A Geezer's Trials & Tribulations

Medicare "Pick-a-Plan" time again

It's a frustrating time of year for geezers - that's anyone of Medicare age.

It's the annual time to "Pick A Plan."

I have a pretty good plan. I like my Primary Care Physician (PCP), a fellow by the name of Eduardo Perez-Stable. He's a Family Practitioner which, as a geezer, I translate to be "general practitioner" or "GP." I've got a lot of respect for GPs and this one in particular.

(When I was in the Air Force, back when Orville and Wilber were testing the winds at Kitty Hawk, NC, a surgeon told me that if I ever went into medicine - I was a corpsman then - I should specialize because, he said, you work half as hard and make twice the money. The guy was a gas passer and cutter and only slightly crazy, but that's why most GPs became Family Practitioners or Internal Medicine specialists.)

Anyway, I had my PCP before I had my Medicare Advantage program. When I joined The Plan, he wasn't a provider and I was forced to find a new PCP. Shortly thereafter I discovered that he had signed on with my Advantage plan and I immediately went back to his office.

Now, when it comes time to renew with The Plan I make certain that Eduardo Perez-Stable still is on the PCP list; if he's not, I'll go elsewhere.

The first year I was with this plan I had a really good ophthalmologist.

But he got dropped.

However he had a partner who the plan deemed acceptable.

Effective January 1, the partner no longer will be a plan provider, so I have to find a new ophthalmologist. Since I have borderline diabetes and since I am developing cataracts, it's in my best interest to keep the same physician over the long term.

But apparently that is not a concern of the Medicare Advantage provider.

I also am dealing with a cutter and that is "double jeopardy."

The cutter (surgeon) was on the provider list, but he and his partner changed practice affiliations, basically from one hospital to another. My plan has him on its provider list through the end of the year - but after that? When I called the plan's Help line I was told the cutter was terminating his relationship with the plan. The cutter's office manager denies this.

With Medicare Advantage, anything costing more than $9.95 (I'm being facetious) requires pre-approval, "authorization." It took about 3 weeks to get a CAT scan authorized. Question is, was the delay due to the plan or was it due to the cutter's office manager dragging her heels. She told me last Friday she would start the pre-surgery authorization process that afternoon; now, Tuesday, it still hasn't gone to the insurance company, I'm beginning to suspect the problem is with the cutter's office staff.

Less-than-efficient medical office staffs seem a constant in south Florida.

Approvals or not, the surgery - which is not an option - will result in a long-term relationship with the cutter; not just a few weeks or months, but annual checks. I would hope he and the Medicare Advantage provider can put the patient first - that's me, by the way - and engage in their own long-term relationship.

Of course there are other cutters who can read my records. I've moved around the country and transferred medical records from one doctor to another, but now I'm "situated" and have no plans to relocate.

I've got a good PCP - he actually listens (which is why he's always running late) - and I will sign up for any plan that includes him.

But I don't like hunting up new specialists every year.

To be fair, I don't know if my second local ophthalmologist quit the plan or the plan quit him.

The plan I'm on is pretty good - I compare plans annually - but I really would like a continuing relationship with my specialists. Apparently that is not a luxury I will enjoy.

The rabbi said

In the morning blessings (ברכות השחר) of traditional congregations, men read "שלא עשני גוי."

According to the rabbi, in some non-traditional congregations, men read "שעשני ישראל."

According to the rabbi, the second version is not an option; it is not "acceptable." I'm not sure of the rabbi's source; perhaps Ben Ish Hai.

It seems to me that the latter - the non-traditional version - is the better of the two.

Why?

First, some words about the word "goy."

Goy means nation and many times in the Torah - the Final Authority - we, Jews, are referred to as "goy." To cite just two well-known instances:

G-d promises Abraham to make his progeny a "goy gadol" (לך לך, בראשית י''ב ב')

G-d tells us we are a "goy kadosh," a holy nation. (יתרו, שמות י''ט ו')

According to a Wikipedia entry (http://en.wikipedia.org/wiki/Goy), the word "goy and its variants" appear more than 550 times in the Torah.

It wasn't until the luminaries of the Talmuds that "goy" begin referring to non-Jews.

The word nokre (נוכרי) is the word for a non-Jew, literally a "foreigner."

It's interesting to note that at one time אם הארץ meant community leaders, not as it does now, simpletons and uneducated people.

Second, what about converts, גרי צדק ? While a convert who leads a service is to read "שלא עשני גוי," a convert hardly can recite those words privately since HaShem did make the convert a נוכר. It might be argued that HaShem moved the person's heart to convert, but in the context of the whole, that doesn't work.

ברכות השחר are not inviolable. Neither is the amedah; proof is comparing the Sefardi/Mizrachi version with the standard Ashkenazi version. Where we have two distinct paragraphs dealing with weather - ברכנו" בקיץ ו"ברך עלינו" בחרף - the Ashkenazi has one paragraph with a few words swapped out depending upon the season. For the record, if an Ashkenazi is heading services for an Sefardi/Mizrachi minyan, he reads the Sefardi/Mizrachi version (just as an Ashkenazi cohen is obliged to bless the congregation during morning services). Equally, a Sefardi/Mizrachi leading services for an Ashkenazi congregation reads the Ashkenazi version of the amedah.

The "bottom line" for me is that it matters less WHAT is said than that the prayers are said.

גשם, גשם, מתי הגשם?

Praying for rain

The other day on שמיני חג עצרת we did תרקון הגשם which, for Sefardim and Mizrachim at least means a change in the introduction of the amedah from מוריד התל to משיב הרוח ומוריד הגשם.

As it happened, that morning we were blessed with a deluge - it came before the "official" appeal for rain, but in Florida, summer is the rainy season.

But there are, again, "for Sefardim and Mizrachim at least," there is another rain change in the amedah.

The problem, if it is a problem, is that the second change doesn't happen in concert with the first change.

The second change, when we go from ברכנו ד' ...בכל-מעשי ידינו to ברך עלינו ד' ... את השנה הזות happens on the 7th of MarHasvan (מרחשון), two weeks after שמיני חג עצרת.

Why?

The rabbis were being considerate. Really.

We have three "pilgrimage" holidays each year, holidays when we would go up to Jerusalem with our offerings.

Since "back in the day" travel was a bit slower - although with all the airline snafus maybe not much slower - time was allowed following a Sukot for people to make it home before we seriously prayed - asked for - rain.

On the flip side. we start to ask for תל (dew) from the end of the first Passover seder - people still had time to bring their Pesach sacrifices without fearing a rain storm on the way. Unlike תרקון הגשם, תרקון התל changes in both places in the amedah on the same day.

Sources:

וזרח השמש של נרה''ג שלום משאש

מחזור לשלש רגלים

While we start to dry out in Florida, the rains have begun in Israel

Why 30 minutes?

Israel's "defense minister," who often seems less than pro-Israel, praised the IDF for downing a drone - UPV or UnPiloted Vehicle - after it had been in Israeli airspace for only 30 minutes.

The IDF contends that the drone "probably" was performing electronic surveillance.

Near Dimona.

The IDF reports that it thinks the drone came from someplace other than Aza (Gaza).

That does not rule out the Sinai nor does it eliminate the possibility of a ship-launched attack.

Even though the drone apparently did no damage to anything, the drone's presence was very much an attack on Israel.

Granted, low-flying drones are difficult to detect, but given the payloads they can carry - everything from intelligence-gathering equipment to explosives - it seems that the IDF needs to do better than to allow a half-hour fly over by an drone from an unknown source.

Consider how much territory a high-flying drone can photograph within a half-hour.

Even a propeller-driven drone can send back thousands of images; images that can be programmed into long-range missiles.

Contrary to the defense minister's noise, the IDF was 35 minutes too late in responding to the drone attack. It should - it must - identify and destroy invading aircraft before they cross into Israeli airspaces. (A high-flying reconnaissance aircraft can photograph objects at sufficient angles that the vehicle need not cross over into enemy territory.)

Most people reading this are too young to remember the damage caused by V-series rocket bombs the nazis sent over England during World War Two. The drones, albeit with different engines, can cause the dame damage to Israel if they are loaded with explosives rather than cameras.

The IDF does NOT deserve commendation for downing the drone after "only" 30 minutes in Israeli airspace and the defense minister needs to make that clear to the IDF's commanders. He must stop praising the IDF for failures.

AARP

NOT for me

I am AARP-eligible. Have been for years.

I even joined one year for the "discounts."

I quit AARP when I discovered the discounts were of no value to me.

But now, there is "no way" I'd ever buy AARP membership or any product associated with the AARP.

It is endorsing candidates.

AARP OUGHT to be politically neutral.

AARP currently is propagating the Obama lies - how healthcare will be lost to seniors, how our taxes will soar if Romney is elected.

That's pure and simple bovine excrement.

I'm not suggesting that some things coming out of the Romney camp don't smell like nature's own fertilizer - I've lived on horse and cattle ranches and I've moved an outhouse or two so I of what I "smell."

Probably the thing I find most egregious about AARP's claiming into bed with the incumbent is that fact that AARP members - certainly not all of whom are enamored by the president with a questionable past - are paying to place advertisements for Obama.

If Romney wins in November, and frankly I hope he does, the AARP organization stands to lose some clout in the District. It's paid management just shot itself in the foot.

No longer representing ALL seniors, AARP now represents only liberal seniors, seniors who will swallow the president's malarkey. Maybe seniors who want to hobnob with Hollywood's rich and - at least in their own minds - famous.

While I cannot - while I will not - object to individual AARP members following Obama's yellow brick road - and we now know, after nearly 4 years of Obama's care that "this isn't Kansas anymore, Toto" - I object to an organization that claims to represent me based solely on my "advanced years". AARP does NOT represent me.

I did not fall for the Democrats "creative bookkeeping."

I know my sons will not have Medicare as I know it.

They know they won't have Medicare as I know it today.

Social Security, once a "voluntary tax" by the way, also will be "modified" over the coming decades, sooner if Obama and his cronies stay in office and raid the once sacrosanct Social Security fund.

Change is inevitable.

In order to keep Medicare and Social Security well into the future, someone has to pay the piper.

The United States has one of the lowest tax rates - even for the middle class - of any country in the world. It also has one of the least funded social networks. A typical Norwegian pays a roughly 43% tax rate.

An Israeli earning more than US$125,000 can expect to pay a whopping 48% tax rate.

But Norway and Israel both offer many more social services, including subsidized health care.

Americans so far are unwilling to pay for Norway-type social services.

Whether or not the social services are "worth" it is in the eye of the beholder. I lived in Israel and know that health care, especially for the elderly, is not all that great; on the other hand, my daughter and grand-daughter do well by the system, a system into which they contribute.

I suppose I would not object quite so strongly to AARP's political stance if it was based on facts, on reality.

Only a Democrat with blinders can believe the numbers the AARP is pandering to the people.

And as for Sesame Street and PBS - I, too, like Oscar the Grouch and the Cookie Monster, but given some of the federally funded programming I think a small stipend from the Federal pocket is sufficient. There are plenty of organizations around that will sponsor PBS' liberal viewpoints; besides, unless you are living in Never-Never Land, PBS already has a abundance of commercials - out and out advertising.

(I'm waiting for Cookie Monster to have a Betty Crocker logo on his furry blue chest or Oscar the Grouch to sport a Waste Management baseball cap.)