Category Archives: History and Politics

Republican Health Care Plan

I inadvertently gave myself a nice taste of the shit sandwich that is the proposed Republican Health Care Plan, Trumpcare, as far as I can tell from the details I’ve learned.  I heard an interview last night that laid out the main differences between Obamacare and Birthercare and realized– fuck, I did it to myself in 2017!  The Republican plan would greatly increase premiums, co-pays and deductibles on older Americans, an age-based pricing scheme not currently allowed under the ACA.  I’ve had a taste of that in 2017, hoping for better care than I had in 2016 I am paying 600% more for the same coverage I had last year.  You don’t need me to tell you what a shit sandwich tastes like.

Obamacare, basically Romneycare, which was in part based on the Heritage Foundation’s conservative plan to keep private industry in charge of American health care, had two or three major improvements over what came before.  In exchange for the mandate that would force younger, healthier people, on pain of a tax penalty, to buy insurance, thereby funding the pool for older, sicker citizens, American patients were freed from the industry’s “pre-existing condition” loophole and ensured delivery of what are deemed essential medical services.   It used to be possible to sell insurance with serious limitations on, say, preventative services.  No more, under Obamacare.

The details of the secret Republican plan, the culmination of a seven year partisan battle against Obama’s health care law, a law they’ve called “worse than slavery”, probably worse than any holocaust, were to be revealed a week before the up or down vote.  No debate was planned because Republicans, being in the majority, believed, at first, that they could pass the law on a strict party-line vote.  When some of the details were revealed, including the CBO report that 22,000,000 Americans would lose health insurance under the proposed law, the deal quickly went south.  It’s hard to cast a principled vote for something with a 12% public approval rating.  Even in today’s lockstep party-line political environment.

There were tremendous tax breaks to the wealthiest Americans as part of the Republican plan.  This would fulfill one promise the current president made to his wealthy friends and more than reverse the tax hike Obama instituted to help fund Obamacare.   Part of the Republican plan shifted more of the cost to older, sicker customers.  Another part removed the mandate but instituted an alternative punishment, a six month waiting period for enrolling if you allowed your prior coverage to lapse.  Under the Republican plan the customer would pay a higher percentage of the cost of medical care, from Obamacare’s 70/30 split to something much fairer to insurance companies, like 58/42.  A sixty-four year old with an income of $26,000, currently paying $1,700 a year under Obamacare, would see the cost of health care increase to more than $6,500 in premiums.   That number does not include increased co-payments and out-of-pocket expenses, devilish little details that could add up to another quarter of that person’s income.

Fatefully, the Republican plan would eliminate millions from the Medicaid Expansion roles.   Obamacare increased the threshold for Medicaid type coverage to people up to 150% above the artificially low poverty guideline and provided subsidies for people living on up to 400% over the poverty line.  11,000,000 to 14,000,000 Americans now have low cost health insurance that is virtually Medicaid.  

The costs of Medicaid Expansion are paid mostly by the federal government, the federal contribution is currently at 95%.  The Republican bill scales it back 5% a year from 2021 to 2014, until it makes the program impossible for states to continue.  States, under the Republican plan, would also be able to get waivers for in-state insurers to opt out of Medicaid expansion programs and offer less than the Essential Benefits mandated under the ACA. The Republican plan would allow patients currently receiving Medicaid Expansion benefits to be grandfathered in, but it is also still famously easy to be chucked off insurance, and once chucked, it’s chuck chuck bo-buck banana fana fo fuck to you for the rest of your earthly lifetime, under the Republican proposal.  The proposed bill also slashes funding for Planned Parenthood.  USA!   USA!!!!

I’ve written critically of Obamacare, which sucks in many ways, especially its fundamental deal to keep the foxes in charge of the sickening American health care henhouse.   That said, there is no question that it is more decent than the unfettered, bare knuckles medical insurance scheme that preceeded it.  People who receive coverage under the ACA, whatever our many frustrations with the idiosyncrasies  of the industry-written plan, prefer it to the way things were before.  Most Americans, it seems, agree.  

Is there still a serious debate over the “pre-existing condition” loophole that saved insurance companies billions while condemning countless sick Americans to death?  Even Mitch McConnell’s bill doesn’t restore an insurance company’s right to refuse to sell insurance to somebody because they once suffered from an expensive medical condition.

It seems apparent that a big part of the motivation for this Repeal and Replace mania is a vicious partisan hatred of this nation’s first mulatto president.   There’s greed by the wealthiest, sure, you always expect a certain amount of that from wealthy materialists obsessed with getting every government advantage to help them become wealthier.  There’s the old partisan bickering that has become a larger and larger feature of our political landscape since Reagan.  

To understand the Republican jihad to repeal Obamacare we must not discount hatred, pure and simple, of the well-spoken half black man for whom the bill is named.  He comported himself with dignity even as Mitch McConnell announced that the Republicans were dedicated to making sure everything the president proposed failed and a coyly racist movement known as Birthers publicly, continually and counter-factually attacked Obama’s legitimacy to be president.  The highest profile “birther” was the celebrity brand who is the president now.

 “Birthers” spoke the lingua franca of millions of Americans, and said it loud and proud: “this man is a nigger and we do not have to have a nigger president of the United States.  We will simply not allow ourselves to be ruled by a nigger.”  If you doubt this widely shared sentiment, look at a large part of the current president’s base.  Millions of readers of websites like The Stormer, named in homage to the Nazis infamous Der Sturmer, whether affiliated with a hate group or not (and these mothercuckers have proliferated wildly since Obama’s election) will have no problem endorsing this view.  I guarantee that not one of these neo-nazi fucks will ever use the politically correct “n-word” to refer to our former president, except perhaps in gleeful air quotes.  These angry young white men, and their fathers, and grandfathers, voted overwhelmingly for the race-baiting panderer-in-chief, an unrepentant leader of the Birthers.

Are we living in Germany 1938?  I’d like to think not. On the other hand, on the eve of Hitler becoming the full-blown Hitler history remembers, the New York Times opined that the institutions of German democracy were too robust, the German people too cultured and sober, to allow the crass little shit-snot Mr. Hitler to run amok.  Run amok the crass little shit-snot Mr. Hitler did.  I’m not comparing this genius of audacious self-branding to any other would-be tyrant.  I’m just sayin’.   The proposed repeal and replacement of Obamacare would be a giant step toward the final victory of America’s crass little shit-snot-in-chief and the third of the nation on which his legitimacy stands.  

Would it not?

The Mooch, betrayed by reporter. SAD!

What is the world coming to when you can’t even curse your colleagues in the White House, in a private conversation with a reporter, without the fuck betraying you in the fucking lying media?

Anthony Scaramucci told an interviewer that the chief of staff, Reince Priebus, was “a fucking paranoid schizophrenic” who would be asked to resign, and that Scaramucci was not like Steve Bannon, the chief strategist, because “I’m not trying to suck my own cock”.  source

Well, at least now we know why Bannon has that look on his face all the time.

Punchline and I rest my case

The previous post, detailing the intricate workings of corporate fraud? Ridiculous.  The contract between me and the insurance company specifically outlines the customer’s lack of rights.   I almost laughed when the lawyer pointed out the language to me, the futility of any kind of appeal or grievance.  Of course.  Reminded me of  the great documentary about the corporation, which you can watch for free on youTube.  

The screenshot below, from the film, is the checklist, from the DSM, of the characteristics of the psychopath, which the psychiatric consultant to the FBI, profiler of serial killers, discusses.   This is around minute 40.  The prior 17 minutes of the film have shown how consistently the modern corporate “person” displays each of these traits.

Screen shot 2017-07-27 at 7.08.21 PM.png

Thankfully we have also had great advances in advertising.

Fuck me blind.  ROTFLMAO!

Dining With Cannibals (part one of many)

Long before he ran for president, Senator Bernie Sanders told national treasure Bill Moyers “the business model for Wall Street is fraud.”  It is hard to dispute this description, even as the law winks at and lawmakers and other canny investors profit from the business model of Wall Street.   The business model for American health insurance companies is fraud.   Their profit is based, in part, on their ability to deny services that customers pay for.   I offer the following maddening illustration.

Leave aside the debate over if it was fair to make insurance companies offer reasonably priced coverage (or any coverage) to people with ‘pre-existing conditions.’   I’d argue it is fair, but fuck my opinion.   You can argue whether it’s fair to make insurance companies, collecting decent premiums from consumers, cover an annual preventative visit to the doctor.  You can argue the fairness of it, it’s your absolute right as an American to argue.  You can even elect a living turd to bully his party into dismantling the timid, conservative think tank-created baby step in the arguably right direction for ‘failing American health care.’  I’m here only to point out a concrete instance of the basic business model of American health insurance: fraud.

You are faced with a single choice for treatment of, let us say, chronic kidney disease.   You are being strong-armed toward the one treatment available to medical science:  immunosuppressive therapy, a kind of chemotherapy described as an “atom bomb that knocks out your entire immune system and hopefully straightens out your auto-immune disease when the immune system comes back on-line.”  The treatment involves IV steroids and other agents with possibly severe side effects.   On the other hand, one third of all sufferers of this mysterious disease are cured from it without medical intervention.   Nephrology does not have a clue about this “spontaneous remission”. You seek a second opinion.    You’d like a medical opinion about how to increase your chances of being in this one third who recover from the disease without undergoing a form of chemotherapy.

The only opinion you will get from an American nephrologist is that immunosuppressive treatment is the only medical treatment currently available, and that you’d probably be wise to start before you suffer permanent kidney damage.    You hope for a thoughtful nephrologist, who will not prey on your fear but allow you to make a fully informed decision about treatment, but the rest is a matter of the chance and the doctor’s personal style, whether they listen well and answer questions, return calls, are supportive or dismissive, sensitive or prick-like.  The one I happened to see was a jerk.  Luck of the draw.

Anyway, better still, let’s leave aside the specifics of the case.  To see an out-of-network provider, paid in part by the insurance company, you need to obtain pre-authorization for the visit.  This pre-authorization is granted , based on medical necessity.  The insurance company gives you a number for the doctor to call to get pre-authorization.  They must convince the Medical Management department that the services they provide are not offered by anyone in-network.

Once the case is made, Medical Management renders a determination.  A week later you learn whether or not the visit will be partially covered by insurance.  Without pre-authorization insurance will never pay anything towards the visit.

Provider calls Medical Management.  They are told that the patient they are calling about does not have coverage in his policy for out-of-network visits.  No request for pre-authorization can be made on behalf of that patient.  Thank you for calling, the end.

When the patient is informed of this, and calls the member’s services number at the insurance company, he is told that he does have coverage for out-of-network visits.  The problem, he is told is that the provider did not have pre-authorization.

You point out that the provider called the number you were given to get pre-authorization.   Perhaps they are referring to some pre-authorization for pre-authorization you have not been informed of.   Or perhaps, since they have told the prospective doctor a plain untruth, which forecloses the request for pre-authorization, their business model is closer to fraud.  If you have the ninety minutes to devote to this discussion, and sufficient patience and skill, you can get it worked out and the provider can submit a request for pre-authorization.  For virtually everybody else– bingo! we just made some more money for our CEO.

You get an Initial Adverse Determination from the insurance company.  There is no need for this esoteric specialist, it informs you, when we can provide you a dozen in-network doctors with the same expertise as the doctor who did not answer your questions, the one you don’t want to see anymore.  

You call the insurance company to ask them what the hell this determination means, as it makes no mention of medical necessity or the argument presented, it merely denies the pre-authorization based on the fact that they have many specialists in the same field, as well qualified as the jerk you no longer trust to give you medical advice.

Here’s the kicker, though.  Membership, the only number you can call, as a member, has no record of any request for pre-authorization or any determination affecting you, adverse or otherwise.   You read to them from the determination you are holding.  They seem to believe you, they just have no record.   You are, of course, free to appeal the Adverse Determination, in fact, you have, under state law, a generous 180 days to do this.  They are Member Services, after all, only the Provider side has any of this information.  

It happens again with the next doctor.  “This consumer has no coverage for out- of-network visits, thanks for calling.”  Now it is a pattern, a pattern and practice.  It is part of a fraudulent scheme.  Only my opinion, of course, but can you think of a word that describes this better than fraud?    

“Did you try calling the Provider number?” suggests Sekhnet, thinking outside the box.

I do.  I am patient, I am persuasive, I do not pretend to be a doctor, I state my case.  The representative is understanding, tries to be helpful.  Her hands are pretty much tied.  She speaks to a supervisor.  Tells me only Member Services can help me.  I describe the fraud again succinctly.  She does not disagree with my description of the ingenious scheme that separates these two parts of the corporate brain.  She asks me to please hold while she speaks to another supervisor.  I listen to the hold music for a few minutes.  She returns with helpful news.  

“You can ask for an EXPEDITED APPEAL,” she tells me happily.  The regular appeal takes at least a month.  I ask how long the expedited appeal takes.  She has no idea, but I can find out at Member Services, she believes.  She can transfer me there now, she tells me for the sixth time.

I rest my case, over and over again, on my own head.  I’ve got to finish that fucking letter to the New York State Attorney General, the one who got the current president to cough up a token $25,000,000 to settle the case against him for his fraudulent university.  New York State needs to regulate these lucrative, legally created pseudo-person psychopaths.

 

 

 

 

Brought to you by our friends the Saudis

Armed with a new $110,000,000,000 shitload of top-of-the-line American military technology, supported by U.S. reconnaissance drones, our longtime ally Saudi Arabia is turning Yemen into a disease ridden slaughterhouse.  

Here is an excellent short-form report on the humanitarian crisis in Yemen from Frontline.  It is happening right now, and we are supporting it.

Take a few minutes to look at what the richest country in the Middle East is doing to the poorest country in the region.  Every ten minutes another child dies in Yemen, of a preventable cause.  Seven million Yemenis face famine, cholera has reached epidemic proportions.   

Our president, after dining with the Saudi royal family, and a clumsy sword dance, promises to get our buddies the Saudis a “good deal” on that great American weaponry.   Thumbs up for the photo op.  This wealthy cynic is not the first American to do this dance with the Saudis, nor will he be the last.

Salute to Israel

I am a Jew and I love that my historically vilified people finally have a state where they can live, for the most part, without fear of abuse or death by government policy.    I don’t exclude myself from my people by referring to a state where “they” can live, I just don’t live there.  I speak Hebrew and have many fond memories of my stays in Israel.   Anti-Semitism is real, and on the rise, here and all over the world.   Anti-Semitism is alive and well in the United Nations, including in its Human Rights Council.  

That said, some of the practices of the current government of Israel are not morally defensible.  They rest solely on Israel’s ability to exert force.   They are not all that far from certain ethnic policies of the German government of the mid-1930s.  These policies, if presented dispassionately, would be opposed by most people anywhere.  There is a vast, depressed group of Israeli citizens who recognize this too, but they are, like fair-minded Americans of every political stripe, unable to effect meaningful change in their democracy.  

Collective punishment, such as the current restriction of electricity to Gaza, which receives only four hours a day now, was a hallmark of the government, led by Mr. Hitler, that persecuted, dehumanized and went on to kill millions of my people and many millions more who were not Jews.   I’m not calling the current government of Israel Nazis, though it’s hard to deny that in certain ways they are acting like them.  

There is only the basest rationale for these inhuman policies, tactics to combat hated enemies, not a strategy toward solving a shared humanitarian crisis going back now several generations.  Nobody could reasonably argue that the mutual tragedy is not immensely complicated, emotionally and historically tangled, seemingly intractable, though courageous people of good will on both sides (I’m thinking of a group of Palestinian and Israeli women I read about) continue to make small inroads toward peace.  I am pointing out that the pro-Israel lobby’s proposed answer to this gnarly moral question of how long-time enemies reconcile and live side by side is to punish those who speak out against Israel’s policies, no matter what those policies are.

Check out what American Jews, on my behalf, and the right wing Christians who say they support Israel, are proposing, the bipartisan Israel Anti-Boycott Act,  to curtail, in one specific setting, the First Amendment right to peacefully protest.  The bill, seeking to criminalize support for the Boycott, Divestment and Sanctions campaign against Israel and imposing huge monetary fines (minimum $250,000 civil fine up to a million) and up to twenty years in prison as punishments, already has a lot of bipartisan support in Congress.  

Was it covered much in the corporate media?  I have no idea, I rarely touch that stuff these days.  A google search found nothing recent in the New York Times.  Here’s the NY Times, an op-ed piece, from a year and a half ago, with an essay that puts the issue of Israel’s lucrative and controversial settlement policy into perspective.   Here’s a summary of what the Israel Anti-Boycott Act proposes.  Really?

The bill amends the Export Administration Act of 1979 to declare that it shall be U.S. policy to oppose:

  • requests by foreign countries to impose restrictive practices or boycotts against other countries friendly to the United States or against U.S. persons; and
  • restrictive trade practices or boycotts fostered or imposed by an international governmental organization, or requests to impose such practices or boycotts, against Israel.

The bill prohibits U.S. persons engaged in interstate or foreign commerce from:

  • requesting the imposition of any boycott by a foreign country against a country which is friendly to the United States; or
  • supporting any boycott fostered or imposed by an international organization, or requesting imposition of any such boycott, against Israel.

Presumably, under this Act, touted by defenders as combatting anti-Semitism, it would be illegal for any business (“U.S. persons” in this context likely means corporations, not folks like ones we tortured some of — though how one puts a corporate “person” in jail for twenty years is a legally absurd question) to call for another country to join any economic boycott against, for example, Saudi Arabia, a country very friendly to the United States.  

The ACLU recently raised a public fuss over this proposed law, in an open letter to legislators, and now many of the bill’s sponsors are actually beginning to read its text.  You can read a summary of the proposed bill on-line, at congress.gov, in a couple of minutes, yet the bill’s sponsors tap-dance when journalists confront them about the bill’s unconstitutional proposals.  

“Haven’t had a two minute break to read the on-line summary of the bill I’m co-sponsoring, neither have any of my aids, sorry, got to call some donors now, got to jet, bro.”

From the ACLU’s letter:

The ACLU has long supported laws prohibiting discrimination, but this bill cannot fairly be characterized as an anti-discrimination measure, as some would argue. For example, the Civil Rights Act of 1964 already prevents businesses from discriminating against customers based on race, color, religion, and national origin. This bill, on the other hand, aims to punish people who support international boycotts that are meant to protest Israeli government policies, while leaving those who agree with Israeli government policies free from the threat of sanctions for engaging in the exact same behavior. Whatever their merits, such boycotts rightly enjoy First Amendment protection.   By penalizing those who support international boycotts of Israel, S.720 seeks only to punish the exercise of constitutional rights.

One shouldn’t be that surprised, sniffing the political winds here, that this unconstitutional law is being enthusiastically entertained by so-called friends of Israel in the U.S. Congress.  The right is presented a golden opportunity to advance its agenda with this group in power now, in Israel and here.  Just recall that our current president’s first foreign trip was to an oil-funded monarchy that executes people,  like the fourteen that the Saudi justice system, under Sharia law, is prepared to decapitate (if they haven’t been beheaded in the last day or two) for the capital crime of attending pro-democracy protests in Saudi Arabia.  They will have their heads cut off for exercising a right in an oligarchic tyranny that tyrannical types in America would be happy to outlaw here as well.  

No point mentioning that Saudi weapons, purchased from America, are currently being used to destroy hospitals and water filtration plants in Yemen, the poorest country in the region, as a plague of cholera spreads.  Americans are understandably much more interested in the resignation of the president’s beleaguered press secretary (and who among us wouldn’t love to know the comically named Scaramucci’s “particularly crude nickname” for the comically named Reince Priebus?).  Why talk about war crimes being committed by our mega-rich Wahabist allies when we can propose laws to harshly punish speech we don’t like, speech that makes our friends look bad?

Bravo, you fucking psychos.

Psychopathy Update

If, in this hot weather, you feel like having a little cold chill run up or down your spine, check out Get Me Roger Stone on Netflix.   It’s a documentary about a man who claims to be, with a good deal of support to those claims, a trail blazing pioneer of political consultant/lobbyist influence selling, unlimited political campaign spending via legal loopholes and negative campaign ads.  He considers himself a genius in these fields and is coy about also being a master of what he calls disinformation.   Trump is this smiling sociopath’s proudest protege.  The president even models his speaking style on Stone’s.

Stone’s Rules, which are featured throughout the documentary, read like a psychopath’s catechism.  “Deny, Deny, Deny” is one of his rules. “Fuck ’em where they breathe” may be another.

The entire exercise for Stone is about winning and forcing his view on others, without regard for what many would consider ethics.   Stone proudly announces that with the election of Donald J. Trump we are all now living in the Age of Stone.   I suppose it could also be phrased as the Stone Age.    Stone’s comments about ethics and morality mirror comments made by no less an authority than the man the New York Times referred to as Mr. Hitler.  According to Mr. Hitler, “conscience is a Jewish invention”, morality is a Jewish device to weaken the will of those destined to rule the earth at any price.  

Roger Stone had a moment of revelation when he was an elementary school student during the Kennedy-Nixon election of 1960.  He loved Kennedy, a fellow Catholic with “great hair”.   During his elementary school’s mock election he told every student in the lunchroom that Nixon had a plan to extend the school week to six days.  Kennedy won in a surprise landslide.  Stone was hooked on the rush of an audacious lie swaying an electoral outcome.  He childish infatuation with JFK was short-lived, he soon developed a lifelong connection with Nixon.

Stone had a political revelation around 1964 after reading Barry Goldwater’s manifesto “Conscience of A Conservative”.  At age twelve he became devoted to increasingly extreme right wing politics.  He worked for Nixon, who he greatly admired.  He was proud to be the youngest person connected to Nixon’s corruption, and has a tattoo of Nixon’s head on his back.   He helped Reagan win with the campaign slogan “Make America Great Again”.  It was one of several slogans Reagan used, decades later it would be the only one Trump needed.

In the same way that the corporation, a “person” with only one legal concern, maximizing profits, fits the human definition of the psychopath (see this wonderful documentary  for a detailed comparison of modern corporations and serial killers — good website too), Mr. Stone and Mr. Trump are the human embodiments of this “no holds barred” kick ’em in the nuts approach to political dominance.  Heedless of anything but “winning”, unabashed about spouting the vilest fictions, they are examples of the great men that history, sadly, produces from time to time.

The Business Judgment Rule

A quick google search will turn up everything you need to know about the Business Judgment Rule, a firm rule of American law.  The highest authorities agree — a court should not substitute its judgment for the judgment of a business making a good faith business decision.    

Economists teach us about externalities.  Externality is an extremely nice, bloodless, abstract term for something that may be otherwise quite hideous. An externality is a cost that is not originally figured on, an unforeseen expense associated with bringing a product to market, a downside to be calculated in determining the bottom line.

A factory makes batteries in a land where labor is cheap.  Not only is labor cheap, there is no regulation against dumping factory waste into the local water system.   Getting rid of toxic chemical waste safely is expensive, as every factory owner in America knows.  If the corporation can just dump the chemical waste in the river they can save a ton of money, make higher profits.  It’s win-win.  Cheap labor force and no health or safety regulations. Huge profit vectors.

The rash of cancer deaths in children downstream in the river valley where the factory is located is an externality.  It is arguably an atrocity, a sin, certainly a public relations nightmare, but its monetary cost is also, like any other business expense, something to be reconciled on the corporate balance sheet, after it is resolved by the corporation’s legal department.  In practice, the families of the dead children, being in dire poverty, will settle the wrongful death cases for rupees on the dollar.  The life of a dead poor kid is about as cheap a life as you can buy.   The cost of paying the parents of these dead children is an externality, as is the death of the children themselves.  These are not intended consequences of the business policy, they are a kind of unfortunate price paid for the business decision made to maximize profits.  

The Supreme Court ruled that a corporation has only one legal responsibility: to provide profit for its shareholders.  The corporation was elevated to personhood, and lately given an unlimited voice in American elections by the Citizens United ruling, but the sole legal duty of the corporation remains, as the Supreme Court decreed many years ago:  to make maximum profit for shareholders and executives. 

People die as a result of corporate policies.  An externality.  Business judgment rule.  Unfair practices are committed routinely, business judgment rule.  The courts will not substitute their judgment for the judgment of those running a business.  It is fucking hard to run a business, Jack.  Let those with the expertise, the vision and the genius, folks who actually run the business, make the business judgments.  We owe them at least that much, Business Judgment Rule.   God bless America, its flag and the republic for which it stands.

Why the poor die young

We are, every one of us, subject to stress.  Some of this stress, if prolonged and unrelieved, will kill you.  It does this by raising the blood pressure, causing unhealthy eating with its associated health problems, providing the random stroke here and there.   Death by stress, the kind that makes us feel utterly powerless, is the death of a thousand cuts.   Multiply the cuts by five if you are poor, because they will come at you at a fairly vigorous rate.  

The life expectancy for poor people is shorter than for affluent people.  The way poverty kills is as interesting as it is sickening.   I have been learning about it daily as I try to get the medical services I buy insurance to help me pay for in the wealthiest country on earth.    

I must point out that I am not poor, though I have no steady income, or unsteady income either, for that matter.   I am not a candidate for pity or sympathy, my subsistence life is a matter of choice based on my priorities.   In 2010, when my mother died, I inherited enough to live for a few years while focusing on the program I was trying to get into public schools.  The money was not enough to retire on, but it was enough, if I lived frugally, to keep me afloat until I can figure out how to make a living.  Fortunately for me, I have never coveted most of the things that money can buy.  I own virtually nothing, beyond the mountain of boxes of paper I am too weary to sort through.  

I am aware that a case can be made that I am living the life of a mad person.  As is true of my kind, the idea that I may be living the life of a mad person does not unduly bother me.   The life I am subjected to, constantly, for living on an income less than 200% over the artificially low poverty line, on the other hand, bothers me continually.   It is the bitter taste in my mouth I often wake up with.

Today, for example, I woke to this note from a lawyer who was helping me on my “appeal”, congratulating me on the overturn of New York State of Health’s January 9, 2017 error that forced me to pay double the legal rate for my monthly premium.  I will now, or at some point, be paying the legal amount for health insurance, based on my taxable income, rather than the full amount.

You won, congrats! NYSOH has 30 days to comply by redetermining your eligibility for tax credits. Provided they do so, you should expect to start paying a lower premium – my guess is for September.

It makes no difference that this redetermination takes, literally, about five seconds using their own on-line calculator.  They have thirty more days, under some obscure federal law regulating the exact parameters of how agencies may fuck with poor people.   You can’t reasonably expect a simple error to be corrected in less than 170 days– not if you are powerless to threaten legal action.  

I read this email as, directly above my bed, an hour before my alarm was set to wake me, the woman recently sprung from the lunatic asylum began caterwauling her imagined vocal exercises.   A dog, hearing this shrill, tuneless whine, began to bark in protest.  I listened to my voicemail.  

It was not the promised call back from the nephrologist’s office I have been waiting for, but a detailed demand from the office of the dermatologist I will see on Thursday about the form of referral I must have sent to them to avoid paying the full, uninsured price for the visit.   A paper referral, like the one I brought to the nephrologist at the same hospital, will not do, the message informed me.  It must be electronic and it must contain the dermatologist’s full name and NPI number and other information, which is recited in detail.   The message ended by giving me a fax number for my primary care doctor to send the “electronic” referral to.

I thought of the stack of medical bills on my kitchen table.  It is a large stack. The bills from the first months’ visits and tests for my kidney disease are close to two thousand dollars.  This is no problem, my deductible is two thousand dollars.  The bills from the hospital demand a number fifty percent higher than the number my insurance company tells me I’m responsible for.   Somebody is right, somebody is wrong, it is up to me to figure out what I actually owe and to pay the proper amount.  Overpayments will not be refunded.  

It is the accumulated devilish details of one’s powerlessness that kill a person. I could whine on in this vain as the hysteric upstairs continues to keen, but it would be less than pointless.   I want to lay out exactly what it’s like for the poor person receiving any government benefit— or handout, as it is often phrased.

 We live in a country where the law permits a billionaire to take an enormous tax loss in a given year, like our president did when he lost $919,000,000 one year, and pay little or no tax for decades as a result of that enormous loss.  It’s a good deal for a very wealthy citizen, no question.  The tremendous saving is well worth the fee you will pay to the tax attorney to set the legal scheme in motion.

If you are not wealthy and receive any sort of government benefit, on the other hand, you will be subjected to more stringent requirements.  You will have very tight deadlines to comply with these requirements.  Miss any single one and you will be removed from the program with little or no right to appeal.  These things are absolute.  

If you are disabled and get a subsidy toward your rent, and you receive a notice to attend a face to face meeting to redetermine your eligibility, or even if you don’t receive it but the agency has prepared such a notice, you will lose your benefits for failing to attend the face to face.  I was involved in many cases in housing court where this happened.  It can take a year or longer, if ever, to have these benefits restored, provided a skilled advocate exerts herself heroically enough on your behalf.   You know this is fair, because you are a fucking loser.  

OK, we all know it’s not fair.  But de minimis non curat lex— the law does not concern itself with trifles.   Your paltry little housing subsidy is nothing compared to the millions a wealthy person stands to save by shrewdly using the tax code.   You will be homeless, with nobody to blame but yourself.  What do you want the rest of us to do?   Be realistic.  We are in an existential war against Terror while politically motivated alarmists are trying to convince us that strip mining the earth and burning everything we find is harming the earth beyond repair.  

Who are you going to listen to anyway, the wealthy, telegenic personalities of the mass media or some artificially poor fuck whining on a blahg in an attempt to drown out the howling of a mentally ill woman upstairs?  Besides, I am reminded that it is summer, time to relax.  Why do I allow myself to get worked up like this?  Jesus.

Plain Language

When I went to law school, more than twenty years ago, there was a big emphasis on plain language.  Lawyers should write as plainly and clearly as possible.  In the old days, we were told, scriveners, who wrote legal papers for lawyers, were paid by the word and so they laid the words on with a trowel.  This practice led to unplain, exceedingly excessive language, writhing, modifier-laden legalese, language embellished, decorated, complicated and modified, as needed, or sometimes not, according to long custom, by a dozen redundant, recursive, tautologous synonyms encompassing a dozen finely calibrated shades of meaning, foreshadowing, portent, legal significance, modified ambiguity, standard boiler-plate ambiguity, ambiguousness intended and incidental, anything to the contrary notwithstanding.   Reading legalese is generally a huge pain in the ass– take a glance at our Constitution or any on-line contract you must accept before getting web-based services.   “Plain language!” we were told, “the law now requires anything a consumer will be bound by to be written in plain language.”

 That was some precatory, aspirational, academic shit, apparently.  We were also taught to use the female pronoun instead of him and his when speaking of general things.   It was a fairly liberal school, I suppose, even though it had its share of rigid sociopaths on the faculty.   There are, I need not point out, rigid sociopaths on every shade of the political spectrum.    

I am thinking about this because I just got a determination from the New York State of Health appeals unit.  It is seven pages of fairly spare legalese that concludes with the determination that NYSOH must rescind its notice of January 9, 2017 and reconsider my case in accordance with the law.   It does not say, anywhere in its learned pages, anything that someone without a background in the law can understand as a clear, five and a half month belated, reversal of NYSOH’s clear error.   An error, moreover (to use a word beloved of scriveners everywhere) that anyone on the NYSOH website can verify in less than five seconds.  

It was only a four and a half month wait for the appeal and then, a speedy 30 days for the determination to be written up and sent out.  I have only been required to loan a large corporation about $1,250 in that time and I am told it will come back to me some time next year when I file my taxes, since I was entitled to what the decision refers to as the APTC, payable on my behalf towards the monthly premium of the QHP.  The subsidy, in other words.    

Rigid sociopaths are currently dickering about the quickest way to dismantle the conservative think tank-born, health care industry-friendly health insurance plan that bears the hated secret Muslim president’s name.  These are some dangerous, cynical, amoral motherfuckers doing this dickering.   Obamacare is bad in many ways, very bad in some ways, but it is a step forward, although not necessarily in the absolutely right direction since it leaves ravenous foxes to supervise the hen house.  The plan these dickheads are trying to push through will be a disaster for millions.  It has a 12% approval rating among the citizens of this nation of poor bastards, which is why it was initially kept secret and why its advocates are refusing to allow public debate on the punitive details of the new bill.

The Republican plan, in fairness to them, while hurting the poor and lower middle class, will greatly benefit the rich.  Who can blame the rich for trying to get richer?  It’s only natural.  

Like trying to repeal the hated DEATH TAX, another long time dream of America’s greediest.  Check this number out– I don’t know why it is not more widely known.  The so-called DEATH TAX affects the top 0.2% of our great, gullible, lynch-mob republic.   For those of you not good in math, that’s 2 estates out of every 1,000.   I don’t know about you, but that number of people affected by the so-called DEATH TAX, the top 2% of the top 1%, gives me goose bumps.   

Have a groovy fucking day, y’all.