Billing - Hospital Style

Yesterday morning I was reading in the Boston Globe that local hospitals are padding their bills with charges as high as $500 called “faculty fees” and/or “facility fees.” (It must be for all that enjoyment that we all feel sitting in the waiting room for the doctor while our parking fees rise.) To, personalize it, later the same day I received bills (there was more than one.) from the Lahey Clinic totaling close to $1,000 for what my coverage did not pay for a recent surgery. I’m part of the 47% for which that is not a trivial amount. The surgeon and staff were very good, no complaints. What irks that hell out of me is that the surgery is routinely performed at the hospital. So the hospital billing department must know within a reasonable amount what the cost was to be. There were no complications. The hospital billing department also deals with my coverage daily. They must know what the difference would be before the surgery. It was not an emergency. So why could they not inform me? Would it possibly have been because I might have shopped around to minimize my out-of-pocket expenses? In addition to the bills, I received a begging letter. Gee, guess how much I am inclined to give? Why is there not some legislation that requires that informed consent also involve information about the costs to the patient? It is time to bug our legislators to create some useful legislation around this.

Sequestration

Sequestration has several different definitions in the dictionary. The first of these is banishment or exile. What exactly is being banished here? It would seem to be common sense and common sense of purpose. In particular it seems to be the Republican Party which has banned any common sense whatsoever. They seem not to have thought about the recent national election or to listen to their own leaders, such as Karl Rove who talks about making the party more inclusive. Instead Republican congressional leaders seem to be focusing on the very few. Of course, those very few provide an awful lot of money. Apparently that short term gain is more important than any long-term survival as a party. However, the Democratic Party has its own problems. They just seem to reflexively oppose everything that the Republicans propose. Some of what they’re asking deserves at least consideration. The second definition of sequestration is retirement. What exactly is being retired? It certainly is not the nation’s debt. The Republicans keep yammering that the cuts are only 2 or 2.3%. And that certainly does not sound like much. Until of course, you think about what 2%. A 2% cut in an earlobe, though painful, wouldn’t be bad. But a 2% cut in brain tissue might have a different effect. Maybe an organ not in evidence is a poor example. A heart/ No there is not much indication of that either, but you get the picture. Certainly 2% of monies to aid the disadvantage is a huge cut. But this 2% will not affect Congress’s retirement pay. Indeed, Congress has excluded itself from having any cuts whatsoever to their pay. So the pain of sequestration certainly does not start at home. The last definition is confiscation. Certainly among those things confiscated is any sense of political dignity. To listen to these people (and I use the word ‘people’ only in a polite sense) is come to believe that any sense of logic has been confiscated. The same people who argued just a short while ago that these dire consequences would certainly force all involved to a compromise. Now these folks seem to think that the sequestration is but a drop in the bucket, a mere irritation, certainly well absorbed by the American economy without any consequences. Perhaps it is time to sequester, retire, this Congress and start again from scratch.

Republicans, do they think?

What is going o n with the Republican Party? They just lost an election during which the President’s proposal to let taxes on the wealthiest citizens revert to their previous levels was thoroughly discussed. The Republicans lost. Yet they still think that should oppose this concept. Are they waiting for a change in results? Did Mr. Rove tell them that it was still too early to judge the results? Or are they just that pig headed? Maybe they cannot count. After all they did try hard not to count minorities. Maybe they just cannot see them. Here in Massachusetts, The Republican party are hoping that John Kerry will be appointed Secretary of State and thus open up his senate seat for a special election. It is the GOP’s thinking that Scott Brown who was elected to finish out Ted Kennedy’s term would then be re-instated to the senate. Brown won election by driving a pickup truck and wearing a barn coat. (He is a former model.) Generally it was perceived that his opponent lost the election rather than Brown won it. Also, he just lost by a wide margin when he stood for re-election against a political neophyte. I don’t that anyone even now can remember exactly what issue Brown was running on. He did seem to indicate that he looked and acted like a Democrat even though he is a Republican. What are the Republicans thinking? Are they thinking? Perhaps they should change their symbol from an elephant to Jiminy Cricket. I guess Disney would sue.

To be or not to be a Republican

It must be hard to be a Republican these days and pretend to any semblance of intelligence. Mr. Romney chose Mr. Ryan to be his running mate and he said that Ryan’s budget largely mirrored his own. But, no, Romney would not endorse it. It was interesting because up to then Romney’s budget has been and continues to be a secret. We only know that he will decrease taxes and therefore revenues, not touch services meaningfully and somehow balance the budget. Mirabile dictum. However, now we do know it is like Ryan’s, but different. That is truly enlightening. In Massachusetts Mr. Brown is running for re-election as a Republican. I tell you this because you’ll find no mention of it in his advertizing. It’s like Romney’s budget. It’s there but where? Actually, if you suffer through Mr. Brown’s TV ads, you would think he is running in the Democratic primary. He runs on his independence even though he all but a minimum amount of the time he aligns himself with the Republican line. Again the same as Romney’s budget the same but different. Actually if you mute the sound on his early ads (always a good idea no matter whose ads.), it is fun to watch the facial expressions of his nearest and dearest. But it better to save your brains cells. I have not watched the latest. I’m waiting for him to find himself. Now we have the most idiotic to date Mr. Akin of the ‘legitimate rape’ fame. In spite of the outrage, he will not drop out of the race claiming a mere slip of the tongue. He may have a point. All the big shot Republicans, including Romney and Brown (who may have been prescient in pretending he was not really a Republican), were rightly quick to condemn him. Yet at the same time the Republican Party was inserting a plank in the party platform condemning abortions no matter what the circumstances, rape, incest or danger to the health of the woman. It is easy to be confused twixt what is said and what is done. Lastly, who are these doctors who Akin claimed told him a woman’s body will ‘shut down’ and prevent pregnancy in case of rape? Can you get a medical degree and license on line? I thought you at least had to wander down to the Caribbean for a few years first.

What was in the punch?

Now that Mitt Romney has all but wrapped up the nomination, he is talking about riding horses. All the while he is trying to project himself as a regular fellow. Did his head get hurt while the Etch-a-Sketch was being shaken? Those of us in Massachusetts though are used to this. When he ran before, he worked a half day or so at manual labor jobs to show us how much of a regular guy he was. Then at the end of the day the working jeans were dropped at the dry cleaners, just like all working folk.

There is also the hyped up (close to ginned up) business of the Democratic operative, Ms. Rose, noting that Mitt’s wife, Ann, didn’t work a day in her life. The woman obviously did not mean that it is not hard work raising children, but, without having to worry also about paying bills, it isn’t quite the same as the regular moms. But, despite never having worked a regular job, Mitt says she is the source of his economic advice. It explains much.

Mitt admits that President Obama didn’t cause the economic mess, but claims he has not done enough to fix the problem. Mitt’s notion is to go back to the previous Republican policies, you know, the ones that caused the problems in the first place. Certainly, he is not once bitten, twice shy.

Lost in all this is the Florida Republican Congressman Alan West, who is reviving the good old Republican days of McCarthyism. He claims that there are 78 to 81 House Democrats who are closet Communists. Why the uncertainty? Did he have trouble with elementary school mathematics, i.e., counting, or are there three who are on the fence? Did his threat of exposure save them? Does this give Mr. West the inside track on the VP nomination?

What is going on in the Republican Party? Did they all attend the same banquet and drink the same potion? Did any of them survive with a few brain cells intact? Or are those the ones that called quits?

Smart or dumb, phonewise

Today for the umpteenth time in the last few months I got accosted about not having a smart phone. I said I could not justify the added monthly cost. She was friendly enough and pointed out all the wonderful things that she could do with her smart phone. She instantly was able to find the temperature in Bangkok. It was hot and humid. I had already suspected as much … granted I did not know previously exactly how hot. But it was of no moment to me and I said so. As should have expected, as a cave dweller, I do not do much international traveling. Annoyed she immediately told me I could get my emails instantly. Now I love email. I think it is a magnificent invention. (Should I thank Al Gore?) It has decimated the interrupting phone calls during which I am asked a question with an immediate expectation of an answer. The answer is usually less thoughtful than I would like and is likely appreciated as that. My choo-choo of thought about what I was doing is also derailed. With email I can wait until I am finished with my immediate chore and respond to the question in what I hope is a thoughtful manner. Isn’t that win win? If I spend my time listening for a chime of a new email on my smart phone, isn’t the advantage of email subverted? You can send data instantly she countered. What data? I’m not a doctor, law officer, spy, etc. What data do I need to send immediately? You can always find your way with a GPS app. I usually look things up on Google before I go. How often will I use it to justify the increased monthly cost? You can download books. I can use a library card for nothing. It does not have to be charged nor is there a charge.

I cannot decide whether I am just being contrary or I really am missing something, besides being charged up to $50/month, more or less.

Ill fares the land ...

As I was reading the newspaper the other day, I came across a quote from Oliver Goldsmith, “Ill fares the land … where wealth accumulates and men decay.” I immediately thought of the current weed crop of Republican candidates. Mr. Goldsmith was an 18th century writer whose combination of thoughtful work, hack writing and dissolute life style earned him the title of “inspired idiot’ from a fellow intellectual. Again I thought of the GOP group. One pretends that he led a job creation venture capital group when the company was in fact primarily a leveraged buyout company that likely laid off far more than its few venture capital investments created. But he worried about pink slips with only a few million to rely on. You, know just little the average worker. He just doesn’t pay taxes like the average worker. Another cries out against the Washington culture, even though he was earning a very high income catering to that culture. Another believes his faith should dictate government policy for all, a true chauvinist. The last in the standings seems to belong to another insular century. (That being said, like him, I also wonder in this age why do we station so many troops overseas? I thought WWII and the cold war were over. Is the USSR making a comeback?) Watching and listening to all of them, it is easy to see that the rot and idiocy have set in deeply without a hint of inspiration. Thank God for the mute button.