The Corporate Brain

First thing to understand–  they’ve got the whole world, in their hands.   Corporations.   We live in a global corporatocracy [1], whatever else is also going on.

There are rules we must understand, living under the rule of “persons” accountable only to shareholder profits.  One is to know the kind of “person” a corporation is:  a psychopath — incapable of empathy, remorse, or moral reflection.  The corporate “person” has one legal interest: the bottom line, increasing stock value for its shareholders.   A corporate person will only do the right thing (like paying to remediate its own negligence, or even intentional defiance of existing laws) if targeted by law enforcement and, after exhausting every legal appeal, being ordered to comply by a court of law.   Since corporations spend a fortune on armies of lawyers and lobbyists to influence the drafting of every law that could have an impact on their profits, good luck there, Charlie.

Two is to understand the nature of the corporate brain — it is purposefully segmented into as many unrelated subdivisions as needed to shield the larger organism from harm.  This is a deliberate device to protect the corporation, in part by exhausting the consumer, who must often speak to many unrelated segments of the corporate brain to try to get a reasonable answer, or redress of any kind.  I provide two examples from my recent, ongoing experiences with two random corporations.

Brand new Dell computer does not perform an essential function, seeing my cellphone as a hotspot.   It sees other nearby hotspots and wireless networks, but it cannot find the only network I can use to connect to the internet.  The computer is under warranty so correcting this defect should not be a major problem.   

Except that Dell has compiled a legally unassailable list of specific exemptions from their limited warranty.  They have me run all the diagnostic tests on the brand new computer and, after an hour or so, tell me that there is no problem with the computer’s hardware, and that therefore the problem, which appears to be a software configuration error, is “out of warranty.”   Not to worry, they tell me, Dell has a paid service that can fix the problem for me.

As is typical in corporations, “Warranty” has no way of communicating with “Out of Warranty”, and therefore has no way of informing a customer that 3 years of “out of warranty” service costs $239, plus tax, a more limited version of this “premium” support goes for $169 and a one-time fix will set you back $129.  The customer can only learn these prices after another long wait on hold.   The customer must listen to a loop of ads for wonderful Dell products and services, while waiting to learn the price, and submit to being thanked over and over for how important their business is to Dell.

Enough reason never to deal with this particular corporate motherfucker ever again, but at the same time, Dell is merely on the vanguard of maximizing profits through express warranty limitations.  Corporations can make a lot more money by making customers pay to fix built in problems than by covering their repair for free.  They hire legal geniuses like now-Justice John Roberts, creator of the arbitration clause, to exclude the most expensive repairs, even of Dell’s own design flaws, from the limited warranty.   “What don’t you understand about the word ‘limited’, sir?   All of the limitations are explicitly set forth in the thousands of words of our warranty, which we will send you for free.”

The beauty is, there is nothing you can do.  It’s all legal and ironclad.  Put the computer back in the box, scrawl “FUCK DELL” on top and bring it back to the store.  (I would advise not scrawling “FUCK DELL” on top, it could void the return and force you to pay at least $129 to be able to use the brand new computer).  Caveat emptor, asshole.

Healthfirst, the corporation I pay for health insurance, told me, on January 22, and again on January 24 (after their internal “appeal”), that my insurance had been terminated for my failure to pay a “binder” payment during a once-a-year ten day “grace period.”   They also informed me that under the law they had no obligation to inform me of this “grace period” before terminating my policy.    Then, on January 28, another department in Healthfirst called to tell me that my insurance had never been terminated and apologized for their “mistake.”  

Since then I have been trying to find out what the law actually is.  No state or federal agency has any idea why I was cut off and why I was reinstated.  Nobody can point me to the section of the law that made Healthfirst reverse its unappealable termination.   None can confirm which of the various complaints I submitted resulted in the overturning of Healthfirst’s original determination.

Finding and publicizing the short answer would provide a valuable service for my fellow citizens, screwed by the thousands exactly as I was.   To put it simply: what protections against termination without notice do patients have under the Patient Protection and Affordable Care Act, Obamacare?   You know, the federal law the right wing has been rabidly trying to abolish since it went into effect? [2]

I finally got a letter of explanation from Healthfirst, in an envelope marked “Grievance and Appeals”.  It was entitled “Notice of Grievance Resolution”, as though on February 14 I had contested Healthfirst’s decision to restore my health insurance after terminating it weeks earlier.   The notice states that my insurance was properly terminated for my failure to pay the binder during the ten-day grace period.  It states that my insurance had never been terminated, as confirmed by the call I received on January 28 apologizing for Healthfirst’s “mistake”.

Why this corporate change of “heart”?   That, sir, is nobody’s goddamned business.  Please continue to hold, your business is very important to us.

 

 

[1]  Wikipedia:

Corporatocracy is a recent term used to refer to an economic and political system controlled by corporations or corporate interests. The concept has been used in explanations of bank bailouts, excessive pay for CEOs as well as complaints such as the exploitation of national treasuries, people and natural resources. Wikipedia

[2] The law itself is now finally under reconsideration by the Supreme Court, in light of a federal court striking down the “mandate” that was upheld by one vote when John Roberts found this requirement of Obamacare constitutional.  Keep your helmets on, my fellow hostages.

For the Love of God, America

After a funeral yesterday we all sat in a restaurant having lunch.   The gentle fellow across from me reported how easy it was to deal with Medicare, one simple statement, everything pretty straightforward.   I asked if he thought it a good idea to have a similar health care system for people before they reached sixty-five. He said he did, but how are we going to pay for it?  A second later he began excoriating Sanders and Warren and I saw that we were nearing the end of a real conversation. At this Sanders/Warren prompt there was a chorus of nearby voices stating how imperative it is we vote Trump out in 2020 (that chorus was joined by a Trump 2016 voter.)  

As far as the current health insurance regime for millions, Obamacare, my interlocutor agreed it was absurd to be given a menu without prices and to be billed six weeks later, as the Patient Protection and Affordable Care Act allows providers and insurers to do.

The buffet most of us were having cost $49 per person, as the waitress readily told us.   Imagine if no price was given and our host simply had to wait six to eight weeks to be billed and learn that the price was $400 per person, and there was no recourse.  That’s the price, deadbeat.  If you have premium level buffet insurance, the price will be $49 per person, but, sadly, you did not take precautions.  Caveat emptor, bitches.

On January 8 I had the first of four endovenous ablations in my legs.  It had been deemed medically necessary and insurance had approved the procedures.   There was, of course, no way to know the price in advance, as per the impressively opaque 906 page Patient Protection Act.   On January 22 I was informed by Healthfirst, the company that I pay for my ACA insurance, that my insurance had been terminated.  This meant I’d be responsible for the full, non-insured price of the first treatment, whatever it turned out to be.  Several days later I managed, by very hard, stressful work and sheer luck, to get the unappealable termination of my insurance overturned.   Insurance would pay after all.

My sickening fight with the insurance company, with every state, local and federal agency, the stonewalling at every turn, another story for another day.   It is ongoing and seemingly will never have an end, until I arbitrarily give up.  The citizen has, according to everyone, no right to know the exact provision of the Patient Protection Act that protects him from the unappealable acts of a health insurance company that are later deemed “mistakes” regarding a wrongful termination of insurance.  OK, I guess that’s some form of democracy, if you’re lucky enough not to be violently sodomized by it. [1]

Anyway, the other day I got the Explanation of Benefits for the first of four ablation treatments.   The full, retail price: $5,460.    The Allowed Amount: $1,572.  My copayment, already paid: $25.   Multiply this hefty sum by four and you will understand that the insurance company had thousands of compelling reasons to terminate my policy, if given the chance.   Without insurance, the cauterization of those two leg veins would have cost over $21,000.   That’s why all Americans need health insurance, to be protected against bankruptcy if one survives the medical challenges themselves.

Which is why, of course, Mr. Trump, who promised better, cheaper, universal health care for all Americans back in 2016 has fought so hard to bring us Trumpcare. Cheaper, better, covering all Americans, brought to us all by Mr. Trump (born American and college graduate, unlike Obama!) and the incorruptible, unconquerable wall of Republican Senators and a vast army of lobbyists and “donors”.  USA!   USA!!!

 

 

[1]  I am always pointing out to the reps I am appealing to for help that I support the ACA, voted for Obama twice, realize Obamacare is a halting, but significant, step forward and that the tweaks needed to make it work better — like every other large government program got in its first few years of administration as problems were discovered–  were all prevented by a partisan lynch mob working with a klanlike zeal to prevent the n-word president from having a second term and then making sure he was able to accomplish nothing in his second term but the divisive election of a White Supremacist successor who would do his damnedest to wipe Obama’s record from history.   I get all that, but still.

How To Avoid The Second Civil War

In a nation that has long been an innovator in the inter-related arts of public relations, advertising and propaganda, most of us get our news in a highly mediated, skillfully filtered form that caters, increasingly, to our own personal prejudices.    It seems impossible to find a reasonable consensus at this historically perilous moment.   At least 45% of the country sees Abuse of Power and unprecedented blanket obstruction of all investigations as not impeachable.

Many now believe that there are facts and there are equally valid alternative facts, in this threatening pre-civil war funhouse we are all living in at the moment [1].  We are living in a historically perilous time, like Kansas 1860, or Berlin 1932, with the unsettling overlay of the foreseeable end of a habitable planet ticking loudly in the foreground.   If we are to spare ourselves another actual bloody civil war, followed by mass extinction, we need to be very smart going forward.

We consumer-citizens rely largely on commercial mass media, run by profit-driven corporations with deeply intrenched interests– largely increasing profits — for most of our information about our limited political choices.   Noncommercial news sources like Democracy Now! and the Intercept, outlets that cover the struggles of activists against institutional injustice unreported elsewhere, (and never to my knowledge successfully sued by anyone over a false report), are unknown to most Americans and the news they report is easily dismissed by low information voters and pundits on the right and center as … choose your favorite word for the ranting of liberty-hating, unAmerican losers.

Old friends rage at each other over perceived political dogmatism, blindness, defeatism, stupidity, idiotic idealism, long friendships sometimes ending in bitter inter-partisan disagreement over how to get to the end result both may desire.   Rage is effortless on social media, where trolls reign, delighting in provocation.   

We are sharply drawn into inimical opposing camps, every one of us powerless except as part of a larger block.  As far as political action, we are largely constrained by the design of the two party system, the only game in town, and forced to vote for whichever candidate is chosen for us by a National Committee.  We try to choose the less hateful of the two and hope for the best, a sorry version of actual democratic participation.  

Both major parties run on corporate dollars and the dark money of our super-wealthy, many of them the privileged inheritors of vast fortunes.  Our Supreme Court is staffed by at least five hardcore corporate rights judges who believe that corporations are “persons” entitled to all the freedoms the rest of us enjoy, including the freedom to all the speech their vast money can buy.  Our highest court holds that corporations are citizens just like the rest of us, only with infinitely more power and influence than any thousand of us regular people working together can hope to exert. [2]   The individual, unless very wealthy (see several billionaires currently vying for the presidency) is almost utterly powerless in our democracy.  Except for our freedom to speak, to reason, and to organize.

(brace for a slightly disjointed next paragraph, citizens)

If you are the victim of an illegal practice committed against you by a corporation, join the club, it’s a gigantic one.   Millions of us are fucked by corporations on a daily, hourly basis — they are not in business to make sure consumers are not being fucked, they are in business for the bottom line– maximizing profit, by any means that is not specifically illegal and enforceable against them.  The Supreme Court itself clarified that the sole legal imperative of the American corporation is maximizing profits for shareholders.   If a corporation violates the law, the consumer must find the precise law it violated and then find a legal remedy.  No specific illegal act under law and/or pertinent regulations found, no remedy, stay screwed, asshole.

I was recently victimized by the corporate “person” that provides my health insurance under Obamacare.  On January 22, when I called to pay my premiums through June, I was told Healthfirst could not accept my payment and that my ACA health insurance for 2020 had been terminated.   A supervisor, Daiya by name, confirmed that this had been done “pursuant to the guidelines” for my failure to pay during a once-a-year ten-day “grace period”.   She told me the corporation had no obligation to inform customers in advance of the severe and irreversible consequence of failing to pay within this one-time “grace period”.  She initiated what she said was the only available appeal, an internal one within the company, and called two days later to pleasantly let me know that Healthfirst had not restored my insurance.

Working hard and having a great piece of good luck, I managed to find the only appeal process that could remedy this particular illegal act (at the NYS Department of Financial Services, naturally– here’s the LINK).   Two business days after my on-line complaint I had a call back from Healthfirst, apologizing for its “mistake” and accepting payment of my premiums through June.

Two weeks later, after my letters to the CEO of the corporation and the Attorney General’s office, I had a call from a “Resolution Supervisor” telling me “billing” had asked her to call me.  She assured me that my insurance had never been cancelled.  I was not reassured and questioned this long-suffering, apologetic woman at length.   She told me she’d try to send me the records of my dozen recent calls with Healthfirst, but had to first run it all by another office.

To my surprise, I learned there is an office at Healthfirst called “Regulatory”.  They were reviewing whether I was entitled to call records of my own calls to the private corporation.  I wrote an angry second letter to the CEO, cc’d it to the Attorney General.  I mailed it, then emailed it to her.   The next day I had a call from Healthfirst — I’d be receiving a written apology from Daiya, the confidently “mistaken” supervisor.  I’d get copies of my phone records with dates, times, person I spoke to, the substance of each call.

I am a perversely insistent motherfucker living in a corporately run nation where we non-corporate persons have  very few protections of any kind from routine predatory practices by largely unaccountable entities.   While I was helpless prey I managed to luck onto to a mechanism to almost immediately reverse an extremely stressful interruption of my ongoing medical treatments.   I was fortunate to find someone in an agency, a sympathetic woman who listened carefully, who told me how to get an emailed copy of the sections of the laws that Healthfirst apparently violated in putting me into that upsetting situation.   

I was surprised to learn today that the corporation is giving me everything I asked for without forcing me to bring a lawsuit against them.  I will soon be able to look over the law itself and see which specific sections and subsections were violated in my non-terminal termination.  I am positive than I am the lucky one in a thousand, or ten thousand, maybe a million,  getting almost immediate relief from intolerable, illegal mistreatment by a health care provider, under the Patient Protection and Affordable Care Act.

I am have a certain skill set, I’m diligent and, in this case, my illegally terminated health coverage was saved only by a miraculously fast resolution process that is well-hidden from the average consumer.   We live in a country where the powerful are free to oppress the rest of us, often without consequences to themselves, the burden being heavily upon those fucked to figure out how to unfuck ourselves (not easy, I can tell you for sure).   The laws that exist are co-written by expert lobbyists providing careful loopholes and provisions (like the now ubiquitous “arbitration clause” in every contract — thanks to now-Justice John Roberts, a genius of corporate law) that protect their fantastically powerful clients against things like class actions.

What was done to me, personally, can be multiplied by a hundred, or a thousand, or tens of thousands, just in New York City, where I live.  The woman at the NYC office I spoke to today (NYSDFS) told me they get HUNDREDS of health insurance complaints every day, many similar to mine.   

Do we have vast institutional problems in our country, including opaque laws that allow gigantic unaccountable private profit-driven institutions to do business largely unrestrained by effective laws?   You betcha.    Are many of our government officials, the people we trust to protect our interests, incompetent, lazy, corrupt, complacent or otherwise of little use?   You betcha.   Is the Republican Party, supported by vast funds from our wealthiest and most greedy, going to address this oppression of the many by the few?  Not likely.  (Picture me holding a fortune-telling 8-ball when I ask these questions)   Is the Democratic Party, supported by vast funds from our wealthiest and arguably slightly less greedy, going to address institutional injustice?   Perhaps over the next hundred years, if history is any guide.  If there are still two political parties by then.   If the earth itself is still a habitable place for human life.

We, people of good faith who are living through these viciously partisan times, when even old friends savagely attack each other like angry rats in a failed lab experiment, must find a way forward.    We must talk to each other as reasonably as we can, allow ourselves to hear and consider reasonable arguments. 

We need to meet likeminded strangers, and strategize and organize for effective influence and representation in our Republic. 

We need to act in concert to put pressure on, and keep pressure on, elected officials and the political parties that choose them.    How we do that is a great challenge in our atomized social media surveillance state.   I embrace that challenge as my only alternative to crippling hopelessness, though I have no immediate way forward to report.

I leave you with these wonderful, wise words from historian Howard Zinn, delivered while accepting a prize, toward the end of his life, for his groundbreaking A People’s History of the United States :

I wanted, in writing this book, to awaken a consciousness in my readers, of class conflict, of racial injustice, of sexual inequality and of national arrogance, and I also wanted to bring into light the hidden resistance of the People against the power of the establishment.   

I thought that to omit these acts of resistance, to omit these victories, however limited, by the people of the United States, was to create the idea that power rests only with those who have the guns, who possess the wealth.  I wanted to point out that people who seem to have no power — working people, people of color, women– once they organize and protest and create national movements, they have a power that no government can suppress.

I don’t want to invent victories for people’s movements, but to think that history writing must simply recapitulate the failures that dominate the past is to make historians collaborators in an endless cycle of defeat. 

And if history is to be creative, if it’s to anticipate a possible future without denying the past, it should, I think, emphasize new possibilities by disclosing those hidden episodes of the past when, even if in brief flashes, people showed their ability to resist, to join together, occasionally to win.

I am supposing, or perhaps only hoping, that our future may be found in the past’s fugitive moments of compassion rather than in the solid centuries of warfare.

(you can watch Zinn deliver these short remarks HERE, highly recommended)

 

 

[1]  fact or alternative fact?   From CNN:

The Department of Justice has dropped its criminal investigation into former FBI Deputy Director Andrew McCabe without bringing charges.

Back to me (channeling an alternative fact citer): a president pursuing “groundless” two year DOJ criminal investigations into his personal enemies is not an abuse of power, and even if it was, fuck off you partisan haters!   See Article Two!   It’s the only one you need to read!

[2]  The great Bill Moyers had the best reply to the legal fiction of “corporate personhood.”   He said “I’ll believe that corporations are people when the State of Texas puts one of them to death.”

What to do if your ACA health insurance is illegally terminated

If your insurance company terminates your insurance, claiming you missed a once a year ten-day “grace period”  for payment, go to this site and make an immediate on-line consumer complaint.   The complaint at this agency restored my illegally terminated health care in two business days.   The New York State Department of Financial Services (yeah, I know) now, finally, does the consumer protections functions of the abolished (in 2011) Department of Insurance.  The NYSDFS does what the Attorney General cannot do.  (I know…)

Here are the numbers of two offices in New York City that were enormously helpful while I was trying to have the illegal decision terminating my insurance overturned:

For immediate support, and solid advice during this illegal termination, contact the New York City Human Resources Administration, Department of Health, Public Engagement Unit (212-331-6266  M-Th  9am-8pm  Fri til 6:30).   Alexa at this office urged me to file the NYS Department of Financial Services’s on-line consumer complaint form.  She also assured me, 100%, that the unappealable corporate decision to terminate my insurance without notice would be reversed, which it was.  Bless her.

In addition to excellent and knowledgable support they will direct you to New York City’s new  program, NYC Care.  It  provides an extensive safety net for low-income individuals who lose access to affordable health care.   This wonderful pilot program can save a lot of lives, because it provides for low cost doctor visits long before a too late, ER diagnosis of a fatal stage of a once treatable disease.  This compassionate, life-saving program should be well-known by all New Yorkers and well-publicized until it is.   

NYC Care has a helpline at 646-NYC-CARE (692-2273).  The program is only active in the Bronx, so far, but if you go to any public hospital (Bellvue, Harlem Hospital, Jacobi, Lincoln, Montefiore and others)  you can enroll, at the Financial Planning or Business Office of that hospital, in the low-cost, pay-as-you-go “Options Program”.   

 

License to Lawlessness

Spoiler:  [ Here is the on-line consumer complaint form, that quickly solved the problem described below.  I have to figure out how to publicize it.}

With the largely incoherent “arguments” about why Abuse of Power is no vice and justifying absolute presidential immunity for obstructing multiple corruption investigations droning on in the foreground of American democracy — let’s examine what happens to the average citizen when the law that protects their health care can be routinely violated without consequences.

In New York State, patients who get their health care through the Patient Protection and Affordable Care Act (“ACA” or “Obamacare”) can, on the eleventh day of January every year, have the health insurance they’ve lawfully reenrolled in canceled at the whim of the private health insurance company they pay for coverage.   I learned this sobering fact when it happened to me on January 22 of this year when I called to pay my premiums through June, as I had done every six months for the last few years.    

The reason given for abruptly canceling the policy I’d renewed on December 6 was that I’d missed the ten-day “grace period” for paying the first month’s premium for a new policy.   My arguments that I’d received no notice of any “grace period”, that it was the same policy I’d had for two or three years, same ID number, same ID card, same premium, fell on deaf ears.

The Healthfirst supervisor, Daya (like the vegan cheese), told me, with great certainty, that Healthfirst was following the “guidelines” and that I’d have to quickly reapply at the New York State of Health Marketplace if I wanted coverage starting March 1.  She informed me there was no requirement that health insurance companies give customers any notice of this ten day “grace period” and that the only appeal was an internal one.   She said she’d refer my “case” to “financial” and get back to me.  She told me I’d be responsible for paying the full price of the expensive, on-going heart-related procedure I’d had on January 8th, mistakenly believing I was still insured.    

In her long experience at Healthfirst, she told me, she’d never known “financial” to overturn a valid termination.  True to her word, I had a cheerful voicemail from her the following day and when I returned the call was informed by a representative that the termination was, unfortunately, final, irrevocable and non-appealable.   

Until two business days later when the company called to apologize for their “mistake”.  They took my payment over the phone, right before January ended, apologizing as much as I demanded.  I pummeled that poor woman, bullied her into admitting she empathized, would be equally outraged if she suddenly and without any warning found herself in my position.  My friends sent me congratulations for my tenacity, my legal skills, for prevailing in a high stakes fight nobody should have to fight just to have the basic right to health care granted to all citizens of every other wealthy nation.  I am as angry now as I was when they cancelled my insurance.  Here is why:

While one of the innovations of the Patient Protection and Affordable Care Act was making it much harder for insurance companies to cancel policies for late payments without notice (an industry-wide practice as widespread and previously legal as non-coverage for “pre-existing conditions”), the first ten days of every  new year apparently offer an annual exemption to this rule allowing health insurance companies to cancel policies without warning.   That might be the law, or it might not be the law.  It’s up to the individual affected by termination for not paying in the “grace period” to try to find out what the law actually is and if any official in their state can help them determine the legality of what has just been done to deprive them of affordable health care.  Oh, and if there’s an available legal remedy if the action taken against them was illegal under the ACA.

An internet search took me to the only public agency that handles health care related consumer complaints.    The Better Business Bureau will help consumers with virtually every business-related conflict, excluding anything to do with health insurance.  The New York City Public Advocate does not get involved with consumers as individuals, only matters of “public policy”.   The state entity that has the monopoly on selling ACA plans, the “New York State of Health Marketplace” (NYSOH)  has no mechanism, outside of a three to four month quasi-judicial appeals process, to help health care consumers correct even NYSOH’s own errors that deprive them of health insurance or payment subsidies.  NYSOH also does not inform us of our basic legal rights as patients protected by the embattled Patient Protection and Affordable Care Act [2].  

The job of helping all of the many New York State health care “consumers” (otherwise known as “patients”) who experience problems with their health insurance falls to the small Health Care Bureau, a desk at the New York State Attorney General’s office, a hotline staffed by one or two decent, well-meaning, overwhelmed and powerless people who are very, very busy.

I contacted the Health Care Bureau and spoke to an extremely sympathetic and harried woman who lamented that there was little they could do for me, except to reach out to the company with a complaint and hope the corporation would change its mind.  I got an email telling me my transcribed complaint had been submitted [3].  The complaint, which stated my dictated complaint verbatim, looked very official, here is what is at the top of the copy they sent me:

Screen shot 2020-02-03 at 3.33.54 PM.png

The next day the extremely kind woman from the Health Care Bureau reached out to let me know that, sadly, Healthfirst  got back to her to say, in essence, “tough noogies.”  She greatly empathized when she called to give me the bad news, told me she wished there was more she could do and advised me that I’d better get busy re-applying to NYSOH for health insurance if it wanted coverage again on March 1.

I called a non-profit advocate for the poor and elderly where a lawyer had helped me in the past, though even that excellent lawyer’s powers were extremely limited when it came to overcoming the refusal of a private health insurance corporation to comply with the law.   They researched my complaint and called me back to inform me that I’d better reapply if I wanted to be insured again on March 1, since there was probably nothing anyone could do.  In a voicemail they regretted they could not be of more help to me and made a reference to the Department of Financial Services consumer help forms.

I spent many more hours on the internet and on the phone, spoke to many more people at several New York City offices [1].  Eventually I found one who told me to file the consumer complaint form I’d already found at the New York State Department of Financial Services.  I’d found a link to this form during my second full day of research but had been skeptical, due to past experience with that agency. The great woman I spoke to at the NYC agency, Alexa, told me confidently that the insurance company would be forced to reverse its decision as a result of this complaint.  I wrote the complaint, filed it on-line and two business days later, Alexa’s prediction came true.  

There is a short explanation for why the corporation changed its unappealable decision: it had violated the law by canceling my health insurance, without notice or warning.   The government’s enforcement of its laws is the only thing that can force an unscrupulous person (or “person”)  to behave ethically, or at least comply with the law.   Without public enforcement, a law is as empty as the words of the lawyer for a vicious criminal arguing that since his client truly believed he was doing nothing wrong it was legally impossible that he’d committed the crime the jury had seen the videotape of him committing.   No intent, no crime, no harm, no foul!

The explanation for why the Department of Financial Services was the place to find and file a new, highly effective, amazingly fast-acting on-line consumer complaint against a health insurance company is a little longer.   When New York State became one of the first states to adopt the ACA, it abolished the Commissioner of Insurance position as well as the state’s Department of Insurance.   All of the functions of that oversight agency were merged into a new agency that also oversees banking and finances in New York State.   This was a full three years after the calamitous fallout from the financial industry’s massive fraud came close to causing a world economic collapse.   What could go wrong?  

The last time I had problems with my health insurance, at some point between my two “successful” several month appeal processes at the New York State of Health Marketplace to overturn errors they had made, I contacted the Department of Financial Services.  At the time, their fraud investigators, one of whom I managed to track down and eventually spoke with for a long time, only had the ability to investigate insurance fraud claims lodged by insurance companies against customers.  There was no consumer help available, though they helpfully referred me to the same 800 number that had begun my twenty hours or so in the useless administrative cul du sac I’d described in a long letter to the Attorney General’s office.

This time I was screwed by a corporation and, amazingly, managed to get quickly unscrewed.  Why am I still angry?  A character flaw, I suppose, I can’t help thinking of countless neighbors of mine, for whom English is a second language, who have no hope of finding this well-hidden, highly effective new remedy for the ILLEGAL practice of terminating affordable health care without notice or warning of any kind.  I think of anyone who does not have my particular skill set and perversity, anyone who has not been a lawyer, trying to navigate the impossibly rough waters of not being illegally thrown off an insurance policy.  

WHY DOES NOBODY (outside of a very cool NYC worker named Alexa) IN ANY OFFICE DEDICATED TO HELPING CITIZENS WITH HEALTH CARE KNOW ABOUT THE SECRET NEW 100% EFFECTIVE CURE for this particular corporate abuse?  Why is the public, particularly its most vulnerable members, not publicly and effectively informed of it?  Why is there no requirement that we be informed of how the law to protect patients actually protects patients?

As for the amazing quickness of the legal relief I got (two business days!), I can only conclude that out of the many hundreds or thousands around the state similarly screwed, I must have been one of very few, perhaps the only one, who filed a complaint with the Department of Financial Services on their new secret on-line form.  I can’t think of how else my vexing problem could have been solved so quickly.    Here is the NYSDFS consumer complaint form, by the way.

Abuse is not a crime, unless the law specifically makes it a crime.  If the law doesn’t specifically say you can’t abuse, it’s perfectly legal to do whatever you want, “abusive” or otherwise (within other legal limits) to anybody,.   If there is a law against a certain kind of abuse, but there is no enforcement available for those abused and no penalty to the abuser, well, that speaks for itself.  It says “I know you are, but what am I?!!”   In that case, effectively, even though a practice is actually against the law, in reality there is no law.  If there is no law, you have the democratic government you vulnerable, helpless, pitiful chumps deserve, losers!  It’s up to us all to … oh, never mind… there must be a good reality show we can all watch to calm down…

 

 

[1]   I learned from a great and knowledgeable woman at the New York City Human Resources Administration, Department of Health, Public Engagement Unit (212-331-6266  M-Th  9am-8pm  Fri til 6:30)  that New York City has a new program, NYC Care, that provides an extensive safety net for low-income individuals who lose access to affordable health care.  

This wonderful pilot program can save a lot of lives, because it provides for low cost doctor visits.  It should be well-known and well-publicized until it is.   NYC Care has a helpline at 646-NYC-CARE (692-2273).  The program is only active in the Bronx, so far, but if you go to any public hospital (Bellvue, Harlem Hospital, Jacobi, Lincoln, Montefiore)  you can enroll, at the Financial Planning or Business Office, in the low-cost, pay-as-you-go “options program”.   I will also post this as a separate piece, a public service announcement.

[2]  The inept public agency that has the state monopoly on providing ACA health plans is run by an unaccountable political appointee, Donna Frescatore, who does not allow consumers to contact her, nor does she allow NYSOH reps to divulge her identity to consumers.   Both of my appeals against NYSOH were necessitated by errors made by NYSOH reps that could only be corrected by winning a quasi-judicial appeal months later.   As a result of her excellent stewardship of NYSOH Frescatore has been promoted to Deputy Director of Medicaid in the State.   She must have EXCELLENT people skills.

[3] their email reads, with all the hallmarks of officialdom:

Thank you for submitting your complaint to the Health Care Bureau. Attached please find a copy for your records. Your assistance is vital to our efforts to serve the people of the State of New York.

The Attorney General takes seriously the legal issues of all New Yorkers, and every complaint to this office is carefully considered. Please be assured that we will thoroughly evaluate each of the issues you have raised, and determine if we, or any bureau within our office, can provide assistance. We may also share your submission with other local, state, or federal agencies, as appropriate.

We will contact you if we require any additional information. Please do not submit follow-up inquiries through the complaint form, which is for new submissions only. If contacting our office regarding this submission, please refer to Intake #1-129605382. Inquiries may be made by phone at (800) 771-7755, or by email.

Advice for Screwed NYS health care consumers

There is a new consumer complaint process for victims of unappealable health insurance company “mistakes” in NYS that is easy, fast and efficient.  It can reverse unappealable termination of your health insurance within two business days.   Here is a link to that on-line complaint form that virtually nobody in New York State knows about:  CONSUMER COMPLAINT.

The only readily available help for someone in NYS who buys insurance under the Patient Protection and Affordable Care Act  (which can only be purchased at the ineptly run New York State of Health Marketplace) and looks on-line for help is the NYS Attorney General’s Consumer Health Bureau.   I reached out to them when I had my health insurance abruptly terminated without notice last week.  The woman I spoke to was very kind.   She sadly got back to me to a couple of days later to tell me that the company that had screwed me had responded to their query and had not changed its mind.

New York State’s Commissioner of Insurance position was abolished in 2011 along with the Department of Insurance.   The regulation of insurance companies in New York State was assumed by the newly reorganized Department of Financial Services which also oversees banking, finance and commerce.  Makes sense, no?  As of a few years ago this agency had no ability to help consumer victims of insurance company fraud or abuse.  It only took complaints against consumers who the insurance companies accused of fraud.  Makes sense.

When the Attorney General’s consumer health bureau gave me the sad news that there was nothing further I could do to get my insurance for 2020 back, until March 1, at the earliest, if I acted quickly, I continued my online research and round of phone calls.  I eventually found a new online consumer complaint form at the NYSDFS website.   That form is here:  https://www.dfs.ny.gov/complaint.

Within two business days I had a call from the insurance company, Healthfirst, informing me that my insurance was in full force and effect.  They apologized for their “mistake” and acknowledged that the DFS complaint had caused them to “escalate” the appeal process they’d previously told me didn’t exist.  Cool, now I can reschedule the appointment for ongoing treatments with the cardiologist that I had to cancel for today.

I emailed to let the kind woman at the AG’s office know that, after only a week of indescribable stress and aggravation, my complaint had been quickly resolved by the DFS complaint process.   She wrote back to tell me she was happy for me and asked if I wouldn’t mind helping a consumer who’d been screwed as I had been, could she give the distraught woman my email address?  I opted to write to the screwed citizen instead.   Here is what I advised her (and anyone else in NYS sodomized by an unaccountable, constantly feeding artificial “person” of eternal life):

Kimberly:
 
I was given your email address by the overwhelmed woman at the AG’s help desk, who asked if I’d be willing to help you.   I am a private citizen who was recently screwed by my health insurance company.   Not sure why the woman at the AG’s help desk couldn’t help you, and I’ll be writing to the assistant AG in charge of the sympathetic but unhelpful help desk (will not mention any names, the woman I spoke to was perfectly nice and really tried to help), but here is my advice.
 
I can’t go into the details of how you were screwed, believe me I know how many ways the virtually unregulated private insurance companies — and the accursed NY State of Health “Marketplace” — have to screw us.    I’m sure thousands are similarly abused.   Here are my recommendations:
 
1) contact the NYS Department of Financial Services today.  They are the agency that oversees health insurance in NY State.   Their NYC phone number is 212-331-6266 * (I don’t know what county you live in).  They are open til 8 pm today.   Wherever you live:  Go to their website https://www.dfs.ny.gov/complaint and submit your complaint today.  You can do it on-line.  
 
If your complaint is complicated, write it out before you work on the on-line form, since you have only 30 minutes to complete the complaint once you start.  Cut and paste the complaint you’ve already written, if you think it will take a long time to put your concerns in order.
 
Keep it brief and to the point.  I was cut off health insurance for 2020 without notice when I called to pay my premium last week.  The AG’s Health Bureau Help Desk called Healthfirst and was told my termination was done properly and in compliance with the “guidelines” and that nothing more could be done.   Within 2 business days of filing my complaint at NYSDFS I had my insurance restored, Healthfirst told me it had been a “mistake” and they were sorry.   I’m sure they were very sorry… corporations always say they are, when they are caught and there is no consequence to them for apologizing.
 
2) If the NYSOH Marketplace screwed you (as they have screwed me twice in the last few years) file a formal appeal over the phone (this cumbersome process will take about 3-4 months for a determination that will likely be in your favor).  I’d recommend also writing directly to the unaccountable political appointee who runs it.  Include a copy of your NYSDFS complaint.    Here is her contact information (as best I can determine it, she keeps a very low profile):
 
Donna Frescatore
Executive Director, New York State of Health Marketplace
New York State Department of Health
Coming Tower
Empire State Plaza
Albany NY 12237
I subsequently learned that Ms. Frescatore, the incompetent political appointee who ran NYSOH so badly for years has since been promoted to a grander title and office, as of January 2019.  I’m told by people at the AG’s office that she is also still Executive Director of the NYSOH, a highly secretive post.  Here is her new title and address:  
 
Donna Frescatore 
Deputy Commissioner and Medicaid Director 
New York State Department of Health 
One Commerce Plaza 
Albany, NY 12110
 
and this (though you’ll likely find it completely useless)  https://www.health.ny.gov/contact/doh800.htm
We are victimized in a state with virtually no protections for health care “consumers” who are screwed.  Log on to the NYSDFS website and file an on-line complaint, that’s your best first stop, and hopefully your last.  
 
Best of luck to you, be direct, give ’em hell, and don’t take this abuse lying down!  Many of us are similarly screwed, take courage from the new help now available at the Department of Financial Services.
* This is actually the telephone number for the New York City Human Resources Administration, Public Engagement Unit.   I’m told the NYSDFS 800 number is as useless as it was the last time I entered their administrative cul du sac several years ago.

Come on now

20190726_210933.jpg

Is this really where we’re at as a culture?   We can all applaud Fidelis Care for its worthy aspiration — that no child in our wealthy nation die a preventable death for lack of health insurance coverage [1] — but, seriously, is this something we as a people really need to have a nuanced discussion about? [2]

We are living in a culture where extreme cruelty to children who look like the kid pictured in this poster is a mere instrument of policy, yawned at, because, you know… what the fuck.  Poor kids die by the millions every day, everywhere, what’s a few more?   Seriously– who among us has not inadvertently murdered some little kid somewhere?   Let he who is without sin cast the first stone at our well-born masters who decide who shall live well and who shall die miserably and unnecessarily, as it is said in the private clubs where these fabulous luxury-loving job creating philanthropists congregate when the unfortunate subject of the stinking poor comes up: why don’t they just go fuck themselves? 

 

[1] And note that it is lack of access to insurance coverage (which allows a lucrative private intermediary to negotiate health care prices with “providers”), not lack of access to affordable health care service itself, that deprives millions of kids of the same chance for a healthy life that that every brat in the poor child’s well-born cohort enjoys as a matter of course.

[2]  While the “well-born” Donald Trump bellows about stupid black bitches who hate our country and wolf-whistles to his enraged base, his party continues to attack hated Obamacare, the rightwing think tank health insurance plan once known, in Massachusetts where it was first implemented, as Romneycare.   The lying demagogue has no plan whatsoever to replace it because, heh, if you’re dumb enough to believe anything I say you deserve what you get, losers.    Here’s an article about the Republican party’s latest attempt to have the Affordable Care Act declared “unconstitutional” by the Federalist Society’s best minds on the federal bench.

Here’s a terrible section of that piece by Paul Waldman:

Let’s go over the relevant history, just so we’re clear:
  • Prior to the Affordable Care Act, insurers could deny anyone coverage or charge them exorbitant premiums if they had a preexisting condition. The ACA outlaws that practice, creating the protections for the first time. Every Republican in both the Senate and the House votes no.

  • Republicans spend the Obama years filing lawsuits to get the entire law struck down and holding congressional votes to repeal it, which if successful would eliminate protections for pre-existing conditions.

  • Republicans take control of the entire federal government in 2017 and realize they had promised repeal but hadn’t bothered to come up with a replacement. They hastily assemble a bill, including ending protections for pre-existing conditions. The overall effort fails when John McCain opposes it at the last minute.

  • Attorneys general and governors from 20 Republican-led states file a lawsuit to strike down the ACA. One attorney general who spearheaded it, Josh Hawley of Missouri, runs ads in his successful Senate bid touting his commitment to pre-existing conditions protections, the very ones was attempting to destroy.

  • Even conservative legal scholars who opposed the ACA argue that the lawsuit is ridiculous.

  • The lawsuit is filed in Texas so that it will be heard by Judge Reed O’Connor, an unusually partisan Republican. He rules that the whole ACA must be wiped out, thereby eliminating those protections.

  • The Trump administration signs on in support of the lawsuit, asking the appeals court to strike down the ACA and its protections for pre-existing conditions.

    source

fueled by partisan outrage

It’s worth taking a closer look at what the pathetic porcine puppet said during his forty minute spin session on national TV before he released the redacted Mueller report on the investigation into Trump’s alleged misconduct.  Let’s take this part of his long statement apart, it’s rich in inventive detail.

ATTORNEY GENERAL WILLIAM BARR: In assessing the president’s actions discussed in the report, it is important to bear in mind the context. President Trump faced an unprecedented situation. As he entered into office and sought to perform his responsibilities as president, federal agents and prosecutors were scrutinizing his conduct before and after taking office, and the conduct of some of his associates. At the same, there was relentless speculation in the news media about the president’s personal culpability.

Yet, as he said from the beginning, there was in fact no collusion. And as the special counsel’s report acknowledges, there is substantial evidence to show that the president was frustrated and angered by his sincere belief that the investigation was undermining his presidency, propelled by his political opponents and fueled by illegal leaks.   Nonetheless, the White House fully cooperated with the special counsel’s investigation, providing unfettered access to campaign and White House documents, directing senior aides to testify freely, and asserting no privilege claims.

President Trump faced an unprecedented situation, Mr. Barr points out sympathetically.  Just because Mr. Trump was constantly sending out angry tweets that made him look guilty, changing his story constantly, repeatedly lying, raging, acting like a guilty man, he was unfairly attacked by his enemies.

Fair enough.

Also, there was this vicious inquiry into his associates, very few of whom were actually indicted and convicted of serious crimes.  These crimes, outside of the financial ones, were crimes of loyalty to the president, in the cases where only a small handful of his closest former associates lied to Congress and the FBI.   Can you really even call lying out of loyalty a  crime?   Just because some of his closest advisors are heading to prison, and others cooperated with the investigation in exchange for staying out of prison, is no reason to believe there is anything dirty or unethical about the president himself.

There was no collusion.  Fair enough.  Mr. Trump’s personal style is chaos, he is not a collaborative leader, he does not listen to advisors or work well with others.  His mother once noted with a chuckle that little Donald never played well with other kids, he always played to win, even in the playroom, even against his baby brother.

Here is my favorite part, a completely meaningless piece of lawyerly bullshit:

And as the special counsel’s report acknowledges, there is substantial evidence to show that the president was frustrated and angered by his sincere belief that the investigation was undermining his presidency, propelled by his political opponents and fueled by illegal leaks.

OK, Mueller provided ample evidence (much of it seen in real time by every American not turning away in horror from all media coverage of this unique president) that Mr. Trump was sincerely frustrated and angry.   Now we know, informed by Mr. Barr, that Trump’s belief was sincere that they couldn’t lay a finger on him because he was innocent, innocent, innocent!  

So his anger was righteous anger, according to Barr, similar to Boof Kavanaugh’s righteous, perfectly understandable rip-snorting, tearful temper tantrum when confronted with  credible testimony describing how he, while a blackout drunk in an elite Catholic prep school, had traumatized at least one teenaged girl while he was in a drunken state.    That allegation was thoroughly investigated in five days by the FBI and, naturally, no corroboration of the woman’s story was found among the small handful of people interviewed by the FBI.   Nothing to see there, unless you are fueled by pent-up rage over being a loser!

Since the president sincerely knew the  Mueller investigation was totally unfair, a witch hunt, knew that he was totally blameless, perhaps the most blameless president in history, he was absolutely right and morally entitled to be frustrated and angry, according to Barr who says that Mueller “acknowledged” all this.  

What?   Get the fuck out of here.

Mueller was, according to Barr, working for the president’s political opponents, even though Mueller belongs to the same political party as the president and the president’s party was in power when Mueller was appointed– and they oversaw his investigation.

I guess Barr’s point was that since Trump sincerely believed he was completely innocent he would have had to have been Jesus Christ himself not to react in frustration and rage, on a several times a day basis, at all the speculation in the press about how guiltily he was acting.   How would YOU feel if YOU were totally innocent and subjected to that kind of vicious, partisan witch hunt?  And the media would not shut up about it!!!  Wouldn’t you instruct your people to shut that shit down, if you had the power to ?!!! Sure you would.

Last bit of great shit from the pathetic, porcine puppet:

Nonetheless, the White House fully cooperated with the special counsel’s investigation, providing unfettered access to campaign and White House documents, directing senior aides to testify freely, and asserting no privilege claims.

This statement is what used to be called a lie, since it asserts things that are not, strictly speaking, true.  The White House merely refused to answer follow-up written questions from the Mueller team, after the president’s lawyers submitted incomplete written answers (that Trump claimed, ludicrously, to have “written” himself)  the first time.   The White House legal team (of which Barr is now, unaccountably, a member) made it clear that they would not let Trump, a habitual, reflexive,well-documented liar, walk into a “perjury trap” by talking to Mueller (taking the lesson of what happened to perjurer slick Willie Clinton, a much more sophisticated, articulate man– and a trained lawyer–  than the smartest president in human history, the man we have now).  The access was fettered, to say the least.

Meanwhile, the president was continually ordering subordinates to bend or break the law, to stifle the investigation and create the public perception that Mueller had absolutely no grounds to pursue his partisan inquiry into a president who, among other suspicious official acts, innocently met with Vladimir Putin twice, alone, with only a translator, and ordered the American translator to destroy his notes of the meeting he translated.  Nothing to fucking see here!

That’s what the pathetic porcine puppet would call full transparency.  The president was sincere in his belief that he could get away with it.   And he did!   Proving, as always, that Mr. Trump’s sincere belief is the best measure of everything in his world, a world the rest of us just live in.

L’histoire de ma vie, part 72

A few times a year I get a comment from a friend on something I write and post here.   These comments, though always welcome, often strike me as mixed blessings, like this recent email: 

Very good. Worthy of publication. You should submit to New Yorker or Onion or …..

I wrote to tell her I was glad she liked it.   I realized her enjoyment of my understatement probably depended on  knowing every hideous detail of my recent hassle with multiple corporate psychopaths (redundant, I know.)  I added that to make the little letter fit for publication it probably needed a little background, a frame like: 

The author of this response to his own letter to the CEO of medical insurance company Healthfirst recently received a replacement drug four times the strength of his current dose.   This new drug was sent to him in error by Healthfirst’s third party pharmacy CVS Caremark.  CVS, during an endless two hour phone call, took no responsibility for their part in the potentially deadly mistake.   

The patient/customer knew from a wealth of past experience that in our corporate healthcare system, even under the Patient Protection and Affordable Care Act, even in New York State, an early adopter of Obamacare, there is no regulatory agency that oversees private health insurance companies.    He wrote directly to his insurance company’s CEO, Pat Wang, to “alert (her) to the negligence and unresponsive customer care of her third party pharmacy.”    It was a mere expression of exasperation, no matter how clearly written or how cogently argued.  

The following is the hypothetical response of a CEO with no obligation to respond to anything, outside of a long-shot lawsuit.

Dear Sir [1]:

My assistant is in receipt of your recently emailed complaint about allegedly getting the wrong medication from our third-party pharmacy.

Apparently, in addition to writing long emails of complaint to strangers, you also, fortunately, had the common sense to research the drug that was, you claim, erroneously sent to you.  You prudently did this research before taking the drug.  As a result you suffered no serious bodily harm, no monetary loss nor any other cognizable legal injury.   

You don’t need to be a lawyer (and I am not) to know that without a cause of action, and a viable, filed lawsuit against our company, you are powerless to compel any kind of response from me.

However, on a personal level, let me simply state the sadness I feel for your situation.  Clearly, by the minimal level of health insurance you are entitled to under the PPACA, you have not thrived in our system.   I suggest a better use of your time would be figuring out the answer to that riddle, you sad fucker.

I hope this addresses the concerns raised in your recently emailed letter.  As always, thank you for your ongoing business and please do not hesitate to contact us if you ever feel the need to whine about things beyond anyone’s control.

Yours sincerely, etc.

 

[1]  NO!  I’m kidding.  She ain’t gonna write back!!!  LOL!