Category Archives: muttering to myself

Integrity 2– imaginary discussion

“I ran against the anti-democratic secrecy of Cheney and Addington.  I promised, many times as a candidate, to run the most transparent administration in history.  I promised I’d protect whistle blowers.  The Bush administration classified literally everything, used sovereign immunity, state secrets, national security rationales, intimidation, the pressure of jailing, lawsuits and everything else, to keep crucial information from the People, from the electorate.  Cheney had a safe in his office big enough to hold half a dozen detainees, for Christ’s sake.”

“That second Bush Administration dramatically shifted the public’s right to know to a need to know basis.  They shifted the traditional burden on government of showing something needed to be secret to the burden on the public of proving it should not be secret.  Tricky for the public to do that when they don’t even know there is a secret.   Testimony by the President and Vice President at the 9/11 Commission was top secret, no recording, no transcript, no notes.   Commission members sworn to secrecy.  What the hell was up with that?  Scandals and war crimes were reported in government reports, the reports were classified.   The press was used as a megaphone to broadcast government policy.  I vowed that my administration would reverse that anti-democratic crap.   Now you’re telling me we should try this American journalist under the 1917 Espionage Act, like the guy is a spy during wartime for doing research for his story on CIA torture?”

“It would send a strong message, Mr. President.  We are still obliged to work in the shadows, sir.”

A long pause.  “Ah, hell with it.  Tell Holder to use the stinking 1917 act.  We can’t ask for the death penalty under it, can we?”

“No, Mr. President.”

“Wait until my supporters get a whiff of this…”

 “Our country is so divided, and your opposition so virulent and irrational, Mr. President, that your supporters will defend you, no matter how foul the cologne you might be obliged to douse yourself in from time to time.”

“Get out of my sight….”

Integrity — exercise in imagination

“You mean to tell me this American citizen has been locked up, without charges, in solitary confinement, for almost a year over there?” asks the president sharply.

“Yes, sir,” says a high ranking advisor, “at our request, sir.  He’s articulate, and pissed off and self-righteous.  He preaches in perfcct English and in native Arabic.  He has a worldwide following of young jihadi types.  He could be lethal winning hearts and minds for al Que’da.”

“Can’t we charge him with anything?  He’s an American citizen, are we now detaining American citizens without charges, without habeas corpus, without any sort of judicial process? Has the Constitution been suspended for citizens who are too critical of our policies and I’m just the last to find out?”

“We really don’t have grounds to charge him with anything, sir, other than abusing the First Amendment.  We need to hold him, though.  He’s dangerous, charismatic, his internet sermons are inspiring fanatical youth around the world.”

“Can’t we shut down his website?”

“We did.  The sermons circulate on DVD.  It’s best to keep him locked up, sir.”

“Under the secret detention black site policies Dick Cheney and David Addington put into place when this country went to the dark side?”

Sometimes no answer is the best answer, the advisors hold their peace.  

“Charge this guy and have him extradited or tell Yemen to cut him loose,” orders the president, turning to the next name on the list.  

A year or so later, still not charged with any crime, the American cleric was released from prison.  

A couple of years later his name appears on a kill list given to the president.  The president is known for his  eidetic memory.

“Isn’t this the guy who Yemen had in solitary without charges, the American citizen we finally told them to cut loose?”

“Yes, Mr. President.  He’s still giving sermons, and his rhetoric is on fire.  We need to silence him.”

“I ask you again, general, can we charge this motherfucker with a crime before we kill him?  Any crime?  At one time extra-judicial executions were frowned upon.  We Americans always frowned upon them, publicly at least.  Are we now killing even American citizens without feeling the need to even charge them with a crime?   Doesn’t his father have a lawsuit in our courts to keep him off the kill list?”

“The law suit will be moot, sir, if we shoot.”

Moment of decision, where one would like to imagine a man of integrity drawing a principled line he will not cross.  An American citizen cannot be killed without judicial review.   Even if he is charged and tried in absentia, there is some legal process, some requirement to prove guilt of a crime serious enough to punish with execution, before we sentence one of our citizens to death.  It’s just wrong, putting a name on a secret list and designating him for death, especially one of our own citizens and it sets a very dangerous precedent.

“Mr. President, he’s been eluding us for many months, for over a year.  He’s becoming a hero in that wild tribal area in Yemen and a symbol of defiance.  We know where he is tonight, we have a small window to act.  We need to kill him now, sir.”  

A long pause.  “Fine,” the signature scrawled left-handed next to the American’s name, marked for death.  “Just don’t come to me in a couple of weeks and tell me you also killed his teenaged son with the dreadlocks, or the kid’s friends listening to hiphop somewhere.”

“Will do, Mr. President, absolutely.  Thank you, sir.”

 

 

Idealism 101

Idealists
have never ruled the world,
grow up!
It’s hard enough
to get rich
without worrying about fucking ideals.
Be serious,
you know very well
what this world does
to people who try too hard
to be saints,
lacking the power to nail it.

Put it this way,
if Jesus had had
the Pope behind him
they’d have put every one
of those crucifiers
to the sword,
end of story.

When were you wont to be so full of songs, sirrah?

Wednesday 2-18, downtown A train

“Oh, happy fucking day,”

said a bitter old face

like mine

ceiling sprung a new leak

drip, drip

onto my last nerve

woman at Obamacare

didn’t know much about benefits

but read my 1099s to me,

including the one I received yesterday

“Do you still work at EVCS?” she asked

teeth and eyes not

needed for our health

not here

in the land where we no longer

tolerate

the lynching of former slaves

here

in the land of the free

and the home

of brave

corporate personhood  

“Whoa! calm down, man…”  

“Don’t you fucking

call me ‘man’, man,

don’t you fucking call me ‘man’!”  

There was a time

my hand would become a fist

where humans

forced to wear signs saying

“I am a man”

would have made me want to holler

arms hard,

ready to strike  

“Who is there to strike?”

a voice asks,

reasonable, kindly.  

“Those who benefit

from the murder

& enslavement of others,”

I say.

 “Ah, yes,” the voice says,

sadly,

“but one can never touch them.”  

ii

“When were you wont to be so full of songs, fool?”

the king asked me  

“Since every sweet lake, sire, receded to shoals of piss

a cool drink not sold by the bottle

living now only in fond nostalgia

while the priapic, tireless

thrusting, twisting, plunging

forms the rhythm section,

the recoiling cringe replacing dance.”

“There is more hope

for a dog returning to his vomit 

than for you, fool,” noted the king

“Yes,” I said,

“another song, sire?”

Shining the Light of Reason

It turns out there is a good reason I am responsible for a few hundred dollars in connection with a preventative procedure 100% covered by the Patient Protection and Affordable Care Act.  Once it was explained to me, it became perfectly understandable.

The procedure is 100% paid for (with only a token $100 payment required from me), a $4,050 colonoscopy that was paid, on my behalf, at the contracted price of $852.  In consideration of this deep discount, the PPACA also protects the interests of doctors shorted by insurance company payments as well as the insurance companies themselves.

The PPACA requires a pre-colonoscopy office visit, something not previously required.  This visit with the specialist is subject to a $50 copay.   The doctor may charge up to $250, but the patient will only be responsible for the difference between the copay and the contracted price for this required visit, $131.   So the bill for the additional $81 is correct and the full responsibility of the patient.  The $131, which goes toward the $1,750 deductible, reflects another deep discount, almost 50% off the sticker price.

The diagnostic code 2113 was properly entered by the doctor’s office, even though no diagnosis was involved.  It’s called a diagnostic code, sir, and you chose a plan with a deductible, even if it was the only plan offered at your income level.  Pay the bill.

Procedure code 88305, level five, means that the patient, and not the insurance company, is responsible for the other half of the pathology charges related to the colonoscopy.  If the preventive procedure had not discovered any abnormalities requiring a pathologist, the patient’s preventive care would have been completely without additional cost, except for the $131 deductible and the $100 pre-colonoscopy fee.

As my father so often reminded me, I’d complain if I was hanged with a new rope.  The main thing is– what a great step forward Obamacare is for every American patient everywhere and how generous the discounts it affords.   And as President Barack Obama himself would say:  what are you going to do about it anyway, bitch?

Here we go, the ACA, in a nutshell

Haven’t discovered how to enforce my right not to receive apparently fraudulent bills from health care providers (so far I’ve had a few hundred dollars for duplicative demands for payment dismissed, after calls to billers).  But part of the difficulty with the law is put in context by the following:

The Patient Protection and Affordable Care Act (PPACA), codified as amended at scattered sections of the Internal Revenue Code and in 42 U.S.C. commonly called the Affordable Care Act (ACA) or “ObamaCare“, is a United Statesfederal statute signed into law by President Barack Obama on March 23, 2010.  (Wikipedia)

When I wrote the other day that it was written by the health insurance and pharmaceutical industry to benefit those industries, I was lacking the name of the author of the ACA.  A friend found it for me in remarkably short order.   Her name is Elizabeth Fowler and she worked closely with former Senator Max Baucus between three separate stints in the industry.

Here’s a good article about Elizabeth Fowler, health industry insider and primary author of the PPACA, now back working for Johnson & Johnson — with a very worthwhile five minute video editorial by Bill Moyers at the end of the article.

(Thanks to JDS for sending link to article on Liz Fowler and her stinking ilk)

If you prefer an article in the New York Times, read this.

A bit more about Ms. Fowler and her former boss, Mr. Baucus:

Fowler’s career in Washington stretches back more than a decade, when she first left a private sector hospital group in Minnesota in 2000 to join the Health Care Financing Administration, a federal agency now known as the Centers for Medicare & Medicaid Services (CMS).

By the following year, Fowler had landed at the powerful Senate Finance Committee, working on health care issues for Montana Democrat Max Baucus. Lobbying records show that Fowler stayed until 2006, when she departed for a two-year stint at health insurance company WellPoint, only to return to the Senate in 2008, again working on health policy for Baucus.

When it comes to health care, and health lobbyists, Baucus isn’t just any senator. Since 1998, he has collected more than $5.1 million in campaign contributions from the insurance, pharmaceutical and nursing industries, making him one of the health care sector’s most heavily backed lawmakers.

 (the rest of the article is here —->)  yawn, yawn 

The Difficulty of Even Researching the ACA

The Patient Protection and Affordable Care Act is one of those taunting, ironic names government sometimes gives to things.   That patients are not protected from billing practices that violate the law, that the rights that must be protected are not discoverable without massive effort (my own efforts continue, I’ll let you know when this lawyer discovers the section of the massive and complicated law that outlines these inviolable rights)  that there is no place to have a clear adjudication of the many violations of protected rights, and that the health care is not necessarily affordable add to this citizen’s sense of being taunted.

My frustration reminds me of how angry I felt, the day after millions gathered across the globe, and I was one of hundreds of thousands in New York City out protesting on an arctic day, threatened by NYPD on horseback and kept blocks from the U.N., when then President Bush announced that we would invade Iraq in a war based on endlessly repeated lies and the profit calculations of a few powerful corporations.

“Those stupid, cynical, Nazi motherfuckers!”  I remember thinking as Operation Shock and Awe began in my name.  That was just my frustration speaking.   The architects of that illegal war were not stupid– they made a ton of money whacking that hornet’s nest and destabilizing an already volatile part of the global warming puzzle. Nobody whose actions lead to amassing a fortune can be called stupid, not here.   Cynical?  Perhaps, you could make a good argument there, but there is no law against being a cynic.  

Nazis?  Well, to put things into perspective, the Nazis started a war that killed tens of millions while deliberately exterminating many millions in specially designed death camps.  The Bush Administration killed only about 500,000 Iraqis, many of them, undoubtedly people who hated America.  Moreover, not one of these Iraqis was killed in a death camp, there simply were no death camps.  Perhaps 1% of that number of Americans were killed liberating Iraq from a monster, so already comparisons with the Nazis seem a bit strained, don’t they?  

The Bush Administration, as President Obama finally admitted “tortured some folks”, but even a quick comparison makes one realize how unfair it is to call them Nazis.  They really believed they were doing the right thing!

Maybe Max Baucus, whose committee wrote the Patient Protection and Affordable Care Act so reviled and attacked by the President’s legions of bitter enemies believed the same thing.  The health insurance industry, and the pharmaceutical industry, two huge supporters of the long-time senator, would be badly hurt by a single payer system that would allow a few hundred million Americans to bargain for health services that could be fairly regulated by the federal government.  Where is the freedom in that?  Stinks of Socialism and restraint of the free market, don’t it?

Don’t believe me, here’s what Wikipedia says about Mr. Baucus  and the practical conflict of conscience * he endured while overseeing creation of the immensely dense Patient Protection and Affordable Care Act.  In a five year period prior to beginning his work on Obamacare he took in almost $5,000,000 in campaign contributions from the industries the new law would either make much more profitable or rob of a good share of its profitability.  Doesn’t take a genius to put the sad facts together.

What I’m looking for, and haven’t found yet, in addition to a clear cut answer on whether I should pay bills for hundreds of dollars for a covered preventive service, on top of my $471 monthly premium, is the name of the woman, one of the primary authors of the grotesquely tangled ACA,  who went through the revolving door President Obama announced would be closed, and returned to work for the health insurance industry at an annual salary in the millions.   Can you say “job well done”?   Good thing Mr. Obama closed that revolving door, as important as his closing of Gitmo.   Ask the prisoners there who are being force fed with tubes down their throats how that closing of Gitmo thing worked out for them.

Sarah Palin winks atcha.

 

 

* Baucus has been criticized for his ties to the health insurance and pharmaceutical industries, and was one of the largest beneficiaries in the Senate of campaign contributions from these industries.[40] From 2003-08, Baucus received $3,973,485 from the health sector, including $852,813 from pharmaceutical companies, $851,141 from health professionals, $784,185 from the insurance industry and $465,750 from HMOs/health services, according to the Center for Responsive Politics.[49][50] A 2006 study by Public Citizen found that between 1999 and 2005 Baucus, along with former Senate majority leader Bill Frist, took in the most special-interest money of any senator.[51]

Only three senators have more former staffers working as lobbyists on K Street, at least two dozen in Baucus’ case.[51] Several of Baucus’s ex-staffers, including former chief of staff David Castagnetti, are now working for the pharmaceutical and health insurance industries.[52]Castagnetti co-founded the lobbying firm of Mehlman Vogel Castagnetti, which representsAmerica’s Health Insurance Plans Inc, the national trade group of health insurance companies, the Medicare Cost Contractors Alliance, as well as Amgen, AstraZeneca PLC and Merck & Co.Another former chief of staff, Jeff Forbes, opened his own lobbying shop and to represent thePharmaceutical Research and Manufacturers of America and the Advanced Medical Technology Association, among other groups.[citation needed]

A statistical analysis of the impact of political contributions on individual senators’ support for the public insurance option conducted by Nate Silver has suggested that Baucus was an unlikely supporter of the public option in the first place. Based on Baucus’s political ideology and the per capita health care spending in Montana, Silver’s model projects that there would be only a 30.6% probability of Baucus supporting a public insurance option even if he had received no relevant campaign contributions. Silver calculates that the impact on Baucus of the significant campaign contributions that he has received from the health care industry further reduces the probability of his supporting a public insurance option from 30.6% to 0.6%.[53]

In response to the questions raised by the large amount of funding he took from the health care industry, Baucus declared a moratorium as of July 1, 2009 on taking more special interest money from health care political action committees.[54] Baucus, however, refused to return as part of his moratorium any of the millions of dollars he has received from health care industry interests before July 1, 2009, or to rule out a resumption of taking the same or greater health care industry contributions in the future.[54] His policy on not taking health care industry money reportedly still allowed him to accept money from lobbyists or corporate executives, who, according to The Washington Post, continued to make donations after July 1, 2009.[54] A watchdog group found that in July 2009 Baucus accepted additional money from the health care industry in violation of his own self-defined moratorium terms, reportedly leading Baucus to return those monies.[55]

source

Obamacare 101

If you receive health insurance under the Affordable Care Act (“ACA”), Obamacare, you already know that it has all of the elements of a corporate scam.  If not, the jury would seem to still be out.   I’m here to tell you that the verdict is in.

I have a politically progressive friend who reads the Wall Street Journal every day.  He argues that the ACA has been a great step forward.  It covers millions more uninsured Americans than ever before and is beginning to rein in runaway medical costs.   As a participant in the ACA, and no fan of the Wall Street Journal, I can tell you from direct experience how closely Obamacare resembles an insurance industry scam.  

On the plus side first, it can’t be denied that eliminating the loophole of “pre-existing conditions”, the term that enabled American health insurance companies to deny insurance if you were ever sick with a particular disease, was welcome, and long-overdue.   There are other good features, no doubt. The perfect should never become the enemy of the good, as the president has said, but for the most part the ACA, that great free market compromise with comprehensive health care reform written primarily by and for the insurance industry, profits mainly that industry.   Like many other boons applauded by the Wall Street Journal, it involves large profits for the canny few at the expense of the clueless many.  

The opacity of the 900 page ACA is one of its most notable features.  If your rights and remedies are hard to discover, most people pay the bills they are sent and kiss their rights and remedies goodbye.

New York State set up a Health Care Marketplace at the earliest possible date.   We were all in for Obamacare.  Visit the New York State of Health website and you will marvel at the opacity of the consumer-friendly system.  From the difficulty of signing in (that’s called Get Started, by the way, no matter how many times you’ve already gotten started), to the lack of easily navigable plan details, to the absence of a clear statement of what the ACA is, or what it guarantees, to the almost completely useless help number (“we are experiencing more than the usual volume of callers, your business is very important to us”) you will see enough to discourage the casual seeker of health insurance from persisting there.  Also, enough to deter anyone looking for the rights guaranteed by the law in clear, unequivocal language.

“Preventative services are 100% covered,” the helpful woman at the NYS of Health assures me, after only 35 minutes on hold.  I ask her where I can see a list of these covered services, since I’ve already paid $150 in co-pays towards my recent colonoscopy and am being dunned, and threatened with collection letters, for an additional $281 connected with this preventative service.   She isn’t sure where I can find that language, the NYS of Health Marketplace only sells the plans, they don’t actually administer them or oversee the individual insurance companies.  

This particular woman is great, sympathetic, smart.  I kick myself that I did not get her name.  We look together for language that says I’m entitled to have my colonoscopy paid for 100% under the ACA, for my $471 monthly premium.  I find, several screens later, in only 4 or 5 clicks, this page, under Resources, and on the pull-down menu there’s a link for Using Your Plan, that eventually takes me to this, at the bottom of that page:    

Sep 26, 2013

Covered Benefits and Out-of-Pocket Costs for 2014 Standard Health Plans

And I read, under What Are Essential Health Benefits, number 9, the closest I will find to any kind of confirmation of this seemingly simple yes or no fact that preventive services are not subject to any deductible, to wit:  

Prevention & wellness services and long-lasting disease management

“You are entitled to be repaid that $150 you already paid for a covered service.  If your insurance company is making you pay any fee in connection with a colonoscopy they are not in compliance with the ACA and you should hold their feet to the fire,” this bright woman, a former health insurance industry appeals expert, tells me firmly.  

She informs me, in answer to my question, that the Department of Financial Services (“DFS”) is the state agency that holds insurance companies accountable for compliance issues.  She gives me their 800 number (800-842-3736  M-F 8:30-4:30).   I ask why there is no information about that on the NYS of Health webpage. They are discouraging frivolous complaints, she explains, since so many people are having problems with the ACA.  Not publishing the complaint number reduces the amount of angry callers making unfounded complaints before they have followed up with their individual insurance plans to make sure the insurers are out of compliance before calling DFS to lodge a complaint.

Makes me think of President Obama’s laudable campaign promises about transparency in government, protection of whistle blowers, and robust protections for consumers. Clear knowledge of one’s rights, after all, is a precondition to exercising them.   Few things are more important to the proper functioning of a just and accountable democratic republic than government transparency.   Few things are more useful to exploiters, despots and profiteers than the secret concealment of devilish details that might galvanize righteous opposition.

I recall the president’s campaign rhetoric and think of the Obama administration, the most opaque in our history, whatever else one might say about it, and my jaws clench. And I have to say, between Obama and Bush, dealing with the latter is much less soul crushing to an idealistic citizen than listening to the glib eloquence of the Equivocator in Chief, great lover of justice and defender of the common citizen that he is.

 

 

Survival Kit

One essential item in this kit is a sense of purpose, the hearty hope that we are not struggling in vain in a senseless universe.  A compelling reason for our existence.

Reason, that most ticklish, sticky and fickle of things.  How many insane fanatics have brandished indisputable Reason as they committed unspeakable acts?    

“Most insane fanatics brandish Authority, which is different than Reason,” she says, reasonably. 

Not a bad point, actually.  Authority is most often cited based on faith, not rationality.  

“Wait a second,” she says.  “Are YOU completely insane?  Why are you sitting there tapping like a blind man across cobblestones when there is so much for you to do today?”

“Faith,” I say, without apparent conviction.

“Faith in what, pray tell?” she says.

“Faith in the sudden eruption of poetry, a moment of music, faith in the essential spark that animates every moment of elation, faith in imagination,” I say.

“Faith that you are, somehow and in the face of massive evidence to the contrary, not a fool,” she says.

“Yes,” I say, and nod my head to the tapping of these keys.

Priapic Corporatism

The corporation, American jurisprudence holds, is a person.   It is a sort of idealized rugged individual type person, having no need for anything but profit.  It also has an insatiable, if impersonal, sexual appetite, with the legally constructed and indefatigable organs to sustain this voraciousness endlessly.  

What makes me think of this today?   A call from a female robot, threatening to cut off my health insurance if full payment is not made by January 30.   This was especially aggravating since I’d made full payment on January 21 and had the email confirming payment.   I snarled the command to connect me to a representative and then was put on the queue as if I’d called the 800 number.

If you are an Anthem customer or member of the Freelancer’s Guild, press one, if you are a health care provider, press two, oprime el tres si no entiendes ingles, then muzak interrupted by the standard, sincere, reminders about how important my business is and urging me to stay on the line.

My blood began to simmer as the ten second muzak loop continued to blare.  Welcome to America, land of the bottom line– our only business is business.  You powerless cocksuckers will wait on hold to be placed on hold while the corporation gives you the chance to find out why you were threatened with cancellation of a policy you have already paid the premium for.

In only ten minutes Mark is on the line, apparently having a hard time making out the spelling of my name.   That D, he asks if it is a G.  “D as in dog,” I say and he hears E.  D as in David works.   Then I go through a similar exercise with my first name, he reads back an Aleutian name instead of the one on my policy.  In a moment he sees the same confirmation of payment I am looking at.  He asks me to please hold for just a few minutes while he checks something.  

“I’m not going to hold, I’m going to get a call back from a human being apologizing for this aggravating error by the corporation you work for,” I tell him and he agrees.  “Do you have my callback number?” I ask him and he says he does, reads me back the number of the robot who called fifteen minutes earlier to inform me that my health insurance is about to be terminated for nonpayment of the January premium.  I give him the correct number, he promises to call back in a minute, and I begin shoveling a cubic ton of snow, snarling as I do.

In a moment he calls back.  Empire generated bills for two month cycles in 2015, this one was for January and February.   Presumably for corporate convenience, saves money on billing, like using robots to call customers and nag them for payments, instead of wasting humans who have to be paid to make these calls.  Since I’d only been required to pay January’s $471 and not the $942 that would have paid for my excellent Obamacare health insurance through March 1, I’d paid only half of the bill, the half I was legally required to pay.   You get the math here?  Pretty straightforward.  

I thought of the ungodly mechanical sexual apparatus of the American corporation, and how it thrusts endlessly onward, upward, downward, sideways, relentless and insatiable.  And I saw another American president, this one very articulate, witty and smooth, smiling next to it, admiring the vigor of the machine that makes him an obscenely wealthy and powerful man.