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Wednesday, November 30, 2016

Health Insurance Woes PP

HIST 3478 - Medicine and Health in US History

Title PP - Health Insurance Woes

Slide 1 - Paying for health

  • Rise of medical establishment via hospitals
  • More people getting access to treatments especially via outpatient department
  • Problem of getting $$$ payment for services

Slide 2 - Solution: Hospital Prepayment Plans

  • Monthly charge for hospital services
  • 1929 A "principal of insurance against the costs of health care." - AHA
  • Blue Cross - Covers hospitals charges
  • Blue Shield - Covers doctors' charges

Slide 3 - Blue Cross Blue Shield Association image

  • BlueCross BlueShield Logo. Digital image. BlueCross BlueShield Association. Accessed 11/23/2016. https://www.bcbs.com.
  • 1st Healthcare insurance developed, nonprofit turned private
  • Blue Cross and Blue Shield combine in 1982

Slide 4 - Cost Sharing & Cutting Cost

  • Deductibles - A specific amount of money the insured must pay out of pocket before coverage kicks in.
  • Copayment - A fixed fee that patients covered by health insurance must pay themselves for a given medical service, usually at the time the service is given.
  • Experience rating - Statistical factors used to adjust health insurance according to sex, age, race, or other factors.
  • Rescission - Canceling insurance coverage, often done in the past to those who hid preexisting health conditions or once an individual hit 65 years old.
  • Prior condition exclusion - Insurance coverage is not given to those with already existing health problems.

Slide 5 - Cartoon image about Major medical

  • Hoffman, Beatrix. Health Care for Some: Rights and Rationing in the United States since 1930. Chicago: University of Chicago Press, 2012. p. 110.
  • Cartoon shows that because of cost sharing, major insurance coverage often feels like minor/no insurance coverage.

Slide 6 - Patient Protection Affordable Care Act (PPACA)

  • Previous prior condition exclusion removed
  • Coverage expanded to a larger group of people, more $$$ needed
  • Cost sharing galore to balance out new costs - deductibles and copay
  • ONLY solution is compulsory, everyone must chip in

Tuesday, November 29, 2016

2nd essay for CORC class - Freudian Mythology [Draft]

Greek mythology has some of the most disturbing stories in written literature. The endless capabilities of human depravity are on full display. Yet despite the horror of these grotesque stories, they fascinate humans. Ideas behind some of these myths continue to influence modern media produced in the present. The strength of these stories lies not in the grotesque gore, but in the mental depiction of people. Freudian theory splits the human mind into three categories: Id, Superego, and Ego. The Id is the base, animalistic part that desires pleasure. The Superego is a system of morals and values incorporated in one’s identity to encourage socially acceptable behavior. The Ego works the middle ground trying to satisfy the Id in the safest way. All three categories work in combination to produce the human condition. Three particular Greek myths that illustrate the dynamics of Freudian psychology are Euripides’ Bacchae, Seneca’s Thyestes, and Ovid’s Metamorphoses. From these stories are three characters: Pentheus, Atreus, and Myrrha that each suffer from a mental problem.
            Pentheus’ insanity in the Bacchae demonstrates the failure of the Ego. When Pentheus first appears he comes with the role of authority. As king of Thebes, he is responsible for maintaining the order within the borders of his kingdom. An important step as king is to know the actions of one’s subjects. Thus, when he attempts to hear about the peculiar “strange new evils” occurring he is confining in the socially acceptable role of leadership[1]. This act of statesmanship is his Superego on full display. Underneath this authoritarian stance of strict order and stability lurks Pentheus’ Id. Although the Ego tries to contain the Id, glimpses of it peek out during the conversation between Pentheus and Tiresias. At the end of Pentheus’ threats towards Tiresias, Pentheus states, “For whenever the liquid joy of the grape comes into women’s festivals, then, I assure you, there’s nothing wholesome in their rites.”[2] This discussion about the maenads’ role in festivals comes from out of nowhere. The sentence right before that was a low-key threat to toss Tiresias into prison. Tiresias even notices Pentheus’ strange obsession with women and goes afar as to say that Pentheus is insane.[3] As the story continues, more of Pentheus’ sexual obsessions leak out.
            When Pentheus converses with Dionysus, the Id continues to seep out of the Ego’s containment until it spills out completely like a flood and takes over. The early signs of a loss of control are evident in Pentheus’ consistent references towards women.[4] He keeps bringing up the idea of promiscuous women even when discussing the punishment of Dionysus, going as far as to suggest making the maenads his slaves. However, Id trickling out in Pentheus’ first meeting with Dionysus does not compare to the flood unleashed during the second meeting. At the second meeting, once Dionysus gives the suggestion to “see those women,” Pentheus is enveloped and transformed by his Id.[5] His previous kingly position is nothing but a fleeting vestige of his former self. He is transformed into a cross dressing voyeur with the desire to watch the maenads fornicating. The primitive urges of pleasure won out over logic and reasoning.
            Atreus’ hesitation about the revenge plan against his brother, Thyestes, indicates the presence of the Superego. At the beginning Atreus is shown as a cunning and malicious actor ready to murder his own nephews in cold blood. Yet at the top of page 58 of Seneca’s Thyestes, he is wracked with self-doubt. This sudden fear in his heart was the Superego trying to maintain Atreus’ morality.[6] Even after he calms down and proceeds to plan out how he will lure Thyestes, he is again struck by his self-conscious.[7] The Superego is making a last ditch effort to deter Atreus. The self-conscious mortality within his heart is screaming out for him to stop. However, he steels his nerves and presses on. The Superego fails and as a result, Atreus’ Ego begins to fall in line with his Id.
            The final and ultimate act of transformation for Atreus comes right before he slaughters Thyestes’ sons. After he gives the funeral prayers, the palace is “rocked over the trembling earth” and “tears drip from ivory in the temples.”[8] While these signs are interpreted as the disfavor of the Gods, they can also been seen as indicating the transformation of Atreus into a beast. Indeed the text even highlights his new appearance as one akin to a “hungry tiger in an Indian forest.”[9] Atreus’ Id finally won out. He then proceeds to murder Thyestes’ three sons in cold blood without any hint of remorse. Again he is compared to an animal, this time a lion, to demonstrate his new bestial nature.[10] Gone are the previous hesitations of the Superego that brought terror to his heart. The Thyestean feast commences.
            Myrrha’s ego faces a similar battle between the mortality of the Superego and the desire of the Id. She secretly lusts for her father, but understands how such desires are immoral. Her Superego reflects society’s standards. Therefore it is quite telling that the story of Cinyras and Myrrha opens with the line, “Cinyras; had he been childless, he might have been a happier man.”[11] The society’s view of incestuous father-daughter relations is that it would have been better for the daughter to never be born. Myrrha’s only effective solution would be suicide. However, she tries to avoid taking that route by focusing all her effort on suppressing her desires. She holds backs “this sin” thorough deep thoughts, wondering how this passion of hers came to be and wishing for these “foolish fancies” to leave her alone.[12] Her Superego applies continuous pressure towards her Ego to prevent her from acting upon her Id.
            Despite all of Myrrha’s efforts, she finally gives into her lust for her father. She is pushed to this breaking point over time, which results in a complete collapse of her Superego. For a while she managed to hold on by suppressing her desires through introspection. However, once Myrrha could take it no longer she was led once again to her last fatal choice. The nursemaid who prevents Myrrha from committing suicide came at the opportune moment when the Superego was in shambles, preparing for a suicide that never happened. Thus, the Ego had full reign for the moment. The Ego’s priority was survival and Myrrha was looking for a way out besides suicide. She ended up telling her tale to the nursemaid, who functioned in a similar manner to the Ego by allowing Myrrha to safely satisfy her passions.
            All three characters, Pentheus, Atreus, and Myrrha demonstrate the Freudian battle among the Id, Superego, and Ego. Pentheus’ Ego was overcome by his overwhelming Id. His own sexual desire was projected on others. In the end he became a victim of his own primal urges. Atreus’ Superego came out in an active attempt to prevent him from committing a horrendous atrocity against his brother. Unfortunately, he strengthened his heart and committed himself to ignoring the voices of mortality within his mind. The result was Atreus’ transformation into an animalistic beast, only capable of craving revenge. Myrrha differed from both Pentheus and Atreus because her Ego managed to satisfy her desires without her being consumed by her Id. The internal conflicts within these characters demonstrate the powerful Freudian forces that humans face when making vital decisions.




[1] Euripides, Bacchae, line 214.
[2] Ibid., lines 260-2.
[3] “Your tongue runs smooth like a wheel, as if you were a man of reason, but your words reveal no reason.” Ibid., lines 268-9.
[4] Ibid., lines 487, 512-14, 786, 796,
[5] Ibid., line 811.
[6] Seneca, Thyestes, p. 58.
[7] Ibid., p. 60.
[8] Ibid., p. 76.
[9] Ibid.
[10] Ibid., p. 77.
[11] Ovid, Metamorphoses: The Story of Cinyras and Myrrha, p. 243.
[12] Ibid., p. 244-5.

Friday, November 25, 2016

2nd essay for CORC class - Freudian Mythology [Outline]

Freudian Mythology

Thesis: Euripides’ Bacchae, Seneca’s Thyestes, and Ovid’s Metamorphoses all demonstrate the hidden psychology of Freudian theory.

Freudian theory: Id = Instincts – pleasure, primitive beast; Superego = Morality – Motivation to follow socially acceptable behavior; Ego = Reality – conscious + unconscious, satisfies demands of Id in safe way.

Bacchae – Pentheus’ insanity          
Thyestes – Atreus’ inner battle
Metamorphoses – Myrrha’s demons

Pentheus’ ego from the Bacchae

      I.         Introduction
    II.         Bacchae – Pentheus’ insanity
A.     Ego can’t satisfy the Id à Trying to maintain order in the name of authority
B.     Id takes over with impulses of peeping à Cross dressing and wanting to look
  III.         Thyestes – Atreus’ inner battle
A.     Atreus’s superego à unsure about murder of his nephews?
B.     Id takes over à Darkness of heart wins out, the Thyestean feast
   IV.         Metamorphoses – Myrrha’s demons
A.     Myrrha’s superego à Staying away from her father, trying to keep to herself
B.     Id takes over à Fornication with father
     V.         Conclusion

Pentheus’ insanity in the Bacchae demonstrates the failure of the Ego.

The Id completely takes over Pentheus and he becomes a perverted beast.

Atreus’ hesitation about the revenge plan against his brother, Thyestes, indicates the presence of the Superego.

Atreus’ Id finally wins out and the Thyestean feast commences.

Myrrha’s ego faces a similar battle between the mortality of the superego and the desire of the Id.


She finally gives into her lust for her father with the help of the nursemaid.

Thursday, November 24, 2016

Health Insurance Woes Report [Final]

Medical care in the US considerably higher than in other countries; the question that arises often is why? The answer lies in health finances. Health insurance was a payment system designed to facilitate medical reimbursement. However with the rise in costs and demands for greater coverage, health insurance became its own special, complex monetary beast. Companies initiated more measures to prevent insurance abuse and run away expenses. They also began to discriminate certain groups based on health factors and possible future liability. These problems of health insurance demonstrate the necessity of compulsory healthcare.
            The rise of modern science propelled the increase in medical cost to newfound heights. New diagnostic medical inventions such as x-rays and CAT scans were complex and expensive equipment. New specialized preparation methods for surgery focused on asepsis and antisepsis. New staff organizations could adequately care for a battery of different fatal illnesses. The hospital was central to the increase of public access to these latest scientific developments.[1] However at the same time the patients were gaining greater access to the fruits of science, they found themselves unable to pay for hospital services. Drastic treatment for patients with acute problems such as appendectomy is expensive upfront and needs to be paid off like credit debt.[2] Those without the wherewithal to pay often found themselves buried in hospital bills. Knowing the expense, some patients refused to pay for services.[3] The inability of hospitals to be reimbursed for their services placed considerable pressure on them to develop payment plans.
            With escalating medical expenses, health insurance became vital to paying off medical costs. The first systems of health insurance were referred to as “hospital prepayment plans.”[4] The American Hospital Association (AHA) envisioned these plans in 1929 as “the principle of insurance against the costs of hospital care.”[5] The popularity of the plans paved way for the development of Blue Cross, an insurance for hospital charges. However, Blue Cross covered only hospital bills not doctors’ fees, which led to patient complaints. The solution was another prepayment plan for doctor fees called Blue Shield. Both of these prepayment plans would eventually become private insurance associations. In 1982, the two separate groups, Blue Cross and Blue Shield, combined to form the Blue Cross Blue Shield Association.[6] However, Blue Cross and Blue Shield faced growing competition from other commercial insurance companies who lowering their premiums using “cost sharing” methods.
            As the years progressed insurance companies were faced with a financial dilemma. Technological innovations of scientific research continued to raise treatment costs. This trend, in combination with a call for greater coverage, strained finances. The original financial plan was for the monthly premiums to cover medical expenses. However, insurance coverage was reaching a larger population. This provided both the benefit of a larger pool of premiums to draw on and the detriment of covering the treatment for a larger pool of patients. The rise in costs was outpacing the growth in revenue. Onto the scene came major medical insurance with cost sharing.[7] Cost sharing balanced out price with more coverage. The basic idea behind cost sharing was to increase the patients’ stake in their own treatment. This out of pocket payment was to prevent patients from overusing health services. Out of this principle came the deductible and copayment. The deductible was “a specific amount of money the insured must pay out of pocket before coverage kicks in.”[8] This idea was intended to prevent patients from being able to immediately use health insurance after purchase. The copayment was “a fixed fee that patients covered by health insurance must pay themselves for a given medical service, usually at the time the service is given.”[9] This concept was to prevent patients from abusing health services after their coverage kicks in.
            The cost sharing measures were often implemented with other insurance measures design to keep expenses low. One method was to discriminate health insurance coverage and premiums based on prior health conditions. This practice fell under the purview of what was classified as “experience rating,” varying insurance plans according to “the particular health conditions and experience of the individual or group.”[10] Another method of keeping costs down under the experience rating was racial and gender discrimination. There were assumptions of women as the weaker gender and more prone to health hazards. Blacks were also statistically shown to suffer from diseases at a higher rate than Whites, a health disparity that continues to affect them to this day. Added to the experience rating was the practice of rescission, canceling insurance coverage.[11] This was practiced often for individual insurance holders especially when they hit the age of 65. The result was that a considerably portion of the elderly were left without health insurance coverage.
            Current US healthcare predicaments involve the same issues that remain unresolved. As new technologies continue to fascinate the American public, the costs continue to climb making the politics around healthcare as one of cost rather than coverage. The recent Patient Protection and Affordable Care Act (PPACA) under the Obama administration has eliminated some of insurance companies cost cutting measures such as excluding patients with preexisting health conditions, but left in place deductibles and copayments. With the new coverage for those with preexisting health conditions the general overall health insurance premiums are expected to rise and/or the deductibles and copayments for new patients are expected to increase. However, the compulsory status of health insurance is a first step towards keeping health expenses down. With more healthy people getting insurance we can hope for benefits in the long run.


[1] William Bynum, The History of Medicine: A Very Short Introduction (Oxford: Oxford University Press, 2008), 124-126.
[2] Philip M. Boffey, “The Money Traps in US Health Care,” New York Times, Jan. 22, 2012.
[3] Beatrix Hoffman, Health Care for Some: Rights and Rationing in the United States since 1930 (Chicago: University of Chicago Press, 2012), 33-34.
[4] Ibid., 34.
[5] Ibid.
[6] Blue Cross Blue Shield Association. "An Industry Pioneer." Blue Cross Blue Shield. Accessed November 21, 2016. https://www.bcbs.com/about-us/industry-pioneer.
[7] Beatrix Hoffman, "Restraining the Health Care Consumer: The History of Deductibles and Co-Payments in U. S. Health Insurance," Social Science History 30, no. 4 (2006): 504.
[8] Hoffman, Health Care for Some, 105.
[9] Ibid., 266.
[10] Ibid.
[11] Ibid., 97.