KOK Edit: Your favorite copyeditor since 1984(SM)
KOK Edit: your favorite copyeditor since 1984(SM) KOK Edit: your favorite copyeditor since 1984(SM) Katharine O'Moore Klopf

Wednesday, May 31, 2006

Killing in God's Name

Fifteen-year-old Alabaman Ava Lowrey received death threats after she created a dramatic animation—WWJD?—that depicts the arrogance of a morally bankrupt president who has said that God told him to start a war in Iraq.

Watch it and weep.

Tuesday, May 23, 2006

"Big Gay GOP Fear Factor Fever"

Parodist Paul HippIf you liked "I Am the Decider" by parodist Paul Hipp, you'll want to hear his slinky new song, "Big Gay GOP Fear Factor Fever."

Surviving the House of AD/HD

If I can survive the House of AD/HD,* where 3 out of 4 males have attention-deficit/hyperactivity disorder, you can too. And now you can proudly tell everyone you're a survivor by wearing T-shirts, drinking from coffee mugs, carrying tote bags, putting up refrigerator magnets, and even giving your dog a shirt, all emblazoned with "I'm surviving in the House of ADHD."

Buy "House of ADHD" merchandise. Design copyright © 2006 by Katharine O'Moore-Klopf.

*When I write, I follow the style of the American Psychiatric Association, which uses the slash to indicate that the hyperactivity part of AD/HD does not occur in all cases. But House of ADHD products don't have the slash in their artwork because the general public is more used to seeing the abbreviation without the slash. There are several subtypes of AD/HD, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: (1) attention-deficit/hyperactivity disorder, combined type; (2) attention-deficit/hyperactivity disorder, predominantly inattentive type; (3) attention-deficit/hyperactivity disorder, predominantly hyperactive-impulsive type. My son Neil and father-in-law A. have type 1, and my husband Ed has type 2.


Monday, May 22, 2006

Disrespecting Veterans: What Health Care?

The health insurance monster has another family in its maw—my friend Martha, her husband Miguel, and their 13-year-old son R. Martha is a full-time freelance writer; Miguel is a self-employed cabinetmaker. They live in upstate New York. Martha tells me:

I just got a notice from our health insurance company.

Because I actually do some work for Miguel—I answer the phone and take messages for him, I balance his checkbook and assemble info for the accountant at tax time—we made his business a partnership. This allows us to get small-group rates for health insurance.

For the past year, we have been paying $786.82 for family coverage, which I simultaneously thought was exorbitant and a bargain.

The group arrangement thing that we belonged to is being canceled. We have our choice among plans that range from $912.78 to $1,276.88 per month. (There are three tiers to choose from, but no explanation as to how they differ.)

Miguel is a Vietnam combat vet who, for myriad and complicated reasons, has never applied for VA [U.S. Department of Veterans Affairs] benefits. Because he inherited some money after his father died, because our house has increased in value since we bought it, and because we manage to live fairly debt free, it is likely that our assets are too high (over $80,000) for him to qualify for VA health care.

Here is what absolutely frosts my shorts: He—and how many millions of other men and women?—risked their fucking lives in service to their country. (Not to mention the 52,000 who died in Vietnam.) And yet if they have $80 grand saved up or make more than $32,000 a year (with one dependent), they don't qualify for health care coverage.

Meanwhile, we have people in Congress who risk getting—what? paper cuts? Getting what kind of health care coverage? Despite incomes of what? With what sort of ceilings on assets? [Most members of Congress pay premiums that are ridiculously low (rate info provided by the U.S. Office of Personnel Management, the human resources department for the federal government) when compared with their salaries.]

That sound is my head exploding.

Although my fury is motivated by our situation, I can't help but wonder about the other Vietnam veterans, as well as the men and women who've served in wars since Vietnam—wars with fewer casualties but with injuries that 30-plus years ago would have been fatal. Injuries that rip apart bodies, spirits, lives; injuries whose recipients do, one hopes, receive some form of medical and financial assistance.

Miguel has an idea of what those injuries are. He saw them in Southeast Asia; he saw them when he returned home and went to the VA to see what he might be eligible for. One of the reasons it's taken him 38 years and a nagging wife to get him to the point where he's actually going to look into this is that conscience will not allow him to take money from an organization with such limited resources when there are people who are in far more desperate need.

Although he wasn't physically wounded, he's lived for decades with stress and anxiety, with the guilt of coming home alive. He is relieved that soldiers today receive therapy as part of their separation, and that they come home as heroes.

Of course, I may be reading the paperwork wrong and there may be some exemption to this $80,000 rule and he may in fact qualify. But I'm not sure how that will affect R. and me. If we can get parent and child rates through Miguel's business as opposed to family rates, we'd pay between $693.70 and $866.46.

I honestly think I can no longer afford to freelance. I hate to have to think about commuting, but our health insurance premiums will have doubled—yes, doubled—in six years. If only our incomes had as well.

What really bites is how few people are aware of how shat-on veterans are.

Many people don't realize that there is a difference between retiring from the military (which you do after 20 years of service) and being discharged (what you do after you are drafted [or enlist] and serve your 2 years of active duty and 4 years of reserve duty). Retired military get better benefits—not great, but better.

It's just the kind of thing you don't think about if it doesn't affect your life. “Soldiers? Oh, they fight, they come home, and if they're wounded, they get taken care of. Don't they? Like, with the VA?"

Apparently, they don’t. Are you listening, George Bush? Senator Clinton? Senator Schumer? State Assemblywoman Nancy Calhoun? State Senator Bill Larkin? Anybody?

Updated June 6: Martha tells me that amazingly, the government's doing the right thing and Miguel now has coverage through the VA. She and their son will have to get a parent-and-child policy, which, where they live, will cost between $600 and $700 a month. Not wonderful, but still barely affordable.

Thursday, May 18, 2006

Fighting for the Little Guy, Part 2

Today's public hearing in the Bronx about the ineptitude and corruption of prescription benefit managers (PBMs, aka mail-order drug companies)—and the need for a New York State law to allow consumers to choose whether to use them—was stupendous! Here's a stream-of-consciousness summary.

Three legislators and a room full of people were riveted when I talked about living in the House of AD/HD and what we have to deal with when my husband Ed's and our son Neil's AD/HD scrips are "lost" or delayed—professional consequences for Ed, interpersonal consequences for all of us as a family, academic consequences for Neil. I talked about how I've been sent too low a dose of the medication I take for hypothyroidism and that at this very moment, Express Scripts (ES, the PBM my family has to use) has just now "found" the scrip for my combo blood pressure–restless leg syndrome med, which it's had for 2 weeks.

I talked about how I lose up to 4 billable work hours a week in hounding ES by phone and/or e-mail. I talked about how we're not "forced" to use ES, but HIP (our HMO) will charge us 50% more for our meds if we take them to the local pharmacy where I would love to go to watch a human being fill our scrips the same day instead of 2 weeks later. In effect, this is financial force used against my family and other HIP subscribers. I talked about how I spend money to send in scrips by UPS, because I think it's insane to trust such things to the U.S. Postal Service, especially the class II controlled substances, for which there is a thriving black market, that Ed and Neil take for their AD/HD. Many times, the signature of the ES person sent to me as proof of delivery by UPS has forced ES to admit that it did receive a scrip it had first told me was "lost."

I think my best line, besides the "House of AD/HD" story (which made everyone laugh and then shake their heads in amazement), was this: "Yes, Express Scripts promises to fill prescriptions within 3 to 5 business days. That's bull hockey!" Cracked everybody up.

Long Island TV news channel 12 was there, so I'm half listening to it now to see if they did a story. (I'd sent the channel and several other news organizations a press release by e-mail ahead of time.)

There was a recorded investigative news report, from a TV station in Texas, that told the story of a heart transplant patient. She was prescribed anti-rejection medication by her doctor. Caremark, another of the big three PBMs in the United States, is the PBM she's forced to use. Caremark took its sweet time filling her prescription. She ended up going more than a week without the medication. It's amazing she's still alive.

There was testimony that PBMs, unlike brick-and-mortar pharmacies, are completely unregulated. Many times, they call prescribing physicians to try to get them to change patients' medications to less expensive ones and include trick language in written communications that end up lowering patients' dosages dangerously when inattentive physicians approve them. They often try to get physicians to change med instructions to include the phrase "take as needed," rather than every so many hours or so many times a day. This effectively decreases the amount of meds that PBMs must dispense and thus the amount of money they must spend. And yes, there was testimony that PBMs jack up the prices of generic drugs by multiple hundreds of percentage points.

There was testimony that PBMs rip off municipalities, unions, and the federal government when they are the med supplier chosen for contracts. (ES alone is under investigation in 19 states, including New York, for this.) PBMs promise these entities huge discounts in the form of rebates to the entities, but when they get the rebates from the big pharmaceuticals, they keep the money and don't hand it over. This is one of the practices that has them under investigation by state attorneys general for fraud. For example, one PBM charged an entity's health care insurance policy subscribers a total of $25,000 for a particular generic medication needed by many. The PBM's actual cost for providing the drug? $7,000. That's obscene.

State Sen. Jeff Klein (34th senatorial district—not my district), sponsor of bill S7610, referred to the Labor Committee of the New York legislature, that would allow state residents to choose where they get their prescription drugs, thanked me profusely for my testimony and asked if I would be willing to testify again at more such public hearings. I said, "You bet!"

Klein's community liaison has promised to provide me with a transcript of today's hearing. Once I have it, I'll post parts of it here, along with my analysis as a consumer; there was so much more than I can remember off the top of my head. (I am merely a medical copyeditor, not a health care professional or medical writer, so keep that in mind when you read my analysis.)

Part 1


Tuesday, May 16, 2006

A Day in the Freelance Life

It ain't all naps and bonbons, being a freelancer. My days often go a lot like the way Amy, my friend and a freelance copyeditor like me, tells me today went for her. Just throw in two young children, change the husband's name, swap the dogs for cats, and her story's mine:

I'm currently juggling five projects. Three had batches that could potentially go out today: one for sure (A) that was ready to go, one for the same client (B) with a few outstanding questions, and one (C) that would be nice to get out so I didn't have to look at it anymore. But C is for the same editor as project D, which has been having a lot of back-and-forth with the publisher, and the author needs to be treated with kid gloves, and the editor is out on vacation until Thursday. I'd like to have C waiting for her when she gets back, and hopefully a few chapters of D, but it's not strictly necessary. And then there's E, whose next batch I'd like to go out tomorrow so I can devote several full days to D.

I get up this morning and finish up B, then send the questions by e-mail. Dive into C. Meanwhile my new e-mail server has gone out, and the tech on live chat assures me that it will be back up soon. Send a note to editor B asking her to copy my old account with her reply. My e-mail eventually comes back up, and editor E e-mails to ask if I can have a batch of it to her tomorrow, as the author is out of town next week. That would be no, as I have only one chapter almost ready, and the other two typemarked only. (I had the remainder of today and tomorrow scheduled for it, to have it ready to ship one day early.) Will she take one chapter tomorrow, or will all three on Thursday be sufficient? Three on Thursday is fine; good, because I don't know how I was going to get B, C, and E ready to go out today. Meanwhile, I realize that I'm still missing some stuff for C that may come today or tomorrow. I finish it as best I can and put it aside. Now editor D's substitute e-mails me with a request from the author to make sure I follow house style on one point. I e-mail back that this conflicts with the special instructions for this project, specifically negating house style, that I already had; which is right? (We've done this already once before on this project.) Dive into E. Editor B responds with answers, and I pack up A and B in the same package. Editor D's sub e-mails to tell me to disregard house style and continue as before. I wrap up the half-done first chapter of batch E and am finally looking at a clean slate.

So phew! A and B are ready, C is on hold, D is waiting for me to finish E, and I have two pristine chapters of E to finish for shipment tomorrow, easy as long as I stay on track.

I have lunch and hang out with [my husband] Boyd and the pups a little bit before he goes to work, and then decide to take a few laps with the lawn mower (after Boyd leaves for work, with my package to drop at the UPS box on the way) before the rain starts again (the weather here has been so wet the last few weeks, I've been thinking of building an ark). I finish two laps through the ankle-high lawn before the storm clouds roll in and the temperature drops. Oh well. I'd better get inside while I still have an Internet connection. As soon as I get to my desk, the connection does indeed go down, but a reboot fixes it. When I check my mail, there's a request for my résumé from a publisher I've never worked for or applied to; she says an editor I did a few jobs for way back when has recommended me. Sweet!

Substitute editor D just called. The project had been an electronic edit originally, but the author (in Japan) is having trouble with showing the tracked changes, so now it's going to be a hard-copy edit. How far along am I on further chapters? Well, I'm almost done with chapter 3; I need to take another pass to try to straighten out the notes, whose numbering system originated on Mars. He says that's great; I can just finish that electronically and send it in, and they'll ship hard copy of the remaining chapters to me tomorrow.

Ah well. I was working out quite a few kinks in my still-being-developed electronic editing procedures, but this will actually help me get the thing done a little faster, I think. I'll de-kink on the next one.

The other day, I picked up a copy of the hardcover NYT best seller that I recently copyedited.

And I have two dogs curled up at my feet under the desk.

So that's why I do it ...

publishing business clients

Sunday, May 14, 2006

A Special Mother's Day's Card

Li and BeckyI want to nominate my daughter's fiancé, Li (pronounced "Lee" and short for Lionel, which is pronounced "Lee-oh-nell"), for best future son-in-law.

This is the note he wrote on the Mother's Day card that he and my daughter, Becky, gave me yesterday:

Happy Momma's Day. Thank you for being cool and understanding with me. Thanks for also having Becky, the future Mrs. Sanchez. Love you, Mom.

Love always,

Is that not adorable?

They'll be married on August 6, my birthday. She is 23; he is about to turn 26.

Saturday, May 13, 2006

Fighting for the Little Guy

On Thursday, May 18, I will strike a blow for New York State residents who are forced, by their health insurance policies, to use prescription benefits managers (PBMs, aka mail-order drug companies). I will testify at a public hearing, held in the Bronx by state senator Jeff Klein (34th senatorial district), sponsor of bill S7610, referred to the Labor Committee of the New York legislature, that would allow state residents to choose where they get their prescription drugs.

How did I end up on the list of consumers who will testify at the hearing? Frank Giancamilli, community liaison for Sen. Klein, found my blog entries about Express Scripts' ineptitude while he was doing research for the bill. He e-mailed me to ask me to testify. I was so glad to have the chance to help that I rearranged my work schedule, working two weekends in a row to make sure my projects are taken care of before I testify.

If this bill becomes law, it means freedom, people! It means freedom from insanely inept and corrupt companies such as Express Scripts, the third largest PBM in the United States. This is the joke of a company that has many times lost or delayed filling my husband’s and son’s prescriptions for medications that treat their attention-deficit/hyperactivity disorder (AD/HD), making life crazy at my house. (You can read all the gory details here, here, here, and here.) It delays filling or loses my prescriptions for Paxil (which I take so that I can survive the House of AD/HD), for clonidine (which treats my hypertension and restless leg syndrome), and for medication that treats my hypothyroidism. If this bill becomes law, my husband Ed and I can take our family’s prescriptions to the local pharmacy, where we can watch people we trust put the proper medications into bottles for us immediately. No longer will I have to spend a good amount of time calling and e-mailing the Express Scripts jokers to prod them into doing their jobs—taking two weeks to fill and ship the prescriptions that they manage not to lose. These people are under investigation in 19 states for fraud, but their lobbyists have convinced legislators in New York State to quash similar legislation for consumer choice in the past.

If you live in New York State, have to deal with PBMs, and can get to the hearing (on May 18, 2006, at 10:00 a.m. at Mercy College, 1200 Waters Place, the Bronx), please come and testify. At the very least, you’ll be entertained by the twilight-zone stories such as mine and that of the female heart patient whom Express Scripts sent Viagra instead of heart medication—and that’s no joke.

Part 2


Friday, May 05, 2006


I'm sick with the cold from hell—throat so sore that swallowing saliva hurts, swollen lymph nodes in my neck, voice pretty much gone, ears feeling stuffed with cotton and on the verge of hurting, and enough phlegm to keep me busy for weeks. And both boys are home from school with the same thing.

Now that I've grossed you out and cheered you up, I'll say good-bye until I'm feeling human again.


Tuesday, May 02, 2006

Racism: Bastante es bastante!

A close relative of mine, near my age and living in Texas, forwarded an e-mail to me from someone she knows, because she agrees with what it said:

After reading some of the reports of the [Day Without Immigrants] walkout yesterday, I got this idea: Why don't we boycott Mexico and anything Mexican on Friday, May 5 (Cinco de Mayo)? That includes Mexican restaurants and anything that may include using "undocumented workers" even if made in this country, such as tortillas from San Antonio, etc. It's hard to know all the occupations where this hidden economy is working, but this would be a start. I know this is a late-coming idea, but I'm hoping others will have the same thoughts.

To carry it further, instead of vacationing in Mexico, why not go to the U.S. Virgin Islands or Puerto Rico, also a U.S. territory, instead? I have been to St. Thomas and San Juan, and can state that the U.S. territories are superior by far, especially since you have the protection of U.S. law. Take this idea and run with it.

Enough is enough! If this unbridled immigration keeps growing, I will have to say, "Basta es basta!"

My relative's friend didn't even bother to get the Spanish right. It's bastante es bastante! (She mixed Italian and Spanish. Basta is Italian for "enough.")

I replied:

You and I will have to agree to disagree on this issue.

The walkout yesterday in New York meant that Southampton, the Long Island resort town full of millionaire movie and rock stars where Ed [my husband] works, had virtually no traffic yesterday. That's because all of the immigrants—whether legal citizens or not—that they pay slave wages to cook, provide child care, landscape estates, staff restaurants, and build gorgeous cabinetry (as Ed does) for them weren't on the job or on their way to work.

Ed works with Marcelo, a legal immigrant from Ecuador who has been trying for years to get the U.S. to allow his wife and daughter, now in kindergarten, to become legal citizens. This guy is talented, works his butt off, and contributes to the economy of this country, yet he's not allowed to have his family here. He is perpetually depressed because he can see them only a couple of times a year, after he's scrimped for months to save up air fare to fly back and spend a few days with them. He came here in the first place to make a better life for his family and hoped to bring them here so they could all have a better life together. But the process of becoming a U.S. citizen became even more insane after 9/11, so his daughter may very well be an adolescent or even an adult before she's living here. He doesn't have the money it takes to pay off the proper government officials to get them here quickly.

The U.S. makes it just about impossible to become a legal citizen these days. It's no wonder, then, that many immigrants get fed up and just remain here illegally.

Ed and I feel so strongly about this that we bought twenty bumper stickers and two T-shirts for Marcelo and his brother, also a legal citizen, to use for yesterday's demonstration in Manhattan. Ed, as foreman, gladly gave Marcelo the day off work (mind you, Marcelo didn't even take a vacation day—he took an unpaid personal day) so that he could join the demonstration in Manhattan. Ever since Marcelo was hired, Ed has stuck up for him at work and gotten him decent pay for a beginner cabinetmaker.

We will be putting bumper stickers on our cars that read "America: A Nation of Immigrants" and "Legalize—Don't Criminalize—Immigrants" because we know that immigrants are not taking jobs away from U.S.-born citizens. Most nonimmigrants won't take the low wages and long hours and the scut work that immigrants are given.

We also know that the big fuss over immigrants has racism at its base, pure and simple. Even Li (Lionel), our future son-in-law who is Puerto Rican, encounters people who assume he's an immigrant who speaks no English and treat him as if he's unintelligent or to be feared.

My relative replied:

Yes, as usual, we are polar opposites.

We live in a place where we cannot even expect to get information in English. Even the teller machines are bilingual.

We will have to disagree on this one, although I won't be buying any shirts or bumper stickers.

What I want to say to my relative but can't, if I want her ever to speak to me again (and I'm not sure I do), is this:

Um ... hello! If the instructions on the teller machines are bilingual and you're in Texas, I know damn well that one of the languages is English, so you are getting information in English. Our ancestors were immigrants, from Ireland, Scotland, French Romania, and so many other places. If they hadn't come to the U.S., you wouldn't exist. You are a member of the white privileged class. But our ancestors, when they came to this country, were reviled and treated as less than human, just as you see Latino immigrants. How would you have felt had you been of our ancestors' generations? Would you not have wanted a chance to make a good life for yourself here? Would you have thought it appropriate that you be treated as subhuman?

Racism—bastante es bastante!

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