Another rant on medical costs

I’m getting another blast of medical bill nuttiness. Where to start…

As you may know, my insurance company has been denying all claims. I’m not going to get into that here, the upshot is that I’m getting the bills. I have had some success with negotiating lower prices at some places, my neurologist’s included. A big part of this negotiation involves me whipping out a credit card and actually paying the bill. Getting paid right away is a big incentive, at least to some people…

I needed a spinal tap, so naturally I was worried about the price. I knew that I could work with the neurologist’s but they made it clear that they lab costs were out of their hands. OK, maybe if I contact the lab and work out something before the test, I can work a good price. Hoo boy. I called my neurologist’s office to find out what lab they are using. I then called the lab. They directed me to another number for billing questions and then they sent me back to the lab. At that time, I was only trying to get a price. It turns out that the person I needed to speak to had already left.

So I went and got my spinal tap the next day, and at the lab I told them that my insurance wasn’t going to cover it. I asked if they had a discount for prepayment. They said they used to, but they stopped doing that on April 1. They did say I could pay for a third and then fill out a form to see if Riverside medical would be willing to forgive the rest. Um, OK. Can’t you do something now, I would prefer to pay now. They would do that only if I paid the entire cost. They would not move an inch.

I got a similar run around with some of the other doctor’s offices I dealt with from Riverside Medical. When I call to the office, they say they do not handle the billing. When I call, they are not willing to lower the price at all even though they were willing to accept my insurance company’s much lower payment. It was common practice for my mother (an orthopedic surgeon) to charge a much lower rate, usually the medicare rate, when the patient didn’t have insurance. So what’s going on?

What my neurologist’s office and my mother’s previous office had in common is that they did their own billing. All of the other people I have dealt with have others do the billing. Why does that matter? It matters because when I deal with people at the other offices, they don’t care if I pay or not. It isn’t their job to collect, their job is to do the paperwork properly. As a matter of fact, they have been conditioned to not get involved in the money aspects of the business, it is uncomfortable and messy. They insulate themselves to the point that they have no idea what things cost.

The problem is that the prices that are charged are set with the idea that the insurance companies will pay a fraction of that. If you do not have insurance, you are stuck with a much larger bill than the insurance companies would get. This isn’t necessarily a problem, reasonable people can quickly come to an agreement based on what the insurance company or the government pays for any given procedure. The key is that the other side has to be interested in getting paid, they have to be willing to make a deal. The companies that do not handle their own billing and the billing companies that do it for them are not interested. They just want to do their job. If you pay, you go into one slot, if you don’t pay, you go into the other…

All of this has had the perverse effect of making it attractive for the medical claim to go into collections. You see, the collection agent is paid based on their ability to get money. They have every incentive to get money, so they have every incentive to wheel and deal on the price. They would be ecstatic to get half of the bill paid. They take their cut, and the rest goes to the medical company. It’s their own stupidity and the incentives set up by their structure that prevent them from getting that money in the first place.

A political joke

What do you call a Republican that is pro-choice, supports Obama, and supports civil unions for homosexuals? ? A Democrat. Zing!

This is what strikes me the most about Arlen Spectre defecting to the democratic party. These days, the only thing that separates dems and republicans is a fondness for different policies. There are no longer any philosophical differences on the nature of government. It is assumed that the president “runs” the country, it is assumed that the “direction” of the country comes from DC.

I think this is worse news for the republicans than for the democrats. There is enough support for the policy direction of the democratic party that they can float along with no problem. The republican agenda has been uncool for some time, and is quickly falling by the wayside. With any luck, this is the beginning of the end of the republican party’s social conservatism as a political force. They have long since abandoned any claim on being the party of fiscal conservatism. For a long time, that was the main identity of republican politics, then they hitched their wagon on social conservatism. That was a long term tactical error that may well end the Republican party.

While my ideal political party would have a platform of fiscal conservatism and an emphasis on civil liberties (I actually think they are the same thing), I would be happy with some politicians that had no other platform than responsible fiscal policies. We need some resistance to the current republican/democratic fetish of spending money without thinking of the consequences. In short, we need a real alternative to business as usual in the political sphere.

More global warming "science"

Isn’t all that news about the ice shelf in Antarctica “collapsing” distressing? Isn’t it an obvious sign of global warming? Ummm, no and no. Anthony Watts has done an excellent job of showing that these alarmist reports are recycled year to year, they even use the same pictures! Read about it here.

In addition, this seemingly annual event is ice breaking off of the shelf, not melting. The breakage shows sharp lines and cliffs, the result of stresses of the water and winds. As a matter of fact, the amount of sea ice in Antarctica has been growing steadily for years and is now well above what we have observed recently.

The supporters of manmade global warming would do themselves a lot of favors if they didn’t make stuff up, they end up looking really stupid…

Tea parties and taxes

Alright, I’ve had about as much as I can take. The reaction to the “tea parties” has been ridiculous for the most part. I am not going to defend the political opportunism that a lot of the people in those protests showed. I’m positive that there were a significant number of people there that just don’t like Obama and would take any opportunity to vent. I’m not going to deal with them because I never take that sort of thing seriously. I’m going to talk about what those protests were nominally about, taxes.

There are two parts to tax protests, the amount of the tax and the use of the tax. I’ll deal with the latter first because it’s easy. I think that the repulsion of what our tax money has been used for stretches across all partisan lines. People of all stripes were appalled by the uses of our money. Bailouts of fabulously wealthy people (and campaign contributors), wars, propping up of failed companies (detroit, I’m looking at you), etc. I was amused when I read about some signs at a counter demonstration that read, “End corporate welfare!” They should have been part of the demonstration, not against it! Going into debt is not necessarily a bad thing, it depends on what you are buying. The recent misuse of our tax dollars is shocking, it should piss everyone off, no matter what their political leanings.

Ok, the other thing I hear in reaction to the tea party protests is that the people are stupid because Obama has actually lowered taxes on the people protesting. Let’s get this straight, OBAMA HAS RAISED TAXES DRAMATICALLY! What? Obama has done exactly what he has (rightfully) accused dubya of doing, piling on debt and leaving it for the next administration. What Bush did was terrible, but Obama has taken it to the next level. Why is no one calling him on this? Debt is simply taxes deferred. All of the debt that is being wracked up needs to be paid. There are two ways for us to pay it off, more taxes, or inflation. Either way, we will be getting the shaft. Why more people are not protesting the tax rate on their children I’ll never understand. Debt is taxes deferred. It’s the perfect political ploy, deliver stuff and don’t be around when the bill comes due. When we are languishing with rampant inflation and/or higher taxes, Obama wil be long gone.

People need to look past political affiliations and concentrate on basic accounting. That’s the main idea with the protests. The press and people that are prone to political partisanship are painting this as a “Which side are you on” issue instead of “We need to pay attention to what’s going on with our money.” Why is this so difficult for people to understand?

Chinks in the shaving cartel’s armor

How often do you wince when you go buy shaving supplies? How often have you noticed the quality of the older, perfectly adequate, blades go down after the introduction of the newest multi-bladed contraption?

I got on a kick the other night trying to figure out why the ultimate shaving system hadn’t been invented yet. Turns out that it has been, and quite a while ago. The straight razor is capable of giving you the best shave that you can get. On top of that, you only ever have to buy it once! The folks over at straight razor place have all of the info you’ll ever need on the subject. It turns out that for a little over a 100 bucks, you could be set for the rest of your life when it comes to your razor.

Too scary? Too much work with all of the stropping and honing and whatnot?Well, there’s always the so called safety razor. These are the once ubiquitous razors that take double sided razor blades. By all accounts, they shave as well as, if not better than the newer many bladed razors of today. The best part? You can get the blades for about 18 cents a piece if you’re willing to buy a bunch of them at once. Here’s a little trick that my dad told me; once you think the blade is too dull, just flip it over! I think that skin acts like an excellent stropping material, making the other side a great shaving surface.

Don’t forget the shaving cream! Use shaving soap instead of the stuff in cans. Just doing this will get you a much nicer shave. The soap is incredibly cheap, wal mart sells a shaving set that has the soap, brush, and a cup for the soap for $7.50. Soap refills are around $2.50. It’s like shaving with skin lotion! Not only am I getting a closer shave, but my face feels great afterwards as well.

And this isn’t just for the guys, you ladies can benefit from this old technology too! So far I’ve only tried the soap. Once I run out of blades, I’m ordering a safety razor. One day, I might try a straight razor, but luckily for me I don’t have a very tough beard, so I doubt that it’ll be necessary. Stop spending so much money for inferior products! Go back to basics, you’ll thank me!!!

ESPN is no longer necessary

There was a time in my life when ESPN was God’s gift to TV. I watched it every day. They had the best sports news shows, great coverage of hockey, and had really interesting on air personalities. Now, the barely mention hockey let alone show any, and with the possible exception of Linda Cohen, the on air personalities are pretty uninteresting. Strike that, they are mostly annoying. These days, they are the all football, basketball, poker, and college sports station, none of which interest me in the slightest.

Now that there is both the NHL network and MLB network, I have very little reason to tune into ESPN. Sure, I’ll watch the occasional baseball game on there, but I will switch over to MLB network for news. I’m sick of ESPN’s all Yankees and Red Sox coverage. I watch the cubs on WGN, the Capitals on CSN, and other games on other networks.

Sorry ESPN, you’re irrelevant these days.

Thoughts on charity

Not that I have any money right now, but I’ve been looking at different types of charities to donate to. To my mind, there are two types of charities. There are ones that are trying to prevent people from starving or some other imminent danger, and then there are ones that try to build something that will benefit people for a long time to come.

It’s important to remember that there are limits to what charity can accomplish. Usually, the more grandiose the idea, the bigger the goal, the more useless the charity is. So, if a charity wants to distribute vaccinations to a village, great! If they want to “end poverty,” it’s best to skip it. I’m also very dubious about the effectiveness of large organizations that have “agendas.”

Not surprisingly, I’ve been attracted to organizations that allow you to pick individuals projects or even people to donate to. The internet has made it possible to link up potential donors with people in need. There are a variety of sites that you can go to in order to make targeted donations. They range from “wish” sites that have Americans in dire straits or are terminally ill that ask for help, to sites that allow you to pick individual projects in third world countries.

For the traditional, give money to alleviate pressing problems right now type of charities, I like Global Giving. They let you pick what kind of cause you would like to help, and then you get to pick the specific project that appeals to you. Take a look around at the site, it’s really amazing.

I’m really amazed with Kiva.org. It is a way for you to get into the whole “microfinance” way of helping people in the third world. This isn’t a charity in the traditional sense. You don’t give money, you lend it. The idea is to stimulate entrepreneurial activity. Here’s how it works. A person approaches a lending institution in the country they live in with a business idea. The institution goes over the numbers and determines the viability of the business. If everything looks good, they post on Kiva and tell you about the idea and the amount they are looking for. You can donate anything from $25 all the way up to the total amount of the loan. The loans tend to be anywhere between $250 and $1000. When enough money has been collected, the loan is issued and repayment is expected within 6 months or a year depending on the loan.

Ok, yes, there is a possibility that the person defaults on the loan. Kiva claims that 98% of the loans are paid back. Here’s where it gets really interesting. Once your money is paid back, you have the option of taking it back, or in funding another loan. In other words, the money you put in can be used over and over again, helping different people over time.

Even $500 can go a very long ways in places like Madagascar or Tanzania. It can change lives. Very often, there are business opportunities to be had, but there is very little credit to go around. The idea that the $25 that you put in can be used over and over is very exciting. Sustainable charity has a nice ring to it, doesn’t it?

Iowa and Afghanistan, cause and effect?

There have been some interesting developments in the news involving marriage recently. Iowa’s supreme court has declared that the banning of same sex marriages is unconstitutional. They even went one step past that and said a “separate but equal” civil union plan would not be lawful either. I get the impression that it is more difficult to amend the Iowan constitution than the Californian one. Expect an attempt, I can’t imagine the rank and file in Iowa being OK with this decision.

There has been general outrage over a newish law in Afghanistan that apparently legalizes the rape of a wife by her husband. There are enormous swaths of the world that assumes that wives have no say when it comes to sex with her husband, but I can’t think of any other place that actually passed a law legalizing it. I don’t even think that Saudi has a law like that. Of course that is only because it is simply assumed that sex is the wife’s duty to her husband… So why did Afghanistan pass a law like that? Here’s the (I assume) British foreign officer Marc Brown to explain.

“The rights of women was one of the reasons the UK and many in the West threw ourselves into the struggle in Afghanistan.”

When you apply external pressure to a culture in order to bring about change that is more in line with the pressuring culture, you will have blowback. Let’s be honest, if a husband rapes his wife in Afghanistan, not a damn thing will be done about it, regardless of what is written in the books in Kabul. No one will ever hear about it. The culture there is what it is, and you just do not talk about sex there. That doesn’t mean we just throw up our hands and accept things as they are though. Cultural change is possible, but not at the point of a gun.

Which brings me back to Iowa. Both the ruling in Iowa and the law in Afghanistan are examples of the government overstepping it’s bounds. There isn’t any reason why the government should be weighing in on what an appropriate marriage is. In the same vein, there isn’t any reason for the government to ever pass a law making it OK to have nonconsensual sex with someone. One is a populist reaction, and the other will most likely cause one.

The bottom line is that cultural change cannot come from the top down. We can’t come into Afghanistan with the Army, shake up their ideas of sex roles, and expect them to just change. In the same way, you can’t expect the supreme court to issue a ruling and make the citizens of that state OK with gay marriage. I’m going to go out on a limb here and say that the probable drop in marital rape in this country had little to do with the laws on the books and everything to do with men thinking that they really should not rape their wives. The change has to come from the bottom up. In an ideal world, men wouldn’t rape their wives and people wouldn’t care who married whom. Do we really think those ideals will be reached by passing laws?