The real economic freedom in America

On Monday, Barack Obama delivered his second Inaugural Address. While the Right and the Left will argue over what was said there, here is the passage that I think embraces the struggle over not only “entitlements,” but of wages and unions, the dignity of work and the value of one’s life over another.

We, the people, still believe that every citizen deserves a basic measure of security and dignity. We must make the hard choices to reduce the cost of health care and the size of our deficit. But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future. For we remember the lessons of our past, when twilight years were spent in poverty, and parents of a child with a disability had nowhere to turn. We do not believe that in this country, freedom is reserved for the lucky, or happiness for the few. We recognize that no matter how responsibly we live our lives, any one of us, at any time, may face a job loss, or a sudden illness, or a home swept away in a terrible storm. The commitments we make to each other – through Medicare, and Medicaid, and Social Security – these things do not sap our initiative; they strengthen us. They do not make us a nation of takers; they free us to take the risks that make this country great.

Systems that take care of our common needs free us to contribute more deeply. Teachers just want to teach, welders want weld. They do not want to be fighting their employers for job security, a livable wage or decent working conditions. That is why we need unions. The energy teachers spend fending off the barbarians nipping at their heels is energy that saps them from being outstanding teachers. Same with artists, poets, writers, musicians, journalists and philosophers. They just want to create, not worry and fight about making enough to make a living. When we rob them of their work, we rob ourselves of our own cultural advancement.

Doctors want to treat patients, not fill out forms, run small businesses and fight insurance companies. Every battle with an insurance agent robs us all of that doctor’s potential contribution to advancing health care to its exception.

Most of us will get old. Most of us will need medical care. All of us need education. When we free ourselves of that worry of how we will gain an education, survive our old age and our health, we free ourselves to live and contribute more deeply. This is not a liberal idea; this is a community idea. This is one area that our government can and should help us achieve.

It is not about cost. It is not about socialism. It is not about creating a nation of takers or Welfare Queens. It is about extracting excellence from citizens by freeing them from the anxiety of old age, student loan debt and bankruptcy due to ill health.

We should keep in mind that when the Founders drafted those documents Conservatives claw back to some almost two hundred fifty years ago, they were looking toward the future and seeing us as we are today. Perhaps we should honor them by looking forward to the country the United States of America will be in the next two hundred fifty years instead of pining to get back to the good ol’ days of the Founders.

Why every private sector company should want single-payer, Medicare-for-all

Yesterday, I made a call to Verizon Wireless to cancel my MiFi card. At $59.99 per month for unlimited use, it was an expense I could live without. But I won’t be saving that money for long.

In March, I am expecting Anthem BCBS of Ohio to increase my health insurance premiums at least 20%. I still have to find about $100.00 in savings I am paying some other private-sector company to break even with where I am today. I may have to stop eating organic food.

I’m most definitely not buying an iPad Mini.

“Why are you canceling your MiFi service?” the woman on the other end asked me, expecting some service issue she could happily resolve with some equipment upgrade.

“Well, I am fixing to transfer some more wealth to the private insurance company, BCBS, that the good folks at the GOP are saying is my freedom of choice,” I explained. “You know, if we had single-payer, Medicare-for-all, we wouldn’t be having this conversation. Pretty soon, the medical industry will have all the money we might be paying you.”

With incomes being flat and no sign of them rising, us middle-aged, middle-class folk will have to get the money from somewhere to pay for our medical care. The private-sector medical industry doesn’t show any slowing for their appetite for increasing costs.

If you are a private sector company, why are you not supporting single-payer, Medicare-for-all? In ten years when you wonder why your customers have no money, won’t you at least wonder why the medical services industry is the only growth industry?

Something to think about.

Emergency rooms, magical thinking, and the poor

Emergency Room

To hear Mitt Romney (and many others) tell it, Emergency Rooms are the physical embodiment of Mother Theresa, treating indigents like Jesus treated the lepers. The great seas of health care are suddenly parted for the poor and ill, and outstanding bills just miraculously become absorbed into the ether of write-off’s and tax exemptions.

This type of magical health care thinking isn’t limited to multi-millionaire politicians. Many in the public also believe ER’s effectively fill the wide gap between sickness and insurance. It’s a fallacy that has become so engrained that its standard line — get sick, get treated by an ER, get the tab picked up by someone else — goes nearly undisputed by those on both the right and the left.

That’s simply not the way it works.

Setting aside the fact that ER’s are not mandated to treat what their doctors may consider a non-emergency — a subject which merits its own, separate discussion — many uninsured ER patients find themselves saddled with bills they can’t hope to pay. These bills are not just from the hospital, but from outside physicians, diagnostic services, and laboratories, none of whom are mandated to treat the indigent or uninsured for free.

Depending upon the state and the hospital, uninsured patients may meet with a hospital social worker who will have them fill out forms for state aid or other programs. There is no guarantee of approval, and even when someone does qualify, benefits may not extend to other services rendered in the course of care.

On a trip across the US, I spoke to several people in dire straights due to medical debt. One of them was a homeless man in his 30s. John M. was a single laborer who was working a temp job when he was hit with over $8,000 in medical bills for non-work related wound that had led to a staph infection. In the hospital, he met with a social worker who helped him apply for aid. Later, he received notice that he didn’t qualify due to his income and status as a single person. The bills started pouring in, not just from the hospital, but from doctors whose names he didn’t recognize and labs that had processed his tests.

When bills like John’s go unpaid, hospitals and other businesses may “write them off,” but contrary to what many people may believe, this does not mean that they disappear. Collection agencies buy such debts for pennies on the dollar and then may vigorously pursue the patient-debtor, through judgments, wage garnishments, and bank account liens. To add to the confusion, medical debts can be bought and sold many times over, involving an almost incomprehensible string of collection agencies.

Like many people with medical debt, John attempted to work with the collection agencies on a payment plan, but there were too many of them, each demanding that their bill take precedence. Desperate for relief, John went to an agency that specializes in helping debtors reach payment agreements and was told he didn’t make enough to carry the minimum monthly payment that would be required. At that point, John considered filing for bankruptcy, but he couldn’t afford the attorney’s fees.

Four years after his illness, with his credit ruined and with several court judgments against him, John’s low wages were garnished and he could no longer afford his rent. He applied for a second job as a cashier at a home goods store and was told that they’d run his credit report as a matter of practice. It was the same at other places he applied. While he was never told why he wasn’t hired, he suspected that his low score had something to do with the lack of call-backs, particularly since he’d never had such a problem finding a minimum wage job before.

John scrambled for a cheaper place to live, but none of them were cheap enough to make up for the loss of wages, and all of them required better credit than his. He was told he’d need a cosigner or a larger deposit, neither of which he had. Feeling he had no choice, John quit his job and found work with another temp agency, hoping to outrun his garnishment and at least catch up on his rent. Within two months, the collection agencies had found his new place of employment and set the wheels in motion to collect their pay. John was eventually evicted. Jobless, he lived out of his 14 year-old truck for a while, but then his truck died and he couldn’t afford repairs. He sold it for scrap so that he could eat. He showed up at the county day labor office every weekday, hoping to make enough money to rent a motel room. Sometimes there was work, sometimes there wasn’t. Sometimes he slept in shelters, but many times he slept in the streets. When winter got to be too much, he scraped together enough to take a bus to a warmer climate. When I met him, he was among many of Florida’s homeless and his prospects for crawling out of the hole were dimmer than ever.

Of course, not all stories are as extreme as John’s, but the fact that some are is a stark reminder of how easily a life can be unraveled, particularly when medical debt can bring a host of life-altering consequences.

Some people do end up qualifying for State programs, and there are some hospitals which have developed their own foundations to assist in care, but there’s no national uniformity to the system. While an uninsured person at one hospital may qualify to have their ER charges reduced or paid for by another entity, another person, at another hospital, may not.

In any case, medical debt is on the rise and collection agencies are becoming increasingly aggressive in pursuing debtors.

The Commonwealth Fund, a private foundation that sponsors health care research, estimates that 22 million Americans were contacted by collection agencies for unpaid medical bills in 2005. That increased to 30 million Americans in 2010. – March 2012, USA Today

As the article in USA Today points out, credit may be wrecked even when medical debt is paid. Slow and late payments can stay on records for seven years, and as much as ten if there is a judgment involved. There is also a valid and growing concern that collection agencies are misusing the court system to have debtors thrown in jail, adding the element of warrants and jail time to people’s background checks which, like poor credit, may diminish their future employment and housing opportunities. Poverty by itself is a vicious cycle that is difficult to escape. Adding collections, garnishments, judgments, bad credit, and arrests to the list of obstacles can make it nearly impossible. In the bigger picture, it would seem to do more harm to our economy and social structure to keep people locked in the cycle of medical debt for years on end, rather than to offer them a real solution.

Despite receiving tax exemptions to care for the uninsured and poor, some hospitals have gone so far as to sue these patients for what they are owed. Others, as noted, turn their debts over to collection agencies. In the mix are the outside services which are not given the same exemptions, and which aren’t subject to the same guidelines.

The result of all of this is that both patients and the medical care industry are suffering, while collection agencies are growing richer. By 2007, the number of collection agents had doubled from the early 1990s, while industry revenue tripled to $15 billion (on $40 billion in collected debt).

So, no, emergency rooms are not the answer for America’s sick and uninsured. The illness that’s treated today should not result in years of financial consequences, which not only affects individuals, but society as a whole. To what end is a culture that binds people to medical debt in ways that may cost them their homes, jobs, and futures? To what end is a medical system that only increases the need for shelters, welfare, and other social services — while burdening the healthcare industry with millions of dollars in extra costs? An America that grows poverty is not as valuable as an America that grows potential. Anyone who would argue against that is as short-sighted as they are unreasonable.

A calculation almost every American man over fifty has made in his head

There is one calculation that almost every American man over fifty* has made in his head that he will almost never admit to. The ones who have made it more than once and many times a year are the ones who have families and responsibilities who now find themselves at the scary end of a medical diagnosis and/or the threat or reality of unemployment.

That calculation is:

Am I worth more dead than alive?

….

The columns and totals never really see a piece of paper, but they are nonetheless very real.

In the assets column:
That term life insurance that has five more years before it expires and has no value: $250,000.00; Cash in the bank: $50,000.00; That 401(k) I started too late; $30,000.00; Stocks and bonds I randomly bought; $35,000.00; House equity, assuming it can actually be sold in this economy: $100,000.00… and on through the value of furniture, cars and power tools in the garage.

In the liabilities column:
I just got fired, so my unemployment is only $481.00 a week but bills with mortgage and food is $2,100 a month, losing $200.00 a month… I’ll soon lose my health insurance and COBRA is a $900.00 set back per month making that $1,100.00 a month just standing still… if I am unemployed for more than six months, that will be about $10,000.00 gone from the bank account, making the past couple years of savings a waste of time… chances are, I will be unemployed for the rest of my life in this economy, so that will just stretch on, losing my family $20,000.00 a year with me being alive. I will lose my health coverage in less than a year and a half… That is a lot of cash, and that life insurance policy just inched its way to being one year less valuable with no employment in sight…

I just got diagnosed with a pretty serious health condition that will make it difficult for me to work. I will soon be out of a job as my employer will get tired of me calling in sick all the time… I will lose my health care coverage.. if I go into the hospital, that will cost about $8,000.00 a day, depleting my cash in about a week… the mortgage is due in a week… the last tuition bill is due in a couple months… and on and on down to how much dog food is left and how much that will cost to replenish…

If I die today, my family will be ok. If I die in a year or two, my family will be bankrupt, penniless and possibly homeless.

Sure, the kids will say that I am worth more to them alive than dead, regardless of how much money I have. Yeah, “I love you even if you are broke,” “you bring joy to others around you” and “life is not always about money” are things I expect to hear from friends and family.

But I know they are not true. Not really.

Our culture rewards those who are healthy and able to work and shuns those who have fallen on hard times. It guts the sick, dying and unemployed quickly in order to salvage what it can before the corpse begins to rot. It knows the time value of money.

Men know it too. We have made those calculations in our head at every turn throughout our lives. When we buy a house, we calculate how long we’ll have to be employed at this job to pay the mortgage in full. When we have kids, we calculate what we’ll have to earn and sock away to pay for the birthday parties, soccer practice, bicycles, cars and college tuition even as we watch them laugh and dance as if they haven’t a care in the world; even as we laugh and dance with them. We worry our backs and minds will give out before we are able to deliver them into adulthood and breath a sigh of relief when we no longer have to be concerned they won’t have enough to eat.

When we get to about fifty, we eventually make the ultimate calculation. We arrive at a break-even, whether anyone wants us to or not; whether we admit it or not.

The only thing we fear more than getting it wrong is losing the ability to execute if we ever needed to.

*With the exception of highly-paid politicians or the super-rich who never have to worry about health care. For clarification, this isn’t me. I’m fine and gainfully employed at my own company despite my best efforts at getting my boss to fire me 🙂 This is a persona of a 50+ year old man who had a “good job” for most of his life.

The naked truth about health insurance

Supreme Court Building

Supreme Court Building

The Supreme Court of the United States of America just listened to three days of argument as to whether or not the recent Affordable Care Act (ACA) is Constitutional. Central to the twenty-six States’ argument is that the Federal government can not compel its citizen to purchase something they they do want to buy.

Like these opponents of the ACA, I have a big problem with the Federal government telling me what I should and should not be buying. But I have an even bigger problem with my fellow citizens who insist on sucking out only the benefits of citizenship without shouldering any of the responsibilities. In short, we should never be at a juncture where the government is forced to make us play nice with each other.

What affects you, affects me. The United States of America is our community and we should never cede control to a government because we can’t figure out how to take care of each other.

Solve that problem and you have a small government.

But I digress.

What we are calling health insurance is not really insurance. It is just a way to pay for health care. Mandating citizens buy health insurance is not at all like forcing them to buy car insurance. Not buying health insurance is an act of denial by some that their bodies will not get sick or injured.

If we want to stick with an automobile metaphor, it is more like being in denial about changing your car’s oil and expecting it to run simply because the oil is healthy today. Ignoring your health care by pretending you will always be healthy only acknowledges you are healthy today but ignores the fact that your body wears over time. Like oil, some bodies break down faster than others. Sometimes, the oil pan gets punctured even when the driver is careful.

In other words, illness and injury are a certitude with a human body. It’s just a matter of when. No business worth a damn capitalizes based on certain loss.

The current health insurance market is unsustainable and the industry knows it. What nobody is saying is that the health insurance companies were unsuccessful at selling insurance to young, healthy people, so they lobbied to get this group covered — and paid for — by their parents. That took care of that group while Medicare takes care of the older group they didn’t want to cover. Now, the only the group left are middle-aged people who are getting fired left and right by employers, thereby getting dropped from coverage.

Individual plans? These are gawd awful expensive for anyone over 45 so most just drop coverage and pray they don’t get cancer or a heart attack. If the ACA is struck down, in ten years there will be nobody left to buy health insurance.

Insurance companies know this.

The ACA gives them 20-30 years to transition their business model. Without it, they probably have fewer than ten years before they will all be frantically merging, trying to pool assets and mitigate losses. The argument against the individual mandate is being driven by the very wealthy, the very healthy and the already Medicare-serviced. Selfish pack of idiots.

You just need to be paying attention halfway with half a brain to figure this out. It just is not that hard. The morality of providing health care or the constitutionality of forcing us to pay for something does not even need to be part of the argument.

The business model is simply unsustainable.

A middle-aged, middle America impression of OccupyWallStreet

I’m a middle-aged mutt in this wasteland between the two coasts commonly known as Middle America. Most of the United States lives here, but we rarely — ok never — get asked about important things like politics and the economy. We are the gun-toting, Bible-banging, slack-jawed, under-educated, corn-fed, polyester-wearing yahoos that the liberal media like to make fun of and Wall Street dismisses.

That is a little harsh. Ok, fair enough. I’ve seen my neighbors in their natural habitat (Kroger during wine and cheese hour) so I get where you’re all coming from. But just because we are out here in your idea of Wastelands doesn’t mean we are any less important and informed as you are.

Try to keep up.

What I know by getting to middle-age
There never was a Middle Class in America. We only ever had two classes; the Rich and Those Who Expected to be Rich (ETBR). It is the American Carrot, that thing that gets dangled in front of us to keep all of us reaching for more. The Middle Class was always a nebulous scale of the lower Rich and the upper ETBR which ebbed and flowed depending on the economy at the time. The indicator of where you were was how much wealth you had relative to what others had.

Equity (or wealth if you want) is a very cold, harsh ledger. There are only two ways you can grow it; invest Liquidity or Time.

For example, if you buy a house, you can add equity only one of two ways: put more cash into the place to quickly reduce the amount of mortgage debt OR accept more mortgage debt and increase equity over time, holding your breath the entire time, hoping the equity will eventually exceed the amount of money you have put in. When the equity teeter-tots over to the asset column, you now have wealth. (Unless others around you get foreclosed on, but we’ll get to that.)

The same thing with those who financed a college degree. They expected that even though the degree cost more than most peoples’ houses, they would get a job and over time, not only pay off the loans but make more than the average salary. (They should have bought a calculator first)

It’s just not that complicated. Most people in the ETBR class have a whole lot more time than liquidity. They trade their time all day long for liquidity with wages, mortgages, three easy monthly payments, etc. The Rich class can choose liquidity or time, depending on the rate of return. A slow rate of return means they can use time. A fast rate of return, they use liquidity. The ETBR class does not really have that choice (or more accurately, the degree of choice is scaled depending on the ratio of liquidity to time one has.)

The lack of choice is mostly what pisses the ETBR off most. This generation thought they had time. They were wrong.

This “law of economics” is about as rock solid as the law of gravity. You can ignore it or deny it, but it is still going to affect you.

People without liquidity tried to accelerate time. People with some liquidity but — not enough — tried to expand the value of each liquid unit too fast. Eventually, the ETBR ran out out time before they had a firm grasp on equity and lost it all. When you are clinging to a rock face on a mountain by your fingertips, when you fall, you don’t just slip; you fall all the way down. It does not matter if you are ten feet up the mountain or ten feet from the summit. (Did you catch that? I equated laws of economics to gravity. Genius. I should be ruling the world by now. Roll your eyes if you got ’em.)

How this all ties into #OccupyWallStreet
I do not support Anonymous or Adbusters. I am not a big fan of the fist-pumping, kill Wall Street bankers rhetoric and other hippy crap like stuffing dollar bills in your mouth and marching like zombies. Sanctimonious hipsters with no life experience annoy me, too. It is unsettling to us out here that the OccupyWallStreet “non-leadership” has connections with these groups if only that they decide unilaterallty who is good and who is bad. I like steak, but the fifth “fact” in their Declaration gives me pause that reads, “PeTA is invited to join us.” All of a sudden, now my support for OccupyWallStreet means I support PeTA? Hell no!

Just because I lean to what this country defines as “left” does not mean I hang with the crazy-left. For the record, people claiming the right of human dignity is not a left-leaning principle. Groups that use terror tactics for good scare the hell out of me just as much as those who use them for evil. In the end game, “there is no good or evil; there is only power.

And she is very, very seductive.

To the middle-class middle America, if a group like Anonymous can target a big bad corporation, what is stopping them from concluding — unilaterally — a mom-and-pop business is supporting a big bad corporation (like Visa) for taking credit cards as payment? I understand how the affiliation is feeding Visa, but the rain nourishes the grass and weeds alike. It is incumbent upon groups like Anonymous to make sure the rain falls on the grass and not the weeds if they choose to pee all over my garden without my consent.

I believe the 1% are and have been exploiting their advantage of liquidity to enhance their fortunes. I also believe the 99% have been exploiting their victimization caused by their unwillingness to learn and adapt to the law of economics stated above.

Money finds the path of least resistance. It is what keeps corporations from innovating, what keeps individuals from having to make changes and politicians from reforming their cheating ways. As we used to say when I worked for The Man; cash hides a lot of sins. The only people entirely unaffected are those who are so rich they could not run out of money if they tried and those so poor they don’t have a hope of becoming a member of the ETBR ever in their lives. The rest are gaming the system in almost every way they know how.

I didn’t buy more house than I could afford nor did I refinance on the house equity I had to finance a non-asset like a college education or vacation. I did not take out or encourage my kids to take out huge student loans so they could attend a swanky out-of-state university. The social contract I had with you, the 99%, was that you would not purchase more than you could afford so that your house would not be foreclosed on or your kids would not be recklessly in debt. We were supposed to be in this together. Without your participation, colleges would not have been able to raise the tuition rates. Banks would not be offering 0% loans if nobody took them.

You broke that social contract by always needing more. I kept my end of the bargain.

I expect the 1% will work tirelessly to extract wealth from me until my last breath. But this much I know also about the 99%: They will not be there to help me guard the gate from the Barbarians. They will be busy guarding their own gates.

What I want
What I want most is my own space that is warm and free from the prying grasp of government tax departments, the whims of landlords, the perils of curable illness and disease or the selfish and short-sighted lust of those in power. Owning my own home is none of these things. Even if I were to get to pay the last payment of my mortgage to the bank, I could still lose my home if I could no longer pay the property tax the county continues to demand. Or lose my freedom due to the ever-increasing criminalization of poverty. Or suffer health problems that deplete the wealth I used a life-time of time to build.

The Barbarians will always be at the gate. This season’s Barbarians are the Wall Street bankers and politicians on the take. Next season, it could be drought and famine. The next could be the City of Englewood deciding that my house sits on a patch of land they want to turn into a park. Or Anthem Blue Cross/Blue Shield increasing my premiums 38% or denying a treatment they pre-approved. The list of Barbarians are endless.

As I move through middle-age and into old-age, I know that my ability and desire to fend off the Barbarians will become less and less while my desire and need for security and warmth will become more and more. I can already feel the fear and rage creep into my bones when some punk-kid behind me in traffic does that dodge-and-weave thing, trying to pass me as I am not speeding fast enough for him. I feel it in the deep sighs of a younger generation who mistake patience for inaction. I know it in my heart when young women no longer look at me with anything less than pity.

What fears me the most, though, is knowing I will not have enough time to build the wealth needed to construct a gate strong enough to keep the Barbarians at bay. I fear they will destroy me before it is my time to go.

*I don’t think the percentages are split 1%-99% but that is a heck of an effective way to market the movement. My use of the numbers are just a short-hand convenience; no more, no less.

You may find this interesting.
And this.
And this from @Karoli who started me thinking down this path, culminating in this here blog post. Blame her 🙂

How not to do customer service in the medical industry

Last summer, I developed some neurological symptoms that are more of an annoyance than anything. So I did what any responsible person would do; researched everything on the Internet and diagnosed myself into the worst possible case scenario. When that failed to cure up my symptoms, I went to see my doctor. He sent me to a battery of tests which were only limited by the amount of money in my bank account.

He could not come up with a diagnosis. Nor could a local neurologist. So, he shrugged and said, “I think you need to go up to the Cleveland Clinic and see what they think.”

Wow! These guys can make paralyzed people walk! Certainly they would have an answer. Or at least a wild guess. Or even a stupid notion. After some calls to my insurance company, clinic, etc., assuring me that things would be covered, I scheduled a day to drive to Cleveland and get poked and prodded and such. Long story short, they ended the day with the same perplexed head-scratching and “We dunno” diagnosis that my doctor gave me.

“But we need to schedule you in about 4 months for some more testing because we think you still have some money left in the bank. Would that be ok?”

Sure, no problem. Until I got their bill.

It turns out my wonderful insurance company discovered that Cleveland was not merely a suburb of Dayton but a whole other city outside my treatment area. They would reimburse at a much, much lower rate than they said. Sorry. You understand.

I didn’t. What could I do?

Call the clinic. Perhaps they can help.

They couldn’t. Or rather, wouldn’t. 90 days, Mr Dogg. You must pay the balance in full within 90 days. “But you guys didn’t actually do anything!”

It is not like I didn’t have the money or was unwilling to pay. I have been paying them; just not at the rate they wanted me to. I even sent them two letters explaining my payment plan with no response. As we were both disappointed in the visit results, I felt that we at least owed it to each other to share in our disappointment, to learn from the experience and grow together. To my surprise, they did not share my point of view and have since sent me to a “goon squad” over the last few hundred dollars.

Bummer.

So, I called them this morning. Surely, they would see the folly of their mistake and call off the goons. Again, I was very, very wrong. I had forgotten for a brief moment that I was not their customer. My insurance company was their customer. How happy or disappointed I am was irrelevant to them.

I will pay them in full eventually. But instead of them this week, I will pay my landscaper. He has not disrespected me. Maybe I’ll pay them next week.

But this little story should not go without a lesson to be learned by the medical industry. After all, you guys will be getting more and more business from us as we all get older and need more care. Health insurance companies are kicking us off plans left and right, employers are jettisoning full-time people in favor of two part-timers they don’t have to pay benefits for and Congress is cutting Medicare. You should probably learn to handle us a little bit better, or at least with some more flexibility. Tightening the deadlines and being quick to send bills into collections rapidly is short-sighted at best. It is not a sustainable strategy.

And then you have folks like me who just shrug and say, “I was gonna pay them today, but I’ll just wait a bit longer.” In truth, if the Cleveland Clinic let me say my piece without being being hard-nose pricks, they would have had their money today. Bummer that, too.

So, with that goal of keeping us both in business, I have some feedback you may want to take to heart.

What you say:
We printed the payment terms on your statement.

What we hear:
You dumbass. Can’t you read the crap you put on your bill with edge-to-edge printing? It’s your fault you are in this mess. We told you 90 days, damn it. Did you think we were kidding? We are an unfeeling, inflexible cold-hearted corporation that needs money paid on time, you deadbeat.

What you say:
Would you like to talk to a supervisor?

What we hear:
I’m getting tired of talking to you and will give you to someone who has no heart and is immune to anything you have to say. He will be a bully to you and will belittle your concerns. At the end of the conversation, you will not only not get any concession from us, but you will feel like a worthless piece of crap.

What you say:
According to the terms of your contract…”

What we hear:
I have stopped listening to you a long time ago and think that you are just too stupid to even be able to read.

What you say:
I can adjust the terms, but I won’t.

What we hear:
I am an arrogant prick. I have power over you and I will wield it without mercy, you piece of crap.

After all is said and done, we all know you are a business. We know that you hold all the cards. We know you can wreck our hard-fought FICO Score with one keystroke. We do not need to be reminded that we are merely walking wallets to you. What we would like to believe is that we have a personal relationship with you, with our doctors. We want to believe you care about us as a whole person, not just our ability and willingness to pay.

If you can’t fix what ails us physically, can you give us that one little lie at least?

AFTERTHOUGHT
It occurs to me that the supervisor I spoke to this morning failed miserably at his job. He got so caught up in his own ego with proving me wrong that he forgot his primary job was to collect money for his employer, The Cleveland Clinic. It occurs to me also that I now have the upper hand in this arrangement as I and the collection agent are in a position to cost CC money they would have had to spend by working directly with me. The direct cost of ego is the fee the collection agency will charge CC. I wonder what sort of deal the collection agent will make with me? It’s now worth a phone call. Are stubborn, combative people in your customer service department costing your company money? Bet they are.

*I don’t mean to pick on the Cleveland Clinic specifically. They were just the organization in my experience. But they did hire some pretty heartless, unempathetic people in their patient financial department who could maybe use some sensitivity training. But, maybe it’s working for them. I won’t ever go there agin, but that should in no way affect your decision to see them if you want. In truth, all these hospitals are getting like that. I won’t go to one local hospital for services any more simply because they start the harassing calls on day 31. There is another hospital across town that waits at least until day 60 to start calling. And they are nicer people.

.

Jumbo

There is an old joke that goes something like this:

I had a nightmare last night I ate a giant marshmallow. When I woke up, my pillow was gone.

Ok, settle down.

Your nightmare joke is now a reality. Meijers had pallets of these JUMBO marshmallows staged alongside the graham crackers and Hershey chocolate bars. Really, these things were grotesquely huge. I think it might be national S’mores week to coincide with Independence day. Nothing says freedom like… marshmallows?

Happy Fourth of July. How much more American can we get? Oh, about another 100 pounds per person, I would reckon.

Be a patriot and eat up.