There was an article in the local paper yesterday about immigration, which started by stating that consensus seems to have been reached that any reform must include a stipulation that, “If unauthorized immigrants in the United States are allowed to stay, they must go to the back of the line.”
I recall hearing Obama say that repeatedly, that those who came here illegally must pay a fine and “go to the back of the line” and thinking at the time, as I did when reading this article, “What does that really mean?”
The article goes into great detail about what it takes to enter the line and the length of time that persons from various countries must spend there, but what neither the article or Obama mentions or seems to comprehend is that the line forms outside of this country. To put it another way, people in the line are outside waiting to get in so how do people already here, illegally, go to the back of that line without leaving the country?
That’s sort of like telling a line of people outside a movie theater waiting to buy tickets see a movie that a group of people walking past them are going to be allowed to wait in line to buy tickets while in the theater watching the movie because they were caught stealing money. “Commit a crime and you, too, can watch the movie while waiting to buy movie tickets.” There may be some planet where that is logical, but…
I would name the local paper, by the way, but it doesn’t seem to know what its own name is. It used to be the Union-Tribune, but the only thing it goes by now is U-T, which is a logo, not a name. I’m not calling an entity by its stupid logo.
Tuesday, April 9, 2013
Sunday, April 7, 2013
Various Matters
John Kerry is condemning another terrorist attack as being “cowardly” because… Well, I’m not sure what makes such an attack an act of cowardice when the attacker is willing to die in the attempt to inflict harm on his enemy. Contrast that with drone pilots who kill people while sitting in a chair several thousand miles distant from harm’s way. Something about pots and kettles comes to mind.
I’m certainly not applauding, or even condoning, terrorist attacks and I can think of many uncomplimentary adjectives that can be applied to describe them. I just don’t think that “cowardly” is one of them.
Interesting the way reporters, or editors, select facts from two different reports for their headlines as they say that the economy “added 88,000 jobs” while unemployment “fell to 7.6%” last period. The former is from the Establishment Report, which doesn’t state unemployment rates, and the latter is from the Household Survey, which provides employment numbers in addition to unemployment rates.
The employment numbers from the Household Survey did not get reported, however, because they conflicted with the Establishment Survey, as they usually do for a number of reasons. Instead of an increase of 88,000 jobs, the Household Survey reported that 206,000 fewer people were employed.
I don’t think it matters much which one you believe, as they are probably both inaccurate. Both numbers are taken from rather limited samples, extrapolated using abstruse mathematical formulas to represent the entire population, and then are “seasonally adjusted.” Defenders of the numbers dispute my “limited sample” claim, saying that 50,000 respondents is not “limited,” but I submit out of 313 million people 50,000 is but tiny sample.
We could use actual numbers, of course, since employers file tax withholding statements every two weeks, but the government won't do that because of "privacy concerns." Right. And I have a bridge in Brooklyn that I can make you such a deal on.
The big picture is, our population increased by 2,252,500 in the past year, while it added only 1,256,000 new jobs. That is not a pretty picture.
Once again we have organizers planning a nationwide rally to draw attention to the plight of people who have come to this country illegally and who have not been granted an opportunity to become citizens despite violating our law by their very presence. The organizers say that they intend “to show that there are many people who are our neighbors, our co-workers who are suffering because of the nation’s broken immigration system.”
No, they are suffering because they are in violation of the law and are hiding from law enforcement officials. Perhaps we should hold a similar rally in sympathy with drug dealers, who are suffering from having to hide in the shadows and live lives of desperation because the law is trying to throw them in jail. Or legalize drugs to "bring them out of the shadows?"
Europe is declining into disaster, and we are hooting about our recovery. Do we really think that we are not going to be affected by the world economy? Carl Sagan once made a comment about "when our critical facilities are in decline, and we are unable to distinguish between what feels good and what's true." I think we have arrived at that point.
The only thing that is "recovering" is the stock market, and the reason for that is simple and has nothing to do with the "working class." The Fed is buying $85 billion of bonds per month, using money that it is creating out of thin air. It is not buying those bonds from working people who will spend it on goods and services, it is buying them from investors who will simply reinvest the money. Where are they going to invest it? Well, there is no place other than the stock market.
So the Fed is printing money which is being pumped into the stock market, and the rest of the economy is continuing to drown.
I’m certainly not applauding, or even condoning, terrorist attacks and I can think of many uncomplimentary adjectives that can be applied to describe them. I just don’t think that “cowardly” is one of them.
Interesting the way reporters, or editors, select facts from two different reports for their headlines as they say that the economy “added 88,000 jobs” while unemployment “fell to 7.6%” last period. The former is from the Establishment Report, which doesn’t state unemployment rates, and the latter is from the Household Survey, which provides employment numbers in addition to unemployment rates.
The employment numbers from the Household Survey did not get reported, however, because they conflicted with the Establishment Survey, as they usually do for a number of reasons. Instead of an increase of 88,000 jobs, the Household Survey reported that 206,000 fewer people were employed.
I don’t think it matters much which one you believe, as they are probably both inaccurate. Both numbers are taken from rather limited samples, extrapolated using abstruse mathematical formulas to represent the entire population, and then are “seasonally adjusted.” Defenders of the numbers dispute my “limited sample” claim, saying that 50,000 respondents is not “limited,” but I submit out of 313 million people 50,000 is but tiny sample.
We could use actual numbers, of course, since employers file tax withholding statements every two weeks, but the government won't do that because of "privacy concerns." Right. And I have a bridge in Brooklyn that I can make you such a deal on.
The big picture is, our population increased by 2,252,500 in the past year, while it added only 1,256,000 new jobs. That is not a pretty picture.
Once again we have organizers planning a nationwide rally to draw attention to the plight of people who have come to this country illegally and who have not been granted an opportunity to become citizens despite violating our law by their very presence. The organizers say that they intend “to show that there are many people who are our neighbors, our co-workers who are suffering because of the nation’s broken immigration system.”
No, they are suffering because they are in violation of the law and are hiding from law enforcement officials. Perhaps we should hold a similar rally in sympathy with drug dealers, who are suffering from having to hide in the shadows and live lives of desperation because the law is trying to throw them in jail. Or legalize drugs to "bring them out of the shadows?"
Europe is declining into disaster, and we are hooting about our recovery. Do we really think that we are not going to be affected by the world economy? Carl Sagan once made a comment about "when our critical facilities are in decline, and we are unable to distinguish between what feels good and what's true." I think we have arrived at that point.
The only thing that is "recovering" is the stock market, and the reason for that is simple and has nothing to do with the "working class." The Fed is buying $85 billion of bonds per month, using money that it is creating out of thin air. It is not buying those bonds from working people who will spend it on goods and services, it is buying them from investors who will simply reinvest the money. Where are they going to invest it? Well, there is no place other than the stock market.
So the Fed is printing money which is being pumped into the stock market, and the rest of the economy is continuing to drown.
Friday, April 5, 2013
Medical Insurance Adventure
In addition to the massive hospital bill after my bout with pneumonia I got, of course, a host of smaller bills from doctors, imaging centers, and laboratories which were peripheral to the process. UnitedHealthCare paid them as expected except that they denied payment on all of the bills from one particular lab which was billing for blood tests, citing a code which explained that “This code, when accompanied by a facility place of service, is not eligible for reimbursement to the physician."
Now, I know that various medical professions each have their own language, but that is not “doctor speak,” or “hospital speak,” or even “insurance speak.” That is just plain gibberish. No one bill was all that large, they ranged from $12.50 up to $135.00, but they totaled close to a thousand bucks, and I’m not coughing up that kind of money without a better explanation than that.
There was one bill, though, for $835.00 which the insurance paid, and that seemed very weird. It will make perfect sense when we finish this little adventure, but it seemed strange at the time.
I called the hospital and verified that they do, in fact, subcontract lab work to that company, and then I contacted the insurance company via a messaging system to ask why they were denying these claims and for a better explanation of the “service in a facility setting” denial.
They replied, “when you are in a hospital, the professional component for reading your lab tests is already incorporated in the hospital fees. In essence, if we pay this charge we would be paying the services twice.”
Okay, the explanation is no longer gibberish, but is now entirely bogus. My doctor might need the services of a radiologist to read an x-ray or a CT scan, but he certainly doesn’t need any help reading a damned blood test. Hell, even I can read a blood test. I might not know what the values mean, but my doctor certainly does.
So, I make an assumption and send another message to the effect that I don’t believe that they are billing for reading tests, but are billing for performing tests which are subcontracted to them by the hospital.
I receive a reply that the lab “is not billing for performing these tests they are billing for the professional component which is the reading of the tests,” and that the bill for performing the tests was submitted by the lab directly to the hospital.
So I call the laboratory and ask what they are billing for, and am told that they don’t read lab reports, all they do is generate them by performing the tests. The very nice person there informed me that they are an “out of network” provider to the insurance company and are therefor not bound by the stipulation prohibiting billing the patient for the difference between full price and the amount paid by insurance. The amount which they were billing direct to insurance is the discount which the hospital extends to the insurance company and which, not being paid by insurance, the hospital does not pay to the lab.
She went on to say that if I would appeal the denial based on the fact that I was a patient at an “in network” facility and had no choice on the performance of the lab work, that the insurance company would pay the claim. She added that she was marking my account to the effect that I was appealing and that they would wait for payment from insurance, thanked me for calling and wished me a nice day.
I then sent another message to the insurance company saying that I wanted to appeal the denials of payment based as the person at the lab had coached me, and received a prompt reply that an appeal was not necessary and that the responder would see to it that the claims were submitted for an “exception” and that payment would be made to the provider. She thanked me for using their messaging system and apologized for the inconvenience that I had incurred on the matter in question. Indeed.
I then went back and looked at the earlier messages and realized that the insurance company was never really taking a very firm stance in denying the claim. In the very first message, after saying that their policy was “not to pay this charge in a facility setting,” there was a statement toward the end that added, “If you are to be billed for this service we will be able to go back and take a second look at the claim for processing at the in network rate” which I had overlooked.
In the second message, after telling me that the lab was billing for reading the lab results and that “In essence, if we pay this charge we would be paying the services twice,” there was a similar admonition that, “Please send me a follow up message if you have received a bill from this provider. I will then be able to have your claims sent back to our transactions team for an exception to be made and benefits allowed for these charges,” which I had also missed because my attention was so focused on the novelty of the claim about the need for a specialist to read a blood test and the insanity about paying for services twice.
It was also a bit weird for her to be wanting to be told if I had received a bill from the provider, since they themselves had received the bill from the provider and sent an “explanation of benefit” to me and to the provider saying that I was expected to pay the bill. So what did they expect the provider to do if not send me a bill?
Now, I will admit that I am engaging in some mind reading here, which is not normally my strong suit. Ask my wife about that. But the evidence strongly supports my conclusion that UnitedHealthCare is filled to the brim with a substance which comes out of the South end of a Northbound horse.
They know that they have to pay the charges which I incur while using an “in network” facility, and the fact that the facility subcontracted some of the work is irrelevant to the agreement that exists between the insurance company and me. The little tale about payment for “reading the tests” is invented out of whole cloth, a polite way of calling it a blatant lie, as a ploy to avoid paying the charge. They know very well that the charge is for the discount which an “out of network” provider does not allow, and they deny the charges in hopes that I will not challenge the denials.
The hint in their very first response to my challenge that they are willing to give in and pay it is one tip-off of my conclusion, and payment of the $835 charge is another. Many patients will not think to challenge bills under $150 when they are looking at a long list of bills which have been paid, but everyone is going to challenge a denial on a bill that large, and they know it. That signals to me very clearly a “We’ll deny these bills and see if we can get away with it” approach on the smaller bills.
Object lesson: don't hesitate to challenge insurance claim denials. Sometimes you win.
Now, I know that various medical professions each have their own language, but that is not “doctor speak,” or “hospital speak,” or even “insurance speak.” That is just plain gibberish. No one bill was all that large, they ranged from $12.50 up to $135.00, but they totaled close to a thousand bucks, and I’m not coughing up that kind of money without a better explanation than that.
There was one bill, though, for $835.00 which the insurance paid, and that seemed very weird. It will make perfect sense when we finish this little adventure, but it seemed strange at the time.
I called the hospital and verified that they do, in fact, subcontract lab work to that company, and then I contacted the insurance company via a messaging system to ask why they were denying these claims and for a better explanation of the “service in a facility setting” denial.
They replied, “when you are in a hospital, the professional component for reading your lab tests is already incorporated in the hospital fees. In essence, if we pay this charge we would be paying the services twice.”
Okay, the explanation is no longer gibberish, but is now entirely bogus. My doctor might need the services of a radiologist to read an x-ray or a CT scan, but he certainly doesn’t need any help reading a damned blood test. Hell, even I can read a blood test. I might not know what the values mean, but my doctor certainly does.
So, I make an assumption and send another message to the effect that I don’t believe that they are billing for reading tests, but are billing for performing tests which are subcontracted to them by the hospital.
I receive a reply that the lab “is not billing for performing these tests they are billing for the professional component which is the reading of the tests,” and that the bill for performing the tests was submitted by the lab directly to the hospital.
So I call the laboratory and ask what they are billing for, and am told that they don’t read lab reports, all they do is generate them by performing the tests. The very nice person there informed me that they are an “out of network” provider to the insurance company and are therefor not bound by the stipulation prohibiting billing the patient for the difference between full price and the amount paid by insurance. The amount which they were billing direct to insurance is the discount which the hospital extends to the insurance company and which, not being paid by insurance, the hospital does not pay to the lab.
She went on to say that if I would appeal the denial based on the fact that I was a patient at an “in network” facility and had no choice on the performance of the lab work, that the insurance company would pay the claim. She added that she was marking my account to the effect that I was appealing and that they would wait for payment from insurance, thanked me for calling and wished me a nice day.
I then sent another message to the insurance company saying that I wanted to appeal the denials of payment based as the person at the lab had coached me, and received a prompt reply that an appeal was not necessary and that the responder would see to it that the claims were submitted for an “exception” and that payment would be made to the provider. She thanked me for using their messaging system and apologized for the inconvenience that I had incurred on the matter in question. Indeed.
I then went back and looked at the earlier messages and realized that the insurance company was never really taking a very firm stance in denying the claim. In the very first message, after saying that their policy was “not to pay this charge in a facility setting,” there was a statement toward the end that added, “If you are to be billed for this service we will be able to go back and take a second look at the claim for processing at the in network rate” which I had overlooked.
In the second message, after telling me that the lab was billing for reading the lab results and that “In essence, if we pay this charge we would be paying the services twice,” there was a similar admonition that, “Please send me a follow up message if you have received a bill from this provider. I will then be able to have your claims sent back to our transactions team for an exception to be made and benefits allowed for these charges,” which I had also missed because my attention was so focused on the novelty of the claim about the need for a specialist to read a blood test and the insanity about paying for services twice.
It was also a bit weird for her to be wanting to be told if I had received a bill from the provider, since they themselves had received the bill from the provider and sent an “explanation of benefit” to me and to the provider saying that I was expected to pay the bill. So what did they expect the provider to do if not send me a bill?
Now, I will admit that I am engaging in some mind reading here, which is not normally my strong suit. Ask my wife about that. But the evidence strongly supports my conclusion that UnitedHealthCare is filled to the brim with a substance which comes out of the South end of a Northbound horse.
They know that they have to pay the charges which I incur while using an “in network” facility, and the fact that the facility subcontracted some of the work is irrelevant to the agreement that exists between the insurance company and me. The little tale about payment for “reading the tests” is invented out of whole cloth, a polite way of calling it a blatant lie, as a ploy to avoid paying the charge. They know very well that the charge is for the discount which an “out of network” provider does not allow, and they deny the charges in hopes that I will not challenge the denials.
The hint in their very first response to my challenge that they are willing to give in and pay it is one tip-off of my conclusion, and payment of the $835 charge is another. Many patients will not think to challenge bills under $150 when they are looking at a long list of bills which have been paid, but everyone is going to challenge a denial on a bill that large, and they know it. That signals to me very clearly a “We’ll deny these bills and see if we can get away with it” approach on the smaller bills.
Object lesson: don't hesitate to challenge insurance claim denials. Sometimes you win.
Wednesday, April 3, 2013
Well, This Is Just Ducky
The Washington Post headline speaks for itself, "Obama administration pushes banks to make home loans to people with weaker credit."
We cannot foretell how this is going to turn out can we? Oh, wait...
We cannot foretell how this is going to turn out can we? Oh, wait...
Burgers Florentine
Over the objections of my wife, we had hamburgers with Swiss cheese, spinach and a dab of Mayo last night. The spinach was sauteed lightly with a trace of olive oil and a little garlic. She did not, of course, refuse to eat it and admitted it was quite tasty, and that I could make it again if I wanted to. Naturally, that was what I expected to happen.
As usual when I use packaged baby spinach, I spent what seemed like half the dratted afternoon picking the stems off of it. Someone should invent a machine to do that, unless my wife is the only person in the country who insists on it. She's worth it, of course, and in any case what cook would prepare a dish that was not pleasing to the palate of the person for whom he was preparing it?
As usual when I use packaged baby spinach, I spent what seemed like half the dratted afternoon picking the stems off of it. Someone should invent a machine to do that, unless my wife is the only person in the country who insists on it. She's worth it, of course, and in any case what cook would prepare a dish that was not pleasing to the palate of the person for whom he was preparing it?
Tuesday, April 2, 2013
Non Sequitur Abounds
Paul Krugman is not alone in his ability to abandon logic, and even common sense, in pursuit of validation of economic theories. Dean Baker is no slouch either. Consider a “point/counterpoint” thread I had with him the other day regarding his statement that, “The BLS actually measures the rate at which jobs are becoming obsolete, it's called ‘productivity growth.’"
My mind immediately went to the manufacture of gas-powered refrigerators. I don’t think that it was “productivity growth” that led to jobs manufacturing those things becoming obsolete. Same with those telephone modems where you put the handset into the cradle. There are no jobs left making those things, but I doubt that “productivity growth” caused that to happen. So I wrote a comment on his post.
His response was truly weird.
I love arguments which begin with the word "presumably." We have no facts, so we will base our argument on presumptions. Excellent.
Well, if that’s true than other jobs were “presumably” created, but those 90,000 jobs still became obsolete, so his argument about people spending money is a complete non sequitur. Jobs which became obsolete and are replaced by other jobs are still obsolete, and the suggestion that the replacement goods have “the same or higher value” as the lost production does not assure that the workers will be paid the same to produce them.
Nor does it assure that the production workers will even be in this country and the BLS does not, I believe, track jobs in China. It doesn't occur to him that people might actually not be spending that money, accounting for something like 14 million jobs that disappeared during the recession, or that they might be spending it on items manufactured overseas. He continued,
And here he admits that jobs would be becoming obsolete not due to “productivity growth,” but rather to “bad macroeconomic policy,” and in so doing shoots himself in the foot as economists tend to do it they babble on long enough.
My mind immediately went to the manufacture of gas-powered refrigerators. I don’t think that it was “productivity growth” that led to jobs manufacturing those things becoming obsolete. Same with those telephone modems where you put the handset into the cradle. There are no jobs left making those things, but I doubt that “productivity growth” caused that to happen. So I wrote a comment on his post.
Productivity does not equate to jobs becoming obsolete as whole industries disappear or jobs are shipped overseas. If making 1 million units by 100,000 workers drops to 100,000 units made by 5,000 workers, you certainly have seen a major productivity growth, but that only explain 5000 job lost. The loss of 900,000 units of production explains the other jobs lost, and those jobs can fairly be said to have become obsolete in a manner that had nothing to do with productivity gains.
His response was truly weird.
Sorry Bill -- you just gave an example of productivity growth -- what is happening to the money that people used to spend on the products that no one wants or are produced overseas? Presumably they spend it on something and that something has the same or higher value than the items the laid off workers were producing.
I love arguments which begin with the word "presumably." We have no facts, so we will base our argument on presumptions. Excellent.
Well, if that’s true than other jobs were “presumably” created, but those 90,000 jobs still became obsolete, so his argument about people spending money is a complete non sequitur. Jobs which became obsolete and are replaced by other jobs are still obsolete, and the suggestion that the replacement goods have “the same or higher value” as the lost production does not assure that the workers will be paid the same to produce them.
Nor does it assure that the production workers will even be in this country and the BLS does not, I believe, track jobs in China. It doesn't occur to him that people might actually not be spending that money, accounting for something like 14 million jobs that disappeared during the recession, or that they might be spending it on items manufactured overseas. He continued,
And if they are not spending it, then the problem is bad macroeconomic policy that is not making up the shortfall in demand. This is a case of policymakers who lack the skills for the jobs they hold.
And here he admits that jobs would be becoming obsolete not due to “productivity growth,” but rather to “bad macroeconomic policy,” and in so doing shoots himself in the foot as economists tend to do it they babble on long enough.
Monday, April 1, 2013
Speaking Out of Turn
When I joined the Navy, I did not do so for any abstruse reasons such as “serving my country” or “defending freedom,” I did it so that I could get awarded some nifty medals and receive a fancy funeral.
Some people just don’t get what military service is all about.
Relatives of a San Diego Marine killed in Iraq have been fighting for four years to get his Navy Cross upgraded to a Medal of Honor. I doubt very much that the fallen Marine really cares. He was not there for the purpose of pinning medals on his chest. He did not fall on that grenade because he wanted a specific medal. They dishonor him by making his action about a medal instead of about saving the lives of his brothers in arms.
I read a post by a conservative blogger today, expressing outrage over a suggestion that the military cease providing ceremonial funerals for service persons not killed in combat. Her outrage is for the veterans themselves, who she claims are owed the burial service regardless of where or how long they served. The fact that they volunteered for their country is enough, she says, that we owe them that final dignity.
When my wife asked a few years back I told her that my preference would be to be buried with my shipmates in a national cemetery, but that her comfort and convenience should prevail in determining what is done with my remains after I die. I won’t care, because I will be in a better place.
When my father was buried at Arlington the ceremony was, indeed, a comfort to my family. It was valuable to know that his 43 years of service to his country was honored and valued, and that his dedication to his nation was returned. Funerals are not for the dead, they are for those who are left behind, a point which that blogger missed.
The column in question was disrespectfully worded, his point was not well made and missed the mark, but there is perhaps a point to be made. For a person who served for a short time and far from combat the trappings of a military funeral may not have as much meaning to the family, and perhaps some thought might be given to reducing the degree of ceremony devoted to burial services for veterans based on length and type of service.
What I do know is that civilians need to quit declaiming that they know what veterans want and need. Let veterans speak for themselves, people, because you don’t know shit. And, yes, the first paragraph was sarcasm.
Some people just don’t get what military service is all about.
Relatives of a San Diego Marine killed in Iraq have been fighting for four years to get his Navy Cross upgraded to a Medal of Honor. I doubt very much that the fallen Marine really cares. He was not there for the purpose of pinning medals on his chest. He did not fall on that grenade because he wanted a specific medal. They dishonor him by making his action about a medal instead of about saving the lives of his brothers in arms.
I read a post by a conservative blogger today, expressing outrage over a suggestion that the military cease providing ceremonial funerals for service persons not killed in combat. Her outrage is for the veterans themselves, who she claims are owed the burial service regardless of where or how long they served. The fact that they volunteered for their country is enough, she says, that we owe them that final dignity.
When my wife asked a few years back I told her that my preference would be to be buried with my shipmates in a national cemetery, but that her comfort and convenience should prevail in determining what is done with my remains after I die. I won’t care, because I will be in a better place.
When my father was buried at Arlington the ceremony was, indeed, a comfort to my family. It was valuable to know that his 43 years of service to his country was honored and valued, and that his dedication to his nation was returned. Funerals are not for the dead, they are for those who are left behind, a point which that blogger missed.
The column in question was disrespectfully worded, his point was not well made and missed the mark, but there is perhaps a point to be made. For a person who served for a short time and far from combat the trappings of a military funeral may not have as much meaning to the family, and perhaps some thought might be given to reducing the degree of ceremony devoted to burial services for veterans based on length and type of service.
What I do know is that civilians need to quit declaiming that they know what veterans want and need. Let veterans speak for themselves, people, because you don’t know shit. And, yes, the first paragraph was sarcasm.
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