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.


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?

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.


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.


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.


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.

Organize the ants again

I am an ant image

“The bigger the government gets, the smaller the people get.”

John Boehner said this on June 29 interview with the Pittsburgh Tribune-Review. Apparently we have gotten so small in Boehner’s eyes that we are no bigger than ants. If not us directly, all the financial woes caused by this most recent recession, caused in part by no ant-sized recklessness of our banks and financial institutions. But we can debate that all day.

On March 3, 2010, I sent a letter to every Senator and Congressman in Ohio, letting them know that Anthem Blue Cross/Blue Shield had just raised my health insurance premiums by 21.8%. In addition, I expressed support for the current bill and urged each to vote for it, but also:

Health care in its current state is unsustainable and is robbing the average family of economic choice. I encourage you to explore a public option and single payer system, where health care is a right of citizenship, not a privilege. We’re not asking for “free health care” just freedom from the private health insurance system that is bleeding us slowly to death.

In response, Rep. Boehner’s office sent back a reply, thanking me for my opposition to health care reform. I’m not sure whether he actually read the letter or if every letter regarding health care reform got a “Hell, No!” response. Regardless, he dismissed me like one would flick away an ant at a picnic. I now know why.

Rep. Boehner should perhaps be reminded that ants have a high degree of socialization, can solve complex problems and are not afraid of swarming anyone or anything that attacks one of their own. Their success as a species is attributed to their ability to modify habitats, tap resources, and defend themselves. They are able to carry 10-50 times their own weight, depending on the species. In short, ants are not to be trifled with nor do they deserve to be belittled.

I am speaking metaphorically, of course, and I am aware of how much stretching I’m doing here with the metaphor. But I don’t think it is a big stretch to say it is clear that the GOP regards most of this countries’ citizens who disagree with them as “ants” to be flicked away. With their recent dismissal of health care reform, their denying long-term unemployment to millions for whom there just are no jobs and the recent attitude toward BP and the financial corporations, it is not a giant leap to assert that they believe citizens as individuals matter less than the giant corporations that magically feeds the “real economy.”

One ant alone would probably not make a difference. In 2008, Barack Obama was able to rally the ants into voting him the 44th President of the United States. It seems pretty clear from Boehner’s remarks that we need the ants to rally again as pundits ask, ‘How long can White House keep Boehner’s “ant” crack alive?,’ playing this out like it is some sort of game.

No matter how small the GOP and Boehner think we are, us “ants” need to show up and vote in November.

*Extra points if you know the reference to the graphic used in this article. Lots of extra points if you can connect it with Glenn Beck’s recent antics.

A 2% tax increase any way you look at it

On the first of April, my health insurance company will start taking a 21.8% increase in premiums out of my butt. They have not increased services nor do I feel more comfortable that my coverage is any more secure. I know that I am one heart attack away from being dropped and two heart attacks away from bankruptcy. But, that appears to be life in America, so as sure as I walk the sidewalks flanking the roads with half-crazed nuts driving around texting like mad, I guess I can breeze along with health insurance as least half as good as those odds.

Then I got to thinking about what that 21.8% increase really means.

Let’s say the average salary is about $48,000 and an increase of 21.8% represents about $1,000 of POST TAX income that I have to spend on health insurance. That is about 2% of an average salary if you don’t count in taxes or anything like that. If you calculate just on take-home pay, it is more. But, let’s leave it at 2%. (If you make less, that percentage goes way up but even if you make twice as much, the tax is still 1%)

That is a 2% tax increase. Whatever else you may want to call it, it is 2% of your wages that is no longer discretionary. You can’t buy a flat-screen TV with that or an iPad (cause you know you’ll want the big one) or even a good German Shepherd. That is 2% of your income that is a private tax to your insurance company who may or may not cover you when you need it. So, I guess it is more like a 2% of your salary bet on red in Las Vegas.

My Australian friends tell me that for a flat 1.5% of their gross income, they get full health care. And they are happy and healthy, despite their lifestyle (if you’re Aussie, you’re grinning, high-fiving your mates and saying stuff like “no worries” cause you know what I mean.)

2% is a tax increase any way you look at it only we can’t vote those bums out.

Can we keep talking about why universal coverage is too expensive? Seems like we’re already conditioned to pay.

We are creating our own nanny state and them is us


The photo above in the Wall Street Journal caught my eye this morning and sent me into a tizzy. For the record, I am a bit upset at the direction the health care reform bill is taking. It favors the preservation of the insurance company system by forcing us to buy the same crap that got us into this mess and rewards job-holders (folks who choose security) over entrepreneurs. In short, it is re-establishing a job-based, status-quo economy instead of an entrepreneurial one where innovation and risk produces growth. I am very disappointed at the turn of events.

But the point that is sending me over the edge is the fifth “right” that says you have a right to stay on your parents’ health insurance policy until you are 27 26. I say it here now and when MSNBC starts saying it, you know you heard it here first.

The unintended consequence of this provision is insurance companies will not provide health insurance to anyone under twenty-six who have living parents. But an even worse consequence is the expansion of a parent-sponsored nanny state in our culture as a whole.

A quick conversation with my 24-year old son reveals that most of his friends with freshly-minted college degrees expect to be able to move back with their parents and live there rent-free and guilt-free indefinitely.

The FAFSA will not allow anyone under twenty-four to get financial aid without parents disclosing their financial resources. Despite almost no benefit to the parents, they are expected to pay a large chunk of an inflated tuition bill by leveraging the equity in their homes.

Almost all landlords in college towns will not rent/lease to a student without parents co-signing, even though the students are over eighteen and legally able to enter into a contract AND be sued in a court of law.

And now insurance companies and the Federal Government want to strap parents even more by obligating them to provide for health insurance for their kids until they are 27, nine years after they have legally become an adult.

What they should do is obligate kids to accepting and embracing their adulthood at eighteen. When parents have no legal right to their children, they should also have no corresponding legal responsibility. Either these kids are adults or they are not.

If they are, start treating them like adults. They should have a right to their own health insurance when they turn eighteen, not the obligation to be parasitic for the next nine years. And parents need to start expecting they act like the adults they are, regardless of how painful self-reliance is.

A metaphor for health insurance even Congress can understand


One of the arguments that always comes back about the number of uninsured is that 64% or so of Americans have insurance and like it. (WaPo)

But, what nobody is doing is actually looking at what the insurance really is. Here is a metaphor that I think might clear up what the insurance problem in this country really is.

Let’s say your insurance policy is a pile of money, or if you are in Congress reading this, a bag of money stuck in a freezer. The only hitch here is that some of these bills are counterfeit, but you don’t know which ones. When you pay for medical procedures, you can only pay for them using bills at the top going down. Obviously, when the medical provider gets paid, he is going to reject the counterfeit bills and want you to swap out real ones for them.

When you run out of a stack of money, you can no longer buy any more medical things. And, the money stack must stay on the table it is on (your job!) so if that gets taken away, the stack of money goes with it.

The 10-47 million uninsured folks are not really a problem. They will either die early or get treated minimally until they do. The real problem this country faces are the 260-197 million or so who have a stack of health insurance money, but have no idea which bills are real and which aren’t until they need to spend them.

Switch out enough bills for counterfeit ones and they will start buying pitchforks instead of CAT scans.

Health care reform my puppy butt

Yesterday, Keith Olbermann had a one-hour special comment about health insurance and health care in America. He has recently had a first-hand experience with his father.

I don’t know how much it cost to produce one hour of Countdown nor do I know what the lost opportunity costs are from insurance ad revenue MSNBC will probably never get because of this and having Wendall Potter as a frequent guest, but I do know how much influence this hour will have on moving the health care debate.

Zip. Nadda. Nothing.

If Keith Olbermann’s celebrity and MSNBC’s money and reach can’t even blow a little breeze into the health care debate in this country, what chance do any of us have of being heard? Exactly.

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