You Are Not Weird

I went Google fishing the other day using the other day using the phrase, “I have a weird job.” What I wanted was people confessing to sanding dildos and training spiders. What I got was people with pretty normal jobs who posted things that were a little silly and had no context.

For example, Austin journalist Emily DePrang posted this image of her inbox subject lines:

These are mildly amusing. One of them uses the word ‘abortion’ in a casual, jokey way, which, OMG, edgy. Way to freak out the squares. The other makes a pun using a well-known 40-year-old song. Nobody has ever done that.

This was the top result and it pains me how boring it is. Other not weird job results include a radio DJ posting the amusing, out of context names of sound clips; Jonah Goldberg misunderstanding the concept; somebody building what I assume is a thermin (my sound is off because courtesy); Jennifer Lawrence; a guy who updates a website that sells electric bikes with really specific guidelines; some guy from Fox Sports who thinks Hulk hands are about the weirdest thing ever; and plenty more mild to unusual situations in pretty mundane jobs.

I did find one legitimately weird job. A brief video where someone rubs paint on another person’s belly and they rub around on a piece of butcher paper. Whether the person is the rubber or the rubbee, that’s weird to have that as a job.

The thing is, people aren’t that weird. Being in a job where you have to come up with entertainment is not that weird. Writing amusing subject lines with co-workers or having a phone call about a giant squid being treated like a rare leopard for pretending really well is not that weird. There may be weird situations and things that, when shown out of context, seem absurd. But you aren’t weird.

A lot of the people who claim weirdness in these situations are actually super normal, boring people. I hate to break it to you. These are high achieving professionals who have colored within the lines in order to achieve a profession that is stimulating and has some variety. People who are legit weird usually don’t get that kind of notice unless it’s negative. But the concept of being “weird” or “crazy” has some cultural cachet, the idea of the mad genius, who taps into some sort of person ley line to draw out an unseen truth, who lives life truer than the rest of us.

I see with the stand-up specials on Netflix. Anytime someone uses the word “crazy” or “weird” in the title of their special, I think, “Man, this guy is gonna be boring.” The two that come to mind are Jeff Dunham’s “Spark of Insanity” and Donald Glover’s “Weirdo.” There’s also one called “Completely Normal” by a guy named Tom Segura, but I have no idea what he’s like, so I won’t talk shit about him. But the other guys, whoa. Jeff Dunham is probably the biggest offender. He does a ventriloquist act for the blue collar comedy tour set. Pretty straight down home stereotype stuff about cranky old people and terrorists. But he does it with his hand up a puppet, so whoa, watch out world. Donald Glover, who I like as a person, is just sort of boring on there. It seems like a guy with a showbiz career trying to branch out.

Painfully Normal.
Painfully Normal.

I get miffed about people claiming weird, because I know some weirdos. I know a guy who once obsessed about the Fibonacci series so much that he incorporated it into doodles and chord progressions. I know a guy who has a semi-mystical philosophy that’s equal parts quantum physics and Aleister Crowley. I’ve met folks who make their livings as dominants and submissives, but without any sex. I know a guy who makes ambient noise music and when I met him, offered me a few drops of his custom tincture of mood altering herbs and supplements. These are proper weird people and none of them would ever say that they themselves are weird.

People who are actually weird don’t advertise it. They don’t have to, because they don’t care if they are weird. They just do the things that interest them, public image be damned. We all can learn a lot from our local weirdos.

 

Why Isn’t My Doctor in My ACA Network?

When I quit my job last May, I also quit my health insurance plan. Not on purpose, really. Like every other health plan I’ve been on during my adult life, it was provided and mostly paid for through my employer. But now that I am footloose and fancy freelance, I’ve got to pay for my own insurance. So I got one through the Affordable Care Act (ACA) exchanges.

I paid a little extra to get a plan that had both my primary care physician and the ENT who has been making my sinuses slightly less terrible. But when I got my insurance card, I had a different physician listed. At the ENT office, they seemed surprised that they were even listed there. “We’re not in any of the ACA networks,” they said. “We’re already in so many networks that it’s not worth it.”

I liked those doctors a lot. But none of them are in any ACA networks. And they aren’t the only ones. According to a study by Avalere Health, plans offered through the ACA exchanges have 34% less providers than the average employer-based or individual non-exchange plan. So you may be able to keep your doctor if you like them, you just have to pay full price for services.

According a report by the Robert Wood Johnson Foundation, 40% of ACA plans are considered small or extra small – that means that less than 25% of available providers are within their networks. I’m lucky; I live in New York City, so I can find another primary care provider nearby. But can you imagine the huge hassle it must be if you live in a small town? 25% of doctors could be one.

Insurance companies are narrowing networks in order to lower the rates they charge. They get pickier about the doctors they use – they want a high quality to efficiency ratio. On the face of it, that seems pretty good, right? You get solid, waste-free doctors, sawbones who get the job done without cost overruns.

But this isn’t exactly right. When the insurance companies narrow their networks to lower costs, it’s not just because they are being choosy. The costs go down because they reimburse less for procedures. Doctors will join these narrow networks because the limited number of available doctors means that more patients will be sent to each individual practice. Narrow networks create volume-based health care providers.

So why are some doctors not on any ACA networks at all?

“The exchanges have become very much like Medicaid,” says Andrew Kleinman, president of the Medical Society of the State of New York . “Physicians who are in solo practices have to be careful to not take too many patients reimbursed at lower rates or they’re not going to be in business very long.”

The short answer is that doctors who take a lot of ACA patients like me will go broke. Now that we get to see the actual costs of insurance instead of having secretly tacked on to the end of our pay as a benefit, we want cheaper plans. But that means lower reimbursements to doctors (the whole reimbursement dance is clusterfuck for another post), which means less doctors sign up. Klienman says the reimbursement rates can be less than 50% of what the commercial plans pay. Plus there the huge deductible you have to burn through before insurance kicks in a pays anything.

On top of that, I have a 90-day grace period for my insurance payments, but the insurer won’t pay reimbursements unless my account is paid up. Doctors on the network have to take me, but won’t get paid until I remember to write that check.

We’re creating a two-tiered system for insurance. People like people who don’t get insurance through their job have less access to providers. On top of that, we get access to doctors who are willing to take lower rates for more patients – either doctors without enough patients, those willing to run a volume business, or new doctors. Single payer, where for art thou?

I still thought I was getting what I wanted. But no, the directory was wrong. And that’s a growing problem. Brian Hoyt, managing director at Berkeley Research Group, wrote in a recent white paper that “Provider directory inaccuracies represent a growing and significant risk both to consumers and health plans. Inaccurate directory information may limit a consumer’s ability to verify if a preferred doctor is in-network, or to know how many and what types of providers would have to be accessed under a particular product offering.”

These inaccuracies have led to lawsuits against the insurance providers. Which is going to raise my health insurance premiums.

I know this is the beginning of a new system. Under the old system, I would have gone for the cheapest plan possible, which was no insurance at all. This way, at least I’m covered if I get hit by a car and they find a brain tumor. But I’m less likely to consider getting that checkup to catch the tumor early.