Debate on Health and Healthcare

Status Update from Lawyer/Solo Practitioner: Eff you, Kaiser. I'm not paying $352 a month for health insurance in 2011. I don't smoke, I exercise, I'm not involved in any risky activities, and I avoid liquor. You people saw me about five times in 2010 and don't even provide me with my hearing aids or dental work. Does anyone have any advice for other health insurance options?

P.S. The biggest long-term medical expenditures will be on Medicare. Do you see what I mean when I say that current American society is financially stealing from the young to benefit the old? Do you really expect us to continue to be the world's superpower when we spend ever-increasing resources--already about 50% of federal tax revenues--on senior citizens? Money is finite. One dollar spent on senior citizens--who've had their chance to save money, have families, and buy homes--is a dollar not spent on the young, who have yet to have families, buy homes, and utilize compound interest.

Rob: Do you drive a car?

Lawyer: Yes, and I have the med pay option on my car insurance.

Older people drive, too. Why not let them pay a higher share of overall insurance costs, given that they've had an additional 30 years to save up for it and have also benefited from the real estate boom--unlike most people under 35 years old? Americans don't understand that the real threat against our way of life isn't Al Qaeda, Iran, or Iraq--it's older people and government workers voting in benefits for themselves at the expense of the young and unborn.

Trent: I have great insurance. Don't use it..have a DR/Hospital phobia. Only go if injured.

Laura: I feel ur pain. I was looking to switch from Anthem BC to Kaiser but rates at Kaiser were slightly higher..

Roger: Start smoking and drinking and engaging in risky activities.

Mary: I've got to point out that I'm certain there are plenty of elderly Republicans reaping the healthcare benefits for which you hold all Democrats responsible.

Lawyer: yes, but the GOP is trying to cut universal healthcare coverage while the Dems passed it, which has caused my premiums to increase drastically over the past three years. I will now have to get a reduced benefit health insurance plan b/c of the Dems. You want me to give them a medal for passing lame, watered-down, insurance-company-friendly legislation? I'd rather cut programs Tea-Party-style if it means I save money.

BTW, isn't it lovely being in a union, where taxpayers like me pay for fed, state, and local gov employees' benefits even as our own costs increase? Ah, those Dems--looking out for their unions. You want me to support a party that doesn't care about small businesses, young people, families, or inflation? I'll take the war-loving whack-jobs over the alternative, b/c the GOP has promised to cut spending and government programs. And Obama's pay freeze on federal gov workers doesn't go far enough--he should have cut salaries by 15% for anyone making more than 75K/year, including himself.

Mary: Oh, and we opened up 3 [police] dispatcher positions today. Check out the CalOpps link on my page, I encourage you to apply.

Lawyer: Re: dispatcher positions, so the government is expanding while the private sector and consumer spending is declining? This will totally work...as long as the laws of economics and math don't apply.

Mary: we aren't expanding. We are perpetually shortstaffed. As a matter of fact, I'm finishing up day 2 of 6, with a 68 hour workweek. For lack of a more appropriate term, I am dog arsed tired... So please, apply, and encourage others to also. I'd love to have my weekends...in all seriousness. I'm thankful for job security, but this still is no cakewalk. :-(

Lawyer: no well-paying job's a cakewalk. If we keep inflation under control, have a balanced budget, and stop relying on accounting gimmicks and constant bond issues, we can hire more gov workers. The private sector is getting more squeezed than the public sector--I've never seen so many hi-tech working so hard b/c of job cuts. Many engineers I know are working 19 hour days...with no job security, pensions, or lifetime medical benefits. The real problem is that so much of our taxes are going into the pockets of retired gov workers, which leaves your department with less money to hire workers now. Why can't more people see this simple fact? Public pensions cost current jobs and are unaffordable during a recession.

Also, if the private sector economy improves, the issue of gov benefits will not be at the forefront of budget discussions. Thus, the best thing gov workers can do is help the private sector get back on its feet.

Until just recently, the Dems controlled Congress for the last four years. All I see is my costs going up and my income getting more and more unstable. In fact, I've begun representing more gov and union employees now than ever before. It's scary to think that I am getting fewer calls from private sector workers because they just aren't enough of them working anymore, and the ones who have jobs are probably not willing to rock the boat under any circumstances. Sigh.

Mary: I credit divorce :-)

Lawyer: It's all a big mess, isn't it?

Mary: So in a way we are paying your salary too then?....

Lawyer: yes, except it's completely voluntary, and if I don't perform well or provide a service better than my competition, I don't get paid. Also, my services create no long term, unpredictable costs to taxpayers, and my fees are negotiable. Oh, and I have no job security or guaranteed income stream from taxpayers. So yes, to an uninformed person, it's exactly the same thing :-)

In the gov world, if you're incompetent or if they don't like you, they tend to reduce your duties and stick you in a corner somewhere until you retire. In the real world, if you don't perform, you get fired, and I might be able to get you a severance package, perhaps between three and twelve months. (It's usually easier to get a severance if you see a lawyer before you get fired, BTW.) Unlike the gov, the effects of a bad employee in the private sector are finite and definite.

Mary: I will absolutely agree with you in that sense. It is infuriating and a slap in the face to all of us that DO come to work and give our jobs and the public our all when we see substandard employees retained and given the same pay.

FWIW, the union really doesn't do everything in the best interest of even its members. I'm fighting what seems an uphill battle on right vs wrong, negligent retention and nepotism...not to mention favoritism and inappropriate relations among ranks. The union's stance is, "well let's see how it pans out." Um, for the $1,000 I pay you each year in membership fees alone, that answer isn't gonna fly! So I applied for the job in question when it opened...my interview was yesterday.

Lawyer: Some unions do a great job protecting their workers, but some are terrible when it comes to protecting the rank and file, especially in some California county hospitals. That's why some union members come to me for advice, even though their union should be the one assisting them. (Hey union reps, you might want to return a phone call once in a while and keep your members appraised of deadlines, including the deadlines to file grievances. I'm just sayin'.)

British Citizen: I love the NHS [national healthcare system in the U.K., which is free for British citizens.]

Rick: I cannot believe I'm attempting to defend Obama, but blaming Obama and fed govt employees for the high cost of your crappy health insurance is just silly and childish. Let me get this right; G.W. Bush and the Republican policies (dragging our troops into Iraq costing us billions of dollars a year, deregulating banks and insurance companies allowing multi billion dollar profits for those companies and their CEOs at the peril of poor and middle class Americans, and more...) took this country into the worst recession in our history since the Great Depression. Now, Obama has been trying to get the country out of recession, stabilize our economy, and yet help millions of Americans who lack any type of health insurance (a very sad condition for any civilized country) and regulate those greedy bank executives. There are many wealthy corporate executives, including the ones at insurance cos, that see their corrupt money-making ways endangered, hence are raising the cost of your less than adequate health insurance to compensate for it. If there are blames to go around, it should be directed to greedy and corrupt corporate executives and their lobbyists and Republican policies, not federal govt employees and the new Health Care law.

Lawyer: it's perfectly consistent to criticize Bush II and also increased healthcare costs. My comments were directed at Congress, which has been in Democratic hands for the last four years. Bush II was a moron, but like any American president, he doesn't have much control over domestic spending. Outside of of a war situation, an American president is just the mouthpiece for his party, especially if his or her party controls Congress.

I don't think the Dems realized that insurance companies would jack up policy premiums so quickly. And I still don't see any plan on their side to deal with the increased premiums.

[Speaking of unfinished business, we also need better financial regulation--we still have not solved the "too big to fail" problem, which is actually worse than before (all the big banks got even bigger).]

With respect to health care, I remember our president saying that the expanded coverage would be paid for by cutting the fat from programs internally, especially Medicare. I supported that and continue to support anything that will cut long term, unpredictable fiscal obligations. I never heard our president say anything about me paying 10 to 15% increased premiums each year for the past three years.

I recently got a pain in a tooth. I have no dental coverage, b/c individual dental coverage plans are generally worthless. (There aren't enough individuals buying dental insurance to make the plans beneficial or worthy of consideration.) I am going to India soon. I am not sure if I should wait to go to India and get dental care there on my vacation, or just pay up here. I am going to take Advil and see what happens in the meantime. It's a bit astounding to me how our country talks so much about small businesses and entrepreneurs and yet does nothing to assist us except when it comes to retirement plans (like individual 401ks, SEPs, etc).

Rick: I completely share your sentiment re rising cost and lower quality of health and dental insurance. Our president and the Congress need to address the outrageous cost of living, including dental and health insurance costs. It's incredible that US corporations are making record breaking profits while unemployment rate and cost of living continue to rise, and the average American is hurting. And then, there are elected politicians who argue less govt and more tax breaks for the wealthy. Meanwhile our country stands in a mountain full of debt which if not properly addressed will break our back. But hey let's give the wealthy more tax breaks so they can enjoy their yachts, luxury cars, and Tiffany & Co jewels, because the rich can stimulate the economy better than average Americans. And let's deregulate big banks, insurance companies and other large corporations and let them make more profits for their executives while they treat their employees like slaves...advantages of smaller government and less regulations.

Lawyer: this post was never about "smaller government," which is a different discussion. My post was about a poorly conceived healthcare law that has caused my premiums to increase 10 to 15% annually over the last three years, when the Democrats controlled Congress. The Dems passed a healthcare law that was supposed to be paid by cutting spending, not increasing premiums. They apparently did not anticipate insurance companies increasing premiums quickly or did not pass a healthcare law properly drafted to protect the young and middle class.

Insurance companies are a necessary evil that keep healthcare costs in check. Without them, our long-term healthcare costs would be even higher. We ought to have better procedures for contesting denials of care and reimbursement, but we shouldn't lose sight of the fact that insurance companies prevent healthcare costs from spiraling out of control.

Democrats like to joke that Republicans want older people to die quickly, and the GOP talks about rationing and death panels, but no one is questioning the wisdom of paying billions of dollars annually to give grandma and grandpa an additional 6 months of life and all the morphine they want. How did healthcare costs increase so much in 30 years? Is it b/c we used to let older people and people with terminal illnesses die comfortably instead of doing everything we could to prolong their last six months of life? How did Americans survive 30 years ago without Xanax, Prozac, etc.? Are we a more healthy society than we were 30 years ago?

The medical doctor who helped draft the original healthcare bill knew that healthcare expenses during the last six months of a patient's life were outrageous and needed to be reduced. In other words, the Democrats did in fact try to pass a law rationing medical care, which would have been a significant achievement. But insurance and drug companies quickly realized that the original bill would cut their profits and watered down the legislation using GOP scare tactics of "death panels." Now, instead of paying for universal coverage via spending cuts, people like me, you, your children, and the middle class will be paying for it. And it's b/c Americans were too naive to understand that rationing over the last six months of a patient's life is necessary to control healthcare costs.

Rick: I agree with end result of your proposal, but the way to get there should be better articulated than to cut govt employee salaries or reduce the size of govt agencies. Now, if studies prove wasteful spending in certain areas of govt, then yes they should be cut off. Govt should be here to protect the citizens not to waste their tax money.

Quotes: Happy New Year

And what does the Lord require of you? Only to act justly, to love tenderly, and to walk humbly with your God. -- Micah 6:8

It’s good to leave each day behind,
like flowing water, free of sadness.
Yesterday is gone and its tale told.
Today new seeds are growing.
-- Jalaluddin Rumi

Good is not that your possessions, wealth and power... increase, but good is that your knowledge increases and your insight grows more powerful, and that the people are proud to serve God. For when you do good, you praise God. -- Imam Ali

Man has three friends on whose company he relies. First, wealth which goes with him only while good fortune lasts. Second, his relatives [but] they go only as far as the grave, [and] leave him there. The third friend, his good deeds, go with him beyond the grave. -- the Talmud

Quote of the Day: Wartime Edition

Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed. This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children...Is there no other way the world may live?

-- Dwight D. Eisenhower, “The Chance for Peace,” speech given to the American Society of Newspaper Editors, Apr. 16, 1953

Gender Gap

The WSJ sometimes disappoints me. In an article dated November 18, 2010 by Pui-Wing Tam, it tried to put the lack of diversity on corporate boards in the best possible light:

Some 56% of Silicon Valley companies now have at least one woman director on their board, up from 51% in 2009 and 41% in 2003...

http://online.wsj.com/article/SB10001424052748704658204575611141839403062.html

There are usually between nine and twelve directors on a board. The study cited above is based on corporate boards that include "at least one woman." Basically, the WSJ is lending support to the idea that diversity is progressing because Boards have added a single woman. Moreover, having a single woman on a Board apparently equals reaching "critical mass":

"There's been a growing critical mass of women on boards" in Silicon Valley, and "now it's really come to fruition," says Jonathan Visbal of Spencer Stuart, who co-wrote the study.

I'm not sure whether to laugh or cry. The only person quoted in the article who doesn't look moronic is Autodesk's general counsel:

"You want board members with divergent experiences and viewpoints, and that leads you down the path of diversity" in directors, says Pascal Di Fronzo, Autodesk's general counsel.

That makes sense. Applauding the addition of a single woman to a Board of Directors does not.

E.B. White

Quotes from E.B. White's essays:

"I think the Court again heard clearly the simple theme that ennobles our Constitution: that no one shall be made to feel uncomfortable or unsafe because of nonconformity."

"The quality in New York that insulates its inhabitants from life may simply weaken them as individuals. Perhaps it is healthier to live in a community where, when a cornice falls, you feel the blow; where, when the governor passes, you see at any rate his hat." ("Here is New York")

"This place has been too much for them; they sit languishing in a cheap restaurant over a speechless meal."

I'm Baaaaack

Good news--I am back in California. My sister is coming tomorrow, so the family will be together for X-Mas!

Virgin Airlines in Delhi, How I Hate Thee

I am now in London, and my sister is safe and sound in the States. Each and every Virgin employee refused to read the Articles I've highlighted and gave me the company line: delays due to weather conditions do not require Virgin to put anyone up in a hotel for more than one night. Even when I pointed out that my situation is different because I have a confirmed outgoing flight that is more than 48 hours away and my flight is international, no one seemed to care.

The problem with Virgin is that no one except one main manager seems to have any authority to do anything. Unless you get in touch with the main manager, each and every other employee seems to do his or her best to actively inconvenience you. For example, when I landed in Heathrow, the first employee at the Virgin counter told me no flights were being scheduled, so I would have to stick to my original departure date of Dec 26 to SFO. (This was actually an improvement over the Virgin employee I first talked to when I came to Delhi's airport--she told me I shouldn't have showed up because no flights were leaving to London that day. I later got a flight to London after speaking to the top manager and explaining the Virgin employee who came to the hotel told me I would be able to fly out that day.)

In London, I asked a Virgin employee about a hotel, and she referred me to another desk. I went to the desk, located in a different building, but that desk was empty. The second Virgin person I spoke to at a different counter told me Virgin would not put me in any hotel because all hotels were booked. His direct manager said the same thing. I finally got in touch with someone who appeared to be the very top Virgin manager. After just a minute of hearing my situation, this top level manager told the Virgin employee to put me in a hotel overnight and get me out on another flight as soon as possible. Then, within ten minutes, the employee who said that I couldn't get an earlier departure time or get a hotel because all of them were booked offered me a hotel (though only for one night) and a new flight leaving on Dec 23. Unbelievable.

Also, it turns out that the idiots at Virgin's Delhi operations actually wrote in my PNR or flight data information sheet that I had agreed to pay 75 pounds to get them to change my flight details. Outright lies.

The airline industry is the worst-run major business in the world. Anytime employees don't read their own rules carefully; have no discretion to assist customers fully without someone else's approval; and actually have disincentives to assist customers to get something done, disaster and fraud await.

Also, I just found out that a fellow traveller from Delhi, the last person there on Dec 19, managed to speak to the head of Delhi airport and get back to the States on Continental Airlines the same night. Virgin's Delhi employees have treated its passengers differently based on a random set of factors and engaged in a pattern of either negligent or intentional misrepresentations. First they told us they couldn't get us on other airlines, and I've personally spoken to three people leaving on partner airlines (all of the three people who got to leave stayed the longest and complained persistently). Then Virgin's Delhi employees told us they had no obligation to put us in a hotel at all, which is false. (After I was in the airport for 7 hours, they put me and others in a hotel, but failed to tell the hotel that they were paying for my stay for more than one night, even though they had booked me to leave a whopping six days later--which they said was the only confirmed outgoing flight from Delhi to London at that time.)

Finally, a London Virgin operations employee told me that Virgin had no hotels available, but then offered me a hotel after a high level manager intervened. Unfortunately, Virgin offered me a hotel for only one night even though my new flight is scheduled to leave on December 23--two nights from now. What the heck am I supposed to do on December 22, I asked? Virgin's London operations didn't seem to care one bit. I managed to get accommodations on my own for two nights.

One last thing: several Virgin employees in Delhi would not provide me with their names. At my Delhi hotel, outside in a public area, I took a picture of the only Virgin employee I saw to have some way of identifying her, and she hounded me for the next several hours, demanding I delete her picture. When she ran into me prior to my departure at the gate, she actually tried to withhold my passport, causing me to snatch it out of her hand to get it. When I asked for her manager, she refused to get her manager immediately, saying she was busy. (Of course I had to get through the gate and couldn't wait.) I asked for her name before I would delete her picture, and she refused to give me her name. (I deleted her picture later on, after I was on my way to Heathrow.)

Names on Virgin's Delhi employee badges are in ten point font and difficult to see. Yet all the badges have the following meaningless words in large, bold font: "Vanil Upto." It's as if Virgin's India employees want to avoid easy ways for passengers to hold them responsible later on. The "best" part? The Virgin employee who showed up on December 21 didn't recognize the name of the Virgin employee who came on December 20 to the hotel to provide us with information. And she wondered why I wanted her name for identification purposes. She had told me Virgin would cover my entire hotel stay once I got to London, which turned out to be false. What a disaster Virgin has turned out to be. Still, I give props to Virgin's top level manager at Heathrow, who managed to help me get an earlier flight to SFO. Thank you, good sir.