Your voice in Democracy & American Exceptionalism

The Electoral College was created to ensure that no foul demagogue, appealing to the lowest impulses and rages of the populace, would ever be elected president. Alexander Hamilton crowed about this ingenious safeguard of our democracy in Federalist Paper No. 68, if memory serves.  He wrote it pseudonymously, under the name of Schmuck, if I recall correctly, and his crowing sure came back to bite him in the posthumous ass, didn’t it?

“Well, I don’t know that Hamilton or any of the founding fathers really gave a shit one way or the other.  This guy who lost the popular vote this time by a fairly impressive three million votes, and eked out Electoral College victories in a few key states by under 100,000 votes total, is a member of that eternal ruling class, born ‘booted and spurred’ in the famous phrase stolen by the eloquent and erudite Thomas Jefferson, also born booted and spurred, to ride the saddled masses of mankind.  You can ask Jeeves about the man who, as he stood about to be executed in the 1680s, uttered the words now ascribed to The Author of Liberty.  

“You know, democracy is the worst form of government in the world, as Churchill said, except for every other form.  American Exceptionalism means that we can have as the Author of Liberty a visionary genius who held 300 humans as chattel, even after his death, although he eloquently argued against the soul-destroying evils of slavery.   American Exceptionalism, as you know, means we can drive the original inhabitants off the land in order to possess it, to the profit of a few privileged speculators, guys like the populist psychopath Andrew Jackson, who will become unimaginably wealthy.   We get to do these kinds of things because we are exceptional, Elie, you understand that, right?” The skeleton fixed me with a look.  

Oh, believe me, dad, I get it.

“So for those who complain that a candidate who got 3,000,000 more votes than her opponent deserves to be the president over a compulsive liar and snake oil salesmen who appealed to every prejudice and hatred imaginable I have two words: American Exceptionalism.   You want a voice in democracy?  Simple solution. Money equals speech, as Scalia and his buddies unappealably ruled.  Just get a lot of money and speak as freely as you like.  Like in the halls of justice, you get the justice you can afford to pay for.  If you are poor, bend over and shut the fuck up.  No whimpering!

“Look, you’ve had a nice taste of being poor, though you’ve never actually been close to poor.  I have hand it to you, though, you’ve managed to live like a poor person, I’ll give you that.  So your income last year, what you actually lived on, was 167% above the arbitrarily low U.S. poverty line.  If they set a realistic poverty line, more than 50% of the country would be living in poverty.  That would be unthinkable.  So we keep the line artificially low and the percentage of the country living in poverty becomes about right.  In the richest country in the history of the world it would not do to have a 50% poverty rate.  25% sounds much better, I’m sure you’d agree.

“So, dig, you eke out your modest lifestyle on 167% of the federal poverty level.  In 2015 that meant a 50% subsidy for your mandated health insurance.  You paid an affordable rate of about $250 a month for mediocre but adequate health insurance.  The care you got was not what a well-to-do person gets, but there was no major nightmare attached to it either.  Then, in 2016, New York State came up with a new innovation called the ‘Essential Plan’ that was virtually free to poor consumers.  At the poverty line you qualify for Medicaid.  Between 101% and 249% of the poverty line you get assigned this new plan, the ‘Essential Plan’.  You pay about $60 a month for your premium, $15-50 every time you see a doctor and have an out-of-pocket annual deductible of $1,500.  Fair enough, right?”

It took me a while to understand why it was called the Essential Plan until I had it for a while.  You essentially get whatever health care you can force them to pay for.

“Hey, you want to live like a poor bitch, make sure you do it under the poverty line.  Then you can have all those fancy programs they give to poor people, live out your days sucking luxuriously at the tit provided by your wealthier tax-paying fellow citizens.  Give ’em the punchline, Elie, I’m not feeling up to chatting much more today.  I’m suddenly remembering I’m dead and the thought is exhausting me.”

OK, in November, after a long bout of numbness in both arms and tightness in my chest,  I went to the Emergency Room on the advice of my doctor, just like in the days before Obamacare.  I’d been waiting only three months by then to see a cardiologist to discuss my dilated left atrium.  To my shock, the ER doctor admitted me to the hospital for tests.   I passed the tests and was released the next afternoon.  

My insurance carrier, fucking Anthem/Empire, the nation’s largest health insurance conglomerate and indefatigable provider of assdicking to marginally poor people, referred me to a cardiologist.  The doctor’s office confirmed I was good to go insurance-wise.  The cardiologist, ten minutes into the Q & A part of my consultation, had second thoughts and sent me away, telling me my insurance had informed his office that he was out of network.  

“So, basically, the cardiologist was a dick who had hypocritically taken his Hippocratic oath,” said the skeleton.  

Basically.  Anyway, this and related fuck-ups had me call the mega-corporation I was paying my premium to every month.  Hours of maddening calls, a long letter to the New York State Attorney General’s office and hours of snarling at inanimate objects around me later I eventually found myself talking to a rep at Anthem/Empire named Jamie.  

I realized that for purposes of any kind of legal action I needed to create the paper trail to support any further complaint I had against this massive engine of fraud I was paying premiums to every month for the ‘Essential Plan’.   My question for Jamie was simple: where do I mail my written complaint, since the website which allows Bronze, Silver, Gold and Platinum level customers to file on-line complaints does not seem to have any on-line complaint form for the Essential Plan.  

Jamie was a good guy.  He diligently looked through his on-line manuals, found the pertinent passage and read it aloud to me, with a tone of disbelief, and though I shared his disbelief, I also laughed the bitter, knowing laugh of a man who had just been handed the golden spike for his arguments to the Attorney General. It’s written in red, he told me, the way I wrote it for the complaint and to the AG, but WordPress doesn’t seem to let me have it appear in red.  Picture, then, these words in a beautiful shade of red.

Essential Plan members do not have a right to file complaint appeal (sic).  If they need assistance filing a grievance or appeal, they may also contact the state independent consumer assistance program at:  Community Health Advocates, 105 E. 22nd Street, NY NY 10010 or 888-614-5400 or email at cha@cssny.org.

source: Anthem’s National Contact Center Document, under NY Market tab for “Essential Plan” updated 12-14-15 at 7:56 a.m.

“They may ALSO contact… you got to love that, Elie,” said the skeleton.  

I love it so much it’s hard to describe.  

“Reminds me of Chief Justice Roger Taney’s great line about Negroes having ‘no rights a white man is bound to respect’, from Dred Scott, one of the final straws before the so-called Civil War, though we can all agree that war was anything but civil,” said the skeleton.  

Heh, reminds me of Taney’s infamous bit of honesty too, dad.

A Culture of Powerlessness

“Powerlessness is the single factor that makes you most angry, if you think about it.  Put powerlessness and frustration together, which they usually are, and you have an explosive mix. It’s at the root of all violence, powerlessness and shame over being powerless.  It’s supposed to be the shame that makes people into violent psychopaths.

“I wish I’d had this insight sixty years ago, had some time to work on it before I was given eternity to mull it over when it was already too late.  

“In fact, I am only having this thought at all due to my son, a dreamer who marches to his own marching band, who carries on this extended conversation, even though he knows he’s not really talking to me. Don’t you, Elie?”

That’s right, dad.

“To everybody else, I’m already long dead, going on twelve years this April 29th.  It’ll be seven years for mom not long after that.  Then, possibly you, motherfucker.”  The skeleton flashed a sardonic smile.  

“Seriously, Elie, I’m glad and touched that you’re doing the book.”

That’s enough of that.

“A culture of powerlessness is an engine of discontent and violence, it produces crowds of people who seethe, but there is nothing they can do about how fucking mad they are all the time. They have their powerlessness shoved in their faces over and over, they are bitches and will be slapped and handled like bitches.  The rage is like a toxic river, ready to overflow its banks and gush forth in a torrent, causing mass death.  The trick of the elites who profit from the utter powerlessness of the majority of the society is to turn the anger away from themselves on to the Other, as that vilified other is called.

“You get the lynch mob killing blacks and whites for being ‘uppity’ and causing trouble, the Ukranians, literally starved to death by the millions courtesy of fucking Stalin, taking some vodka and the satisfaction of getting to shoot a line of Socialist kykes in the heads, taking their clothes and kicking some dirt over their dead bodies.  Over and over in history massive societal rage has called for organized atrocities.  The dark side of the homo sapiens genius for organization, if you will: the pogrom, the lynch mob, war, the chanting, arm raising crowds.

“The other dark side of powerlessness is that the people who are powerless, members of the frightened herd that works for low pay to enlarge the immense profits of a few, having no other healthy outlet, often become extremely mean to those closest to them.  It’s safer to snarl at your kid than at the guy your size, younger and in much better shape, who just cut in front of you on line at the DMV.  

“Since a culture of powerlessmess keeps most people without any power in any sphere of their lives, they become peevish, bossy, and snappish.  So when you’re dealing with a powerless person, you’re often dealing with someone who seems mild mannered enough but who can deliver a nasty bite.  

“There are few happy people in a powerless culture, and these are often low status people in the society, at least as far as my experience.  These are committed and serious artists and people like that who opt out and live by their own values rather than the ‘free market’ values that fuel the engine of our economy.  These low-status people are not weighted down by and preoccupied with their accumulated failings the same way their striving, stressed out, more successful fellow citizens are.”  The skeleton pantomimed the average commuter, hunched grimly under the weight of his life.    

“Or maybe I’m just romanticizing the whole thing.  Homo sapiens has been power thirsty from the start, weak, cunning, terrified, vicious prey animals who figured out how to become the number one predator at the top of the planetary food chain.   As a species, impressive, perhaps.  On a one to one level, in a straightforward ‘power’ relationship, fucking horrifying, Elie, if you think about it for a moment.”

You’re singing to the choir director, pops.

“Hah, you know, I wonder how it can possibly be that I seem to keep hitting every note you have me sing?”  

The universe is mysterious, my father, and God is unknowable.

Rewrite of To Whom it May Go Fuck Yourself

I came to realize the previous draft was lacking in at least two ways.  It was focused on the mind-fucking Patient Protection and Affordable Charismatic Presidential Candidate Legacy Enhancement Act, for one thing.  The focus on the soon-to-be repealed PPACA gave the whole letter a sour overlay of mootness.  

Equally important, the letter as written probably wouldn’t have inspired the A.G. to take any action and didn’t set forth the specific action I was seeking.   This one, I think, does better in those areas.

Here’s the rewrite, which is about as good as I can get it at the moment,  After I post it I will go back to gnawing at my ankle:

January 4, 2017

Office of the Attorney General
The Capitol
Albany, NY 12224-0341

Honorable Attorney General Schneiderman,

I’m writing to alert you to a massive consumer protection failure in New York State and to encourage you to take action.   There is no New York State agency where a citizen can pursue a claim of fraudulent denial of medical service against a health insurance company.

The need for state oversight is more important now than ever, with an incoming administration committed to dismantling government regulation in many areas.

I’ve admired the courageous and proactive steps your office has taken against the perpetrators of various frauds and urge you to consider this letter in the context of systemic healthcare-related fraud against a large class of vulnerable low-income and senior citizens of New York State.

Uncertainty about health care, lack of information about costs and the routine denial of medical services without explanation are all stressful. They negatively affect the health and quality of life of those mandated to participate in income-based “bronze” level health insurance plans in New York State.   As detailed below, NYS health insurance buyers are denied any protection against the practices of private health insurance companies, even when the denial of necessary service appears to be utterly fraudulent.    

This consumer protection emergency transcends the current health care scheme under the Patient Protection and Affordable Care Act (“PPACA”).   The president-elect’s threatened repeal of the PPACA makes it all the more essential for New York State to regulate private insurance companies.   The replacement for the PPACA, whatever it might be, will not eliminate the need for protection of vulnerable older and low-income consumers, the need will likely become even more pronounced.

 In googling your mailing address to mail this letter I came across the New York State Health Care Bureau, a couple of layers down on your office’s website. While that office no doubt provides a welcome shoulder to cry on, the citizens of New York State sorely need a regulatory apparatus that can make timely and binding determinations on when insurance companies cross the line into actual fraud against their mandated customers.  

 Of course, the creation of a regulatory agency is a matter for the legislature. A fraud investigation by your office into practices such as the ones described below would highlight the need for state regulation, and give momentum to the legislative process.  

As stated above, defrauded health insurance consumers (patients) in New York State have no forum where complaints can be resolved, outside of the NYS Department of Financial Services, which, it turns out, does not hear such complaints.

The fraud investigator there could not find a word other than fraud to describe the facts I set forth, but urged me to call the NY State Department of Financial Services Consumer Services Hotline. He assured me that they were the specialists in the area of health insurance. The recorded menu at the hotline, which I recognized from my first call many hours earlier, offers no option for resolving issues with insurance companies of any kind.  

On my original call to the Department of Financial Services, a long wait to speak to a representative yielded the number of the proper federal agency to contact.   Calls to the U.S Department of Health and Human Services are robotically routed to a NY State number that is, sadly, the office of Temporary and Disability Assistance, where some helpful party connects you to a fraud hotline, which turns out to be at the office of the Medicaid Inspector General, where the office of legal affairs is also sympathetic, but unable to help, and so forth.

 As for the PPACA, I understand that it was drafted by Liz Fowler, a career health industry insider who went on to a senior executive position with Johnson & Johnson immediately after her work on the PPACA was done. I‘ve witnessed the many attempts to repeal the law and thwart its implementation, rather than fix any of its original flaws, as most other complicated laws are tweaked and improved over time. Even so, the lack of any provision for oversight of corporations participating in the PPACA by New York State is grotesque. To a sixty year-old cardiac patient unable to see a cardiologist now for many months, the lack of oversight may also be deadly.

Although the situation I’m complaining of is personal and extremely aggravating, it is sadly typical. I’ve commiserated with many others who suffer under similar insurance coverage.  Erroneous bills are a common, if relatively innocuous, theme.

I receive bills that there is no way to resolve, most recently an invoice for $1,324 for a fully covered sonogram I had in August. The x-ray and kidney sonogram I also had that day were fully covered, the sonogram of another body part was not.   The billing issue was resolved with the insurance company (Empire Blue Cross) and the provider to a zero balance in October. Two months later, the full bill for $1,342 was sent to me again in a Third Notice.  

Nobody at Empire could give me the reason the provider had sent that bill, although the representative, who checked my account and called the provider again, informed me that, this time, it was my responsibility to pay it in full.   She offered to send a consumer handbook for my plan that would fully explain the reason, which she claimed was clearly set forth there, though she could not state it.

There is nobody in New York State to adjudicate this billing matter, outside of a judge on some court one must file an actual lawsuit to appear before, assuming one could find a cause of action.

Empire recently sent me an email warning of termination of my insurance for non-payment of December’s premium two weeks after their email confirmation of my payment for December and January.

More ominously, a patient can be denied medical service without explanation (site-specific provider NPI numbers and proper CPT pre-authorization codes notwithstanding), and there is nobody in New York State you can appeal to, except to the company itself.   Empire Blue Cross “Health Plus” recently sent me to two providers for needed medical services, a cardiologist and a physical therapy facility. Neither provided me with any service. 

I received the site-specific NPI number for the cardiologist, scanned and emailed the back and front of my insurance card, got pre-approval from his office. The consultation was halted ten minutes in and I was informed that my insurance would not cover the visit.   When I arrived at the nearby ‘physical therapy facility’ Empire had referred me to, it was a nursing home.  The director told me the facility offers PT, but only to residents.

The circuit of government agencies I have contacted in vain came full circle with the “consumer help line” the NYS Department of Financial Services Fraud Unit investigator had me call, which I immediately recognized as the very first number I’d called.   Here is a summary of that cul du sac:

NYS Department of Financial Services referred me initially to the US Dept of Health and Human Services which, supposedly, connected me to NYS Health and Human Services, although to an incorrect branch of that agency, the pertinent branch apparently having been merged into the NYS Department of Financial Services which took over all functions of the former NYS Insurance Department as well as oversight of banking and several other discrete* and seemingly unrelated areas.  

The NYS Department of Financial Services, one learns, has sole responsibility for oversight of health insurance companies, as well as all fraud investigations related to consumer fraud against insurance companies, and complaints about the practices of banks and brokers.   Everything but, according to John Marconi, a fraud investigator for the Department of Financial Services, investigations of colorable fraud committed by insurance companies against mandated health-care “consumers” in New York State.

My political and legal conclusions are beside the point. Whatever the reasons, the fact remains that in New York State in 2017, even under the PPACA, citizens whose health is menaced by private insurance company denials are denied any legal process to have these vexing, sometimes life-threatening situations resolved.  

Outside of a possible Article 78 (which government agency would you sue for relief, the Department of Financial Services?) or a class action under a private attorney general or qui tam statute, what is a patient trying to get an appointment to see a cardiologist since August to do under the Patient Protection Act in New York State?   At minimum an ombudsperson, or a few hundred of them, would be a good start.

As I stated above, I’ve followed your career from the start and have admired your principled engagement in the fight against injustice.   To have a legal right that cannot be enforced is to have no legal right.   While certain widespread injustice is accounted by some as a kind of ‘externality’, the lack of legal recourse for denial of purchased health care must not be allowed to stand in New York State.

I will be glad to do what I can to help your office take the first steps towards sorely needed due process for denial of health care for some of the State’s most vulnerable citizens.  I am open to being a plaintiff in any lawsuit the State might want to bring and to testifying in any proceeding.   I look forward to hearing from your office and stand ready to give any other details or assistance your office might require.

 Yours sincerely,

 B.B. Rebozo

 * teachable moment!  The previous draft had idiotically read “discreet”, an error imperceptible to homophone-deaf smell check

discreet:  having or showing discernment or good judgment in conduct and especially in speech :  prudent; especially :  capable of preserving prudent silence

discrete: separate

 

Letter to Whom It May Go Fuck Yourself

Office of the Attorney General
The Capitol
Albany, NY 12224-0341

Honorable Attorney General Schneiderman:

I am writing to enlist your efforts to remedy the lack of state oversight of health insurance companies under the Patient Protection and Affordable Care Act (“PPACA”).

I have admired the courageous and proactive steps your office has taken against the perpetrators of various frauds and urge you to consider this letter in the context of systemic healthcare-related fraud against a large class of vulnerable citizens of New York State.

Defrauded health insurance consumers in New York State have no forum where complaints can be resolved, outside of the NYS Department of Financial Services, which, it turns out, does not hear such complaints.

 The fraud department investigator there could not find a word other than fraud to describe what I detailed, but urged me to call the NY State Department of Financial Services Consumer Services Hotline. He assured me that they were the specialists in this area. The answering machine at the hotline, which I recognized from my first call, offers no option for resolving issues with health insurance companies regulated by the ACA, or otherwise.

 On my original call, a long wait to speak to a representative yielded the number of the proper federal agency to contact.   Calls to the U.S Department of Health and Human Services are robotically routed to a NY State number that is, sadly, the office of Temporary and Disability Assistance, where some helpful party connects you to a fraud hotline, which turns out to be at the office of the Medicaid Inspector General, where the office of legal affairs is also sympathetic, but unable to help, and so forth.

 I understand that the PPACA was drafted by Liz Fowler, a career health industry insider who went on to an executive position with Johnson & Johnson immediately after her work on the PPACA was done. I have witnessed the many attempts to repeal the law, rather than fix any of its original flaws, as most other complicated laws are tweaked and improved over time. Even so, the lack of any provision for oversight of ACA programs by New York State is grotesque. As a cardiac patient unable to see a cardiologist now for many months, the lack of oversight may also be deadly.

Although the situation I’m complaining of is personal and extremely aggravating, it is typical.  I’ve commiserated with others who suffer under similar insurance coverage. Erroneous bills are a common, if relatively innocuous, theme.

I receive bills that there is no way to resolve, most recently an invoice for $1,324 for a fully covered sonogram I had in August. It was resolved with the insurance company (Empire) and the provider to a zero balance in October. Two months later, the full bill for $1,342 was sent to me again in a Third Notice.   Nobody at Empire could give me the reason the provider had sent that bill, although the representative, who checked my account and called the provider again, informed me that, this time, it was my responsibility to pay it in full.  

Empire recently sent me an email warning of termination of my insurance for non-payment of December’s premium two weeks after their email confirmation of my payment for December and January.

More ominously, you can be denied medical service without explanation (provider NPI numbers and CPT codes notwithstanding), and there is nobody in New York State you can appeal to, except to the company itself.  Empire Blue Cross “Health Plus” recently sent me to two providers for needed medical services, a cardiologist and a physical therapy facility. Neither provided me with any service. 

I received the site-specific NPI number for the cardiologist, scanned and emailed the back and front of my insurance card, got pre-approval from his office. The consultation was halted ten minutes in and I was informed that my insurance would not cover the visit.   When I arrived at the nearby ‘physical therapy facility’ Empire had referred me to, it was a nursing home. They offer PT, but only to residents.

The circuit of government agencies I have contacted in vain came full circle with the “consumer help line” the NYS Department of Financial Services Fraud Unit investigator had me call, which I immediately recognized as the very first number I’d called.   Here is a summary of that cul du sac:

NYS Department of Financial Services referred me initially to the US Dept of Health and Human Services which connected me to NYS Health and Human Services, although an incorrect branch of that agency, the pertinent branch apparently having been merged into the NYS Department of Financial Services which took over all functions of the former NYS Insurance Department, as well as the NYS Banking Department.

The NYS Department of Financial services, it appears, conducts all oversight of health insurance, as well as all fraud investigations related to consumer fraud against insurance companies, and complaints about the practices of banks and brokers. Everything but, according to John Marconi, a fraud investigator there, apparent fraud committed by insurance companies against mandated health-care “consumers” in New York State.

My political and legal conclusions are beside the point. Whatever the reasons, the fact remains that in New York State in 2017, even under the PPACA, citizens whose health is menaced by private insurance company denials have no redress.  

Outside of a possible Article 78 (which government agency would you sue for relief?  The Department of Financial Services?) or a class action under a private attorney general or qui tam statute, what is a patient trying to get an appointment to see a cardiologist since August to do under the Patient Protection Act in New York State?   At minimum an ombudsperson, or a few hundred of them, would be a good start.

As I stated above, I’ve followed your career from the start and have admired your principled engagement in the fight against injustice.   To have a legal right that cannot be enforced is to have no legal right.   While certain injustice is accounted “the price of freedom”, the lack of legal recourse for denial of health care must not be allowed to stand in New York State.

I look forward to hearing from your office and stand ready to give any other details needed.

 Yours sincerely,

A. Schicklegruber

Freedom from Want– the difficulty of that freedom

“Well, you know, Elie, there have always been two sets of laws– one for wealthy transgressors and the other for everybody else.  The poor get their own subset of laws which were established thousands of years ago under the ancient principle that translates to ‘go fuck yourself, asshole.’  None of this is at all surprising, once you’ve been around a few years, every society reeks of this double standard.  You get the justice you can afford to pay for.

“It’s a very galling state of affairs, of course, but it’s nothing new.  You’re waiting for a call back from some ‘supervisor’ named ‘Julie’ at the ‘NY Call Center’ of the health insurance company that’s committed fraud against you on at least two recent occasions.  I can hear them now ‘sir, fraud is such a judgmental word, and it’s a legal conclusion.  Can you make a firm legal conclusion before you’ve read all 2,700 pages of the PPACA?  You seem completely unaware of the third footnote to amendment three in Appendix Two of your plan-specific consumer handbook.’

Oh, now that you mention it, I remember that footnote.  It stipulates that external body parts, the outside of ears, noses, breasts and so forth, are not ‘body parts’ for purposes of diagnostic testing.   Kidney?  Totally enclosed, body part, sonogram fully paid for.  Testicles, which hang outside of the body proper, are therefore clearly exempt from insurance payment for all diagnostic procedures.  

“Well, you make a joke out of it, but I notice you’re not smiling.   Why would you smile?  You remember Dubya smiling like a baby with gas every time he talked about something horrible? One thing I could always say about you, Elie, you never had an inappropriate smile about things like people jumping off tall buildings and the horrors of war.

“Of course, a chat with the skeleton of your dear old dad is not what kindly old Doctor Mengele ordered today.  You’re distracted because your balls are caught in a vise and your heart may be slowly killing you.  We learned last time, in only ninety minutes, that in addition to the site-specific NPI number for each provider there is the additional complication of the precise CPT code required from that provider to pre-authorize certain service referrals.  

“There is nothing complicated in this.  Fail to verify the NPI number?  You, not the insurance company is responsible to pay the provider. Provider submits wrong CPT code?  Same deal. ‘Read the law, motherfucker! Read the law!'” the skeleton grinned broadly and grotesquely.

Excuse me, dad, just had a call from a robot at the insurance company with a surveybot asking about my recent customer service experience.  They wanted to make sure I was completely happy with the service I received from “Julie”, the “supervisor” at the “NY Call Center” of “Empire” that I was connected to after less than an hour the other day.  “Julie” was going to research the issues, since she had not a single answer to four separate questions about fraud and radically changing answers to seemingly simple billing questions, and call me with answers today, now.  The placatory, friendly “supervisor” Julie, who gave neither last name nor ID # (‘I’m the only Julie in the NY Call Center’ she assured me brightly– although it turns out nobody at Empire, or anywhere else in the world, can connect you to that call center) proves to be completely unreachable.  ‘Press one if you were the person who placed the customer service call, bitch-ass motherfucker.’

“Well, you know from your own experience in the Housing Court, Elie, that the rules for poor people are very strict.  When that obese Brooklynite, a house-bound diabetic amputee, got a letter scheduling an appointment and did not make it to her mandated face-to-face meeting at Section 8 two days later she lost her rent subsidy and all other government benefits.  You went to court 13 times on her behalf, over more than a year, before finally figuring out how to haul the director of Section 8 into court and instantly resolve an insoluble bureaucratic problem– and pay almost two years’ worth of rent arrears.  The law is clear: one notice for poor motherfuckers, failure to jump through the indicated arbitrary hoop: immediate termination of all benefits.

“You want health insurance, bitch?  They could have rolling admissions very easily, submit on the anniversary of your first premium, or your birthday, or within 90 days of some arbitrary date.  Wait, here’s a better idea for poor motherfuckers:  you have the ten days before Christmas, and the ten days immediately after New Years to submit all your paperwork, be assigned your level of insurance coverage, and choose a company to provide your health care on the marketplace for the following year.  Failure to wait on endless hold, exercise superhuman patience with non-working websites, servers that crash because thousands of desperados are submitting and resubmitting their required documentation within that short window of business days, with offices closed for several legal holidays during that window, and Christmas parties, and hangovers:  no health coverage for at least sixty days.  Hey, you want health insurance, you low-income cunt?  Come and get it.  If you can, bitch.  Please have a very nice day and continue to hold.”

God must have loved poor people, he made so many of them, as some poor wit once observed.  God, it must also pointed out, long ago became severely demented after centuries of despair watching the abusiveness and cruelty of the creature he fashioned in his own image.  

“Leave God out of this, Elie, hasn’t he suffered enough?   The present conversation with Ashanti D. at the Empire Blue Baboon’s Asshole Health Insurance Syndicate should give you fodder enough without bringing God into it.  You’ve only been on hold for less than 50% of the so far 39:42 you’ve been speaking to Ashanti D. and she’s been trying very hard to find you answers, answers she doesn’t have, but she’s concerned that you’re having a good experience with her, outside of the fact that nobody at that criminal syndicate has any answers for you.  

“Good for you getting her ID # and the specific call reference number for your call, that will really help you going forward … oh, look, Elie, it’s ringing now.  Maybe this is the NY Call Center.”

It rang three times and then the call terminated. Typical.  These motherfuckers aren’t accountable to anyone because — you’ll be shocked, dad, when I tell you that when Obama’s PPACA went into effect they abolished the NYS Department of Health’s Office of Health Insurance.  The New York State Insurance Department was also abolished, its functions subsumed by the New York State Department of Financial Sevices, along with all banking, as you know.  I have a map of hours of calls to offices that could not help and my futile conversations with corporate employees who were not authorized to help.  

I was able to consult that list just now and verify that the fraud and complaint hotline number Ashanti gave me was the fourth call I made that day, the Medicaid Inspector General, an office that, while very sympathetic, could not help me.  I told Ashanti as much.  She told me she was sorry then tried to connect me, via an internal number, to the NY Call Center.  There is no consumer number to reach Julie, the possible supervisor, of that office.  After a bit of a hold the phone rang three times, at the NY Call Center, presumably, then the line went dead.

 Now, there’s nothing left for me to do.   I’ve got to go write my fucking complaint to the Attorney General, make it short, snappy and effective.  I’ll post it up here, as I rein in the impulse to say something cruel about the charismatic, hilarious architect of this vast empire of perfectly legal health insurance fraud.  Or smash his smug, perfectly composed, handsome, fucking soon-to-be billionaire speaker/performer face.  

“Now, now, Elie, don’t be so bitter.  You have it much better than 99% of the Third World and even most Americans.”  

Yeah, and don’t I know it, pops?

Freedom from Want

“Whatever else you may want to say about me, Elie, I want you to acknowledge that I always kept you and your sister free from want.  You never knew hunger or any other kind of physical deprivation when you were kids.  All that stuff on the physiological and safety strata of Abraham Maslow’s hierarchy of needs pyramid, I always took care of all that,” said the skeleton of my father.    

You always kept my sister and me free from want.

“I might have missed a few beats on that safety layer at the foundation of Maslow’s pyramid, since you two were never safe from my rage, but for the most part, I gave you and your sister freedom from want.  

“I realize now that when I was fuming at you two for being fucking spoiled middle class whiners, that your feeling of entitlement to decent food, and nice clothes and a warm place to sleep, was not unreasonable.  Why would you not expect those things, things that everyone you knew had?  

“On the other hand, it would probably be impossible for you to understand how crucial those things you took for granted were unless you’d experienced not having them.  How can you appreciate getting enough good food every day if you’ve never been hungry?  Clean drinking water, even, if you’ve spent years thirsty.  Or how can you not take for granted your right to select the exact clothes you want to wear if you’ve never been humiliated by the other kids making fun of the shabby clothes your parents sent you out into the world in?  Safety in your home?  You can’t appreciate the importance of that if you’ve never lived in a house that wasn’t safe, if you never had to sprint in terror in the middle of the night to wake up a tough guy cousin to come over  and strong-arm the drunks who were about to beat up your old man.  Unless you’ve suffered want, something most of the world experiences every day, you’ll have no idea how important it is to be kept free of want.”

I grant you all of that, every word of it.

“Heh, there you go again,” said the skeleton, making air quotes with bony fingers over the word “you”.  

“Good of you to grant me what you just had me say, but let’s go one step further. My brother and I were not safe in our house, not safe from our mother, not safe to eat, shit, walk down the street.  I didn’t tell you much about this when I was alive, and so necessarily you are speculating here, but my brother and I were very often hungry.  You see how skinny we were in those pictures, it’s not because we were on gluten-free diets and doing Pilates.   We were skinny because we got barely enough to eat.  

“So you and your sister always fasted on Yom Kippur, and you still do.  One day a year you get a taste of the feeling my brother and I knew on a daily basis.  Every day was Yom Kippur for us, and at the end of our normal twelve or fifteen hour fast they’d dress us in our synagogue clothes and drag us down to First Hebrew Congregation of Peekskill, that narrow white church-looking building not far from 1123 Howard Street.   We’d sit in the synagogue for three or four hours, our stomachs rumbling, enduring an endless service in a language we didn’t understand.   We were forced to praise God for his limitless kindness and mercy even as we had no breakfast or lunch.  

“I never mentioned it to you guys because it would have sounded like the typical bitter self-pitying whine of the father cursing his kids who complain about a mere a five mile walk to school, when he had walked twenty miles to school every day, barefoot in the snow and ice, after six hours of chores in the little cabin he was born in, a cabin he’d built with his own hands.  

“You know, everybody had it worse than everybody else.  I grew up in the Depression, in the deepest part of it, in a godforsaken town that was a magnet for local anti-Semites, as far as we could tell.   I was five when the stock market crashed.   My father was already out of work when the world economy went into the toilet after the World War and ten roaring years of reckless profiteering.  We were the poorest of the poor.  You cannot have a clue how much damage that simple thing, being poor, does to a child.  

“When FDR was talking about his second Bill of Rights, the right to be free of want was the biggest of them.  Essential things no American child should find herself wanting include the right to not be hungry, the right not to be afraid, the right to have a decent shelter, and clothes, and a quality public education, along with the ability to go immediately to a reasonably priced doctor if you had a health concern.   These things seem beyond dispute as minimums for all citizens in the wealthiest nation in the history of the world, but we have to remember that this has always been a slave nation, too.  

“You’ll have your well-meaning post-racial racists point out the cold fact that slavery was abolished over 150 years ago.  However, the values of a nation that had no problem building its wealth based on slave labor, and mass murder of the locals, have not really changed.  45,000 unneccesary deaths in Emergency Rooms every year in America?  Part of the price of freedom, Elie.  There are people who can afford to not be treated essentially like slaves and the rest, who can afford nothing but being kicked in the nuts, powerless as slaves.  

“America has always been an experiment in democracy based on the consent of the governed subject to what was in the best interests of the the owners of massive slave work forces.  You had brief periods of social mobility, I was lucky enough to be born in one of those, as shitily unlucky as the first few decades of it were for me.  Millions of us in those years moved out of poverty into the middle class, we achieved the American Dream.  

“That Dream is largely an opium hallucination now, a poor person in the USA is less likely to emerge from poverty than a poor person in most other wealthy nations.   Not that the poor anywhere have easy access to an escape from poverty, but part of our American Exceptionalism is that it is, in fact, exceptionally hard for an American to climb out of poverty, no matter how tightly he grasps his bootstraps.  

“Now I know what some people who are reading this ms. on-line are thinking now– Widaen is just ranting with his ventriloquist dummy, a smart, likable, sometimes cruel skeleton, using this crude literary device to vent and rant about current events.”  

Not an unfair charge, I suppose.  

“Unless, of course, you consider the deeper implications of this part of my life story.   I was hungry, raised my status enough that my children never knew hunger.  I can say that, or you can have my skeleton say that, or however you want to put it.   Few people alive and poor today can have the same expectation in America.  Do you get this?  Do you truly grasp how fucking bad and fucked up this is?   People in poverty are fucked, their children, who had no say in the matter, are almost all doomed to be fucked in perpetuity.

 “The only people who prosper at this moment in American history are the wealthy, the investor class, most of the richest of whom got the bulk, if not all of their great fortunes, the old fashioned way, by inheritance.  Talk about a right to feel superior.  Their life, in a wrongful death action, is worth thousands, or millions, of times the value of the life of a poor person who dies in identical circumstances.  You can tell them about the value of the life of that busboy who died in Windows on the World compared to the lives of the millionaire financial guys who died with him.

“And it has always been thus, it’s only that now it’s been smoothed into a so-called ideology, justified.  A rich person, no matter how shiftless and dissolute, is still respectable.  A poor person who takes any form of government assistance is a lazy parasite, an immoral taker, someone who feels ‘entitled’ to the lavish $600 monthly benefit for their ‘disability’ that the rest of us have to pay for, or the monthly $150 some of them get for food.

“You’ve always been, or often been, a hyperbolist, so let’s set out your hyperbolic formulation of this.  Leaving aside the terrible failings of Communism in practice, the mass-murder in China under Mao and the Soviet Union under Stalin, the corruption of the party aparatchiks and so on, Capitalism and Communism are always posited as two polar opposite philosophies of the world.  

“In the war between Capitalism and Communism, Capitalist ideology accepts as a cost of individual freedom that a certain number of people, a large number, maybe most, will be fucked, some a gently, others roughly, so that a few of us can own everything.  The Communist ideal is more collective, based on the right of every person to enjoyment of basic dignity and freedoms, a just society being more of a social priority than concentrating fabulous wealth in the hands of a tiny group of modern day aristocrats and the perpetuation of a huge, impoverished, permanent underclass. 

“Then you introduce fascism which, in its German form, actually brought back good old slave labor on a massive scale.  Corporations that did business with the Nazis were given access to a slave labor force, an unscrupulous Capitalist’s wet dream– no minimum wage, no health insurance, pensions, sick pay, work ’em to death, toss ’em, order replacements.  

“You go so far as to argue that the Nazis actually won the war, ideologically, in that America moved much further toward their philosophy, governing subject to the demands of a ruthless unelected clique, its methods of mass propaganda and management of public opinion, business and political supremacy over citizens rights, than it ever did toward Marxism’s meritocratic from each according to their ability to each according to their needs.  

“After the war you had Nazis like fucking General Reinhard Gehlen, and his handpicked SS and Gestapo contractors, drafted into what would become the CIA.  None of the SS or Gestapo cronies were tried at Nuremberg, they became wealthy Americans with new false identities instead, because they were rabid anti-Communists.  Gehlen and his entire team got immunity, citizenship, nice houses, got in on the ground floor of the Commie fighting CIA — it was more important to win the Cold War, even if it took actual Nazis to help us do it.

“So, I suppose I have to agree that you live in an increasingly Nazi-like country, Elie.  Suck it up and try to make the best of it.  It’s unlikely that this clown, the petulant, bullshit-spouting cancerous orange chicken come home to roost, will actually carry out his hate threats and build detention centers and torture and killing facilities.   Most likely he’ll just make it easier for his friends to enjoy endless forced sex on the rest of you powerless bastards.  Nothing to get all pissy about.  Nobody likes a whiner, Elie.”  

Then, the skeleton winked, got comfortable and went back to sleep.

Merry Christmas From New York

I was headed downtown to visit friends in from far away.  After a groggy start to Christmas Day, a day that generally fills me with despair,  I was running late, well after the time I’d told my friend I’d aim for.   I had a twenty minute or so southward train ride to get there, then a short walk west.  

As you approach the elevated Number One line at Dyckman Street you can see up the track almost to the next station north.   If you see the southbound train coming around that bend, experience teaches you can catch that train if you run into the station, Metrocard in hand, and make a smart dash straight up the steep steps.  

I went through the turnstile and made my dash smartly, but there was no train.  The one I’d seen, apparently a mirage.  There was no train on the horizon either.  I noticed how winded I was, I’ve run up these stairs many times– this was the most winded I’ve been.  I walked it off.  

At the end of the platform a man was talking on the phone with his back to me.  He had a baby carriage with him.  The baby was also turned away from me, but I noticed how solicitous the man was, walking the baby carriage in little circles to soothe the baby.  I watched them absently for a moment, thinking of the human parent’s instinct, if everything falls right, to comfort their child.  I recall feeling impressed with how this guy was taking care of his baby.

The train came.  The man turned the baby carriage slightly to move his child on to the train.  I could now see that the baby was a full grown beagle, sitting very patiently upright in the baby carriage.   I made a note to tell this story to my friends when I arrived, but as things happened I forgot about it.

We exchanged handshakes, hugs and pleasantries and then my friend said “I have a small gift for you,” as if remembering some trifle.  He went into the other room and returned with the best gift anybody has ever given me, possibly the best gift anyone has ever given anybody.  “It’s really nothing,” he said, handing me a hard-shell ukulele case with the imprint of a palm tree on its shell.

Over the years my friend has mentioned a dream image he has, of himself, sitting on a porch somewhere beautiful at sunset after his work day is done.  His work would be gently but firmly bending wood, plying it, smoothing it, skillfully using tools to turn beautiful wood into a beautiful musical instrument.  In another life, he’d have loved to have been a luthier.  

A few years ago he took a course from a master luthier and made a tenor ukulele, out of beautiful wood, over the course of several weeks.  He sent me photos of it at the time and mildly self-effacing comments about the instrument when it was done.   I opened the case and there was the hand-made ukulele, a very beautiful one.  Everyone I showed it to later could not help stroking it.  It is lovingly detailed, with several unique flourishes, and finished to the texture of perfect skin or something like that.  It is so silky that it’s hard not to pet it if you hold it in your hands.   Everyone who held it did.

It plays beautifully, with a rich tone I haven’t heard from most ukuleles.   He also somehow rigged the lowest string to be in a lower octave, as on a guitar, making this uke a much more useful instrument to play melodies on.  I smiled as I played a little Django ending that had been impossible to play on my other ukes.  Sekhnet could not stop commenting on its beautiful tone, just as I could not stop playing it in the car after we left our friends.  

“What an amazing gift!” Sekhnet said, “I hope you really thanked him.”  I assured her I did.  I think I did, I’m sure I did, I had to have.  Of course, now that I’ve played it for hours, and re-tuned it to concert pitch, I’ll sing its praises some more when I talk to him tomorrow.  He’d looked at the label inside, with his name and the year he made it, 2009, and told me, since he never played it (although he certainly could), that I should have it, since I would play it.  I certainly am playing it.

I played it happily for an hour or so in the background with Sekhet’s family.  Each of them had admiringly held and petted the beautiful instrument, a few even strummed the open chord it plays if you don’t finger the frets.  I then played it all the way back to the city.  When we got back I was concerned that the constantly sleep deprived Sekhnet get some sleep.  I left her and walked to the subway to head uptown.

Being Christmas, it was only natural that the train service would be fucked up.   The high-tech interactive electronic information signs on the subway platform gave random misinformation.   According to the fancy new sign the next A train was a Brooklyn-bound one scheduled to arrive in 46 minutes (average wait is supposed to be about twelve minutes).  There was no information about any uptown trains at all.   “We’re working harder to serve you better,” I said finally to two other sour-faced men waiting for information on the uptown train to take them home Christmas night.

A moment later there was an incomprehensible PA announcement and a Brooklyn-bound A train rumbled in on the downtown platform.   Another announcement began as the Brooklyn-bound train was departing, making a great racket across the station.

The MTA had decided, in its infinite puckishness, to have the crackling, irrelevant, over-driven announcement delivered by the employee with the heaviest and hardest to decipher foreign accent.   I don’t know where this guy was born, but I’m sure the last thing his parents ever dreamed of for him was delivering this incomprehensible message to disgusted New Yorkers over the public address system moments after the end of Christmas Day. I have no idea what he said, but I do recall sincerely muttering something about fucking retards that I do not now feel very proud about having muttered.  

A dirty, smelly beggar was striking out as he made his way toward me on the platform.  He’d start to speak and get waved off.  I saw this happen a few times, found I had a single dollar bill in my pocket and thought “what the fuck?”   When he came toward me I handed him the dollar, which he dropped.  

Before he picked it up, he looked me in the eyes and asked “could you please help me out with two or three more?”  I told him I didn’t have it.  It was true.  My other bills were twenties, and outside of that, I had two pennies.  He continued down the platform and I was reminded of my dislike of people who don’t have the grace to say thanks. 

On the uptown A, which finally arrived, a large man asked “may I sit next to you?”  This is not a question anybody phrases this way on the New York City Subway.  It was the only seat in the car, and I nodded, almost imperceptibly, and without looking up from my book, only because it was the right thing to do.  

Then, because you know what they say about unpunished good deeds, he began humming in a soulful way, and turned his head toward me as I tried to read, which made his humming suddenly way too loud.  He began to sing, in the same manner as his humming, turning his head like a slow moving leslie-speaker to heighten the effect.  

He did that African spiritual-inspired melisma, making every quavering note a long, stylized, if cliched, statement of his soul.   After a few minutes of this I wanted to do something to make him stop. I thought about my vow to remain mild and kept reading.  

A seat opened across the way, and I took it.  I couldn’t hear his fucking singing from over there, and it was a relief.  Suddenly, I smelled ass, dirty feet, filthy clothes.  The smell was coming from the seat behind me, turned out to be a homeless woman.  But the smell wasn’t that bad, it was better than the fucking soul singer.  

The singer got off a few stops later and I went back to where I’d been sitting.  I watched the poor homeless woman, who appeared to be very much insane.  I thought of the almost infinite varieties of suffering in this world, and of God and the mythical baby Jesus weeping over it all, less than an hour after Christmas.  I  took out the ukulele, played a bit of Django’s version of “I’ll See You In My Dreams” and put the lovely instrument into its protective case as the train pulled into Dyckman Street.

As I walked up the hill to my apartment, carrying the perfect tenor ukulele my old friend had made, I thought of the blessings of this life. Those blessings are not the physical things everyone is taught to covet, of course, but what lies behind them, what we might call their spiritual dimension– what they represent in terms of our souls.   If the physical manifestation is also a beautiful thing, that’s ideal.

I thought of my friend’s ancient mother, now well-past ninety and noticeably much older than the last time I saw her, not that long ago.  She made mention tonight of her approaching death.  I’d never heard her speak of death, but when I quickly broached the subject of Trump, during a moment when her son had gone back upstairs to fetch something she’d forgotten, she told me that the only good in it for her is that this would be a good time for her to die.  

I told her that my mother, at the end of her life, had begged me to promise her that Sarah Palin would never be the president.  I made the promise and I’m as sure as it is reasonable to be that Sarah Palin will never be the president of the United States.  There are things as unthinkable as President Sarah Palin, but that’s an imponderable story for another time.

When I put her son’s ukulele in her hands she immediately began stroking it.   She admired it for a long time, and mused about how many other hidden talents her talented son had (he was cooking a delicious smelling dinner at the time).  

Later, sitting around the coffee table, my friend’s mother smiled, and pointed at her son and her grandson, huddled over the young man’s cellphone, looking at photos of some of the grandson’s recent architectural projects, I assume.   To her daughter, with a big smile, she said “kvelling…” This is Yiddish for a parent’s pleasure in seeing their child do something that makes them kvell with pride.  The daughter looked at her blankly and asked “who?”   

“Me,” said the old woman happily, as she pointed to her chest with a gnarled hand.

Don’t Torture Yourself

President Obama, a man who can be counted on to deliver an inspirational speech, made an unambiguous admission about the systematic brutality visited on Muslims who fell into American hands after the invasions of Afghanistan and Iraq.   He left no ambiguity about the “enhanced interrogation techniques”.  In one of the most regrettable phrases the great speechmaker ever uttered he made it clear that “we tortured some folks.”  

That was in the summer of 2014, and the remark was prefaced by “after 9/11 we did a lot of good things, but…”  His legal training was on display in the way he buried that terrible admission in the second half of a sentence that began reminding us of all the correct things we did after 9/11.

Great rhetorical speaking often calls for a stirring generality that can unite listeners and make the bitter medicine go down easier.  Obama did not disappoint, making the larger, more abstract and more palatable point that “one of the strengths that makes America exceptional is our willingness to openly confront our past, face our imperfections, make changes and do better.”  Keep that remark in mind, we’ll get back to it in the punchline.

His high-minded (to give him the benefit of the doubt) decision not to prosecute anyone for these war crimes, American crimes, flagrant violations of international treaties, etc. fails to account for one dependable human tendency.  If you admit what your country did was abhorrent and then vow to look forward, without any accountability for those who ordered the savage, illegal acts committed, it’s not hard to imagine what will happen the next time you and other good people feel pushed into a desperate corner, surrounded by implacable, murderous enemies who hate your freedom.  

This guy we have coming into office loves tough talk and loves the idea of inflicting maximum pain on our enemies.  Waterboarding is not enough for him, he boasted, he’d do really bad shit, much worse than just controlled drowning over and over as you’re strapped to a board upside down, between punches in the face as you vomit and gag for air, at the very edge of cardiac arrest (which is why they always had a doctor by the waterboard– how about that for a post 9-11 turn on the Hippocratic Oath?)

I have whined about all this torture done in our names since I heard the U.S. had secretly “legalized” torture during the Cheney-Addington-Bush years.   I was glad to hear, even as I winced at the grotesque nonchalance of the expression, an American president admit “we tortured some folks”.  It was like hearing Bill Clinton say what no other American president had ever said: slavery was an atrocity and America should apologize for it.  Another great moment of national healing that should have made folks feel much better.

Why am I whinging about this today of all days? Last week there was some debate, way in the background, about the fate of the 6,700 page Senate Torture Report.   Although the Obama Administration has kept the report top secret since its release, it appears that the full scope of the torture program is laid out in its pages, specific atrocities are described in detail, it contains the testimony of the torturers themselves about gaining no useful intel from the torture, details the eventual insistence of the torturers and their bosses that the program be stopped because it did far more harm than good, and so on.  

The full report is apparently a ringing slap in the face to tough talking guys like Dick Cheney, who continue to insist that torture works, that we got plenty of good intel from it, that those we tortured fucking deserved it, and worse, and that countless American lives were saved by torture, even if many of those tortured were wrongfully imprisoned detainees who had no connection to terrorist activities and were eventually released from indefinite detention.

When Republicans regained control of the Senate in 2015, Republican Senator Richard Burr, the new chairman of the Senate Select Committee on Intelligence, the committee responsible for the Senate Torture Report, apparently sought to collect all copies of the report that had been distributed so that the report could be classified and/or destroyed once and for all.  

It seems mad to destroy the report, erase its still classified findings, but, that’s partisan politics, I suppose.   Objection to torture is seen as largely a liberal tic in current American politics. Why that would be the case is hard for me to understand, I am certain that many conservative people also abhor torture, which has long been considered antithetical to American values, but there it is:  torture  is now another snarling partisan issue in our Divided States of America, like abortion, global warming, full rights of citizenship for homosexuals.

Obama took decisive action the other day to preserve the Senate Torture Report.  He’s including a copy in his presidential library.  He has been praised for this action.   He has also classified the report for the maximum twelve years under the Presidential Records Act.   Nobody, including, presumably, the incoming president and his administration, who are unlikely to consult it in any case, will be able to have access to the report until 2029, at the earliest.  

The cliche about the unlearned lessons of history comes to mind.  Along with this stirring epitaph about American Exceptionalism: “one of the strengths that makes America exceptional is our willingness to openly confront our past, face our imperfections, make changes and do better.”  We can start to do that on the subject of torture in a mere twelve years, maybe.

Opacity is all that is needed for evil to flourish

One of the stated reasons wealthy American colonists revolted against King George was that they were being subjected to ‘confiscatory’ taxation without representation.  Nor were they offered any meaningful process for redress of their grievances, no way to have their concerns heard and their honest grievances dealt with.  Government secrecy and lack of voice in governance are vexations members of a democracy are not supposed to endure.

A transparent democracy is the best cure for citizen misery, knowing who to contact to solve a problem.  Mr. Obama constantly and correctly reminds us of the importance of transparency in a healthy democracy (even as he does things like classifying the Senate Report on Torture for twelve additional years under the Presidential Records Act — see, and, and). * A transparent democracy is what the Founding Fathers set up, for members of their social class.   The rest of  you bitches?  Go talk to King George.

No requirement in the Patient Protection and Affordable Care Act for a grievance procedure?  Not a problem, bitch.  Just keep quiet, you’ll be dead soon enough, shhhh, shhhhh…. no reason to get excited.  If you had any power, we couldn’t treat you this way.  Be reasonable, little n-word.  

If you’re skillful enough, and manage to choke down your rage and describe the situation coolly enough, maybe you can write something the New York Times will run in the back of their paper of record.  There, there.

Here, here:

Obamacare subsidy income limits

Premium tax credits and cost-sharing reductions have different income limits based on the federal poverty level (i.e., poverty guidelines). They are as follows:

  • Premium tax credits: 100 – 400 percent of the federal poverty level
  • Cost-sharing reductions: 100 – 200 percent of the federal poverty level

Your health insurance subsidy for the current year is based on the previous year’s federal poverty guidelines. That means 2017 subsidies are based on the 2016 federal poverty guidelines, which are available through the Department of Health & Human Services.

The 2016 poverty guidelines show that $12,071 is the poverty threshold for a one-person household. Based on these numbers alone, 100 to 400 percent of the federal poverty level for a single person would be $12,071 to $48,284. However, this person may or may not be eligible for a premium tax credit.

Please be aware that your subsidy eligibility may be impacted by the state you live in due to Medicaid expansion decisions and other savings programs available there.[1] Furthermore, state benchmark plans (i.e., the second lowest cost silver plan) can also impact subsidy amounts and eligibility.[2] You can estimate your premium tax credit using online calculator tools such as the one available through healthedeals.com.

* The New York Times editorial board weighs in  on declassifying the now secret 6,700 Senate Torture Report and Senators Levin and Rockefeller ask Obama, who they quote as saying:  “one of the strengths that makes America exceptional is our willingness to openly confront our past, face our imperfections, make changes and do better” to do the right thing.

 

Obamacare, a last word

I got a phone call just now from John Marconi, an investigator at the NYS Department of Financial Services Fraud Office.   His number came up as 212-555-5555, which can’t be called back, as it happens– it’s not a working number.   I spoke to John for fifteen minutes.  

He listened carefully to my description of being denied services by doctors I was referred to by Empire Blue Baboon’s Asshole, the private insurance company I chose after being assigned my income-based level of PPACA “health care” by the New York State of Health Marketplace.

I read John the 800 number for the New York State Insurance Department I’d been given yesterday, ninety minutes into my investigative work, by the kind woman at the office of the Medicaid Inspector General, who got it from her supervisors.   John explained to me that the NYS Insurance Department had been abolished in 2012, but that the 800 number I’d been given was currently the Department of Financial Services consumer help hotline.  

The governor, while abolishing the Insurance Department in 2012 also abolished the Banking Department.   These abolished agencies were merged into the more streamlined and user friendly NYS Department of Financial Services.   John thought it was a good move, though he admitted it might be more confusing for the public.    He urged me to call that hotline, since his office usually investigates consumer fraud against insurance companies, and fraud by brokers, and things like that. 

I asked him to use a word other than fraud to describe an insurance company sending you to, so far, two doctors and then denying coverage when you arrived for needed medical services, or informing you that an ultrasound of your kidney was covered but that an ultrasound of your pelvis was not.  

He conceded he didn’t have a word that described this behavior better than ‘fraud’, but urged me again to speak to the consumer hotline, they were the experts.  If need be they would refer the matter back to his office.  He modestly told me he was not an expert on fraud under the PPACA (apparently impossible to commit, unless you are a health insurance consumer), though he was the fraud investigator on duty today (they rotate, apparently, today was his day on the phones).  

John said he could connect me to the consumer services hotline.  I told him I’d expect to have a long wait to speak to anyone at the consumer hotline.  He assured me that wasn’t the case, that they picked up right away.  He then connected me to the number I was planning to call today, foolishly thinking it was the NYS Insurance Department, 800-342-3736.

It will not surprise you, dear reader,  to learn that I found myself instantly back in a nightmare cul-de-sac.  This was the 800 version of the very first number I’d called yesterday, 212-480-6400.  I recognized the voice prompt tree: abandoned “zombie” properties — press one, mortgages– press 2, something else was three and “all others”, like those defrauded by a private medical insurance company they are forced to buy services from, press 4.

I pressed four and learned that the expected waiting time to speak to the same office I’d talked to the day before, on my first of six calls, was fifteen minutes. I called John Marconi back, but he’d called from a blocked number and the call could not be completed.

In the interest of completeness I dialed the final number I’d been given, for The New York State Department of Health, Division of Health Insurance, 800-343-9000.  A female robot greeted me:

“Thank you for calling E-Med Meade provider services.  This call may be monitored or recorded for quality purposes.   Please have your NPI number available.  

“For claims, billing, remittance form orders and prior approval questions, press option one.  For new enrollment into the NYS Medicaid program, revalidation… blah blah… and provider maintenance, press option two.  For explanation of eligibility response, press option three.  For MOAZ and threshold override applications press option four.   For Peatzar support, press option 5.”

It had taken less than three hours of my life to come full circle in the cycle of futility that is our current United States of voracious, psychopathic corporations and their human personifications.  

Our current president-elect is making good on all the business stimulating promises of the recent past: complete opacity, secret presidential kill lists, elimination of all health and safety regulations, denial of decades of science on the destructiveness of carbon released from burning fossil fuel, destruction of collective bargaining for workers, dismantling of the social safety net, nominating the CEO of the most lucrative private corporation in history, one devoted to extracting and exploiting every last bit of the fossil-based product that is doing the most to destroy life on the planet,  to negotiate on our behalf, etc.  

Let’s be honest, though.   He got a good start in all this from his celebrity all-star predecessor, that brilliant, caring, charismatic soon to be self-made billionaire, who is taking his subdued victory lap now prior to his sensational, highly engaging, funny, record-shattering “Raking in the Tubmans Tour.”  

God bless us all.