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.

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.

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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.

You are a deadbeat piece of crap

help wanted cheap

When did the United States of America go from “shoot for the moon” to “circle the wagons?”

We appear to be on a race to become the sickest and dumbest of the developed nations where nothing is going to be possible. The enemy this time is not the Communists, Soviets or al-Qaeda. The enemy is your deadbeat neighbor who is sucking your hard-earned money out of the tax coffers to finance his lavish lifestyle. He is buying big-screen TVs with his unemployment checks and taking extravagant vacations with his Social Security checks. If he is a teacher, he is enriching his pension plan from your sweat and aching back. If he works for the government, he is an over-paid lazy bum who is the reason your health insurance plan at the plant stinks.

Do we really want armed police officers and firefighters hired by municipalities at bargain-basement prices? How stupid and ill-trained do you want the teacher to be teaching your children? Have we abandoned the notion altogether that good schools increase property values? We seem to accept the argument without question from the Right that the public employees need to lower their expectations of compensation and the value of work rather than the private sector workers increasing their expectations.

Smart people are being driven out of politics by zealots and bullies under the mis-guided notion that small government is good government. But a small government that enables corporations to rape the human resources unchecked for the sake of profit only is not a good small. Even small government must be balanced.

The secret to getting cheap labor appears to be convincing everyone that they are not worth the salary or benefits they are asking. From the Tea Party to the GOP to the media, the message appears to be consistent — human beings are just too darn expensive.

Break out the torches and pitch forks, folks. We are turning against each other and it isn’t a healthy debate.

The weak link in the “ObamaCare” argument

US District Court Judge Roger Vinson just handed the Democrats a victory with his ruling against the Affordable Care Act (ACA). So did Judge Henry Hudson of the Eastern District of Virginia with his ruling on the individual mandate earlier.

Stay with me folks. I haven’t jumped to the red side of the force.

The Democrats in the House should immediately draft a bill repealing the clause requiring every American to purchase health insurance. You are right, Mr. Speaker, the 111th Congress did indeed overstep its authority. Mea culpa, mea culpa. Here, let’s fix this thing.

The Republicans would have to vote for it in light of the recent rulings in their favor. It is their central argument against the ACA and the Democrats are willing to concede they are right. Then it goes to the Senate where the Democratically-controlled body would pass it and off to the president’s desk where he would sign it.

Why?

Without the individual mandate clause, insurance companies could not afford to be in the insurance business. All the other parts of the Act would remain intact, including covering pre-existing conditions, no life-time cap, etc, etc. Shareholders would bolt from the stock and the industry would collapse. That would leave the door open for a Medicare-for-All, single-payer system based on health rather than sickness, driving down the cost of care as there would be no third-party profit motive behind medical care. Hospitals would still get paid as would doctors and drug companies.

The only industry harmed would be the for-profit insurance industry. What value do they really have now anyway, other than being in the middle collecting and distributing payments? Besides, the Federal Government could hire them back as contractors to process the billings at about 1/10 their current staff levels. That is one thing they are really good at and it would be a shame to let that go to waste.

The more elite, well-funded insurance companies can set up shop to provide expensive health care in private clinics to an exclusive client base who don’t want to mingle with the common folk. Heavily taxed and regulated, of course.

The logic of group coverage is the larger the group, the cheaper the premiums. The Republicans use this argument to justify selling insurance across state lines, another point the Democrats could concede. What bigger group can you assemble in The United States than all 300 million citizens? And we already have a universal way of billing for and collecting premiums called the IRS.

But this won’t happen because the health insurance companies need the mandate more than the Democrats do. For the Republican state’s attorneys general who are bringing lawsuits against the ACA based on the Constitutional commerce clause, the argument is short-sighted. But they’ve already committed to the path. If they win in the US Supreme Court, the insurance industry loses and collapses. They will win every battle, but lose the war.

The health insurance industry will not let that happen.

If the Democrats thought a bit faster, they could put every Republican — especially the Tea Party-backed ones — in a very uncomfortable position of having to vote against the Individual Mandate Clause repeal.

That alone would make an exciting November 2012!

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Don’t touch my junk; a TSA stand-off anthem for anti-healthcare reform and other government good stuff

In the 1970s, the government told us lead paint was perfectly safe. In the 1960s, the government told us asbestos was perfectly safe. In the 1950s, the government told us smoking was perfectly safe. In the 1940s, the government told us prenatal drugs were safe. Need I go on?

What are we missing here? Why are we being prodded into being hyper-focused on the prudery of being seen naked and ignoring the very questionable health safety claims of these airport full-body scanners? If we were told that in order to board a plane, we would need to each be given a flu shot, for our own protection from travelers who may be coughing and that shot would be administered by a TSA agent who carries no medical malpractice insurance or verifiable certification, would we submit to that? If we didn’t, we couldn’t board the plane. Nor could we leave once we entered the security area without being subject to arrest and fines. Would 98% of the flying public submit to that? Probably. We’re sheep and the TSA knows it.

CBS, NBC and other networks are saying that 81% of the public support the full-body scanners and 98% of all passengers are submitting to the full-body scan. They are in effect, saying that the “don’t touch my junk, opt-out” protestors are marginal, fringe, prudish nut-jobs. While the public is being corralled into the propaganda of the scanners as a “strip search,” the real concern of the scanner is being downplayed and all but ignored by both the TSA and the media. The real concern should be the health issues associated with using x-rays in a non-medical environment for non-medical reasons. The real concern should be how the TSA uses and abuses power once challenged by those who gave them the power — the American voters.

The double-down, dig-in, jaw-clenching, frustration-laden, totalitarian, “you don’t have to fly” rhetoric of Sec. of Homeland Security Janet Napolitano and TSA Director John Pistole is adding fuel to the fire of the debate. Not only is it adding fuel to the TSA v flying public, but it is giving ammunition to the GOP for health care repeal. “See how they act when you resist?” they will point. “This is your government doing what they think is best for you.”

And that has consequences. Even people who voted for Health Care reform will be doing a second take and asking themselves, “If this is how they treat me when I resist at the airport, what if I resist that mandated health care? Do I really want to be treated like this when I go to the doctor?”

What the TSA is doing is not real security. Barking at people non-stop, aggressively callously and disrespectfully patting down travelers, irresponsibly submitting them to doses of radiation that may or may not be a “safe dose,” threatening resisters with arrest or detainment is not security. It is a circus and a breeding ground for small-minded people to wield power over helpless citizens with impunity. We’re seeing this vein in Napolitano and Pistole. We see and feel it in the hands of the TSA agent who neither sees nor hears us as he gropes and recites the policy he has memorized but never listened to.

A calm, control of the environment is real security. While I don’t generally use Hollywood as an example of real life, a quick viewing of Roadhouse should be part of the training. Bouncers who yell, grab and provoke only increase violence. Coolers who quickly, calmly and quietly diffuse the situation leave most of the patrons not even knowing there was ever a threat. I’ve seen this work in many European airports.

You can feel a difference in the air between Amsterdam Airport Schiphol (AMS) and New York John F. Kennedy (JFK) that is more than a little subtle. In AMS, you see the heavily armed guards around the perimeter, but they are not showy. You know you are being watched but not threatened. The guard who asks you questions in rapid succession is always calm, polite and respectful, but you are not able to goad him/her into an argument or force a break in character. (I’ve seen Americans try.) They ask you if it is ok to reach inside your coat in a soft, polite tone that makes you feel like you have a choice (you really don’t.) When you land on the US side, the transportation and customs people start yelling into the crowd to “get your passports out,” “make sure you have your Declaration Form 6059B complete,” “US citizens in this line, everyone else here” and on and on. The anxiety and circus continues to mount as the luggage moves through customs and you are “greeted” by agents. “Where were you? How long were you there? Did you visit any farms….” without respect or emotion except frustration and contempt.

But I digress.

The Federal Government has very few real opportunities to interact directly with the American public. Most of the time, we buy and sell things from corporations. But of the three government points most citizens touch — IRS, USPS and TSA — it seems to me that they could at least stop and think about how their most intimate interaction policy is affecting all others, seen and unseen. No less than the setback of modern healthcare for several more generations is at stake.

If you lose the trust of mothers with children at the TSA, you lose them at the doctor’s office as well.

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Anthem Blue Cross Blue Shield of Ohio is calling me a liar. Again.

I’ve had three small, routine claims this year so far and that triggered the letter I posted here. More accurately, my daughter went to the doctor for a routine physical because that is the responsible thing to do.

I know that from an insurance company’s point of view, determining if they can shove off costs to another insurance company is the fiscally responsible thing to do and I understand subrogation. I used to buy insurance for groups of employees in a past life as an HR VP and I also understand insurance laws as a result of me selling medical devices in a past life. I get all that. Goodie for you, Anthem BCBS of Ohio, you are saving your shareholders money.

As a customer of your plan where you increased my premiums 21.8% last year and 18.2% the year before and consistently for the past seven years, let me tell you how I read your letter.

Dear Double-dipping pile of crap customer,

We think you are lying to us about what insurance plans you have and think you’re trying to stick us with the latest medical bill you generated. Since we have your nuts in our hand anyway, we’re going to make you jump through all these stupid hoops just because we can and you can’t do a damn thing about it because this is legal. And while we’re sending out this stupid letter, we’re going to hold up payments to your doctor until we get your response back. But it’s not likely we’ll pay any part of the claim anyway; we just like to watch you dance you miserable piece of crap.

Thanks for your money. And since you really don’t have much a choice in Ohio anyway, we really don’t care if we piss you off. You’ll come crawling back.

Have a really crappy day.

Regards,
Faceless person blah, blah, blah.

Before anyone jumps in here and tells me that I should shop around and not buy from Anthem if that is the way they treat customers, buying individual health insurance in Ohio is like a torturer showing you the implements he is going to use on you and you picking out the one that will hurt the least and will kill you the fastest if used. Then hoping he’ll not ever use it. Anthem Blue Cross Blue Shield sucks, but the other choices suck worse.

And now insurance companies claim they have to raise premiums 20%+ to offset the costs of the Health Care Reforms passed earlier this year? What were the increases for last year?

And why again should we not be furious with health insurance companies? Is it the wholesale leeching or the blatant insults? Or is it a dread fear that our lawmakers who may be in power starting next year are entirely clueless about the state of health care insurance in HIS OWN STATE?? Please, somebody tell me as with my health insurance choices, I am literally dying to know.

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Real patriots die at 55

When you turn fifty in America, you are old. When you turn fifty-five you are too old and should consider dying to make room for the next generation of revenue-producing units. It’s the patriotic thing to do. Hear me out on this.

When you turn fifty-five, the human resources department is looking for a legal way to get rid of you despite what they say about you having vital experience. You’re making too much money, you don’t go to as many training classes as they think you should, you are not as mobile with that family and mortgage anchoring you down and you are starting to contribute a whole lot more to the 401(k) than they had planned for matching funds. They will lay you off in a heartbeat and you will not be able to find another job. Ever. Not in this economy.

When you turn fifty-five, the health insurance premiums for the plan you had to buy on your own because your employer could no longer afford to provide benefits will double over last year. Your out-of-pocket health care costs will also go up and you will start racking up pre-existing conditions, making you ineligible for any other insurance. But you only have ten more years to go to qualify for Medicare, so maybe… oh, wait, they are going to raise that to seventy. You’re screwed.

By the time you are fifty-five, you should have already produced at least one, maybe two future revenue-generating units for the corporate consumer machine. They were far more expensive than you thought they would be, but you’ve put off saving for retirement until they finished school and left. You are now ready to front-load your 401(k) and mutual fund portfolio…

But wait! CNN tells you that you have only about a 30% chance of outliving your retirement plan at the rate you’re going. Oh, sure you’ve helped fuel the economy by having kids, buying a larger house than you could afford, paying for their tuition and feeding and clothing them, but now, you are on the taking end of the economy. Whoa, there! Your country frowns on those who take out of the system, regardless of much you’ve contributed in.

Business wants your money. They tell you this all the time by marketing to Boomers. But they don’t want you actually working for them, drawing a salary and sucking up the benefits. Heck, those young GenY brats will work for half what you need and still think it a fortune. Thank God Walmart hires old people as greeters. Oh, you can’t stand for eight hours a day because your sciatica has been acting up? You should go see a doctor about that. Insurance? Man, that’s tough luck buddy.

Next!

The business of America is business and you are standing in the way when you start getting old. Manup and die off when you hit fifty-five. Your country needs you to make that sacrifice to help reduce the unemployment rate and the federal deficit all at the same time. Moreover, you are likely to have life insurance and your kids could sure use that money to prop up retail sales.

Have you lost hope yet? Really? The great United States of America does not need its future derailed by negative-thinking pinheads like you. Is you or is you ain’t a patriot? Time to decide.