Confirming All Your Comments: Update on Anthem

Just a brief update for those who’ve asked: the doctors at Methodist have called Anthem several times, to appeal the denial of my move to rehab.

Anthem’s personnel have not deigned to respond. They have simply not returned any of the calls.

Think about that. I am a patient whose care is in dispute: Doctors and therapists who have actually treated me are advising a certain course of treatment. Functionaries with unknown credentials–none of whom has ever seen me–decline to accept their medical judgment.

And then they blithely ignore requests to even talk about their reasons. The calculus seems obvious: if we don’t call back, these people will eventually tire of their appeal effort and go away. We win!

The doctors, nurses and caseworker are apologetic, but this impasse isn’t their fault. They are frustrated and angry; my situation is just one of many they encounter on a daily basis. They are convinced–as I have become convinced–that Anthem and other insurers care nothing about the health of their policyholders. (A caseworker told me she met an Anthem claims adjuster who cheerfully admitted that denials are rewarded with bonuses.)

We talk a lot about transparency in government. It’s long past time to talk about transparency in health insurance.  Indiana’s Insurance regulators need to investigate these practices; to the extent we still have that quaint occupation called journalism, reporters need to investigate and report on them.

If my experience is remotely typical, they’ll find plenty of health providers and patients who are ready and eager to talk.

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Theocrats or Panderers? It Doesn’t Really Matter…

Politicians at all levels keep giving God a bad name. God doesn’t want LGBT folks to have equal rights, and certainly doesn’t want them to get married, at least to each other. God doesn’t want women controlling our own reproduction. God doesn’t like immigrants, or refugees, or Muslims (wrong God). In Indiana, just ask Mike Pence. Or Marlin Stutzman.

As a recurring Facebook meme puts it, “Isn’t it nice that God hates all the same people you do?”

The Republican presidential contenders are, if anything, worse. Herb Silverman has a great commentary up at Huffington Post.

Recently I wrote about presidential candidate Marco Rubio’s comment that “all the answers are in the Bible” and his remarks to an atheist that our rights could only come from a creator. A number of readers agreed that Rubio’s view made no sense, but they also mentioned that religious views of other candidates are just as bad, or worse. I agree. Rubio has never claimed that God told him to run for president. That alone distinguishes him from current candidates Ted Cruz and John Kasich, and dropout candidates Ben Carson, Mike Huckabee, Bobby Jindal, Rick Perry, Rick Santorum, and Scott Walker.

Of those who dropped out, despite God’s support, Ben Carson remains the most active politically. He is the new national chairman of My Faith Votes, an organization that wants Christians to decide who will be the next president and all national and local leaders.

What’s so ironic about these posturing theocrats is that they also go to great lengths to present themselves as constitutional “originalists” and “strict constructionists,” a facade that requires them to ignore pretty much everything the Founders said and wrote about religion and the meaning of the First Amendment’s Establishment Clause.

Ted Cruz is by far the smartest–and creepiest–of the GOP field. A graduate of Harvard Law, he should know both the history and operation of the First Amendment, but either he missed those classes or he chooses to ignore both the Founders’ own words and 200+ years of constitutional jurisprudence. As Silverman writes,

Fittingly, Cruz launched his campaign at Liberty University, founded by Jerry Falwell. At a National Religious Liberties Conference, Cruz said, “Any president who doesn’t begin every day on his knees isn’t fit to be commander in chief.” In addition to eliminating atheists from presidential consideration, Cruz apparently would also like a prayer test for all candidates. His Religious Liberty Council seems to equate religious liberty with a God-given right to discriminate against gays. Pastor Rafael Cruz, Ted’s father, has served as a surrogate for Ted’s campaign. Pastor Cruz says that there is no such thing as separation of church and state, America is a Christian nation, and the Ten Commandments are the foundation of the Constitution and Declaration of Independence.

No wonder America is seeing the “rise of the nones.” Who in her right mind would believe in or worship the sanctimonious, repellent and vindictive God who motivates these people?

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Inexplicable, Costly and Wrong; An “Extra” Blog

Okay, I defy anyone to explain this to me.

As regular readers know, I’m in the hospital recuperating from a nasty fall. I broke my pelvis and my clavicle. I’ve been here 8 days, although the doctors wanted to send me to acute rehab three days ago. (Acute rehab is apparently more intensive, appropriate for people who have been active and can be expected to respond to longer sessions of physical therapy–and thus leave for home more quickly.)

This morning, I was finally supposed to be transferred. But then, Anthem, my “insurance” company (note the quotes) rejected the doctors’ advice and denied the move. According to the caseworker, since the first of the year, insurers have been denying approximately 50% of requested moves to acute rehab. Without seeing the patients, without consulting with their doctors. The hospital can and does appeal, and about half of those “peer to peer” appeals are granted–we’ll see what happens with mine–but even the appeal process evidently becomes a game; calls are routinely returned after hours, for example, when the insurance company knows the physician won’t be available, prolonging the process.

But here’s what is insane: keeping me in the hospital costs more than sending me to rehab.

Why would a company that should want to keep costs down opt for a placement that (1) is medically inappropriate; and (2) costs more? Why did the approval process suddenly become more arduous at the beginning of the year? What is the larger game being played in which I find myself a pawn? And what therapy will Anthem pay for? Anything? Or is my 83-year-old husband supposed to drag me up the stairs at our home and help me in and out of bed when nature calls?

Tell me again how horrible single-payer systems are

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Political Choices and Imperfect Information

We’re deep into presidential primary season, and Americans are taking our imperfect knowledge of the candidates to the polls.

Given the sheer amount of ink–digital or real–devoted to American presidential candidates, you’d think voters would have ample, detailed information about those competing for our votes and contributions. But it doesn’t seem to work that way. Verifiable information is “supplemented” with rumor (scurrilous or fawning, depending upon the source and its motivation), and what we do read or hear is filtered through a partisan lens.

Unless we actually know a candidate–or know someone who does–we have only imperfect impressions on which to make judgments about character and intellect. That’s one reason why, in a more perfect world, voters would pay more attention to a candidate’s positions and less to the hype. Marco Rubio’s desire to outlaw all abortions–even in cases of rape and incest–tells you more about his character than softball interviews or even hardball debates.

I remember when George W. Bush was first running for President. He came across as more personable than Al Gore, and the meme was that here was a guy you’d enjoy having a beer with. At the time, I was working with an IUPUI professor whose (very Republican) doctor husband had practiced many years in Midland, Texas. When a dinner party conversation turned to the campaign, he mentioned that he’d gone jogging three or four times a week with George W. and a couple of others for several of those years.

“Really!” I said. “What’s he like?”

The doctor thought for a couple of minutes, then said “Dumb and mean.”

I don’t offer this as irrefutable evidence of George W’s intellect or temperament; I have no idea what their relationship might have been, or how accurate the doctor’s assessment. But it is evidence that widely shared impressions of public figures do not necessarily saccord with assessments by people who actually know and work with those figures.

I thought about that conversation when I read this description of Hillary Clinton at the Political Animal.

As President Obama’s former speechwriter (including during the 2008 primary), Jon Favreau admits that he was not always a fan of Hillary Clinton. He writes about how his view changed while he worked with her in the White House.

“The most famous woman in the world would walk through the White House with no entourage, casually chatting up junior staffers along the way. She was by far the most prepared, impressive person at every Cabinet meeting. She worked harder and logged more miles than anyone in the administration, including the president. And she’d spend large amounts of time and energy on things that offered no discernible benefit to her political future—saving elephants from ivory poachers, listening to the plight of female coffee farmers in Timor-Leste, defending LGBT rights in places like Uganda.”

Given the sustained assault on her character over the years, many of us have had a less-than-enthusiastic response to Hillary’s candidacy. She is clearly the most knowledgable and experienced, but she has also been the most tarnished–sometimes fairly, often not. People I’ve met who actually know her tend to share Favreau’s impressions.

Who’s right, who’s wrong? Who knows?

At least she isn’t arguing about who has the biggest penis.

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The Question Is: Now What?

Will Saletan has a must-read essay at Slate. 

Saletan is responding to a bizarre accusation making the rounds on the Right to the effect that President Obama is really the reason for the rise of Donald Trump. (I notice that I use the word “bizarre” more frequently these days.) The American public, according to this “analysis,” is rejecting the extreme leftism of the Obama presidency.

As Saletan notes, this is bunk. In saner times, President Obama would have been a liberal Republican or, at most, a moderate Democrat. Saletan ticks off the policies of this administration and the place of those policies on the political spectrum, and forcefully rejects the thesis.

No, Obama didn’t cause Trump. What caused Trump was the GOP’s decision to negate Obama in every way, and thereby become the party of Trump….

If Obama had been a leftist, the GOP’s policy of negating him on every issue might have positioned Republicans in the mainstream. Instead, because Obama was a moderate, the GOP’s negation strategy pushed it toward the fringe. Obama was for fiscal responsibility and compromise, so Republicans were for absolutism and drama, risking a federal shutdown and a credit default. Obama was for respecting the Supreme Court, so the GOP was for defying judicial orders. Obama was for using sanctions to pressure Iran into a nuclear deal, so Republicans were for scrapping the deal and daring Iran to provoke a war. Obama, like Bush, was for drawing a clear distinction between terrorists and Muslims. So Republicans were for blurring that distinction.

In Trump, Republican voters have found their anti-Obama. Trump spurns not just political correctness, but correctness of any kind. He lies about Muslims and 9/11, insults women and people with disabilities, accuses a judge of bias for being Hispanic, and hurls profanities. Trump validates the maxim that in presidential primaries, the opposition party tends to choose a candidate who differs temperamentally from the incumbent. Obama is an adult. Therefore, Republicans are nominating a child.

You really should click through and read the entire thing–these few extracts don’t do it justice.

Here’s the conclusion:

So, yes, Obama led to Trump. But that’s only because the Republican Party decided to be what Obama wasn’t. And what Obama wasn’t—insecure, bitter, vindictive, xenophobic, sectarian—is what the GOP, in the era of Trump, has become.

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