Saturday, December 28, 2013

Our DIY Bathroom Renovation: Timeline & Photos

April 20, 2012: First bath time with a one-year-old and two-year-old in your new home. Realize you can't fit both kids in the bathroom with the door shut, and you can't put the kids in the bathtub with the door open. Make do while other more important projects get done around the house

May 20, 2013: Fall in love with a laundry chute bathroom cabinet at Ikea. Decide it's time to renovate the bathroom.

June 4, 2013: Buy discount tile at the Habitat for Humanity Restore, with the intent to re-tile the bathroom. Impulsively buy enough to tile the hallway too.

June 24, 2013: Buy a $40 toilet at the Habitat for Humanity Restore.

July 28, 2013: Attend a Home Depot workshop on how to install tile. Be inspired! A pro who's been doing it for 30 years says, "It's easy!"

August 11, 2013: Pocket door kit arrives, ready to be installed in an open frame.

     1. Google "Open frame."

     2. Just go for it.

August 15, 2013: Order the door jamb to complete the pocket door frame. 

August 20, 2013: Door jamb arrives. Put giant box behind couch. Leave it there.

September 15, 2013: Drywall the gaping hole in the hallway from the pocket door frame installation.

September 30, 2013: Remove the vanity and sink. (Put a bottle of hand sanitizer on back of the toilet tank.) 

October 14 - November 21, 2013: Plaster and texture the drywall in the hallway. Paint the hallway with leftover paint from the bedroom desk DIY project.

Plaster and texture the drywall in the bathroom. Paint the bathroom with new pretty paint from Home Depot. 

December 2, 2013: Get the door jamb box out from behind the couch and open it.

     1. Curse that you could've bought scrap pieces of wood at Home Depot for a quarter of the cost of this "online kit."

     2. Curse that it doesn't actually fit the door frame.

     3. Buy scrap wood at Home Depot to finish the pocket door jamb.

December 5, 2013: Remove the toilet.

December 6 - 9, 2013: Kids stay at Mommom & Poppop's House.

Celebrate your 5-year anniversary with a non-stop around-the-clock tiling party during Icepocalypse 2013. 

Some highlights:

     1. Fit a 150-pound wet saw in the backseat of a Passat.

     2. Park a block over and haul a 150-pound wet saw up the hill to your house, because the street is iced over and cars can't make it through the neighborhood.

December 12, 2013: Install a toilet for 3 hours. (Google & rig your way to a working toilet. Voila!)

December 15, 2013: Go to Ikea to pick up the amazing laundry chute that you saw there 6 months ago. They no longer carry it. Find amazing bookshelves that are even better, cheaper, and already put together in the "As Is" section of the store, and buy those instead. Pick up your traumatized 3-year-old from Småland.

"They wouldn't let us play in the ball pit!"
December 16 - 19, 2013: Complete all the finishing touches. Bathroom looks amazing!

December 27, 2013: Escape to a B&B for the night to celebrate!

Friday, November 8, 2013

7 Quick Takes: In Which Cars Wreck and Cats Fall (Vol. 13)

1. The space-time continuum is very unstable in my house, especially overnight. There's a portal right over my feet in the bed, and the cat keeps falling through it. So I guess I'll do Quick Takes.

2. I wrecked my car last week and felt too stupid to say anything about it on Facebook, because Facebook is only for shiny happy things.

3. So I posted pictures of RadioLab on tour instead. #mayzen

This guy met me at the door with a margarita when I got home from wrecking my car. And waited until the next morning to talk about what a bad driver I am. (Seriously, I am.) #loveis

4. Somehow with a folded up hood and broken grill (from driving under an SUV), the car's totaled, and the insurance company would rather give me money to pay for 20% of a new/used car than fix the one that's paid off and running beautifully. Well, um, was.

5. (Kids weren't in the car with me. Everyone's fine.)

The picture you want to see -- which only exists on a random passerby's Instagram under the headline "Look at this idiot!" -- is the one where I'm standing on the side of the freeway trying to pull the hood back down. Nothing declares, "I'm a Sicilian AND a Texan!" quite like trying to bend steel with your bare hands.

6. So this week's schizo rave has been exhausting, oscillating between a stern solo guilt trip, internal gratitude lectures, and the lamest pity party ever. (The guilt trip keeps nixing impulse shopping and fast food, so the pity party really does suck.)

7. And in a classic case of denial, my whiny toddler self has joined arms with my Sicilian Texan self to think I can deal with all the repercussions of this "all by myself!" The truth is, I've cried to Husband, Mommy, Daddy, Teenage Sister, and the Ghosts of Friends Past all week, and there's really no such thing as doing it all by myself. (Cue Internal Gratitude Lecture)

Visit Jen for more & happier Quick Takes! And post your own!

Friday, October 25, 2013

Meaningful Life versus Health-Insured Life

A few years ago, I stopped in my boss' office to drop off some papers, and we began discussing new legislation under debate in Congress, the beginnings of the Affordable Care Act. 
When I mentioned it seems many people choose jobs just for the security of health insurance, he laughed and said he hoped that wasn't the case for me.

And I responded how any insecure, new, secretly pregnant employee would around the person who signs her paychecks: laughed nervously and agreed.

But I continue to think, as Obamacare begins to unfold, and millions of Americans gain access to comprehensive health insurance (and possibly health care): how many people have given up dreams, for the sake of health insurance?
We grow up hearing how important it is to become something meaningful. My preschoolers alternate between future vocations as firefighters or priests (more similar than one might think). And we talk all day about the importance of teachers, youth ministers, and all those who mentor our kids in karate, music lessons, and dance.

I was a sell-out: an unapologetic, steel-faced sell-out, in the choice between a meaningful job versus a livable wage. But by "livable wage," I don't mean high income, because we've survived happily on low wage jobs. I mean the one thing that up until possibly 2014, you have to work 40-hour weeks at a for-profit company to access: health insurance.

The pursuit of health insurance has made us more than just hardworking business casual drones: it's reprogrammed our national work ethic. Which companies can afford to provide the best health insurance? Those who make the most profits. We subtly adopt the attitudes of these pedestaled companies: our goal in work is no longer a self-expression of our talents or a self-giving toward the good of our communities. We become motivated by profits and benefits, instead of life and inspiration.

I hate health insurance. It's not health care. It doesn't want to be health care (though some of their commercials can be deceptively convincing against that point). Health insurance organizations are for-profit companies, who make profits specifically by NOT providing health care. My family, and thousands of others across the nation, has discovered an alternative healthcare co-op that more than meets our needs. But explaining the self-pay co-op system to an ER billing specialist is like paying with traveler's checks at 7-Eleven.

Access to health care is tied to employment, so all of the good-for-nothin' lazy welfare bums are motivated to work, or so people keep telling me. But I don't think the amateur theorists who push this idea realize how many low- and middle-class families work very hard, often with both parents in the rat race of corporate America, and still don't have access to health insurance, the golden key of access to healthcare.

Sure we can get emergency treatment at the ER, which means stabilizing you enough to push you out the door and back to the sidewalk -- hope your ride comes soon, no you can't use our phones. But preventive care and basic healthcare should not be luxuries for the wealthy.

So I've joined the ranks of professional paper-pushers, and comfort myself with the idea that I'm pushing meaningful papers that support good work.

But I continue to wonder, what would happen if health care weren't tied to employment?  There would be a renaissance in entrepreneurship, the arts, non-profit endeavors, and teaching. Without the fear of medical bankruptcy or insufficient healthcare, I believe Americans would discover new and greater freedom, to choose work that is diverse and significant.

Wednesday, September 18, 2013

Top 10 Ways Kids Make Life Easier

1. Door-to-door salespeople don't want to come in your home. 


2. You're the last person anyone calls for help. 

"Hey, in the Austin caravan last weekend, my car got a flat, so I left it in Hillsboro. Could you drive me down to pick it up? Oh, we'll need to take all the kids with us for three hours in the car and stop every 30 minutes for potty breaks? I think my other friend said they might be able to help..."

3. Long, awkward conversations end before they get long and awkward.

You know those one-sided conversations with someone you just met who mistakenly thought you'd be super interested in the polymer building blocks of food-grade plastic storage containers? "Emergency texts" from the babysitter are always a valid out.

4. Weird personal questions can be avoided. 

"So, havin' any more, or are ya done?"

"Well, my kids are getting antsy, I need to go now. Let's pick this up again soon, stranger!" 

5. Someone will answer your weird personal questions for you. 

"Mom said she doesn't need any more little monkeys in the house." 

6. You're too old to act like a baby over long check-out lines, but your kids aren't. 

After 4 minutes in the check-out line, I stop singing "Twinkle, Twinkle," and "The Itsy Bitsy Spider," and just let the kids wail. Usually another line will open pretty quickly. 

7. Property taxes plummet. 
Did you know... the Appraisal Board can lower your property value and as a result your taxes owed, based on an overview of damages? (i.e. the missing drywall where a kid skateboarded into the wall, the water damage from a kid leaving the window open in a rainstorm, the patio door shattered by an errant soccer ball)

8. Kids think anything you do is hilarious.

"Peek-a-boo!" "...and this little piggy cried, 'Whee-whee-whee' all the way home!"


9. Uh, uh, uh...

I tried to make this a Top Ten list, but after weeks of wracking my brain, I've got nothing. Let's be real here. Kids bring messes, ER trips, and exhaustion. I'll grant that they make life more crazy, hopeful, fascinating, loving, and fun, but easier? No way.


Thursday, September 12, 2013

7 Quick Takes: Tried and True Coping Mechanisms, Saving the Environment, and More DIY (vol. 11)

1.  Kummerspeck (German; literally translated "emotional bacon")
It's been a rough couple of weeks. Emotional eating is cheaper than therapy, and I love a bargain. More on good words that don't translate well into English.
2. Straws
I bought straws for the sole purpose of blending frozen fruit and yogurt into smoothies and eating healthier. So far, they have only been used for milkshakes. (See #1)
3. Popcorn also a great emotional food, especially if you melt Nutella with butter and mix it all together.

Except frugalista-me found out you can pour popcorn kernels in any paper bag, roll the top, and pop it in the microwave. And when you overfill the kernels because it was that kind of day, and then you walk away to try to get something else done while it pops, that's how you catch things on fire in the microwave.

4. Kids Can Kill You

This week I looked up Mother's Day Out and preschool options for our kids, because I am going NUTS. And I was like, "You can't put a price on a mother's sanity, so whatever it costs, we're doing this!"

But then I saw the prices.

We're going to try an intermediary step of Wally and I giving each other regular time off each week. I think this set-up, with a little more Kummerspeck, should do the trick.

And if not, a mental institution is still less expensive than preschool, so I guess you can put a price on mothers' mental health.

5. When Things Get Out Of Control

When I go nuts, I organize and micro-manage. People think we keep a clean, organized house, because we're clean, organized people. No, it's more an indicator of where I currently register on the insanity scale. Which is why our kids' closet looks like this:

You can't see the labels I put on all the boxes. Those are in case a stranger is putting away our laundry and can't tell that socks go in the box with all the other socks.

6. DIY Successes and Failures

The army green cabinets in our kitchen didn't look too bad when we moved in 18 months ago, but I imagined how nice the original wood grain would look and spent hours (and hours and hours) of naptimes and evenings refinishing them to reveal the original, gleaming wood. They turned out awful. I guess they were cheap cabinets, designed to be painted, because the wood grain is inconsistent on each door, so each cabinet absorbs "red oak" stain differently. The overall look is shades of 1980s brown.

At the same time, I refinished our $10 garage sale kitchen table to match the cabinets. The table turned out great.

So now the beautiful table matches the horrible cabinets. And "Fixing the kitchen cabinets" returns to [the bottom of] our Home Projects List.

7. Saving the Environment One Baby Bottom At A Time

This kid has super-sensitive skin. So we're trying out cloth diapering. So far, I love it!

I didn't anticipate how much wet clothes weigh on a clothesline, so the line is about 18 inches off the grass. The boys are enjoying the new obstacle course in our backyard.

Monday, September 9, 2013


Pope John Paul II wrote a letter in 1981. It was an official letter to the whole church, and proud Catholic intellectuals would probably refer to it as an encyclical, sigh deeply, and then correct the Latin pronunciation I haven't bothered to learn: Dives in Misericordia.

I kind of write off popes. They're holy, pious, important in the spiritual leadership of the Church, but they don't seem to understand the real world, what we're dealing with down here in the 9 - 5 / 5 - 9 tedium of every day over and over and over.

I think a lot of people feel that way about God. Nice idea, probably necessary in some sense, but not really relevant to me.

Well once again, the English language has failed us.

The same language that failed to give us backpfeifengesicht ("a face badly in need of a fist") and kummerspeck (literally, "emotional bacon"), also translated mercy into some meaningless God-word, best chanted, definitely with head bowed, maybe with eyes closed, pairs well with faith, hope, or love.

There's a man Catholics and Protestants both claim as their own, and truth be told, he probably laughs at us and prays indifferently for everyone. [Saint] Augustine was a late convert, early bishop, born in 354 AD. He broke mercy down for us, and somewhere along the way, we butchered it.

Mercy = Misericordia (Latin) = Miseris Cor Dare = "A heart which gives itself to the miserable"

This is a God I want to know. A God who gives his heart to the miserable.

Pope John Paul II must have known the trenches. Because in his letter, he wrote about mercy as "the greatest attribute of God," not as the ying-yang of justice, or a nice way to balance out the wrath of a God who won't be pleased.

The big takeaway JPII wanted us to know: there is a God who gives his heart to the miserable.

Wednesday, August 28, 2013

7 Quick Takes: Christian Carpool Lanes, Texans in Nu-Yark-Sitty, and The Man I Married (vol. 10)

1. The Dog Ate My Homework

Alright, I'm 5 days late to the "Quick Takes Friday" game, but in honor of the first week of school, I have a good excuse! (see #5)

2. Telltale Texan

While visiting my sisters in New York City, I witnessed a sharply-dressed man, quickly but calmly running late, indifferently dodging pedestrians as he crossed 5th Avenue, and then casually raising his coffee cup in one hand to successfully and immediately hail a cab.

Cut to hours later, me trying to catch a cab to LaGuardia:

Talked myself up for a block, then nonchalantly lifted one hand as a swarm of traffic came toward me. An unmarked black sedan pulled over and told me to get in. I did. 

A few seconds later I got dumped back on the street, a block from my starting point, because I couldn't pay in cash. He didn't even offer me candy or a puppy. 

Two attempts later, I resolved to just jump in the back of the next cab that slowed down. Cabbies kept sticking their heads out the window, asking where I needed to go, and then speeding off when I asked for a ride to the airport. Did I mention it was rush hour in Manhattan?

3. Hypochondria

Sadly, I've completely worn out my sense of invincibility. So I took out a term life insurance plan, to ensure the family's okay until Wally can re-marry ASAP (for money, not for love, of course). It's a generous enough plan that I needed to take a physical before final approval, and after my approval paperwork was several weeks delayed, I knew they'd found something terrible, and death was imminent. Turns out, they had the wrong zip code on the hand-written envelope, and it circled around town for awhile until someone got it to the right house.

4. Can't Fix Stupid.

They're doing construction in our neighborhood, so the main access road is temporarily one-way. It is incredibly inconvenient. Still, not inconvenient enough to play chicken with oncoming traffic, risk driving into a ditch, and jam up an entire neighborhood, as this lady did, not just once, but THREE TIMES yesterday. We were out for a walk, and I was feeling neighborly, so I parked the stroller to watch and take her picture:

That's license plate #CBG 5790, and feel free to just leave her address in the comments below, if you're the tech-savvy type who can find out that kind of stuff. I'd like to stop by and visit her.

5. Oh, It's Not Our Season For Health
We had an awful parent experience last week, taking our 2-year-old to the ER with breathing issues. I'm sure I'll process it all and come out with some brave blog post about how we're all stronger and wiser, but I've got nothing like that yet.
Nonetheless, at least we're not bankrupt or poor over another ER trip in 3 months, because we're part of a great healthcare co-op. If you're like us, and traditional health insurance isn't an option because of accessibility or price, check out Samaritan Ministries. Or if you just think private health insurance sucks.
6. Christian Carpool Lanes

With the start of a new school year, I've picked up my sister from her [Omniplex] Christian Academy via the carpool lane a few times. The whole "last shall be first" thing is totally lost on them.

I haven't seen so many line-cutters and rule-breakers since the 3rd grade cafeteria line.

This lady is hilarious. And knows how to address a Carpool Nazi.

 7. I Married This Man

I say, "I can't bathe the kids, because we don't all fit in the bathroom when the door is closed, but when it's open, I don't have access to the bathtub."

He puts in a pocket door. 

So much for wanting a man who would just listen to my problems without trying to solve them.

Sunday, July 28, 2013

7 Quick Takes: In Which A DIY Lifestyle Moves Slowly

(vol. 8)

It's not that I find the work of a DIY lifestyle enjoyable. To be honest, I would happily pay someone else to do all of our work, if I didn't have that nagging sense of budget and fear of debt.

Happily, Google interprets my nonsensical home maintenance questions (what to do if my toilet is overflowing -- #1: don't wait until you've flushed it twice more to look this up). And between Youtube, home improvement store seminars, and "This Old House" reruns, we have free access to every how-to video ever, occasionally accompanied by the patience to actually watch them.

Unfortunately, the previous owners of our home also had strong DIY tendencies, albeit expressed more superficially. Someone drilled the gutters, sans brackets, unevenly into the side of the house; so they're more of a leaky trench than a water-draining system. Someone painted over rotten eaves fascia and structural cracks. Someone didn't paint walls behind overgrowth or trees. It seems all of our home projects begin with undoing whatever the previous owners "fixed."

1. The Unfinished Refinished Kitchen Cabinets

My mistake here was a failure to realize just how many layers of paint a kitchen cabinet can hold. And how many layers of paint the hardware and hinges of a kitchen cabinet can hold. Just getting the doors off the frame took hours. Now my system is a messy time-consuming combination of chemical paint stripper and sanding, and chances are, there will be an indefinite hold on the project after the butler's pantry is complete.

I also plan to experiment with cutting plywood to fit our custom cabinet door sizes (which are about 45 years old and don't fit any standard replacement cabinet doors, which means replacing the entire cabinets, if we want to replace the doors, which is super expensive, super labor intensive, and super out-of-budget). It sounds a little ghetto, but I'm holding high hopes for what a little sanding, staining, and polyurethane can do for plywood.

Stalled-out butler's pantry, because I can't bring myself to finish sanding the doors.

2. The Toilet Replacement

We have a tiny bathroom with a giant water-guzzling toilet. The Habitat for Humanity Re-Store (if you haven't been -- go visit!) has toilets for $40 each, and we found this little jewel that will slide nicely into our bathroom, once we replace the laminate floor with tile, and pull out the oversized sink and vanity.

Old Giant Toilet (left); New Sleek, Yet-To-Be-Installed Toilet (right)

3. The Gutter Install

We're about to find out just how far we can stretch the Home Depot customer satisfaction guarantee. We meant to replace the gutters last April, which is when we bought all the supplies. But a combination of working on Saturdays, weddings, and rain delays have brought us to a project workday that is 10 days past the returns date on our receipt. Here's to hoping...*

4. The Vanity Replacement

For a 25-square-foot bathroom, there's no reason for the vanity to take up 10 square feet. However, I recently found out that Ikea sells a 10-inch sink. I've marked out in blue painter's tape where the new sink and side cabinets will go, and cannot wait to attempt bath time with toddlers with the extra 14 inches of space!

[Soon?] to come! Space in the bathroom!

5. The Deck Replacement (a.k.a. "Please let us give you our money!")

We've spent a year planning the replacement of a rotting, splitting deck across the back of our house. It's a feature our kids love and is an ideal place for toddlers to toddle. In the interest of longevity and low-maintenance, we've decided to replace it with composite decking, which is significantly more expensive than pressure-treated decking. You'd think we were trying to replace it with moon dust.

Composite decking isn't popular enough for home improvement stores to carry it in bulk, but their customer service desks and websites and promotional flyers are full of DIY-friendly promises about deck planning and special orders.

We called Home Depot to see how to place a special order. "Just come in and talk to Javier!" they said. We scheduled babysitting for the kids, and went in to talk to Javier. He dismissively said they don't special order composite decking; it's just not something they do. So we went to lunch instead.

We called Lowes to see how to place a special order. "Just schedule an appointment with John!" We scheduled an appointment with John, scheduled babysitting for the kids, and then John no-showed at Lowe's. He didn't really sound interested in follow-up when we called back. Actually, he didn't really sound that interested in decking either.

6. The Vegetable Garden

We stocked up on lawn timbers when they were 99 cents each at Home Depot's 2012 Memorial Day sale.

I suppose the picture below simply indicates where vegetables fall on our life priorities list.

Future vegetable garden.

7. The Completed Projects

Just for some encouragement -- lest I communicate that we're stalled and not just slow -- here's a list of our completed DIY projects (supported by much Googling and Youtube how-to videos), since April 2012:

- Replaced carpet with wood laminate in living room (after removing carpet and tiles that we're pretty sure were full of asbestos, but we just held our breath as long as we could while scraping)
- Insulated the garage door
- Insulated the large sliding glass door
- Replaced the kitchen shade with blinds (my favorite upgrade -- sunlight!)
- Built an inset desk in place of a vanity (with open shelving for stowing laptops)
- Replaced the rotting wood in the eaves fascia
- Removed overgrowth and 5 trees (and some beautiful oleander, because we didn't want to kill our kids or pets)
- Removed wallpaper from entryway and re-painted
- Sanded and painted wood paneling in living room (so much wood paneling...)
- Installed new kitchen faucet (a retractable spray faucet with one lever for hot/cold water -- a huge upgrade for us, and purchased for $45 from the Habitat for Humanity Re-Store)
- Built an insulated box for the attic door
- Insulated the attic fan
- Installed new ceiling fan in kitchen
- Moved kitchen ceiling fan to master bedroom
- Removed brick privacy walls from front entry (rented a concrete saw)
- Cleaned the main sewage pipes under the house, removed a major blockage
- Installed lots of shelving and organizational aids throughout the house and garage to try to give everything a place
- Repainted and replaced hardware of bathroom vanity
- Repainted entryway light fixture
- Repainted bathroom light fixture
- Repainted bathroom towel rack
- Replaced entry door
- Replaced locks with keyed deadbolts on every exterior door
- Built garden and planted bushes across front of house (twice, because we let the first ones die)

Visit Jen for more Quick Takes! No doubt more interesting than incomplete DIY!

*Home Depot accepted our returns, 10-days past the deadline, no complaints, no questions asked.

Friday, July 12, 2013

7 Quick Takes Friday: The Social Justice Series

(volume 7)

1. Please don't forget the women.

The Texas Senate votes today on HB 2, which would require clinics that perform abortions to meet ambulatory surgical center standards, require abortionists to have admitting privileges at a hospital within 30 miles, and make abortion illegal after 20 weeks gestation.

According to current projections, the bill will pass easily, and is considered a "win" for the pro-life movement.

Sadly, Amendment 23 to HB 2 was tabled: to make more public the undeniable causal link between abortion/miscarriage and breast cancer.

Amendment 24 was also tabled: to provide prenatal, delivery, and postnatal care to women who seek and are denied abortion.

Yes, children's lives will be saved through this legislation, and I am encouraged these children will not be written off, because they dared to be conceived in less-than-ideal circumstances.

But may we not forget that children are not the only victims in abortion. Let us multiply our efforts to support the women who feel their situations are dire enough to need abortion.

2. Life without health insurance.

Ever wonder what the medical bills would look like for a person without health insurance who needs to go to the Emergency Room? Here's my experience: the kidney stone revelation.

3. Life. is life is life is life.

Do you see the irony that the same legislators who are meeting in a special session to passionately push through pro-life legislation, these same legislators work in the state with the most executions, in the country with the fifth most executions in the world?

Many claim those on death row are career criminals who just plain "deserve to die." Or, who cares about the details of their particular situations, "it doesn't change the fact that the world is just better off without them." 

Do we not realize, these are the same dehumanizing arguments used to justify abortion and euthanasia, especially of those who veer from the norm of our mental or physical expectations, those who are weak, disabled, or sick? In every person, always, regardless of past or present situations, is hope, is potential, is the opportunity to love and be loved. To write off just one person begins the process of writing off any one person.

More rant on the needlessness and uselessness of the death penalty here: is killing okay if it's only done by the government?

4. Health Insurance Alternatives

Sorry, back to the disenchantment with healthcare in America topic.

Lots of people ask me how our healthcare co-op works, so I put together some of our thoughts on the good and the bad we've experienced here: health care sharing ministries as an alternative to traditional health insurance.

Samaritan Ministries is a national program that currently has 24,000 households participating. Membership legally fulfills the requirement to carry health insurance, a part of the Affordable Care Act that is scheduled to take effect in January 2014.

5. Students, Loans, Debt, and Advising

I do think it's a step backward that student loan interest rates are going up. But I think the current advising system in most public colleges and universities is a bigger travesty.

Perhaps if 18-year-olds could be made to understand what $1000 means in tuition, work, and debt, they could better prepare for the future. I don't even know if this is possible.

But I sure wish in my 30,000+ student college experience, the advisors hadn't just been grad students pushing us through a course list and then out the door with a diploma.

Some real mentoring is needed. What are your talents and interests? What kinds of jobs could that lead to? What kind of lifestyle do you want to live? Do you know how much the bill will be each month after graduation to repay the loans you're taking out today?

6. Back to healthcare.

Never thought I'd say this, but Oregon seems to have a good system in place.

7. Geez, we've got a saint for everything.

I go to my mom when I need prayer for my kids.

I go to my friend when I need prayer for my job.

I go to my mentor when I need prayer for spiritual direction.

I wonder if St. Anthony rolls his eyes and sighs when we go to him looking for our key fobs.

Something's lost that can't be found; please, St. Anthony, look around.
Lots of people post Quick Takes over at Jen's!

Thursday, July 11, 2013

What An Uninsured Emergency Room Visit Looks Like

I panicked and called 911, because it was 5 o'clock in the morning, and my husband had run to Walgreens for something to help alleviate this intense pain. Massage, heat, cold, baths, Pepto, Motrin, and Phillips had done nothing. I imagined an exploding appendix.
Our family joined a healthcare co-op of sorts that shares medical bills among members. It's a novel and appealing idea, though the claims process can be gritty. 

Here's a picture of our medical bills for a 4-hour early-morning stint to the Emergency Room, followed by our co-op experience:

Ambulance: $725.00
Discount: 0%
Total Paid: $725.00

The City of Carrollton does not contract with any health insurance companies, so their ambulatory services are out-of-network for everyone, nor do they offer financial assistance based on ability to pay.

For us, this means we can't negotiate a discount based on the discounts they offer insurance companies. It also means our middle-class household of four doesn't qualify for a break on the total.

For most residents of Carrollton, who carry traditional health insurance, this billing structure means paying toward an out-of-network deductible, which is usually significantly higher than the deductible for in-network providers. (A deductible is the amount of money a person pays out of pocket before insurance covers anything.) Once a person's out-of-network annual deductible has been met, the out-of-network coinsurance is also significantly higher, with the patient usually being responsible for 30-50% of the total bill.

Hebron Emergency Physicians: $1,403.00
Discount: 50%
Total Paid: $701.50

I was thrilled when we received this bill. I'd heard so many stories about hospitals offering great self-pay discounts to patients without health insurance that I thought this was the all-inclusive medical bill from Baylor Carrollton.

There was a 50% discount offered, if paid in full online, so I logged in, paid up, and thought everything was covered.

As it turns out, this was a bill for the doctor who poked his head in the door to say, "Hey, you're scheduled for a CT scan."

And then 90 minutes later: "Yep, it's a kidney stone. Call this other guy for follow-up."

Our three-sentence-seven-hundred-dollar relationship ended there.

Baylor Medical Center at Carrollton: $6,522.09
Discount: 78%
Total Paid: $1,400.42

So this was the actual bill for a private closet in the ER for four hours. Granted, it included two doses of morphine, and at the time, I would have happily paid much, much more.

I did the compulsory call to their billing department, requesting the same discount that they negotiate with health insurance companies. But they said discounts were only provided if I submitted a financial aid application.

Now, I don't consider our family impoverished by any stretch of the imagination. We have spending limits, naturally. But we also have food, shelter, clothing, and plenty more. Somehow, after filling out the financial aid application with our income information, Baylor Medical determined we are 80% indigent. 80 percent! If our family falls in the bottom 20% of wage-earners, then we are a blessed nation indeed.

Medical Imaging of Dallas: $917.00
Discount: 49.6%
Total Paid: $462.00

I called Medical Imaging when I received this bill, because I thought there was a mistake. In the line items of my Baylor Medical bill ($6,552.09), I'd seen a $4,000 charge for a CT scan. I knew I had already paid $701 to the doctor who told me the results, so surely this extra thousand-dollar bill was some kind of duplicate.

The billing representative who took my call was so helpful, tired, patronizing. "Yes, the hospital charges a technical fee for use of their equipment, the doctor charges a general fee, which includes telling you the results, but we charge a professional fee, which actually interprets the results."

I offered to join the assembly line of payees with an interpretation fee to communicate to the patient the ridiculous billing process to follow, but she just laughed awkwardly and asked for my credit card info.

I sent them an email asking about discounts for self-pay patients, and the responding representative said they could bring the total down to $641.

When I called in to pay the bill, the rep who answered said there was no record of the email I received and no note on my account. Luckily, my appalled disbelief at their traceless recordkeeping resulted in silence instead of profanity, because she then said, "But I can settle your account for $462."

Go figure.

Texas Urology Carrollton: $205.00
Discount: 37.1%
Total Paid: $128.80

After being discharged, with lots of hydrocodone, but sadly, no morphine, I received a referral to a urologist for follow-up. The doctor wasn't available on short notice, but I got an appointment with the physician's assistant.

As a self-pay patient, they offered a 20% discount, so I actually paid $128.80 for this appointment. (Two months after this appointment, I received a bill for an additional $82.20, and it's good I called for clarification, instead of blindly mailing my check in their self-addressed envelope. As it turns out, the balance due was a mistake, and our account was already paid-in-full.)

After looking at my CT scan, the PA found the doctor to see about scheduling some intervention. He had the urgent, technical speech of a man with a medical degree, but I was able to piece together the following about my situation:

They preferred to do a procedure with sound waves to break up the 6-mm kidney stone, but their outpatient clinic refuses patients without traditional health insurance. So they decided to schedule an operating room, anesthesiologist, and x-ray at the hospital to do an invasive procedure with a scope instead.

Luckily, the hospital also refused to schedule me until a payment plan was set, by which time, I sourced people who had the operation and strongly advised against it, and so had changed my mind about any intervention.

Unfortunately, this all happened after the pre-op lab work was ordered and completed.

Clinical Pathology Labs: $171.00
Discount: 20%
Total Paid: $136.80

Basic Metabolic Panel: $64.50
Pregnancy Test, Serum: $65.00
Complete Blood Count: $41.50

There's actually a note on the bill that says, "Perhaps your doctor did not tell you that a specimen was sent to us... and that you would receive a separate charge. Should you have questions concerning results of the test, please call your doctor."

It made me feel better that apparently it's a thing for doctors to order tests and not call their patients with the results.

In Closing:

As the kidney stone shifted, the pain lessened significantly, and the side effects of a low-functioning kidney set in. Five weeks, gallons of water, and countless home remedies later, the kidney stone passed!

Our healthcare co-op, Samaritan Ministries, will actually cover all of these bills. (You can follow this link to a post about how Samaritan Ministries actually works. Our family pays $405 a month, and our deductible is $300 per claim, which was waived in my kidney stone issues, because we negotiated discounts of at least $300 from the medical providers.)

So all of my complaining isn't so much about the cost of my inaugural kidney stone experience. I'm just frustrated and concerned for the millions without access to health insurance, who are then also without access to healthcare.

Since health insurance in the United States is provided by employers for full-time employees, my family doesn't qualify for any of the comprehensive plans. I work part-time, and my husband is listed as a "contract" employee with the company for whom he's worked six years. He used to regularly work full-time hours, but with the sweeping overhaul of the Affordable Care Act, intended to provide healthcare (re: health insurance) to all, his hours were cut to just below the minimum requirement for employer-sponsored health insurance.

Our only option for traditional health insurance is to purchase directly from the insurance companies in the private market. Needless to say, without the clout of a large pool of participants or appeal of a significant corporate account, the private health insurance companies hold all the cards. There's no such thing as negotiation or patient advocacy in this market, and in consequence, not a single private health insurance in Texas covers the basic family healthcare need of maternity. For real. (This changed after the Affordable Care Act took effect. Now every health insurance plan covers maternity.)

On a final note, the premium/deductible ratios are such that one might be culpable to the sin of gambling just for playing the health insurance game. It would at least seem wiser to buy a Texas Powerball Lottery ticket.