theory and free market principles to health care. Health care is fundamentally different and should be considered a public good.

First, health care is completely self-regulated and controlled. A person does not have free choice when choosing a provider. Due to an unholy alliance of provider networks, insurance underwriters, pharmaceutical conglomerates and private for profit hospital corporations such as HCA.

By negotiating with providers and developing one-size-fits-all prescription formularies and treatment protocols, we remove the ability for the consumer to make independent informed decisions about the value of various treatment options.

We rely upon one the ratings of physicians who have a self-interest in controlling access and information to accurate information through their reliance upon Certification and Licensing Boards. By limiting access into the profession, health care costs are inflated and it is near impossible for the consumer to determine the fair value of a health care service.

Second, the consumer is far removed from the negotiating process, so we do not have a good sense of the fair, free market value of one particular service in comparison to another. All you need to do is look at any EOB (explanation of benefits) report for your last trip to the hospital.

Billing codes are used and assigned through various service departments and the insurance carrier then decides which services are covered and at what rate. They use the terms like "Reasonable and Customary Rates" and then choose to pay 80% of that. So by definition, that 20% must be built in to the billing rates to adjust for the actual (and expected) rate of reimbursement.

Such complicated billing procedures and methods are so complicated and technical that the end recipient of services (the consumer) really has no idea if an X-ray costs $90 or $73. Add into that a separate fee for the radiologist, and sometimes a charge just to use the facility, and even smart people find it difficult to understand.

The bills are then processed by an insurance adjuster who must determine primary and secondary (supplemental) plans and determine who is responsible for what, the end cost and intricate design is truly "priceless."

A false sense of security is unfair and unjust. I would rather have nothing than false expectations and disappointment.

Without regulation, intervention and enforcement, many people will continue to believe they are prepared and protected from that ultimate for "just in case" scenario that results in major, catastrophic medical loss.

Yeah, right. The administrative cost alone on the part of the "Responsible Party" is probably more costly than the initial service they received at whatever hospital for whatever condition.

The bottom line is this, we can pass laws, we can file injunctive, pass symbolic legislation, and spew feel good if oration about public programs that fall short if their promise to assist those in crisis. However, unless we demand accountability from state and federal agencies (1) demanding a timely response; (2) create and external entity to do an independent audit to ensure compliance, (3) enforce those laws through whatever means necessary; we have no recourse.

As more and more people continue to lose their benefits, and their unemployment benefits run out... the state will continue to be overburdened, and people in crisis can only go so long without before it is too late. Social Security and DHS MUST be held accountable, and we must pressure our legislators to create a separate entity to conduct external reviews IMMEDIATELY.

I would write more, but I have some forms that MUST be filed out and faxed immediately to appeal the termination of my benefits. Since the Dept of Human Services only have 20 days to appeal, they should be required to respond in a timely fashion.

It is on us to see that this happens. Regardless of whether we chose a public or private option, without regulation, accountability and strict enforcement... we have no recourse. Please fix it. I can't do this alone!



Elyssa Durant, Ed.M.
Nashville, Tennessee

Work to Welfare: The Hardest Job I Never Had

Work to Welfare: The Hardest Job I Never Had
By Elyssa Durant - Feb 11th, 2009
(Previously posted online at:http://my.barackobama.com/page/community/blog/elyssadurant)

I remember how difficult it was for me to obtain benefits when I first applied several years ago. I am deeply concerned about how the most recent decision to eradicate yet another class of TennCare / Medicaid recipients (the Daniels class made up of SSI recipients by way of a pending federal waiver) will affect the poor and disabled residents in Tennessee. Without my current level of benefits, I simply do not function.

Before my benefits were stabilized, learning to navigate the system consumed every waking moment of my life. I was unable to work or attend school on any substantial level and I am frightened to see at might happen if I were to stray from my established, stabilized, treatment plan. If I lose my benefits, will I still be able to work? To function? To be productive?

Any new public program requires careful planning if it is to be effective. Recent discussions have not focused on the true impact these changes will have on the "street-level."

Has anyone asked recipients how they feel the new program (safety- net) should be designed, implemented, or evaluated? How will this impact the community and other social service or welfare agencies??? I want access, quality, and outcomes. I want... I want... I want!!!

The massive number of people being dis-enrolled or limited in their access to medical care and other social services will no doubt create significant anxiety, confusion, and chaos for everyone involved in the social service and health care industries.

I remember when Mr. Brian Lapps was somewhere very high up on the corporate TennCare ladder in 1999 when they adjusted the prescription formulary over Memorial Day in 1999. I see Mr. Lapps quite frequently since he now works at the local gas station down the street from where I live.

To this day, he insists that cell phones and TennCare are somehow contraindicated. Perhaps he knows nothing of the population he claims to know just all-too-well... housing conditions that may or may not have electricity, broken families-some riddled with community violence and domestic disturbances. In the hood, your cell phone is your very best friend. 9-1-1.

These people plagued by domestic violence and community instability makes a cell phone the only logical option. How can you find a job with out a phone? How can you find a home with out a job? Yet even 6 years later, Mr. Lapps uses cellular phones as an example how the TennCare program is being abused by lazy, cheap, and unscrupulous second hand citizens who are just shiftless lazy bums waiting around for their next free hand-out.

Anyone who has EVER applied for or relied upon any kind of government subsidy to have their basic needs met, e.g., food, shelter, medical care, dental treatment, etc... let me personally assure you that there has never been a single time where I felt I was "pulling one over" on the government. I am not just one of the poor saps who believed what they told me they in school, I bought it hook, line, and sinker for the mere price of $179,982.00 and not a shred of financial security to show for it.

Even after consolidating my student loans, the interest alone is $10 less than my monthly income from social security.

Tennesseee is in the process of applying for yet ANOTHER federal waiver to eliminate the "Daniels" class of Medicaid recipients-- the poorest and sickest of all. SSI Recipients. Can you live on $623.00 / month? Can anyone?

So what happens now that the state of Tennessee will begin to cut off social security recipients from TennCare? I honestly do not think I can survive yet another re-certification process-- God knows the first one almost killed me. After three years of appeals, my condition had deteriorated so severely that I was forced to drop out of school, lost my home, lost my sanity, and lost hope. In short-- I lost my dignity and my belief in the social welfare system.

By the time my benefits were approved, I had already checked myself in to NYU Psych Ward because simply could not cope with the reality of what my life I had become. I weighed 94 pounds and suffered in excruciating pain that has only gotten worse with time. My extremities were ice cold, and my hands were numb since I went without medical treatment for the spinal injury that was first discovered when I was 22.

I am now 36 years old. My spinal cord is now damaged from years of delayed, sub-standard medical treatment. I owe the federal government $179,982.00 in student loans and when I am able to work, I make $10.46 / hour as a substitute teacher in an urban school district. That job comes with no security and no benefits. It does however offer the flexibility I need to receive the bi-monthly epidural injections and other procedures necessary to manage my pain and alleviate the numbness I feel because of the damage to my nerves. And even though I cannot afford the gas money to get my appointments, pay for all of my medication, or even to get back and forth to work, it does allow me a few weeks of mobility so I can drive, use my mouse or hold a pen.

I have an advanced master's degree from an Ivy League Institution. I am 12 credits shy of a PhD in public policy. And despite maintaining a 3.83 grade point average while completing an advanced masters in social and educational policy at an, "Ivy League" institution; a 3.2 GPA during the 3 years I spent working on my doctorate at a not-quite-so-prestigious Graduate School; The Powers That Beat in that damn Ivory Tower don't will not grant me any leniency by extending the amount or time permitted to complete my degree-- a rule that was changed while I was on a formal leave of absence tending to my health (and my Medicaid appeals!). Not only did they decide 8 years was the rule instead of the 10 it had been previously, I was also told that I could not even transfer the credits I had earned toward a different degree towards another program at the same institution. It has been just over ten years since I first enrolled. What a mistake that was!

The "Harvard of the South" no longer offerers the degree to which I was admitted-- and enrolled so they actually suggested that I pay for a 3rd application to the school (I was admitted into two degrees-- the MPP as well as the PhD program in a separate college) requiring two independent applications, fees, transcripts, test scores, even way back when I was still considered a promising candidate. Now "they" think it is reasonable to ask that I do it all over again??? It goes without saying that I do not have the financial resources available to finish my last semester, take the GREs or GMATs one more time, or even the money to release my transcripts from the Graduate School into any other program at the same University, I guess I am just shit out of luck.

To be clear, WE ARE ALL PAYING for that student debt because I can assure you that their endowment is far greater than any income or earning potential I have given my current financial status and student loan debt! To be clear, YOU ARE ALL PAYING to keep me on Welfare. Yes, all of us are paying some price..... We I want to work. I want to be productive. I want to be a part of something greater than myself. I want to share what I've learned.

So throughout the years I struggled to stay in school, believing somehow that social justice would prevail, and my heart and dedication towards the greater good would show through to whomever, wherever, or whatever that could make my degree worth while-- the Medicaid and disability applications managed to take front seat. So as I filed appeal after appeal after appeal, I managed to acquire well over 1/4 million (yes-- MILLION) dollars in debt due to uninsured medical expenses and student loans. Despite having 3 Major Medical insurance policies, I still went bankrupt applying for Medicaid. Morally Bankrupt.

My life will never be the same. My heart will never be the same. I want to pay my bills on time. I want to get off welfare, but no one ever taught me how to be poor.

So after all this-- now I face losing my healthcare once again? Where is the safety net? Where is the American Dream that I so diligently chased after for so many years? What was the point spending so much on an education that will never be utilized? I understand the how; I just don't understand why.

Maybe one of these days Vanderbilt University or and the Department of Education will realize it might just be cheaper to hire me that harass me, because unless I find a real paying job soon, their collections department will no longer be able to reach me on that extravagant lifeline my friend, Brian Lapps, refers to as a luxury.

If anyone on your staff would like to "trade places" with me for one month-I will gladly assume his/her responsibilities for that position if you can find a writer who is willing to endure and write about the reality of social services in our fine state. I do not want a paycheck from your organization; I just want the opportunity to put the myth of freeloading welfare mother s to rest. Live in my shoes for 30 days. Can you find the out? Can you balance my budget and make it work? Can you get the bill collectors of my back? Can you afford Internet service to file state job applications and apply for services online? Can you maintain pride and dignity without feeling the least bit sorry for yourself and the choices you have made?

When I go to the pharmacy, I am humiliated that I do not have the $3.00 necessary for the co-pay on my covered TennCare prescriptions. At least when it was $40 dollars, I was not so damn embarrassed by my lack of funds.

Remind me again why I went to school. Remind me once more why I bother to speak out. Then remind me right now that that there is somebody listening. I cannot be the only one who actually gives a crap. My contact information is listed below.


Elyssa Durant, Ed.M.
Nashville, Tennessee
elyssa.durant@columbia.edu
(Former doctoral student in public policy)


___________________________________________________

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Understand Report to Admin
By Karen-Missouri Ozarks for Obama! Feb 11th 2009 at 7:48 am EST

(Updated Feb 11th 2009 at 7:48 am EST)

Your writing is very good. Have you considered writing articles and books?

I will turn 60 this summer, worked very hard to put myself through college and support my kids (ex skipped out and never paid the $52,000plus he owed for child support and of course the system never collected it either). I worked in accounting then lacked 2 courses of having my Master's but did teach for 13 years (both private post-secondary and high school).

A heart attack and 2 stents later and Type 2 diabetes...I too wonder sometimes why I spent so much on college. I now work from home with crafts, thinking about doing some writing (I did win 3rd place on a Christian writing website...that's encouraging), and live on a very tiny tiny tiny pension. Even with good insurance, I no longer take medicines or go to doctor's and for the past 3 years have been just doing all the "natural" ways...diet, less stress in my life, etc. Even with good insurance, medicines were over $100 a month...ridiculous! I have no other choice but to live life to its fullest and spend time with grandkids and pray for the best and a relatively longer life.

I ache not so much for me, but for my kids and grandchildren who have to really, really struggle right now.

I had to deal with the awful Nixon wage/price controls where the only way to get a raise was quit and get a new higher-paying one. I dealt with Reagan's so-called "trickle down" economics" and watched the greed of corporate CEOs take over this country (and we've never recovered from either president's ill-conceived policies). Notice how the Republicans always bring up Reagan but never Nixon's failed policies!

Anyway, thanks for your writing...I understand what you're talking about.


ALSO AVAILABLE:
http://my.barackobama.com/page/community/post/elyssadurant/gGxh4R/commentary

Independence Day: March 15, 2009

"It seems painfully obvious to me now that the only way out was through…


If had known then what I know now, I would not have wasted so much precious time searching for the source of my profound sadness.

I must no longer allow myself to be drawn into this circle of madness.

I will write more later I can dig up enough money for a cell phone that answers.

DRAFT/edd copyLEFT 2009

You may dispose of my photos, writings and more, I am sorry you don't realize you have officially now
escalated funny money into an unfortunate civil war!

I can no longer protect the one who hurt me the most, and I officially declare myself as
independent and free. Goodbye for now to The Powers That Beat, I am tired of that nightmare where I can't move my feet.

I am one today, but I am not alone; my DNA and birthright does not make me a clone.

Any genetic disorders, whatever they may be; will never again stand in the way for my fight to be free.

My bloodline alone comes right back to you, and your ridiculous denials are nothing new.

I must protect myself from your twisted mind, never forget, late last night, you left ME behind.

You may think I've forgotten all your hysterical pleas, but I am legally required to remind you of
these.

I hope your are ready for what lies ahead, because I don't think anyone else will agree this was all
in my head.

You declared this yourself, on March the fourteenth, one month to the day, and I will expect it in writing before the next April 15th.

You no longer manipulate my ID or actions and blame; for I am not the one who falsely claims
to be poor. You may find it a little bit harder to blame it on crazy and point the finger at me, I'm posting it here for the whole to see.

Do not blame my siblings, or my father's new wife; your priority should be focused on your own fucked up life.

I hate to think that you must pay to board poor dear, Ziggy; and if it disturbs you that much I life material greed should not be of more value than your own child's life.

I got excluded from
the human genome, stop feeding me crazy, just bring it back home.

The suicide note I
once left in your possession, should no longer be guarded as your greatest
protection.

I defy the heritage
that left me broken inside, any tears I have shed will at long last
subside.

I no longer will allow myself to be tried by the ridiculous facade that has given YOU a false sense of pride.

I'm now on my own, as was always the case; it is so very sad you thought of this as a race.

I will honor your request to sever ALL ties; it is long overdue that I be set free from your lies.

I never signed on to your game of deception; me thinks much more was at stake than some a strangers
perception.

When I think of the time photographed my bare naked tatoo; sadly but surely this last joke is on you.

In case you forgot my last words to you, they were words of sincerity I hope you'll review.

My concern for my sister is so very genuine, but your emergency calls are just all too familiar, I may just camp out in Vegas, to watch over you. Surely my "fans" know we discussed nothing new.

I defy my heritage and claim my last stake, At least one with Faith believes I was never intended to be an aborted mistake.

I declare my freedom and accept your last dare, because if this hell, I'll be seeing you there.

I am sorry you believe I was your biggest mistake, but for the love of my sisters, I must throw up a flair... No child deserves to be barely there.

You are so transparent, it is easy to see, I hope you leave this behind you, the same way you left me.

My bloodline runs deeper than your foolish pride, I will pray for you today, that you take this in stride.

I do hope to all hope your psychosis is real, for until you address it you will never be healed.

I am over and done with this stupid game, I gave you more than one warning to ammend your tax claim.

So as I fight for my freedom, my health and my name, I hope your Glaucoma blind eye will protect you and keep you free from the shame.

I must no longer allow trauma to guide me through life; I can not worry about makeup and urgent details and lies, WHY WON'T YOU ALLOW ME TO IND YOUR DISCARDED trash, you donated Pepe, I adopted him twice, if you only knew how many people thought twice...

I can't be concerned with your refunded fair, if you won't let me use it, I'll find some other way there.

I'm sure you will make a very beautiful wife, for as much as you paid, you sure dumped it on me.... I won't have that surgery since you now look just like me.

You are correct in your assessment that you have earned all you have, had you paid just four bucks, ii wouldn't have cared!

If there ever was a time to say, "this too shall pass...," then please go ahead and kiss my Size 8 tatooed ass!

It is time for me to focus on answers...

The events leading me into this circle of despair must no longer guide me through life.

If I am to escape the vivid memories of past.

Now, it is time to live free or die, I hope for one day that my focus can last.

I have spent too many years asking, “Now how did I wind up here?”
Today I am asking for hope, “To live free from fear.”

Elyssa Durant Nashville, TN, March 15, 2009

DRAFT: copyLEFT 2009

Elyssa Durant, Nashville, TN

Petition: Forgive Student Loans

PLEASE SIGN THIS PETITION BY CLICKING ON THE FOLLOWING LINK:
http://www.thepetitionsite.com/1/Real-Economic-Stimulus-Forgive-Student-Loans

Please circulate to any or everyone you know who may be burried underneath a pile of debt in a really bad job market. Unless Congress can agree on an economic recovery plan soon, we will all be in big trouble. I urge you to contact your Senators and compel them to take action before it is too late.

______________________________
# 9271: Feb 10, 2009, Elyssa Durant, Tennessee

I am 36 years old. My spinal cord is damaged from years of delayed, sub-standard medical treatment. I owe the federal government $179,982.00 in student loans. When I am able to work, I make $10.46/hour as a substitute teacher in an urban school district. That job comes with no security and no benefits. It does however offer the flexibility I need to receive the bi-monthly epidural injections and other procedures necessary to manage my pain and alleviate the numbness I feel because of the damage to my nerves. I have an advanced masters degree from an Ivy League Institution. I am 9 credits shy of a Ph.D. in public policy. Despite having maintained a 3.83 grade point average while earning my masters, and just over 3.2 during the three years I was enrolled full time in a doctoral program. The graduate school I will not grant me any leniency by extending the amount or time permitted to complete my degree-- or allow me to transfer those credits towards another program at the same institution. Vanderbilt will not even transfer any of the credits I paid for (in spades) towards another degree at the same university since they no longer have the program I was initially enrolled in. I think it goes without saying that I do not have the financial resources available to finish my last semester, take the GREs over again, or pay the associated application fees necessary to make the time spent there worth while. Throughout the three year process of filing appeal after appeal after appeal, I acquired well over 1/4 million dollars in debt due to uninsured medical expenses and student loans. My life will never be the same. My heart will never be the same. So after all this-- now I face losing my healthcare once again. Where is the safety net? Where is the American Dream that I so diligently chased after for so many years? What was the point spending so much on an education that will never be utilized? I understand the how; I just don't understand why. Maybe one of these days Vanderbilt University and the Department of Education will realize it might just be cheaper to hire me that harass me, because unless I find a real paying job soon, their collections department will no longer be able to reach me on that extravagant lifeline my friend, Mr. Brian Lapps, refers to as a luxury.

Elyssa Durant, Ed.M. Nashville, Tennessee (former doctoral student in public policy)
Reply to: ed70@columbia.edu

On silencing? Not yet.

">

The Worst Day Ever

Take a look this ridiculous system we have created of "care" we have: no one accepts responsibility for their mistakes and no one is held accountable for their actions (Or lack thereof). For those of you who do not understand how I can be so busy without a full time job, let me offer you a glimpse inside a day in the life of a TennCare recipient. I spend day after day after may doing the same thing without any result: I offer you an only a glimpse because you wouldn't be able to sit in my car, and I believe my apartment may truly be a fire hazard... This was my daily update posted at 7:30am:

I have done everything humanly possible to clean up the slack; however, I feel I have no other choice than to file a formal complaint so that my entire case is reviewed. The number of mistakes is so overwhelming that I simply don't have enough time to documents each and every one with the respective agency.

I will try to be more specific later without going into too much detail, but unfortunately, that level of detail is required to file the necessary appeals. Ironic huh? This apartment is like my own little cage, and I am just pathetic enough to run around in circles, hoping to find the much like a hamster wheel, rodent chasing in circles hoping to found my way out my way out before I run out air. If only I had finished my damn PhD, I would do my own case study or reality show on how far we'll go to have nothing at all...

I have taken care of the subrogation claim, however, that does bot minimize my level of frustration because I am DROWNING in paperwork. I have contacted several agencies to assistance such as the Disability Law and Advocacy Center; however, I do not have the resources necessary to provide them with timely response. There is a very limited time allowed to Request Reconsideration, or file an appeal.

I also want to be clear that every time I have to call Social Security or DHS, it only compounds my cost of living expenses (40 cents per minute on the telephone -- a bill which is not even considered to be a justifiable expense) Most agencies do not include self-addressed stamped envelopes, and I cannot afford the postage required to mail out all of the requested documentation (e.g., utility bills, medical bills, pay stubs, etc.)

Fortunately, a number of agencies will take online complaints. Unfortunately, my Internet was interrupted for non-payment for several weeks and there is no funding resource or community agency that provides subsidized Internet access or free printer ink.

Transportation costs are ridiculous so going to the library is not an option. Neither is returning to work right now, since it would cost too much to get to the interview or provide official (expensive) copies of my graduate school transcripts that were oh, such a good investment!

Set aside, I am not the most user friendly person right about now, so I have found it difficult to put on a happy face so I can work at McDonald's which pays more than Metro anyway.

The subrogation claim has been resolved but I just learned that my breast biopsy was not pre-authorized and I was told by my INSURANCE CSR (the person who answers the phone!!!) that I should not have the surgery that has already been scheduled at the Women's Hospital for 8/21/2008. AmeriChoice (United HealthCare) did they did not authorize the biopsy last month, and have not, as of yet, received a request prior authorization for the surgery next week...

This was a lovely 54 minute conversation because he would not mail me copies of my EOBs or confirm that what, if any, requests have been submitted for payment since my last inquiry and change of address. He finally told me to call the state (Tennessee) which I have already done several times, and they told me to call Social Security but it was already past business hours and I am not authorized to make changes to my file anyway.

I'll be in touch when I can. Unfortunately each agency has different deadlines, and it takes a lot of energy and time to scan in, copy, or respond to each inquiry in writing, so I find myself running out of time since I can't seem to get anything done unless I just do nothing at all.

And even though my life is a living hell, I have almost learned how to enjoy the sheer irony of it all... for someone with OCD and post-traumatic stress, this is truly a ridiculous little experiment.

I am becoming increasingly inspired to just burn every last document I own, throw away my keys and my cell phone and take Spotty some place where we can live off the land and ignore the fact that society has me chained to a computer screen that screen that does provide the basic necessities I need to live in this .

I have come this far, and I am becoming rather skilled and at expressing myself without needing an audience or the obsessive need to check every fact, throw, and typo for capitalization and perfection.

So for now... I write. Maybe later, I'll read, but if there is any justice left in this world, someday, I'll actually live.

Good-bye for now. I need a break.


With love,

e