S-townMike as a Medical and Insurance Case Study for the Cavalcade of Capitalists

I was going through our medical bills this morning and I found $264 dollars that the Vanderbilt Medical Center charged me for a test that according to my doctor ended up being "not processed properly as ordered." No where on the bill is the $264 credited. There was also a $45 blood test that did yield results according to my MD. My insurance company credited the $309 bill $222.04 for "contractual discount," which friends in the medical profession tell me is a standard discount that insurance companies give to hospitals for supplies and service. And my MD tells me that I will need to do the test over again in the future.

Do you see the problem here? Not only is the hospital going to make a percentage of the $87.00 that they say I owe on a test that they screwed up, but the insurance company is going to count a percentage of the $222 they paid toward a total lump sum of expenses that they will use to calculate future costs to be passed along to consumers. Once I am charged a second time for the test, then both the medical and insurance entrepreneurs will be guilty of double-dipping for what will be only a single set of results. If the hospital labs screwed up the test, then the hospital should eat the loss and not pass them along to their consumers and the insurance company discount should not be paid on the charges.

But do you think that Vanderbilt Medical Center or the insurance company really care about questions of fairness when it comes to passing along future costs to consumers? I'm going to fight these overcharges for the sake of my own pocketbook, but what if this irresponsible billing occurs on a more widespread basis? Who's going to fight the societal costs of hospitals demanding payment for services not rendered?

Cavalcade of Capitalists: Can Any Good Insurance Come from Florida?

On the one hand, Florida insurers--who are prohibited from using short-timeline equations for passing on higher recent hurricane claim costs to consumers--rely on their "reinsurers" to use short-timeline equations for passing on higher recent hurricane claims to them, and then they pass those costs on to consumers. On the other hand, what look like the "insurance entrepreneur" equivalent of predatory lenders or the sub-prime mortgagers are moving around the gulf coast pushing risky policies that they probably do not have the capital to support in the event of a disaster.

Disaster capitalism is alive and well and ready to skim a quick buck off any crisis mode. If coastal residents are not confronted with phantoms, then they are swimming with sharks.

Socialized Rescues of Corporations

Socialism is alive and well in America, but not at the bottom of the market, where conservatives claim it is. Government bailouts of corporations amount to socialism for the very rich, and the same social Darwinism used as a weapon against the lower and middle classes is not brandished on the wealthy.

In the case of Bear-Stearns: insurance companies appear to be the "welfare queens" (absent food stamps) in the Federal Reserve's hands-on salvation of Bear-Sterns. Does anybody blame those queens? Not without risk of being ironically labeled as socialists who oppose "free" markets. But we know for whom American socialism truly works.

The Ancient Art of Tearing the Life of a Child Apart

Ezra Klein's response to the conservative blogosphere, which honed on and harrassed a 12-year-old and his family after the child publicly spoke about how SCHIP has helped his family:

This is the politics of hate. Screaming, sobbing, inchoate, hate. It would never, not in a million years, occur to me to drive to the home of a Republican small business owner to see if he "really" needed that tax cut. It would never, not in a million years, occur to me to call his family and demand their personal information. It would never occur to me to interrogate his neighbors. It would never occur to me to his smear his children.

This is not politics. This is, in symbolism and emotion, a violent group ritual. It is savages tearing at the body of a captured enemy. It is the group reminding itself that the Other is always disingenuous, always evil, always lying, always pitiful and pathetic and grotesque. It is a bonding experience -- the collaborative nature of these hateful orgies proves that much -- in which the enemy is exposed as base and vile and then ripped apart by the community. In that way, it sustains itself, each attack preemptively justifying the next vicious assault, justifying the whole hateful edifice on which their politics rest.

Looks like leading Congressional Republicans could be joining in the group ritual, as Energy and Commerce Committee Republicans have posted a little Simpson's satire on the public tab to lampoon what they call "rental children":


The hateful length to which blind and unquestioned loyalty will send people is considerable.

Bush Administration Opposes States Setting Local Healthcare Insurance Guidelines for Their Children

Congress has compromised on Children's Health Insurance Bill (SCHIP), which President Bush intends to veto because he opposes states setting their own criteria for the children's eligibility.

During his latest press conference he attacked Dems for attempting to increase health care coverage for more poor children, and during that event his defense of his record on SCHIP both as Texas's Governor and as President was somewhat less than honest, as TexObBlog points out.

New Boating Opportunities Make Earmarks Okay, But Children's Healthcare Coverage Does Not?

U.S. Representative Jim Cooper joined U.S. Senator Lamar Alexander and Nashville Mayor Bill Purcell today on the Shelby Street Bridge to promote The Water Resources Development Act of 2007, which would pump $10 million into a study on Cumberland Riverfront Development. But the bill is going to cost a lot more than the $10 million allocated to Nashville (it still has to be approved by the Senate and signed by the President). The Congressional Budget Office's May 2007 estimate is that the entire bill--which includes earmarks for water, recreation, and transportation-related projects around the country--will cost "$8.1 billion over the 2008-2012 period and an additional $6.8 billion over the 10 years after 2012."

I do not have a problem with supporting this bill as it stands, because I think that developing the various water resources in these United States are a proper role for the federal government to play. But I think that Jim Cooper has a problem with inconsistency between his reasons for voting for this bill and those he used for voting against the State Children's Health Insurance Program bill. On the one hand, he voted against the SCHIP bill on the basis of his argument that a good project was "drowned" in unnecessary spending.

On the other hand, he voted for a water bill which itself could be and has been accused of frivolous earmarks, largely focused on studies rather than the delivery of actual services. One of the water bill earmarks is a project that Mr. Cooper himself has criticized: Alaska's "bridges to nowhere." Mr. Cooper could have easily made the case that some water bill money had more to do with beach resort development and less to do with community water projects per se. But he did not criticize and vote against the water bill's earmarks in the same way he did the SCHIP earmarks. Instead, he called the water bill "fiscally responsible."

While some boaters might appreciate Mr. Cooper's comments about "new recreational opportunities" for Middle Tennesseans, I wonder whether recreation should merit greater gravitas and support than the initiative to provide health insurance for the children of working families in spite of earmarks designated for areas outside of Middle Tennessee?

Bush Administration Undermines States' Attempts to Increase Children's Access to Adequate Health Care

Progressive States Network is reporting that on last Friday night President Bush quietly signed new SCHIP (State Children's Health Insurance Program) restrictions on states that expand coverage to children in families earning more than $51,000 for a family of four. States have to:

• Show they've enrolled 95% of children below 200% of poverty who are eligible for either Medicaid or SCHIP (no state has achieved 95% enrollment and, under Bush's budgets, none ever will).
• Prevent children from leaving private coverage; the new guidelines say states should charge premiums that approximate private coverage and impose a one-year waiting period, during children children are uninsured.
• Show that children's coverage by the private market has not decreased by more than 2% over the past five years.

In true partisan style, the restrictions fall most heavily on blue states that have tried to give their working-class children the same access to health care that middle- and upper-classes enjoy.

They won't affect us here in Tennessee, where we apparently care more about protecting the health insurance industry than our own children. Those second and third bullets should be particularly protective of private insurance corporations and deadly to many childen's well-being. Mandating private coverage is another form of subsidizing industry and sacrificing universal access to healthcare for kids, who have no control over whether they can afford treatment.

"My First Michael Moore Post" or "CNN Needs Double the Proctologists Now that He Tore Them Another One"

Michael Moore appeared on CNN to answer Wolf Blitzer and Sanjay Gupta's Reality Check on his new movie SiCKO and corporate criticism of it. He turned it around in the live interview (and later on-line) to give them a whopping dose of reality himself.

HT to R. Neal, who in an earlier post shared his family's harrowing treatment at the hands of a health insurance corporation who publicly claims to be trying to reduce the number of uninsured.

If you read this and feel thankful that you are insured, just keep in mind that you are probably just an interoffice memo or a balance sheet away from being among the throng of uninsured in America. Hence, advocating for the uninsured and the underinsured is essentially protecting yourself, too:

The [health insurance] system is broken, and they know it. Now they're just scrambling to keep their jobs.

That second point about "working together to reduce the number of uninsured" is a cruel joke. This same company refused to write me an individual policy at any price at any deductible. They would, however, write my company a policy that covers me. That's because there's no state law in Tennessee that requires them to write individual policies, but they are required to offer employer group plans. I'm not sure what I would have done if I wasn't self employed with the means to pay the company premiums.

Prior to that, we had an individual policy that got canceled when the company decided to get out of the health insurance business and sold the policy group to another company. The new company said everyone would have to reapply but gave assurances of continued coverage. They canceled our policy and denied our new application without any explanation.

At the time that policy was canceled, we had paid approx. $100,000 in premiums over eighteen years or so, with a net present value of approx. $250,000 based on the S&P 500 rate of return during that period. The policy had a $10,000 deductible (I thought it was $5,000, but the Mrs. corrected me). They never paid out a single penny because we never filed a claim, and still haven't to this day.

We would have been better off opting out of the system and stashing the money in a mutual fund for a rainy medical day. But that's what you get for trying to be responsible and for playing a game with the deck stacked in favor of big corporations.