On the other hand... insurance companies come up with the wildest excuses for not covering something. Fortunately this one has been taken care of and generally my insurance company is actually pretty good. But this one is just too much. I recently found out that they wouldn't cover a generic medicine that is actually pretty cheap (about $12 for a month if I bought it cash from the pharmacy), but they had been covering it for a long time with no problem and all of a sudden out of the blue they wanted prior authorization and then I received this today, which doesn't even seem to coincide well with the prior authorization requirement excuse:
"We denied this request because:
Ths medication is currently at the lowest possible copay and further copay lowering cannot be approved. Providing a lower tier copay for this medication is excluded under the terms of your EOC (Evidence of Coverage)."
Huh? Since when did I ask for a lower copay? Where did that come from? I swear they pull these things out from a hat or something. ("Let's see, which will it be this time...").
And the real ironic thing? When I went to pick it up and went to pay for it (before I got this letter and knew anything about this denial reason), the clerk told me I didn't need to pay so then I thought I must be in my catastrophic coverage for the year already, when I've paid enough in co-pays that I don't need to pay any more so all my prescriptions medicines are free. (This is for Medicare and Medicare advantage plans in the USA.) So it's a bit ironic that my copay could actually get less, like zero. Sorry, guys, you just denied my claim in vain (although I never made such a claim to begin with, so I don't know where it came from).
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This is a historic moment... well, at least historic as far as this blog is concerned. I have actually, believe it or not, actually completed the Organizational Behavior file. This file is much smaller, but hopefully will be enough to pack a punch, or at least get a point across. As the title of the post indicates, the file is titled "Culture Shock." The significance of this file is that that is what the military chaplain/Vienna mission H.R. director accused me of 5 months into my stay with the mission although my stance always has been that I was doing just great in Vienna, it's the mission I was having problems with and I always did have problems with the mission until the day I left. I'll just leave it at that for now, although I've said more in other places already in this blog.This first article is actually from someone from the University of Miami, although I'm not sure if he's still here, or still alive, for that matter.
Befus, Consance P. (1988). A multilevel treatment approach for culture shock experienced by sojourners. International Journal of Intercultural Relations, 12(4), 381-400.
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"Culture shock may be briefly defined as that period of transition and adjustment during which a person who has been relocated experiences some degree of anxiety, confusion, and disruption related to living in the new culture. (p. 381)
That's a brief definition to get us started.
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The author discusses several perspectives on culture shock an the behavioral view struck me as interesting regarding my situation with the mission:
"The behavioral view of cultural shock is advocated by Kenneth David (1972, 1976). He explains that the problems of cross-cultural adjustment may be viewed as a consequence of punishment found in the new host culture. The punishment consists of either a removed reinforcer, which the sojourner was accustomed to having in the home culture, or an aversive stimulus, which is often the result of not knowing how to act appropriately in the new environment. The solution of this problem, David suggests, is that the sojourner should learn the stimulous cues of the new culture, so as to avoid aversive stimuli, should transfer as many reinforcers as possible from the previous culture, and should develop a repertoire of as many new reinforcers as possible in the new environment." (p.384)
So the thing was to get to know the Vienna mission culture. Although I was working with mostly fellow Americans of the same faith I found it generally easier to understand the Austrians than my fellow Vienna mission colleagues. Was there really possibly a removed reinforcer that made it impossible for me to understand my fellow mission workers? What kind of reinforcer might that be? I suppose it would be something from church since we were in church work. So I'd have to think through that and maybe there could be adverse stimuli also. These would all take a lot of thought.
The thing that I have the problem with though is that this assumes a certain naivete with the mission, that it's just there minding it's own business and all these differences are just happenstance and everyone would be just as surprised as I would be to learn that they exist. I know to much for that to sit well with me.
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"A second cause of stress for the sojourner could be called 'lifestyle adaptation,' and concerns the many behaviors which make the sojourner feel either at home and comfortable or homesick and unhappy. David's (1972, 1976) writings on behavioral view of culture shock have aptly described and analyzed how sojourners feel 'punished' by missing familiar contacts and activities and by confusing interactions in the new country. His suggestion that sojourners learn a new repertoire of positively reinforcing behaviors seems logical. Unfortunately, most sojourners do not know how to go about reorganizing their behaviors for maximal adjustment in a foreign country; they need guidance in how to do so." (p. 386)The ironic thing was that I was, as I've repeatedly said, getting along find in Austria. I was not homesick. I now have all my letters to mom and I can go through them and quickly find if there's anything smacking of homesickness, but I'm 100% sure there wasn't because I was doing fine in Austria itself. I got around okay by myself okay and went to an Austrian church.
If you're new here, you don't know that I was in Europe in 1981 for 5 months and 1983 for 6 months. In 1983 I was in Austria for about 3 months of those 6. And the Vienna mission wanted to make it out that I had culture shock when I didn't. What I had was mission shock. That is, I was doing fine in Austria, but not so well in the mission. So that's what the culture shock file is all about.
I never felt "punished" by missing familiar contacts and activities or any of that stuff.
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"In addition to all of the above, few sojourners can avoid some physiological reactions to (a) relocations and (b) the stressors occurring on the intellectual, behavioral, and emotional levels described above. Thus the sojourner's body.....may experience symptoms associated with psychological distress - such as fatigue, asthma, hives, headaches, or ulcers." (p. 386)I did start getting headaches and even asthma from the stress, but that can hardly be blamed on Austria. I did admit to a couple people that I was feeling the stress and I remember being given some suggestions, such as jogging and also a herbal remedy. It may be that that is what eventually was what drove them to want to send me home, but they told me it was culture shock, and they were very explicit about it and used an article complete with chart showing the stages of culture shock the over the months of time one is abroad.
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Here's the updated definition:"[C]ulture shock is an adjustment reaction syndrome caused by cumulative, multiple and interactive stress in the intellectual, behavioral, emotional, and psychological levels of a person recently relocated to an unfamiliar culture, and is characterized by a variety of symptoms of psychological stress." (p. 387)
