I miss Bree.

Heath Care Debate, Just Put Your Fingers in Your Ears and Hum

The health care debate is something I am really glad I was not in the US to see. I think if I had been there I would have gone into the woods, put my fingers in my ears and hummed. It looked ugly, real ugly, and I still have yet to see a news article that tells me what the new health care bill means. Fortunately Peace Corps was kind enough to send us a summary to help put us out-of-towners back into the loop.

On March 23, 2010, President Obama signed into law the “Patient Protection and Affordable Care Act,” Public Law 111‐148, a complex piece of legislation.

Of particular interest to employees with children is the requirement that health insurance carriers allow adult children to stay on their parents' health care plan until they turn 26, instead of removing them from the policy when they turn 22. The effective date of this provision is the first day of the plan year that is six months following enactment of the law.

Other Highlights
The law will extend health insurance coverage to approximately 32 million Americans who are currently uninsured, making insurance available to an estimated 95 percent of non‐elderly citizens by 2019.

Starting in 2014 and by 2016, citizens must purchase insurance or pay a penalty. The penalty will be $95 in 2014, $325 in 2015 and in 2016 the greater of $695 or 2.5 percent of income. Families will pay half the amount for children, up to a cap of $2,250 per family. After 2016, penalties are indexed to the Consumer Price Index. Subsidies to purchase insurance in the form of tax credits are provided to individuals making up to $43,000 and to families of four making up to $88,000, or 400 percent of the federal poverty level. There is a hardship exemption for poorer Americans.

Health insurance exchanges will be created to make it easier for the self‐employed, the unemployed and small businesses to purchase less expensive coverage. The law would establish 50 insurance marketplaces, administered by the states, with insurance coverage that meets new federal standards. Small businesses with 25 employees or less and average wages of less than $50,000 will qualify for tax credits of up to 50% of the costs of providing health insurance.

Employers are not required to provide health insurance coverage, but the law penalizes companies that do not provide coverage if they have 50 or more employees (full‐time equivalents). The penalty is a tax of $2,000 per employee. However, assistance is provided for mid‐size businesses by exempting the first 30 employees when calculating the tax. For example, a business with 51 employees would pay the $2,000 penalty on only 21 (51‐30) employees for a total of $42,000 instead of $102,000. Waiting periods before insurance takes effect will be limited to 90 days.

Insurance companies will be prevented from denying coverage for pre‐existing conditions, cancelling coverage for sick people, having unlimited out‐of‐pocket expenses and charging higher premiums based on a person’s medical history or gender.

Medicaid would be expanded to cover everyone with income less than 133 percent of the federal poverty level‐‐$29,327 for a family of four.

Medicare prescription drug coverage: Under current law, Medicare stops covering drug costs after more than $2,830 is spent, but starts paying again after an individual’s out‐of‐pocket expenses exceed $4,550. Under the new law, seniors who hit the gap (so‐called “donut hole”) this year would get $250 to help cover the costs of their medications. Starting in 2011, they would receive a 50‐percent discount on brand‐name drugs, with the cost borne by the drug industry. In subsequent years, the discounts would expand and begin covering generic drugs, with the expense picked up by the Government. By 2020, the discounts would reach 75 percent.

Over the next 10 years, the cost of the plan is projected to be $940 billion and to decrease the federal deficit by $143 billion. To pay for the plan, Medicare outlays will be reduced by eliminating waste, fraud and abuse. Starting in 2013, single taxpayers making $200,000 or more and couples earning $250,000 or more will see a 0.9‐percent increase in Medicare payroll taxes and a 3.8‐percent Medicare tax on unearned income. Starting in 2018, a 40‐percent tax will be imposed on insurance companies providing high‐level (so‐called “Cadillac”) plans valued at more than $10,200 for individuals and $27,500 for families. The thresholds are higher for retirees and employees in high‐risk professions ($11,850 for individuals and $30,950 for families).

Major Provisions With Effective Dates

Within 90 days of enactment
Provides access to high‐risk pools for individuals who have no insurance because of pre‐existing conditions.

Within six months
Prohibits insurers from rescinding policies to avoid paying medical bills when a person becomes ill.
Prohibits insurers from denying coverage to children (under the age of 19) who have pre‐existing conditions.
Prohibits insurers from imposing lifetime caps on coverage.

Within a year
Provides a $250 rebate to Medicare prescription drug plan participants whose initial benefits have been exhausted.
Requires new plans to provide coverage for preventive services without co‐pays. All plans must comply by 2018.

2011
Requires individual and small group market insurance plans to spend 80 percent of premium dollars on medical services. Large group plans will have to spend at least 85 percent.

2013
Imposes limits on contributions to flexible spending accounts to $2,500 per year, indexed by the Consumer Price Index in subsequent years.
Increases the Medicare payroll tax and extends the tax to dividends, interest and other unearned income for individuals earning more than $200,000 and joint filers making more than $250,000.
Requires health plans to implement uniform standards for electronic exchange of health information to reduce paperwork and administrative costs.
Eliminates the Employer Medicare Part D deduction for subsidizing prescription drug plans for eligible retirees.

2014
Requires most employers to provide coverage or face penalties.
Requires most people to obtain coverage or face penalties.
Provides subsidies for families earning up to 400 percent of the federal poverty level, or approximately $88,000 a year, to purchase health insurance.

2018
Imposes a 40‐percent tax on high‐end insurance policies.

2019
Expands health insurance coverage to 32 million Americans.

'Beauty Scho....' I'm mean 'Peace Corps Dropout'

Our group started with 18 people. 10 Rural Economic Development (RED); 8 Municipal Services Development (Muni)

Recently we lost our 5th member of the RED group; Munis are still holding strong. So we're down to 13.

I was pondering this and the song 'Beauty School Dropout' from Grease popped into my head.

And so I present this rendition to you in honor of my former companions.

Your story sad to tell,
A twenty-something ne'er do well,
Most mixed up non-delinquent on the cuadra!
Your future's so unclear now,
What's left of your career now?
Can't even get a trade in on your smile!

Angels: (La lalala lalala lalala...)

Peace Corps dropout,
No readjustment allowance for you.
Peace Corps dropout,
Missed your IST and flunked cutting bamboo!
Well at least you could have taken time, to wash and clean
your clothes up,
After spending all that Guarani to have your vecino fix your baño up!

Baby get moving (Baby get movin),
Why keep your feeble hopes alive?
What are you proving (What are you provin)?
You've got the dream but not the drive.

If you ET, you could join the grad pool

Cash in on your airline ticket and go back to studying at the school!

Peace Corps dropout (Peace Corps dropout),
Hanging around the chipa store.
Peace Corps dropout (Peace Corps dropout),
It's about time you knew the score.

Well they couldn't teach you anything,
You think you're such a trail blazer,
But no Paraguayan would go to you unless he was a drunkard!

Baby don't sweat it (Don't sweat it),
You're not cut out to hold the job.
Better forget it (Forget it),
Who wants their Mapa mundial done by a slob?

Now your bangs are curled, your lashes whirled, but still the
world is cruel.
Wipe off that angel face and go back to grad school!

Baby don't blow it,
Don't put my good advice to shame.
Baby you know it,
Even Dear Abby'd say the same!

Now I've called the shot, get off the block, I really gotta fly!
Gotta be going to that, Caña shop, in the sky!

Peace Corps dropout (Peace Corps dropout)
Go back to grad school
Peace Corps dropout (Peace Corps dropout)
Go back to grad school
Peace Corps dropout (Peace Corps dropout)
Go back to grad school....

Tickle Tickle

March of the Ants:

In my last house I had a rat problem. I could hear them running back and forth, scratching at the wood paneling, chasing one another and tumbling around, skweaking and fighting. I also had roaches, which were so big I think they were mice when I heard them scampering around on the floor or in my dresser.

In my new house I still have some roaches, and they still sound like small mice…which is why I keep a can of Raid next to my bed. However I have discovered I may have an ant problem as well.

For the second time, there were so many ants (HUGE ants btw)crawling in the ceiling above my bathroom that they started falling through the cracks. It’s raining ants hallelujah, it’s raining ants. They made me think of the computer game Lemmings…Fall, and walk and walk and walk.

I’ve already dealt with a ceiling that did let actual rain on me during bad weather, but I think the ants are a little more off-setting.

I took my can of Raid, designed for roaches, but has proven itself on crickets, ants, grasshopper, etc and I sprayed into the ceiling. I then heard the sound of THOUSANDS of tiny feet scuttling on the wood above me. The ants continued to fall out of the ceiling but they were writhing around instead of walk, walk, walking.

I avoided the bathroom for the rest of the night and woke up to carnage the next morning. Impressive. No pitter patter of little feet since then.

This little incident however, does not compare to the first night I stayed in my new house.

Prequel: March of the Spiders:

Carly was still living in the house when I moved in; she had about a week left but my host family needed me to leave to make room for the new renters they had found. I set up my mattress on a tarp on the garage floor and laid down to go to sleep.

After a little while I felt something on my arm, figured it was a mosquito, smashed it, the tickle went away, and I went back to trying to sleep. A minute or two pass and I start to feel the tickle again, smack, tickle goes away….tickle tickle….I turn on my flashlight and see that the perp is a small, almost transparent spider, smack. Tickle tickle. WTF! Another spider! So I take my flashlight and shine the beam down the length of my body and mattress. Dozens of little transparent spiders are crawling all over me and the bed. EEEEK!!!!

After quickly getting out of bed and brushing off the spiders I can see, I go to Carly’s bedroom and ask if I can sleep in the queen-sized with her. After she removes the spiders on my back and in my hair, we try to go to bed again.

I felt phantom tickle tickles all night long.

Peace Corps Guilt

I find it a bit funny to be writing about feeling guilty when all I want to do is skip.

Today I made actual progress on getting two projects started. One is a workshop for teachers and other interested people in how to manage a library. The other is a class on how to start a small business for youth.

I’ve been working with a funcionario, Luis, in the Muni for the last month and a half, but things aren’t really progressing. The last notable thing he said to me that last time I met with him was ‘We need to think about how much decorations are going to cost!’ I must mention the schools we want to do the project with haven’t even been informed about it and Luis and I haven’t sat down and discussed any of the details for the plan yet.

Anyway, back to guilt and skipping. Many of the volunteers are extremely nice and caring people who are more than willing to do any and everything possible for their community. Seriously, I know one volunteer who teaches typing classes for 6 hours a day everyday. He works with one student each hour because his personal laptop is the only computer in the community. On the other extreme I know of a volunteer who pretty much didn’t leave her house for a month.

For many of us finding work to fill our days is like trying to catch a butterfly…with a blindfold on….in a lightning storm…on a hilltop. It is a bit frustrating. Most of us have found the Munis we were assigned to be, at the very least, unhelpful or at the worst, outright hostile towards working with us. Trying to find someone to work within the community is equally difficult, especially if the community is small or spread out.

We’re told during training that it may take 3-6 months for us to even begin to start finding projects. I’m in month 8 btw. Even with that in mind however, it is really challenging to take someone used to 9-5 work down to… well you might find work in a few months.

Many volunteers feel guilty because we've been sent to the community that supposedly wants to work with us and yet all we do is fix our houses, do chores, hang out with people in the community, read, read, oh and um read. And if you’re lucky like me, you also get to play on the internet.

We feel like we’re letting PC down, or we’re letting the community down, or we’re letting our fellow volunteers down, or we’re letting ourselves down. We want to DO something. Anything! Please!

Sometimes people back in the states will comment about how what we are doing is so amazing and we doing such a good thing. But when you’ve been twiddling your thumbs for almost a year, that is the last thing you want to hear, because it makes the guilt worse because now you’re letting the people back home down too by not actually doing anything amazing yet.

Damn these gosh darn consciences. Why can’t we just be content to mooch?! But alas…no.

Fortunately many other volunteers are either in this stage or have been through it so there is a good support network in place. But most of us don’t live with other volunteers, so we’re on our own day-to-day, trudging through the trenches.

Volunteers all have their own ways of dealing with this. The most common is just leaving site often. However I really like Campo 9. Not working sucks, but I have a really comfortable life here. When I came to PC and went through training, I told myself that I wasn’t going to do projects on my own. I am very confident in my ability to get things done. I don’t have to prove that to myself. No, I decided that if I was going to do a project someone in the community, other than me, had to be in-charge and I would help. I don’t mind being a facilitator, but I am not here to push my own personal projects through. I have ideas, I’ll let people know what they are but I’m not leading the charge. Not this time. Facilitate, yes, pull all nighters and then be the only one at the meeting. No sir.

With this in mind I promised myself that I would wait until I could work someone. I also promised myself that I would not feel guilty about however long it took for that someone to appear. I would do my part by going out of my house and talking to people and being open to work, but I would not push my own agenda. It would only create unsustainable projects and wouldn’t encourage the Paraguayans to break free from the mini-dictator managements style that dominates business and government…

...And so I’ve been waiting, and reading, and playing with Lila, and doing housework, and cooking really tasty food…and waiting. And so I’ve managed to free myself from most, though admittedly not all, of the PC guilt.

No Worries: Just a Little Ole' State of Emergency

While I doubt this will make major headlines back in the states, there have been some recent events here that may look a bit serious to the outside viewer.

President Lugo declared a state of emergency for the country due to the killing of a police officer and three other individuals in the northern part of the country near Concepcion. A local land reform group that has periodically resorted to violence has taken credit for the attacks. As a part of the state of emergency he has sent additional police forces into that area.

Fortunately I am not anywhere near Concepcion and don’t have any reason to go there. The volunteers in that area have been evacuated to the capital for the time being or on ‘Stand-fast’ which means they aren’t allowed to travel around.

So no worries, PC has it handed for the volunteers in the areas of concern, which thankfully doesn’t include me. My life and travels go on as usual.

Help Ahecha!

I have been working with a group called Ahecha Paraguay, which means, “I see Paraguay” (in Guaraní). It is a participatory photography project that puts digital cameras in the hands of Paraguayan youth and fosters artistic exchange between communities. To date, this project has gone a long way towards promoting artistic expression and boosting self esteem among its participants.

We recently won the Peace Corps technology award for our project and local demand for this project has far exceeded our capacity to provideaccess to camera kits.

The wait list is over a year-and-a-half long & our term is for only 2 years. Meaning volunteers who sign up to participate now, will have to wait until about May 2011 to actually start the project!

This is where you come in! We want to buy some more cameras so that we can continue to grow this successful project – and for that, I need your help.

If you want to help out with this project, please donate through the Peace Corps Partnership Program:

https://www.peacecorps.gov/index.cfm?shell=resources.donors.contribute.projDetail&projdesc=526-200

You can read more about the project details by following that link. All donations are tax-deductible, and please remember that even $10 or $20 goes a long way once you exchange it for the local currency, the Guaraní. Our goal is to raise $4,813 by mid-2010.

For more information about the program, please visit our blog at:

http://ahechaparaguay.blogspot.com/.

To view Ahecha photographs selected for this year's national exhibition, please visit:

http://www.flickr.com/photos/ahechaparaguay/tags/expo/.

Thanks