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Posts Tagged ‘health insurance’

M was home yesterday when I got some bad news, and he got the full force of my anger and frustration.  It wasn’t fair to take it out on him — he’s got enough on his mind at the moment — but he was there.

He was there because his company had sent him home with no hours.  Again.  It’s become a regular occurrence these past four months.  Every week like clockwork, when the pay-week comes to a close on Thursday, he gets up and gets ready, gets in his truck and heads out for work, and then they send him home with no hours.   Since the beginning of December, he’s had only three weeks of full-time hours, only three paycheques that really cover the bills.

My birthday is coming up in the next couple of weeks, and it’s a big one.  Apparently, Life Begins at this age.  M may be all manner of wonderful things, but he is not good at remembering me when it comes to  important occasions — I have not had a birthday or Christmas gift from him for three years running — so I have been reminding him of this impending event almost every other day since before the turn of the year, like a count down.  This is a Big Birthday, and I do not want to be forgotten this year.

I had emailed out my birthday wishlist to everyone who would likely find it useful but, knowing that M uses a computer about as often as a camel uses an umbrella, I have been coaching him separately for a long time.  More than anything, I want a Lendrum spinning wheel to replace the ancient, second-hand wheel that I have been using (and which has served me well) for the past 12 years.  But a shiny new Lendrum is nothing to be purchased lightly — it’s $622 — and so I’d hoped that maybe if everyone pitched in together, then what remained would be more within our grasp.

And just the day before, I’d made a furtive phone call to a local yarn shop to see if there were any places left on the knitting class they were offering this month with knitting guru Brandon Mably.  I had already taken this same class  six years ago — it was a treat to cheer myself up after I miscarried our first child — and I had enjoyed it so much out of it that when I saw that he was coming to the area, I immediately began to muse over taking the class again.   It was an expensive class, at least for me…  The amount left each month for spending money for me and the girls rarely tops $50 — and that includes everything: shoes, clothes, magazines, coffee — and this one class would blow that out of the water, but how often does one turn…  erm…  How often does Life Begin?  I felt guilty making the call to the yarn shop and I felt guilty at the thought of booking the class…  But there were spaces left!  And I wanted to take it — I really wanted to!  I decided  I’d wait a couple of days to be sure the idea settled right, and then — damn it! — I’d do it!

Yesterday morning I received a bill from the doctor’s office which treated my sprained ankle.  It wasn’t for much — almost exactly the co-pay amount — and so I assumed it was an error.  Somehow, the insurance company must not have realised I’d paid the co-pay on the day, so I picked up the phone to sort it out.  It was a beautiful day, sunny day and my husband was home — I’d get this out the way, it shouldn’t take long.

The lady on the phone sounded weary.  “That’s your deductible amount,” she explained, and then added, slowly and with a tinge of irritation, “You’re responsible for the deductible.”

“Oh, I know!” I said with deliberate cheerfulness, because the lady sounded like she needed it.  “I understand we pay the deductible but… I’m confused…  Before I went to the doctor’s, I spoke to a lady in your office who explained that my husband’s employer pays the first $1000 of the deductible.  Have we gone through a thousand dollars in two visits…?”

She tapped on her keyboard and then paused.  Then a deep breath.  “No, but I’m afraid whoever spoke to you got it wrong.  You’re responsible for the first thousand; your husband’s employer pays the second thousand.”

Oh.

My stomach dropped instantly, and then my mind began tallying, very quickly: doctor’s visit, three x-rays, the airboot, follow-up visit, three more x-rays, the lace-up brace…   How much had we run up?

The lady was tallying too.  “We’ve negotiated a nice discount for you on that bill…”  I could see that they had indeed — they’d reduced the bill by 75%.  “And I can see that you’ll also be receiving a bill from a rehabilitation equipment company…”  Yes, that’d be the airboot.  She told me the amount, and I winced.  “And… let me see…  another bill from the doctor’s office…”  The follow-up appointment.  “And another… oh, from the equipment company again.”  That’d be the brace.  “Let me add that up for you, ” she offered helpfully, her irritation subsided now that she realised I wasn’t going to put up a fight.  The amount came to around $400.

Four hundred dollars…  for one moment of stupidity.  Four hundred dollars, after months and months of short weeks and short pay.  Four hundred dollars!  If I had known that, I never would have taken off the tape that was holding my ankle still and let them replace it with a brand-spanking new lace-up brace.  If I had known that, I would have paused at the offer of the airboot, and grabbed my mobile to ask my mother if her old airboot would fit my foot.  If I had known how much it would cost us, I honestly think I might not have gone to the doctor at all — certainly not to that follow-up appointment.  M had said it was only a sprain and it would heal on its own, and he was right.  I could have gotten by without the doctor.

The day had seemed to have suddenly lost all its sunniness…  I felt sick to my stomach (again! again!) and deflated.  My hoped-for birthday gift now sounded extortionate, and the thought of booking that Brandon Mably class seemed frivolous, if not downright irresponsible.  Spend money on my birthday like that?  Spend money?!? What fool thinks she’d get to spend money on a milestone birthday?!?

And with that, deflation turned to anger — real, seething, boiling, red-hot rage — and  so I yelled.  I yelled and I yelled and I yelled at this country, at this joke of a “system”, at the waste and the complication and the confusion and the callousness of it all.  I yelled at the lack of transparency, at the miscommunications, at M’s lack of hours, at his too-short paycheques when he works so hard, at the recession, and at the ludicrous idea that somehow this is all ok, that this is the American Way.  I yelled because, apparently, going to the doctor when I sprained my ankle was my birthday gift this year.

M thought I was yelling at him.  And he came up and held my hands and, with tears in his eyes, he said, “Your birthday will be alright.  We’ll make it alright.”  And then I felt terrible for all the yelling, and tears came to my eyes too.  Sod my stinkin’ birthday — what I’m really scared of is losing the house.

The door woke me when M left this morning: 6.11am.  That’s early, I thought, and then drifted heavily back to sleep, hopeful that it meant he had a busy day scheduled.  He was back home again just after 1pm, having worked three hours, and then hung around for another three in the hopes that some more work would come in, before he finally gave up and drove back home to us.

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This morning, when the pain was a little less of a shock and the cold shiveriness had passed, I was better able to assess the situation.  The night had not been good — there was no comfortable position to lie in, and so sleep came in fits and starts — but the situation seemed better… and worse.

On the plus side, I wasn’t as limited in the positions I could hold my foot in.  I could lie with my legs outstretched and my foot falling forward naturally, and  rest my leg to one side without too much pain.  I could adjust my hips or even turn in bed without gasping from the shock of it.  But where I could put weight on the foot last night and hobble forward a few paces, that was now impossible.  There was a pain running up my shin that I hadn’t registered before.  And the bruising was coming out, which always makes things look downright alarming.

My mother watched me crawl — and gasp — my way to the loo and asked, shouldn’t we maybe have that looked at…?  Maybe it was broken?  Mmmmm…  she might be right

I rang the insurance company to find out what they covered and where we stood.  Now that it’s not an emergency, the lady explained, they preferred that we see a doctor before going to hospital.  Yes,  the doctor my mum had recommended did participate in their plan.  Yes, they would cover all the scans and tests he might feel were necessary.  There would be a $40 copay — I knew that already and, even though that’s a significant sum to us at the moment, we could handle it.  And, she continued, there was a deductible we had to cover before the insurance began covering the costs.  It was…  the lady on the phone paused, looking through the numbers on her screen…  It was $2,000 — my heart skipped a beat — but… she looked at the numbers again…  M’s company paid the first thousand.

Ok.  Ohhhh-kaaay…  Just at the moment, having to pay almost any part of that deductible would be difficult, but that little gem about M’s company might save the day.  I looked at my ankle and began to tally: x-ray… MRI…  What might the doctor order?  How much do these things cost?  I don’t have a clue — it might well all come in under a thousand or we could just as easily blow right past it.  I really don’t know.  But — oh! — that swelling just did not look good!

My mum rang the doctor to check if they had appointments available.  The earliest was not for two days and, phone still to her ear, she raised her eyebrows to ask…  Did I want to take it?  I paused for a moment…  wiggled my toes and winced.   Yes. “Yes,” I said, looking back up to her.  “Make the appointment.”

The ankle is painful but stable, my mum is here so I can rest (thank goodness for her!), and the two-day delay still allows us 48 hours to watch things and decide if the appointment is necessary.

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Hold on…  lifts hand with index finger raised
Hold on…   I’m be with you in a minute — I’m just reading through these papers…  I’m choosing between some of these military protection plans.  I’ll be getting all the standard coverage of course: basic national defense, overseas campaigns, that sort of thing.  And I’m including all branches of the military on that and the Coast Guard as well.  But… do I want to add the foreign and domestic terrorism riders?  I mean, domestic terrorists could hit anywhere really, so I think I’m going to go with that, but…  do I think foreign terrorists are going to go for Western Pennsylvania?  Probably not, so I could save some money there.  Except, wait… the G20 summit is being held in Pittsburgh next month, so maybe I do need to worry about foreign terrorists.  And… oh, what’s that in the fine print?  The domestic terrorism rider does not cover terrorist activities of any person, foreign or domestic, who received training at any time lasting more than two months in any of the following countries: Pakistan, Afghanistan, Yemen… Hmmm, that complicates things.  I don’t know how likely…  Mmmm… Well, I’m not sure what to choose there…

Choosing the school options was much easier.  The girls are bright and I want to give them the best chance in life, so I went for the most comprehensive choices I could get.  I didn’t take the remedial tutoring option, of course — they won’t be needing that and I feel confident I can ensure that by taking a greater hand in their studies at home.  And I saved quite a bit by opting out of the school lunch option — with their allergies, they can’t eat the school lunches anyway, and I don’t want to be paying for anyone else’s peanutbutter sandwiches.  I’m only going to pay for what’s right for us!

Choosing the police coverage was pretty straightforward — we want full coverage there — and I chose the elite force even though it costs a bit more, because the faster response time is worth it.  Same with fire, although I did opt out of the cat-stuck-in-a-tree rider, seeing as we can’t have the cat with us anymore-.  For public roads, I went for all the entire local road network, and added the option for occasional roaming.  It doesn’t include the Erie-Cleveland network though — I can’t see us ever needing to go there…

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The response to my blog post on the NHS was overwhelming, and I found it fascinating to read the comments as they came pouring in.  It’s been equally interesting to Google my blog post and see all the various sites that have linked to it, and then read the comments that have been left there as well.  But time and time again, there have been replies from people who say that they like the current American system because they want “choice” in their healthcare.  They want to “choose the right plan” that suits their personal situation.   Being  covered for anything and everything that might happen in their lives doesn’t fit that scenario — they want to be able to specify exactly what ill may befall them and what benefits they’ll be entitled to.

Several people said they liked choice in healthcare because they didn’t want to pay for someone else’s maternity care or stomach-stapling operation.  It makes me wonder if they just don’t understand how the insurance they’re buying actually works.   If they’re getting major medical, of course they are paying for other people’s benefits, even the ones they don’t receive themselves or perhaps don’t want to support.  Insurance companies take everyone’s money — whether they’re paying a lot for comprehensive coverage or a just little for bare-bones coverage — and then put it into one big pot to use when they have to pay out on claims.  In choosing a plan, these people are only limiting the benefits they will receive, not controlling how their premiums will be spent.

But to the rest — the ones who do understand how insurance works and are still saying that, instead of being covered for everything, they want choose  a plan that will suit the healthcare they personally will need — to them I want to ask, how do they know?  Yes, major medical covers a wide spectrum and catches the most likely scenarios in its net.  And yes, there are armies of actuaries working out the probability that one person will be more likely to contract Disease A over Disease B, so that people can make “informed” choices.  But nature can (and does) defy even mathematical probabilities.  The unexpected does happen.  The unforeseen is… well, unforeseen.   Aside from the obvious probability that most single men and nuns won’t require maternity cover, it defies my understanding how someone can actually know ahead of time what kind of medical care they will need in the future.

The girls’ insurance does not cover seeing a nutritionist.  It’s a moot point as to whether I would have chosen a plan that did, because this was the single only long-term policy that I could find that would cover them under our circumstances, but if it had been a few years ago and I’d have been in a position to choose between several plans, I never would have even considered that we’d one day need — be desperate — to see a nutritionist.  I mean, I know how to cook, we have a varied diet, and we’re none of us really overweight.  What do I need a nutritionist for?  A few years ago, I’d never have guessed that I’d have a baby who would suffer from food allergies so severe that she’d drop from the 98th percentile to the 1st percentile in her first year, who would stop gaining weight for seven months and grow so thin I could count her ribs, who wouldn’t double her birth weight (something most babies achieve by four months) until she was nearly two years old.  And so, not knowing that, but guessing that we wouldn’t need a nutritionist, I would have happily foregone that option.  And though it wouldn’t have been a disaster in our case (nutritionists being at the more affordable end of medical care), it serves as an example that people simply cannot really know what kind of care they’ll need in the future.

Or even that they’ll need care.  When we were preparing for our move and I was speaking to insurance agent after insurance agent (before I realised that none of their policies could cover us due to residency requirements), they all asked me the same questions: “Are you generally healthy?” and “How often do you feel you’ll need to the see the doctor?”  I hardly knew how to respond.  The first question implied that past performance predicts future results — in which case I’d have made millions in the stockmarket — and the second assumed I could see the future — in which case I’d have made sure I’d won the lottery by now.  But we were relatively healthy and we didn’t see the doctor that often, and that satisfied the agents.  “Then you probably won’t need very extensive cover,” they all predicted, and suggested low-premium high-deductible plans.  And then we immediately turned all that on its head by developing significant health problems as soon as we arrived, and running up thousands in medical bills within a couple of months.

Now I realise that most of the time, when people talk about choosing a plan, the “needs” they are talking about are not the diseases they think they’ll get, or even the structure of their care, but the premiums and deductible they can or want to pay.  They are not making choices about their care — they are weighing up their probable future health against what’s in their wallets and then hoping what they’ve bought will align with whatever may befall them in the future.  And therein lies the unappealing truth that we all know: in the choice between care and money, we tell ourselves that it’s all about care, but the system — and thus the choice — is all about the money.  The idea of having that choice, of picking amongst a series of plans — with varying (and often confusing) benefits, various (and confusing) restrictions, and a range of prices — is appealing because it gives people the feeling that they are in control, they are tailoring their coverage for themselves.  And it blinds them the fact that the NHS system that I described — and so many disagree with — gives no such choice because it’s simply not necessary, because the system’s mission is to cover everything, for everyone, for their entire lives — and that where it is restrictive, it is no more restrictive than the insurance companies who take their money and then decide — sometimes retroactively — whether their claims match the fine print.

We fund the police, the military, and our public schools in a collective, socialised way, and we accept that when we receive the services they provide, they will be comprehensive — we don’t pick and choose the “package” we want because we know they will cover (or attempt to cover) whatever needs may arise.  In fact, the concept of trying to anticipate our potential future needs to these services and limiting our access that way just might look a little silly, if someone were to write it out.

Does it make a person lefty to support comprehensive universal health?  No more than it makes a person lefty to support their local schools, their police and fire departments, or our military.  These are socialised institutions that have been in our midst for generations, and which we have chosen to support and fund this way because they are so vital to the fabric of our society that we are willing to work collectively to ensure these key services remain in place.  And yet our national character has survived!  Having a public schools, collectively funded police and fire services, and socialised military has not wrought havoc on the nation — our country has remained capitalist.  Healthcare — with its ability to bankrupt overnight; with its ability to create a life-sentence of astronomical on-going costs; with its central role in the health of the nation and of its workforce and its economy — is one of these same essential services.  We have ignored that fact for too long and now that we face this rare opportunity to reform healthcare, it’s essential that we see the situation for exactly what it really is.  A public healthcare option — like public schools, like our police and military —  is not something to be feared as some sort of Great Socialisation of America.  It is simply a logical step that will ensure this one other essential service is accessible to all Americans — for the betterment of our countrymen, our businesses, our economy, and our country.

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A letter came in the post last Friday and after I read it, all I could do for a few minutes was stare at it in shock.  I sat down and put my hand on the couch to steady myself, and then read it again.  It wasn’t so much the news that it brought — though that was bad enough — but the way it made me feel: vulnerable… so, so very vulnerable and out of control.  The letter was from the girls’ insurance company and it informed me that, due to “increasing [insurance company] financial losses”, the premiums for their cover will be increased from October by 350%.

The girls are covered by the state’s CHIP programme — the only long-term cover I could find that they qualified for when we lost our health insurance because M was suddenly laid off three months after we arrived in the US.  Because the girls are US citizens, they did not qualify for the insurance policies that are usually offered to incoming immigrants.  And because we had just moved from abroad, they did not qualify for most normal insurance policies which, I discovered to my utter bewilderment, all seemed to have “residency requirements” that disqualified anyone who had not lived in the US for the last 6 to 24 months.  My daughters had both been recently diagnosed with potentially life-threatening food allergies (my elder daughter to eggs, my younger daughter to no less than eight foods, which later rose to 12) which had had a huge impact on our daily lives, and I was desperate to get them onto a good, long-term policy that would give us some peace of mind.  We were still reeling from a string of devastating events that had begun almost as soon as we arrived and had consumed nearly all our mental, physical, and financial resources (besides M losing his job and our insurance, I suddenly developed incredible pain that debilitated me for months before we got on top of it, the medical bills started rolling in and  ate up half our moving fund, we found we had to pay the IRS a huge sum which wiped out the other half of our moving fund, the house we were renting was put the market, we were going through  all the stress, isolation, and disorientation that an international move almost always brings, and it felt like we were doing everything wrong).  Looking for insurance under these circumstances was turning into a nightmare and when I found out the girls qualified for CHIP, the relief  was so strong I burst into tears.

The coverage was excellent; the price surprisingly affordable.  The programme is funded by the state, but administered through a choice of several large insurance companies.  I picked the one that we’d been on with M’s previous job, out of sense of familiarity more than anything, and got the girls signed up as fast as possible.  Each month a bill arrived with bold letters telling me that one missed payment would result in permanent cancellation of the policy — I began sending the premiums in two months in advance just to make sure I never paid that price.  In a world that felt like it was falling apart, knowing the girls had such excellent coverage gave me a sense of stability that I clung to like a rock in a stormy sea.

So as I read that letter — and reread it, and then read it again — all that stability seemed to drain away and the horrid, terrifying, desperation of a year ago rushed in to fill its place.  Could they do this?!?  Could they just casually send me a one-page letter which matter-of-factly stated they were increasing the premiums not once, not twice, not three times, but a full three-and-a-half times what they were now?  No warning, no alternatives, no choice…  This is our only option, this is our salvation!..  Could they do this?!? I rang M up at work and he listened patiently while I told him the news, then began to cry, and then composed myself and told him I’d be alright and thanked him for listening.  My tears were more out of fear and uncertainty; we will  be able to make the new payments (just, and with sacrifices), but it’s what they represented — the lack of control — that put me over the edge.

When I told my mother, she was shocked, then horrified, and then began to rant.  Was this what Obama had in mind for the middle and lower classes?!? Or was it the Governor’s doing?!?  It didn’t seem ethical!  I pointed out that it wasn’t Obama’s doing — his reforms haven’t even taken shape yet, let alone been enacted — and it wasn’t the Governor’s either.  It wasn’t to do with the CHIP programme itself at all.  It was the insurance company’s doing: they take the money the state gives them and then set their price within an approved range — but times are harder now than were before, there are these “increasing financial losses”, and so they’ve raised their price.  And, no, I told her, it didn’t seem ethical… but I don’t know that I think ethics plays any part in this.

I have to admit to feeling rather annoyed with her, to harbouring some deep-set and mostly unjustified feelings of blame.  I had been concerned about healthcare before I moved back to the US… concerned… afraid… frightened…  But my mother and my father and my sister had all assured me that I was making a mountain out of a molehill.  It’s fine, they told me.  It’s a system!  It’s not the system you’re used to, but it’s a system.  As long as you work hard, you’ll be fine.  My husband, I thought to myself, does work very, very hard.  And I do too, in my own way.

My had mother added that she didn’t know anyone who had a healthcare problem.  What about my sister?, I asked, pointing out that she’d gone for years without health insurance, avoiding going to a doctor even when she needed one.  “Oh… yes… ” my mother’s voice trailed off, and then came back again with strength, “But she never had a problem!”  I felt misgivings at that, paused, and then… brushed them aside.  It would be fine.  It would be fine.  …And so if there is blame to laid, perhaps some goes to my mother for closing her eyes to the problem, but some goes to me too for choosing to believe.

There is series of ads for one of the largest insurance companies in the region which they run on television all the time.  It shows someone walking a dog, or jogging, or riding a bike.  At some point the camera closes in on the person, and they look directly into it, before raising a hand and pressing it with palm forward and fingers spread, so that it appears to be just on the other side of the glass of the television screen.  And as the person fades out of focus, the handprint remains, glowing blue and pulsing gently, and a warm and reassuring voiceover says, “Giving you a greater hand in your health.

As I sat there staring at this letter, with its incredible, horrible news, I had to wonder: is that hand meant to be pulling us up… or pushing us away?

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An envelope arrived today from the insurance company and I knew immediately that it would be the paperwork for E2’s trip to the Emergency Room. Every time we’ve got one of these envelopes before, it’s always been bad news — thousands of dollars worth of bad — and so my hand nearly shook as I began to open this one. I quickly scanned past line after line of itemised costs and focused on the big number at the bottom…

Just over $3000.  My heart stopped.  $3000 in one night!

And then I looked over to the box marked “Amount You Owe Provider”. It said $25. I closed my eyes with relief and lent my head back against the wall, and thanked God in his heaven that my kids are covered by the state’s CHIP programme (the only policy that I could find in the entire marketplace that they qualified for). To owe so little for a bill so high is really quite extraordinary here in the US.  Even most “good” policies here would require me to pay a percentage of that amount and the most common split I’ve seen is 80/20. That would put our portion of E2’s impromptu night in hospital at $600 and — with a gas bill that was higher than that last month and M’s hours ever fluctuating — even that reduced amount would have been a crippling bill for us to pay.  And if, God forbid, we’d been uninsured…

This is why I believe, wholly and completely, that the US healthcare system is fatally flawed and needs to be overhauled entirely.  I have heard the arguments for the status quo — argued with passion, most often, by people who have never been in a position of being trapped by their (un)insurance.   I understand the concept of a person neatly choosing the coverage they need, of deciding how much deductible and max-out-of-pocket they want to budget for.  But the reality is simply not that neat.  Most people can’t choose the coverage they want, because their healthcare options are dictated by their employer.  And buying the policy that suits your pocketbook best simply doesn’t work once you have a pre-existing condition — and we will all have one eventually — and so you can no longer pick and choose freely in the marketplace.  And even when you can, the cost of buying that coverage outright is completely prohibitive for most people on average wages.

Buying healthcare coverage is completely unlike any other purchase a person usually makes in their entire lives.  Nothing other than healthcare is so fundamentally compelling — truly life and death — and yet has such devastating potential to create skyrocketing and utterly unmanageable costs literally overnight.  Healthcare provision is quite simply in class by itself and, as such, it has to be treated differently.  To leave to the marketplace as if it were any other ordinary commodity is…  well, is to create an unacceptable situation like the one we’ve got at the moment.

And it’s unacceptable because of this horrifiying thought:  if, when that on-call doctor told me to take E2 to the Emergency Room… if I’d had to think about what 20% of that trip was likely to cost, then I might not have been hesitating solely on account of the snow and my mistaken belief that things weren’t yet that bad.  I might well have been weighing up the doctor’s advice — and my daughter’s well-being — against my wallet.  And if — as so easily could have happened to us — we’d been completely uninsured, I think it’s quite likely that I would have followed my own flawed judgment and waited to see how the night went, and thus brought on all the unthinkable consequences that could have created.

It was not us that night, but there are 47 million others.

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Today I am grateful for:

  1. The very good news that the girls will at last be covered by the state CHIP program come August.  Now I can focus on getting M and I sorted.
  2. A lovely newsy letter from a friend I haven’t heard from in a while.
  3. The peaceful house at naptime.

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It was only when I was tidying a cluttered windowsill today and came across a ticket stub from our flight over that I realised we’ve been in the US six months today. I was more than a bit shocked — I would have thought that today would have loomed larger in my consciousness, but it very nearly slipped by unnoticed. I stopped my tidying and sat down to look at it, feeling that I ought to reflect for a moment to commemorate the milestone.

Except that when I tried to think deep thoughts, I found I didn’t want to.  Not that I couldn’t — that I didn’t want to.  I feel the same way now — I feel like I ought to write a really deep and insightful blog post that will do justice to such a significant day, but I really don’t want to. I don’t want to think about today at all. I just want to let the day go on like any day and then disappear into the past. And… I’m not quite sure why.

I guess the obvious answer is that the last six months have been hard and, if I spent time reflecting on them, I won’t be going over much that brings me much joy.  In the last half-a-year, I’ve spent two-thirds of it in the most incredible pain I’ve known other than childbirth; been poked and prodded by half a dozen different doctors; run up thousands in medical bills; had to restrict my diet so severely to control the pain that I cannot eat out anywhere — indeed, I barely eat at all these days, all the joy has gone out of food, and I lost a stone in about a month; ended up having to skip most social events I’ve had the chance to go to because they take place either in restaurants or in food-centred settings — and therefore have really had trouble making new friends; found out that E2 has multiple food allergies, severe enough to be life-threatening, which further restricted not only her diet but the rest of ours as well; M was laid off; we lost our health insurance;  the two insurance companies we were covered by at the same time began (and still are) arguing about who was primarily responsible for the bills, which resulted in a mountain of paperwork for us several inches deep and a situation that I am having to spend quite a bit of time managing in order to stay on top of; discovered I’d been doing out taxes wrong for years and got hit with a massive tax bill which tore a hole in our house deposit only a few weeks after we arrived; our househunt, which had been centred in one area of the city, came to a complete halt when M was made redundant and then had to be started from scratch all over again in another area of the city when he found another job; we had really frustrating troubles organising a mortgage because our credit histories wouldn’t transfer from Britain; I’ve had no transport of my own and no way of getting anywhere for most of this time and have been completely dependent on my mother; I lost us money just because I didn’t know what I was doing; my mother told me she has skin cancer; and the whole time, the house we’re renting has been up for sale, with prospective buyers trouping through to look at it and the very real possibility that it might sell at any time and we’ll have to scramble to get another roof over our heads.  Looking back, that’s a lot to deal with in such a short space of time.  Combine all that with the upheaval and disorientation of a move as big as we had just done, and all the emotional turmoil that is bound to come with it, and that makes for a six-month period that I’m not much inclined to sit back and reflect on.

But I suspect an even more accurate reason is that if I reflect too much on where we’ve been these last six months, then it begs the question of where we’re going in the future, and I just don’t know and it frightens me to contemplate that. The plan was to move here permanently — to come home at last and put down the roots I’ve been longing for for so many years. But almost immediately we got here, that felt wrong wrong wrong. The place just doesn’t feel like home to M or — much more worryingly — to me. And though I know that’s a classic expat feeling which is to be expected initially, and which will have only been exacerbated by all the things that have gone wrong, it’s left us both feeling more unsure about our future direction than either of us have ever felt in our lives. This was not what was supposed to happen! This is not why we spent all this energy and all this money and made this move! We did this to feel more certain about our future, more settled — not less.

To be fair, there has been a lot of good in the last six months as well — a lot of little moments that have been wonderful.  The girls have grown and changed and filled me with wonder so much in the time we’ve been here.  M has had me in hysterics over and over again as he tries to come to grips with his new country.  We are still together as a family, and — thank God — dealing with all this stress by coming together rather than pulling apart.  And M is changing, as the challenges he’s faced have really stretched him and he’s responded by growing into a stronger and more capable person.  I expect I’ve changed as well, though it’s hard to see in oneself, and don’t know if I’ve handled things by becoming more capable …or more snappy and shrill.

So, there it is — the first six months are over.  No matter what happens from this point, those six months are what they are and nothing will change them.  We can fold them up neatly and put them in our pocket, as experiences both good and bad that we will always carry around with us and which will always be a part of us.  And having finished with them and put them away, I think perhaps we should resolve to simply look to the future, uncertain though it is, and hope that it brings good things.

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