Saturday, September 26, 2009

Sink or swim week in my adoption experience

I adopted a Labrador retriever/Siberian Husky mix from the Humane Society almost two months ago, called Roxy. Roxy's a pretty good dog - housebroken, great with kids, reasonably smart. But she has separation anxiety, and I have been working with the Humane Society trainers on that; in addition, I've had her on anti-anxiety medication (Clomipramine/Clamiprazole). But the past week hasn't been good, and this is an e-mail I sent earlier today to the HSBV trainer:

It's been a while since we spoke about my HSBV adoptee, Roxy. Mainly because work has been hectic, so I have to some extent put off the problem of separation anxiety with doggy day care five days/week. I have got Roxy up to about 5-6 minutes of separation, though I haven't tested longer durations. A couple of times she displayed some anxiety even during those five minutes - she was standing up in her crate as I walked out the door, and whined throughout. On a later try, though, she was initially anxious, but then settled down. I suppose the Clamiprazole (spelling?) should be kicking in about now, which should help.

I was writing mainly to give you a heads-up and ask for any advice you have. This week, Roxy has not been visibly happy to see me - I use her tailwagging as a marker, but one can tell even otherwise. She seems happy to meet random strangers on the road during her walks, or when she enters the Dog Spot and greets Shannon or Ann. But when I go to pick her up, she's less enthused; earlier she used to try and jump on me, but these days it's more a "meh!" attitude. When I try to pet her at home, she's very reluctant to come over, and just turns over and lets me rub her belly or whatever - what I interpret as "let's get this over with." At the same time, if I get up and move around, she keeps an eye on me, which tells me she isn't over her separation anxiety.

I keep thinking of reasons - I am the fun Nazi who doesn't allow her to chase cats/squirrels/hares, takes her away from doggy daycare where she plays; or she's just tired/burnt out from day care that when she gets home, she just wants to curl up and sleep. The only time I see a slow wag is if I have a treat or am taking her out for a walk.

Obviously, I am not too thrilled with the situation, and it's not a good time, given that if I want to have her at doggy day care next week, I'll have to pony up more $$$ (and at $480 for a month...). So I will work with her more over the weekend, and next week it will be sink-or-swim time for Roxy and me. I plan on leaving her at home while I go to work, and if she's OK staying alone, fine. Otherwise - if she's happier with other people, we don't seem to be bonding, and she just "needs" me but doesn't "want" me, I don't see why I should keep pouring my time and money into her. It's like a bad marriage...

Any advice/tips would be appreciated. I'd be happy to come in and talk, if that would help - I really want this to work. She's a great dog otherwise - housebroken, a reasonably good learner, good with my friends' kids.

Sink or swim. [Though as a friend pointed out, since I am already looking at HSBV cats, I might have made up my mind. OTOH, I have also been looking at HSBV dogs for a companion to Roxy if required, so I don't know... She also says that maybe I am just not a dog person, and Roxy senses that. Who knows?!]

Wednesday, September 9, 2009

My (current) take on healthcare reform

Some folks on the left are saying "public option or bust" - no healthcare reform without the public option. I am not so sure this is the right way to go, or even if the public option is such a great deal. Some thoughts on current proposals:

1. Healthcare reform can include a condition of "no pre-existing conditions". This in itself would be a huge improvement over the current state of affairs.
2. #1 necessitates a universal mandate to be "fair" to the insurance companies; if they have to take the sick, they should have adequate "pay-in"s from healthy people.
3. #2 implies federal subsidies for those who can't afford to pay insurance premiums, including expansion of Medicaid.
4. #3 means the money has to come from somewhere - possibly efficiencies in Medicare, including getting rid of "Medicare Advantage" - which would be a loss for insurance companies, but better use of our tax dollars.
5. Removal of annual/lifetime caps on out-of-pocket expenses would be great (what's that about half of current bankruptcies occurring due to medical bills?)

All of these five objectives seem pretty good to me.

Now, #3 can also be taken to mean "we need a public option" to avoid insurance companies increasing premiums/denying care to increase their profits (which already happens). But how will a public option work? Say it can't deny care as freely as private for-profits. That means insurance premiums will likely rise each year (or else we get rationing of care*). Otherwise, the public option operates at a loss, which means subsidies are needed from the federal government to keep the public option solvent. Which means private companies could be driven out of business, and we eventually get to single-payer (if you are a liberal)/a government take0ver of healthcare (if you are a conservative).

* Unlike what Tom Coburn says, a non-profit public option will be less likely to ration care than a for-profit private insurance company for the same premiums.

Couple of other thoughts:
1. If you really want single-payer, say that and work for it - don't be try to force a backdoor entry with the public option.
2. One alternative I like is a universal, minimum-benefits/catastrophic insurance public option. Private companies can offer this level of service, as well as better coverage for higher premiums.
3. If I understand correctly, the public option and other reforms don't even come into effect till 2013 (coincidentally, *after* POTUS election.) So if a triggered-public-option is offered that also comes into effect in 2013 if insurance companies don't clean up their act - why not? One answer offered is that the trigger may be too hard to press (Senator Ben Nelson has already said "we don't want a hair-trigger." We don't want an inoperative trigger either.) So the devil's in the details - the language of the trigger has to be very clear - and impose stringent rules on private insurers.
4. I think the "fees on insurance companies' "Cadillac" plans" is a chicken-s*** way of raising individual taxes, and I am annoyed that liberals like Schumer/Rockefeller and Max Baucus are proposing this. These fees *will* be passed on to the consumer, and likely to *all* consumers. This is a backdoor tax, and I'd rather see a tax on individuals with these Cadillac plans; "if you want this gold-plated option, you gotta pay for it."

I'd love to hear President Obama say #2 in today's speech; it seems similar to what some proposals say, but the message coming out of DC is way too complex and doesn't state this as clearly as I think I have.
As for #3 - I'd be open to setting up non-profit co-ops *now*, and evaluating their performance in 5 years - if they don't work, amalgamate the co-ops into a public option in 2013.