My Own Story Why I am Wary of Medicare Advantage

 I'm 57. I will be 58 in April. I am getting thisclose to retiring, or at least contemplating it. One thing I was looking forward to was continuing to have a great health plan when I turned 65. But this Medicare (Dis)Advantage that might be awaiting be is making me nervous.

I have two concerns how Medicare (Dis)Advantage can affect me if and when it comes into effect.

The photo on the right is my right shoulder. Actually, my new right shoulder. 

In 1987 I fell hard on it and tore the labrum. Bad. My shoulder was unstable for years. Arthritis set in. Pain. It was bad. I didn't have insurance when I hurt it and I suffered the consequences. In 2002 I had it scoped out but all it did was put off the inevitable.

In 2019 the pain was the worse it had ever been. I was popping Aleve like M&M's. I went to a shoulder surgeon. He said I needed a new shoulder but want to give physical therapy I try. I had bone on bone. How the hell was PT going to help?

I went to a second doctor. He said PT was a waste of time, but agreed I needed a new shoulder. However, I just didn't feel right with him.

I went to a third doctor, Dr Young Kwon at NYU (Yes, a shameless plug, but he is the best shoulder surgeon!). He saved me. He made me feel whole. 

Here's my issue. Artificial shoulders last from 10-15 years. I'm lucky, I'm a lefty. The artificial joint is in my non dominant arm, but you never know. Dr Kwon even told me that I was a bit too young for shoulder replacement.

What happens when I am between 65 and 70, on Medicare (Dis)Advantage and need another shoulder? I will need to get pre-approval? Will I be considered too old to get a replacement? I might be told since it is my right shoulder and that being left handed, a new joint is not a priority. Heck, will I be allowed to see Dr Kwon again? 

My dad had his hip replaced at Special Surgery at the age of 74 in 2005. My step mom was retired from DOE and everything copacetic. No fuss, no muss. 

Will Medicare (Dis)Advantage let me visit three doctors? I doubt it. 

My other concern is I am Type 2 diabetic. My numbers are great. My A1C is very close to where it should be. My weight is the best since high school. I go to the gym three times a week. I eat better than I have, but of course I can do better. But I am on several medications. I'm not on insulin and don't plan on it. I see the eye doctor every year. I don't want anything chopped off or to go blind.

But what happens if  insulin is needed? Will I be sufficiently covered? Will my medications be covered? Even if I am covered what out of pocket charges will I face? I see my endocrinologist every three months. Will I be able to continue this? Like Dr Kwon, my diabetes doctor is one of the top in her field. Under Medicare (Dis)Advantage will I still be able to see my doctors or still be able to choose from the best physicians? Or will I be left to choose between Dr Nick and Dr Hartman?

I don't like what I have read or heard of Medicare (Dis)Advantage. Someone, somewhere is getting rich over this being forced upon us and it's not someone at Emblem/Blue Cross or Joe Namath. 

I have a fantasy of moving to Corning NY, for a year after I retire. How many providers will I find there? One? None? Or maybe Hudson NY. There might be three providers in Hudson.

I don't need nor want a Fitbit. I don't need or want rides to and fro. I don't want meals sent to me. There is one thing I want with my health insurance when I am 65. 

I want certainty. And I want myself and my health professional to make the decisions what is best .

Been Thinking of My Blood Sugar, The UFT, and the MORE Caucus

In the summer of 2012 I was diagnosed with Type 2 diabetes. In retrospect I think I had
been having symptoms, constant thirst and always running to the bathroom, for two years before that.

At the time of my diagnosis my blood sugar level was nearly 500 as as my cholesterol level. My A1C was over 13. And my weight was 30 pounds heavier than it is now. I went from a size 38 waist to 32.

I am not on insulin, yet I am on Metformin, Glimepiride, and Jardiance for the Diabetes and Lipitor for the cholesterol. My cholesterol is now normal and my blood sugar, well it can always be improved, but my A1C is usually around 7 (it should be less, closer to 6.5) but I have cut out a lot from my diet.

I'm saying this because I remember several years ago talking about going on a hunger strike. Hunger strikes are hard. No food at all. Only water.

What's easy is going off my medications (OK, I have opened myself up to a litany of jokes!) . Flush it down the toilet. Stop going to CVS once a month for refills (except my Lipitor which comes mail order).

Why am I sharing this? Because something needs to be done with how our union elections and how decisions are made.

The UFT is calling, or at least exploring, earlier than usual elections for 2019. ATRs still have no voice, no functional chapter, no nothing. All teachers, all members of the UFT vote for every single officer. Why as an elementary teacher am I voting for HS VP? What purpose does an at-large executive board serve? Why at the DA is modern technology not used for voting of resolutions (simple, use an app to vote yes or no). There are a slew of other things to complain about.

That is one group. The other group is the MORE Caucus.

The MORE Caucus has gone bat shit crazy of late and is controlled by its patróns at the ISO and Gus Hall Superfriends Club, not to mention some truly demented human beings there. Worse yet, the purges of earlier this year in which the MORE Caucus stuck to the playbook of Stalin, Mao, and Saddam Hussein. The MORE Caucus still cares more for all this extraneous bullshit stuff rather than for the rank and file.

So what am I thinking.

I am really think choosing one of these two groups, that if things don't change I am going to go off the meds and set myself if I go hypoglycemic, or worse, so be it. But at least I will be doing it for for change, for the rank and file, a for a cause that means something.

If I do this I will be all in. Live on camera and streaming I will take my blood sugar. Instead of seeing between 90 and 150 2 hours after I eat, what will be seen are numbers like 600, 700, 900 or higher two hours after I eat. If I stroke out let it be on the UFT or the MORE Caucus.

I'm getting tired of the bullshit. I don't know what else to do. I am open to other ideas.

Principal of Arts & Media Preparatory Academy in Brooklyn Writes up ATR for Testing Blood Sugar!

Principal Deborah Glauner

Oh, we just can't keep making this sh** up now can we?

Sit down, here comes another round of ridiculousness heaped upon a ATR.

But first, a little background.

There are two types of diabetes. Type I in which your pancreas has shut down and no longer produces insulin. You really have to watch what you eat and you need to either inject yourself with insulin several times a day or have a pump attached to you and inserted in you which pumps insulin as needed throughout the day. The most known reason for someone having Type I is that a virus attacks the pancreas and which in turn shuts down the production of insulin.

Then there is Type II. The body does not produce enough insulin. This is caused by heredity, weight, eating habits, etc... I have Type II and have cut out the carbs, the fried foods, the ice cream, etc.. I take Metformin and Glimepiride and have no plans to ever take insulin.

Both types need to have their blood sugar below 150 after meals and their A1c levels at below 6.5 ideally. Mine is currently 7.1 and it is tough. I also need to get my weight down.

But the worse part is testing the blood. Got to carry that darn test kit around all the time and sometimes you have to test when you really need to. So it really boils my britches when I get a story from an ATR who needs to test her blood and gets written up for it.

As the ATR wrote to The Crack Team;

I went to 10 schools as an ATR this year. Just received an S rating and perfect attendance.

Regardless, my efforts at school #9 the (I.A.)principal Deborah Glauner (2002 Teaching Fellow) of (Arts & Media Preparatory Academy in Brooklyn) is placing a disciplinary letter on my file. Reason? For checking my blood glucose in front of one student. She assigned me 6 periods per day: first 3, last 3. I had to walk a mile from a parking spot and walk/run 4 floors up, no elevator. There was no place to test BG (Blood glucose) before first 3 periods. The class roster had 4 students but only one student was present. But she wrote students (plural) big difference. At the same school a student threw a calculator at me hitting my shoulder. And my iPhone 6 was stolen in the last day.

Can this be true? Let's have a looksee (Click to enlarge).

Have you read it? OK, let's get past all the gobbledegook about who said what and where who was and concentrate on the part about blood borne pathogens. Principal Glauner states that the teacher in question placed students...

"at risk of exposure of bodily fluids." 

Dear God, where have we heard of this before? This ATR has stole Principal Glauner's essence .


Risk? Look at this video (At about 1:38 in) see the blood gushing everywhere? Take a reeeeeeeeeaaaaaaaal close look. It's a pin prick. The strip soaks up 99% of the blood.

In fact one, and I have been guilty of it, one can use the needle for the next test therefore not having to dispose of the needle.

In fact, by checking the NYCDOE Occupational Safety and Health website on blood borne pathogens there is not one single link to anything to do diabetes testing. It all has to do with HIV/AIDS, hepatitis, and basically what to do if someone is hemorrhaging blood.

A member of The Crack Team spoke with someone today at OSAH and asked if checking for diabetes, whether in front of students, adults, or anywhere can be considered a risk. The gentleman, who was quite kind, replied unequivocally, "NO!! Not at that tiny amount." When asked about proper disposal of the testing strip he said, "A testing strip is safe enough to dispose of in the regular trash."

So why then did Principal Glauner (Or if we won't to go with the bodily fluid theme, "Principal Ripper) have to write up this ATR?

Simple. The teacher is an ATR. Principal Glauner is a Interim Acting principal and feels she show she is tough. The ATR knows more than she. The ATR is nicer. There are a littany of reasons.

What would have been the harm in a) giving a counseling memo or just have an informal conversation with the teacher? Or b) Reach out to someone at Tweed and truly find out if the itty bitty bit of blood is dangerous. It is not.

But here is the main problem. Principal Glauner could have taken this moment and turned it into a true teachable moment. Isn't this what education and being an educator is all about?

Sadly, Principal Glauner is too infatuated with her new found power. She does not feel she is capable and must make others feel bad to build herself up in her mind.