The Rise Of High Deductible Insurance Plans: How Your Health Insurance Company Keeps Finding New Ways To Lessen Your Care and Make More Money

The Rise Of High Deductible Insurance Plans: How Your Health Insurance Company Keeps Finding New Ways To Lessen Your Care and Make More Money

I wanted to write a really short blog post about a phenomenon I've been noticing more and more in my work: the rise of high-deductible insurance plans. (If you're bored by this topic, may I suggest my last blog post).

What is a high-deductible insurance plan?

Essentially it's this: you don't actually get any health insurance until you meet deductible of several thousand dollars first. For most of us under 50, that means we are essentially getting no insurance even though we often pay a high monthly premium. 

How does this work? Let's say you go to a doctor for a bad back, for an annual physical and because you get pneumonia in a given year. And let's say all those doctor's visits total up to $2000. But unfortunately, because you have an ACA plan (otherwise known as Obamacare), your deductible is $3000. And that means you are fitting the bill for all those visits, despite paying a premium monthly of $250 or more a month. That's right, your insurance doesn't pay a thing. Quite frankly it's a joke. 

The Status Quo Is Not Good Enough: A Philosophy Of Grace

The Status Quo Is Not Good Enough: A Philosophy Of Grace

Being a "liberal" has turned into pejorative for me these days. It's a vacuous moral philosophy in my humble opinion, which falls apart when it's actually tested. Liberalism says that it believes in the liberty and equality regardless of race, class, gender or creed. But in reality, if many liberals are pushed, they turn out to be as conservative as anyone and will look for themselves or their tribe first and foremost. 

I see it in school segregation even in liberal Brooklyn Heights. Or in the Upper West Side.  Or in housing desegregation in this city.  The people who get to enjoy the American Dream often are reluctant give up any of it for the betterment of humanity. Only their family or tribe matters. Not the common good. 

Yes, I am a socialist and I think that's part of the solution. But it's really only a small part of it. I The bigger solution is a radical shift in values. Fundamentally I think that shift is religious in nature. This religious shift is not tied to any religion per se. I think of it as a philosophy of grace. 

Rollo May: Quotes From A Great Existential Psychotherapist

I've been reading some Rollo May and have been blown away by the depth and insight of his thought. I thought I'd share some of his quotes for you to enjoy: 

"Anxiety is an even better teacher than reality, for one can temporarily evade reality by avoiding the distasteful situation; but anxiety is a source of education always present because one carries it within." -The Meaning of Anxiety (1950)

"Therapy isn't curing somebody of something; it is a means of helping a person explore himself, his life, his consciousness. My purpose as a therapist is to find out what it means to be human. Every human being must have a point at which he stands against the culture, where he says, "This is me and the world be damned!" Leaders have always been the ones to stand against the society — SocratesChristFreud, all the way down the line." - As quoted in Marriage Today : Problems, Issues, and Alternatives (1977) by James E. De Burger, p. 444

The human being cannot live in a condition of emptiness for very long: if he is not growing toward something, he does not merely stagnate; the pent-up potentialities turn into morbidity and despair, and eventually into destructive activities.- Man's Search For Himself (1953)

Vanity and narcissism — the compulsive need to be admired and praised — undermine one's courage, for one then fights on someone else's conviction rather than one's own. - Man's Search For Himself (1953)

To love means to open ourselves to the negative as well as the positive — to grief, sorrow, and disappointment as well as to joy, fulfillment, and an intensity of consciousness we did not know was possible before.- Love and Will (1969)

Art is a substitute for violence. The same impulses that drive persons to violence — the hunger for meaning, the need for ecstasy, the impulse to risk all — drive the artist to create. He is by nature our archrebel. … the essence of the rebellion is in the new way of seeing nature and life. - Power and Innocent (1972)  

David Platt And Rejecting The American Dream


I don't have a lot of time or energy to write anything in depth today, but I wanted to share an interview with a pastor named David Platt, who is a Christian pastor out of Alabama. 

If you follow this blog at all, you'll know that I am no Christian. I do admire Jesus greatly but I generally think that Christianity has done far more harm than good on the earth. The message of the gospels has been bastardized throughout the centuries. And today in America, it has taken on maybe one of it's ugliest forms: the prosperity gospel.

I was drawn to the work of David Platt in part because he rejects the prosperity gospel and any reading of the bible based on material wealth. As he says in an interview with Christian Post: 

"There is obviously a cultural and historical disconnect between us, 21st century America, and the disciples in the first century. As a result of that, there are a lot of things that we tend to cloud our Christianity with that unknowingly, in many cases, miss the entire point of the gospel.

I think with the way we have unprecedented material blessing, with the way we have a culture built on self, self-esteem, self-confidence. All of these things we begin to twist the gospel into something that it is not. We make it look like us and fit into our lifestyle instead of adjusting our lifestyle to the gospel. In the process we make following Jesus more American than it is biblical. "

Platt's big insight, it seems to me, is that modern American culture and the classical liberalism of Edmund Burke is built on the edifice of the self; but that the spirit of Christianity has little of anything to do with the self. It has to do with sacrifice and surrender to a great power. 

There's a lot to love about this notion. After all, every great religion at some point is built on submission of the ego to the power of a higher power. It's a quaint notion to have faith today, though, as God has died for many of us. But I wonder, maybe a new form of spirituality needs to be found where a higher power isn't the center... it's something I plan to write about for many years to come.  

The World Is Better Than Ever. Why Are We Miserable?

The World Is Better Than Ever. Why Are We Miserable?

Andrew Sullivan recently published an interesting piece in New York Magazine called, "The World Is Better Than Ever. Why Are We Miserable?" It is a topic I've written extensively about on this blog. 

Sullivan wonders out loud if everything seems to be getting better, as Steven Pinker argues, why does everyone seem so unhappy? Why are drug use, anxiety, depression, loneliness so ubiquitous?  It's a great question. 

Sullivan's answer is

"As we have slowly and surely attained more progress, we have lost something that undergirds all of it: meaning, cohesion, and a different, deeper kind of happiness than the satiation of all our earthly needs. We’ve forgotten the human flourishing that comes from a common idea of virtue, and a concept of virtue that is based on our nature. This is the core of Deneen’s argument, and it rests on a different, classical, pre-liberal understanding of freedom. For most of the Ancients, freedom was freedom from our natural desires and material needs. It rested on a mastery of these deep, natural urges in favor of self-control, restraint, and education into virtue. It placed the community — the polis — ahead of the individual, and indeed could not conceive of the individual apart from the community into which he or she was born. They’d look at our freedom and see licentiousness, chaos, and slavery to desire. They’d predict misery not happiness to be the result."

It's All Absurd: Albert Camus and The Meaninglessness of Life

It's All Absurd: Albert Camus and The Meaninglessness of Life

“Man stands face to face with the irrational. He feels within him his longing for happiness and for reason. The absurd is born of this confrontation between the human need and the unreasonable silence of the world.” -Albert Camus

I'm making my way through Camus's "The Myth Of Sisyphus" currently. It's a fascinating book, mostly because I find that my existential worldview and his matchup rather well...

I do not think life has meaning. That is probably blasphemous for a psychotherapist to say. But I believe that meaning is largely a human concoction. The outside world is terrifying and makes little sense for most animals. Survival is the only true imperative. Everything is built around this.

Because of this terror and the deep anxiety we feel, our species seeks unity and understanding to make sense of our experiences. This is what a narrative is. Each of us tells a narrative to ourselves about our life. In this way, it makes sense to us. Human existence can be described as finding unity where there is none. 

Most human narratives fall apart on examination. I think about my own life. I was blissful about my own narrative for too long, well into my adulthood, until I tasted real suffering for the first time. Once that happened, my narrative exploded. The course of my life was thrown off course.

I see this continually with my patients as well. It's not necessarily the event that is painful for them but that the narrative they have has been destroyed. And suddenly their lives feel out of control. And suddenly anxiety fills them up. 

The Art of Listening: 3 Steps To Becoming A Better Listener

The Art of Listening: 3 Steps To Becoming A Better Listener

How many times when you're speaking to a friend or spouse do you speak over them? I'm guessing you think "not very often." I certainly did, not only among my friends but among my patients.

But recently I did an experiment. In an effort to improve my listening skills in therapy, I started to note all the times I interrupted a patient during a session. Like most people, I thought too highly of myself and my own abilities! Surely I'd find that I rarely interrupted people. I'm a therapist after all. That means I'm a great listener. 

As you can probably guess, I interrupted my patients far more often than I'd like to admit. Some of it was necessary. I can think of a few people who tend to shame themselves often, and the need to interrupt that kind of thinking is often necessary. But often it wasn't. It was hardly malicious. Often I just had a comment on something they said, and I didn't wait till they were done. 

But interrupting was not a good thing. At its best, I was adding to the conversation but stunting a complete thought from my patient. At it's worse I was not letting my patient be heard. This had to change. 

Advertising Is Making You Unhappy

Advertising Is Making You Unhappy

"Advertising at its best is making people feel that without their product, you're a loser. Kids are very sensitive to that. If you tell them to buy something, they are resistant. But if you tell them that they'll be a dork if they don't, you've got their attention. You open up emotional vulnerabilities, and it's very easy to do with kids because they're the most emotionally vulnerable." - Nancy Shalek, advertising head of the Shalek Agency

I'm happier today than I've ever been in my adult life. I say this not to brag; more so it surprised me when I reflected on it. There are a number of reasons for this change. For one, I've become eternally grateful for the life I have because I know how fragile it is and how it changes. Suffering awaits all of us. So I try to be present with the joy I feel right now. This is my version of a spiritual life. Also, I work for myself, doing work I absolutely love. That has been a game changer from the grind of the 9-5. 

But there has been another underrated aspect to my newfound happiness: the lack of advertising in my life. Sometime in the last year, I started to watch a lot less television, and it's the point now where I maybe watch 2 hours a week. This doesn't make me better than anyone of course, but I knew I wanted to read and write a lot more, and that watching television would just distract me. 

How To Be More Emotionally Attuned in Life And Therapy

How To Be More Emotionally Attuned in Life And Therapy

I've been thinking and reading a lot about the idea of emotional attunement. Emotional attunement means not only being in tune with yourself but with the people around you.  It's a hard skill to master.

I often think the when problems arise in a relationship, whether it's therapeutic, a friendship or romantic, it is because we are lacking emotional attunement with our own feelings as well with the other.  This leads to disconnection. And disconnection means a feeling of loneliness and unbelonging, which is are the seeds of real depression. 

How Do We Become More Emotionally Attuned? 

The first step, I think, in any of this is being in tune with one's emotions. How do we learn to be in tune with our emotions? Mindfulness is often the first step. To check in with our feelings when we're sad, or lonely and anxious, to notice them and meet them with compassion sounds simple but much harder to do in practice. Mindfulness can be aided by a real meditation practice. Meditation helps us remain open to our feelings as they arise. 

Therapy is also important. A good therapeutic relationship will help us know ourselves and what we haven't been able to express in our everyday lives. Therapy will help us dig into all those unwanted feelings we have that have pushed deep down, and that need real love and compassion to unearth. This sort of attunement can change every relationship we have. 

Meaning vs. Happiness

Meaning vs. Happiness

I've given a lot of thought to depression lately. How politics influences it. How we maybe have gotten a lot of the causes it around it wrong, and that our current solution-- to medicate one's self out of depression-- is misguided and misses the point. That there's a reason that so many people are depressed and that suicide rates are rising at alarming rates.

I think part of the problem is distinguishing between happiness and meaningfulness. Happiness implies a life of pleasure. It means being able to sleep in late, and drink with friends and travel and buy things that you want. It's a life of thrills and leisure. It is about the individual. It is about making us feel some sort of joy. It often does not concern the rest of the world but concerns the self above all else. 

Meaning is a different ball of wax. I turn to Aristotle and his concept of "Eudaimonia," which is often mistranslated as "happiness" but implies much more. It suggests a meaningful life isn't selfish but has selfless elements. It implies virtue and sacrifice but also kindness and good relationships. It has little to do with materialism and the accumulation of wealth. 

I think this part of where the problem lies. Our culture stresses individualism as a way to reach happiness. Success and fame and wealth are overvalued and rarely seen for its superficiality.  Our world tells us over and over "this is happiness" in magazines, in movies and even the news. But maybe happiness is overrated. And maybe what happiness is often at odds with what is meaningful.