More Dead Children

Democracy Now reports today that nine more children were  reportedly killed on Monday, outside the Syrian city of Tabqa, near Raqqa, as American-led coalition air strikes blew the shit out of their families.    Two of the kids were babies, one a toddler, the other six months old, too young to toddle, but that’s the price of freedom, one supposes.  Also the price for being born in ISIS’s capital in Syria.   It is best if we don’t think of collateral damage as having names, though Amy Goodman recited the names of the two youngest dead and showed photographs of them.

I know the number of dead children in the link to the Minnesota Public Radio article above was less than nine, the mass-media is pretty hard-pressed to keep track of all the civilians reduced to collateral damage over there.  In fairness to them, Americans have more pressing things to worry about than dead kids in some far off war-zone, even if we ourselves are killing them.  The mass media reports on what people want to know about.  Here’s a recent one from the NY Times, which can’t be faulted for not covering every such terrible event.  

I am beyond being sickened at the cheer-leading by wealthy mass-media talking heads every time an American president rains down death like a super-virile psychopath winning a video game.  Pundits of many political orientations raise their voices in a chorus of awed praise when an American president launches an impressive number of explosives and the explosions look dramatic.  “Now this despicable, divisive weasel is finally OUR PRESIDENT!” they gush in unison under the rockets’ red glare.

There are, I assume, rare strategic situations where we have good intelligence that a particular group of very bad actors, bad hombres, you know, are in the final stage of planning some mass murder.   A rare strategic situation where we know with virtual certainty that by killing these people, and even any innocents around them, we will prevent mass killing of many more innocent civilians.  Not many people, not even a ‘bleeding heart’ like myself, would object to lethal state action under this rare, unambiguous, self-defense scenario, killing a few violent ones to prevent a much worse slaughter.  

That said, “killing your way to peace” is generally just a way to kill and spend billions keeping the lucrative killing machine killing.   Killing for peace is like fucking for chastity, as the old anti-war t-shirt used to read. The scenario where you drone the actual murderers as they are on their way to commit mass murder might be as rare as the ticking time bomb hypothetical used by patriotic American tough guys to justify America’s use of torture.  

You know the one: to save a football stadium full of innocents who are sitting within range of the ticking time bomb you have to torture the bomber til he gives up the location of the bomb and the code to disarm the bomb.  

The absurdity of this scenario is underscored when you consider the high-minded, committed type of fanatic who would plant such a bomb and be willing to die to serve his perverted notion of the holy.  

The other side of this argument —  that we must be as violent as our most violent enemies — of course, is that even though neither of these situations might ever have happened, it doesn’t mean they are not real hypotheticals. This logic is an example of why it is almost always pointless to argue with true believers.  They will stop at nothing.

  In a case where you could have targeted the nineteen fanatics who were about to blow up the airliners and all the people on 9/11– sure, bombs away, kill them all.  Fuck ’em, drone ’em, drown ’em.  Bring ’em back to life, kill ’em again, repeat.

Most of the airstrikes being launched by our military are nothing like that, though.   The MOAB (“Mother of All Bombs”, tip of the hat to the lynched Saddam Hussein for that great name), that giant American bomb exploding a square mile of Afghanistan a week or two ago — the one that made this shaky, greedy, deliberately ill-informed president suddenly appear so irresistibly presidential to the mass media– nobody knows what that was for, exactly, though we must say, it appears to have served its intended public relations purpose.

I don’t wish anything bad on these talking heads on TV who applaud indiscriminate, dramatic destruction, nor on the career politicians who advocate and applaud unlimited murderous airstrikes.    Oh, actually, just one bad thing, a drop of Biblical-style justice.  Let their young children be accidentally reduced to chopped meat by missiles launched in American-led coalition airstrikes, you know “friendly fire” collateral damage.   Might change the timbre of their fucking hosannas to American presidents who commit these things once quaintly considered war crimes.  Might make them slightly more circumspect about beating the war drums and cheering into the megaphone when the president blows things up, or when the going starts getting tough for them.

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Happy Day for Motherfuckers

It’s pouring outside, rain gurgling merrily in the air shaft, a perfect day to do a little writing.  I’m working on a book about my father I’ve been neglecting recently and I thought of a great little chapter about his generosity.  I am also working on a book proposal for a much easier to complete book that I have more than half-written.    I’m also working on a letter to the New York State Attorney General, to convince him to propose legislation to regulate the out-of-control fraud of unregulated health insurance companies who do their lucrative business, sometimes enhanced by sharp practices they are not accountable for, in our state.  

But first, I needed to make two key medical appointments.  These having been hanging over me for months; in the case of the dermatologist, for three or four years.  The new kidney doctor (the excellent one I saw a few months ago is not on any QHP I could find) needs to tell me if my membranous nephropathy has yielded to my low-sodium diet and ban on non-steroidal anti-inflammatory drugs (ibuprofen) or if I need to go on an auto-immune drug regimen to avoid the worst case scenarios of dialysis or a kidney transplant.   The skin doctor needs to look at a variety of odd things growing on my skin and tell me which, if any, I have to worry about.  

A nurse friend found me a nephrologist the other day and in a relatively short time today I was able to make an appointment.  I’ll see the new doctor in a few weeks.  Thank God for friends in the field.  

I have the number of a young dermatologist I’ve been trying to make an appointment with the last few days.  I was referred to her by my current insurance company.  I am paying literally ten times what I was last year, for a “higher” level of medical insurance and better care than I was able to get last year.   This doctor’s name came up, and as I found nothing bad about her on-line, I’ve been calling her office to make an appointment.   Although she’s listed as in-network on the “provider” list for my specific silver-level QH fucking P, her office doesn’t think she’s in-network.  They were going to get back to me, but you know how that goes.  When I called yesterday Melanie had no update for me, so today I asked Norma, an extremely nice woman at Healthfirst, to make the appointment for me.  

Norma laughed when I asked if she could put me on hold without the Dr. Mengele String Quartet, and she was able to do so.  I heard only a few notes of their infernal nerve-jangling sawing.  We soon had another receptionist at the dermatologist’s office on the line.   We learned, about 40 seconds in, that the dermatologist was not able to see new patients because she didn’t have an NPI number yet.

If you live in the cocksucking United States of America, and do not have insurance through work, or enough money to buy an expensive but good private plan, and sign up for the PPACA’s mandated product, you quickly learn about things like NPI numbers, which are site specific (the doctor with multiple offices apparently has multiple NPI numbers, or maybe not) and CPT codes, which, if not perfectly transcribed, prevent treatment.  Wrong NPI number?  You pay.   Incorrect CPT code?  No service.  

You want to call someone to fix this?  Call your insurance company, baby, they work for you.   New York State, is there any state agency I can call to get this straightened out?   Uh, no, first work this out with your insurance company, everything’s going to be fine.  Or call this 800 number for the New York State Department of Financial Services which puts you into a cul du sac from the hell our smiling former commander-in-chief, and our glowering present one, for that matter, ought to be frying in.

“Norma, I’m sorry to be venting like this to you…” but Norma was fine, so many customers are experiencing similar horrors.   She worries for her kids, living in an out of control plutocracy with two working parents, a country where it’s no national scandal that tens of thousands die every year for lack of decent medical options, while billionaires compare taxation to Auschwitz.  She worries about the increasingly demonstrative boa constrictor that is life for working people in our great nation.  She is fine with my complaints, interested in my analysis.  But it helps neither of us, helps nobody.  

When I venture my opinion on the precedent, created by our recent two-term chief executive, of killing American citizens without trial or charges, passed on to this angry, unstable fellow occupying the oval office now, she becomes quiet.  It is horrible, she agrees.  Then I cross the line, as one ranting and venting while caught in a chafing trap often does.  

“When we droned a sixteen year-old American citizen, not charged with anything, and the press secretary said, in response to a question at a televised news conference,  ‘he should have been more careful about who his father was’, the proper response for the reporter was to break the press secretary’s nose.  To show that unaccountable violence by the State, in our names, is an unacceptable answer– wipe up your blood and try again.  The American people will no longer accept that kind of crap… our government is not a reality TV show where anything flies that makes people tune in and the cash registers cah-ching.”

Now Norma was silent, and I didn’t blame her at all.  A patient and empathetic woman, she’d been wonderful throughout a long, frustrating chat.  This was more than she was being paid for.  I told her as much, thanked her for her kindness.  She told me, gently, that it had been her pleasure, wished me luck and I sat down to type.  I figured that was as good an option as going to fuck myself.  

I’m going to call my nurse friend and ask her to get me a recommendation for a dermatologist.  If I have to travel an hour from my place to get my skin scanned, as I will to see this nephrologist to have my urine and blood re-tested, so be it.  Now just sit back and enjoy the rain, it’s another happy day for motherfuckers.

 

 

Kudos to the New York Times

The Grey Lady, America’s newspaper of record, reports on the recent accidental killing, by Navy SEALs, of eight year-old Nora al-Awlaki, daughter of the previously executed Anwar al-Awlaki.   Awlaki’s father, Nora’s grandfather, Nasser al-Awlaki, is quoted in the piece:

Nasser al-Awlaki, the girl’s grandfather, gave NBC News a different version of events of what took place. “My granddaughter was staying for a while with her mother, so when the attack came, they were sitting in the house, and a bullet struck her in her neck at 2:30 past midnight. Other children in the same house were killed,” he said. Nora died from her injuries two hours after suffering the gunshot wound, he said. The grandfather went on to say that the SEALs burned the home after raiding it, and that Nora’s mother escaped the raid with only a minor injury. The U.S. has also killed Anwar al-Awlaki’s father and son in previous drone strikes.    source

I know I’m a nitpicky, mean-spirited motherfucker, but the Times concludes the paragraph above by reporting that the man who spoke to NBC news about the recent killing of his granddaughter had been himself killed in the drone strikes of 2011.  

We presume the Times will print a correction, if a reader writes in to point it out.  Who has the time?  Who really cares about such a seemingly insignificant detail?  There are larger issues of accuracy and credibility to concern their editors.

In a larger sense, the Grey Lady may have had it right.  It might very well feel true for Nasser al-Awlaki, that he was already killed by American drones several times over.  His petition to save his son Anwar from Obama’s kill list was thrown out of court.  His son was soon thereafter killed by a drone strike. Two weeks later his 16 year-old grandson Abdulrahim was killed by another American missile strike, also remotely launched from a Predator drone.  

Those two killings may have, metaphorically, killed Nasser al-Awlaki.  One can only imagine how troubling to his dead body the gunshot mutilated little corpse of his eight-year old grand-daughter must be.

But in fairness, and truly, America, who really gives a fuck about some family’s tragedy in far away Yemen?  Anwar al-Awlaki (you will read everywhere but in Scahill’s Dirty Wars) wasn’t a dissenting American citizen forcefully exercising his First Amendment right to oppose government actions he found hateful.   He was a dangerous terrorist, pure and simple, a powerful recruiter for hateful, murdering fanatics, the President said so.   He was very highly placed in al Q’eada when he was put on the Presidential Kill List, you can confirm that with the New York Times and NPR as well as on Fox, CNN, MSNBC.  

Chances are they all hate our freedom over there anyway, isn’t that right?   As for the beautiful little girl bystander left to die slowly in that raid, an American bullet in her spine, without medical treatment, remember that every terrorist was once an adorable eight year-old.  

Move along now, America, nothing to see here.  USA!  USA!!!!

 

 

Letter to Whom It May Go Fuck Yourself

Office of the Attorney General
The Capitol
Albany, NY 12224-0341

Honorable Attorney General Schneiderman:

I am writing to enlist your efforts to remedy the lack of state oversight of health insurance companies under the Patient Protection and Affordable Care Act (“PPACA”).

I have admired the courageous and proactive steps your office has taken against the perpetrators of various frauds and urge you to consider this letter in the context of systemic healthcare-related fraud against a large class of vulnerable citizens of New York State.

Defrauded health insurance consumers in New York State have no forum where complaints can be resolved, outside of the NYS Department of Financial Services, which, it turns out, does not hear such complaints.

 The fraud department investigator there could not find a word other than fraud to describe what I detailed, but urged me to call the NY State Department of Financial Services Consumer Services Hotline. He assured me that they were the specialists in this area. The answering machine at the hotline, which I recognized from my first call, offers no option for resolving issues with health insurance companies regulated by the ACA, or otherwise.

 On my original call, a long wait to speak to a representative yielded the number of the proper federal agency to contact.   Calls to the U.S Department of Health and Human Services are robotically routed to a NY State number that is, sadly, the office of Temporary and Disability Assistance, where some helpful party connects you to a fraud hotline, which turns out to be at the office of the Medicaid Inspector General, where the office of legal affairs is also sympathetic, but unable to help, and so forth.

 I understand that the PPACA was drafted by Liz Fowler, a career health industry insider who went on to an executive position with Johnson & Johnson immediately after her work on the PPACA was done. I have witnessed the many attempts to repeal the law, rather than fix any of its original flaws, as most other complicated laws are tweaked and improved over time. Even so, the lack of any provision for oversight of ACA programs by New York State is grotesque. As a cardiac patient unable to see a cardiologist now for many months, the lack of oversight may also be deadly.

Although the situation I’m complaining of is personal and extremely aggravating, it is typical.  I’ve commiserated with others who suffer under similar insurance coverage. Erroneous bills are a common, if relatively innocuous, theme.

I receive bills that there is no way to resolve, most recently an invoice for $1,324 for a fully covered sonogram I had in August. It was resolved with the insurance company (Empire) and the provider to a zero balance in October. Two months later, the full bill for $1,342 was sent to me again in a Third Notice.   Nobody at Empire could give me the reason the provider had sent that bill, although the representative, who checked my account and called the provider again, informed me that, this time, it was my responsibility to pay it in full.  

Empire recently sent me an email warning of termination of my insurance for non-payment of December’s premium two weeks after their email confirmation of my payment for December and January.

More ominously, you can be denied medical service without explanation (provider NPI numbers and CPT codes notwithstanding), and there is nobody in New York State you can appeal to, except to the company itself.  Empire Blue Cross “Health Plus” recently sent me to two providers for needed medical services, a cardiologist and a physical therapy facility. Neither provided me with any service. 

I received the site-specific NPI number for the cardiologist, scanned and emailed the back and front of my insurance card, got pre-approval from his office. The consultation was halted ten minutes in and I was informed that my insurance would not cover the visit.   When I arrived at the nearby ‘physical therapy facility’ Empire had referred me to, it was a nursing home. They offer PT, but only to residents.

The circuit of government agencies I have contacted in vain came full circle with the “consumer help line” the NYS Department of Financial Services Fraud Unit investigator had me call, which I immediately recognized as the very first number I’d called.   Here is a summary of that cul du sac:

NYS Department of Financial Services referred me initially to the US Dept of Health and Human Services which connected me to NYS Health and Human Services, although an incorrect branch of that agency, the pertinent branch apparently having been merged into the NYS Department of Financial Services which took over all functions of the former NYS Insurance Department, as well as the NYS Banking Department.

The NYS Department of Financial services, it appears, conducts all oversight of health insurance, as well as all fraud investigations related to consumer fraud against insurance companies, and complaints about the practices of banks and brokers. Everything but, according to John Marconi, a fraud investigator there, apparent fraud committed by insurance companies against mandated health-care “consumers” in New York State.

My political and legal conclusions are beside the point. Whatever the reasons, the fact remains that in New York State in 2017, even under the PPACA, citizens whose health is menaced by private insurance company denials have no redress.  

Outside of a possible Article 78 (which government agency would you sue for relief?  The Department of Financial Services?) or a class action under a private attorney general or qui tam statute, what is a patient trying to get an appointment to see a cardiologist since August to do under the Patient Protection Act in New York State?   At minimum an ombudsperson, or a few hundred of them, would be a good start.

As I stated above, I’ve followed your career from the start and have admired your principled engagement in the fight against injustice.   To have a legal right that cannot be enforced is to have no legal right.   While certain injustice is accounted “the price of freedom”, the lack of legal recourse for denial of health care must not be allowed to stand in New York State.

I look forward to hearing from your office and stand ready to give any other details needed.

 Yours sincerely,

A. Schicklegruber

Opacity is all that is needed for evil to flourish

One of the stated reasons wealthy American colonists revolted against King George was that they were being subjected to ‘confiscatory’ taxation without representation.  Nor were they offered any meaningful process for redress of their grievances, no way to have their concerns heard and their honest grievances dealt with.  Government secrecy and lack of voice in governance are vexations members of a democracy are not supposed to endure.

A transparent democracy is the best cure for citizen misery, knowing who to contact to solve a problem.  Mr. Obama constantly and correctly reminds us of the importance of transparency in a healthy democracy (even as he does things like classifying the Senate Report on Torture for twelve additional years under the Presidential Records Act — see, and, and). * A transparent democracy is what the Founding Fathers set up, for members of their social class.   The rest of  you bitches?  Go talk to King George.

No requirement in the Patient Protection and Affordable Care Act for a grievance procedure?  Not a problem, bitch.  Just keep quiet, you’ll be dead soon enough, shhhh, shhhhh…. no reason to get excited.  If you had any power, we couldn’t treat you this way.  Be reasonable, little n-word.  

If you’re skillful enough, and manage to choke down your rage and describe the situation coolly enough, maybe you can write something the New York Times will run in the back of their paper of record.  There, there.

Here, here:

Obamacare subsidy income limits

Premium tax credits and cost-sharing reductions have different income limits based on the federal poverty level (i.e., poverty guidelines). They are as follows:

  • Premium tax credits: 100 – 400 percent of the federal poverty level
  • Cost-sharing reductions: 100 – 200 percent of the federal poverty level

Your health insurance subsidy for the current year is based on the previous year’s federal poverty guidelines. That means 2017 subsidies are based on the 2016 federal poverty guidelines, which are available through the Department of Health & Human Services.

The 2016 poverty guidelines show that $12,071 is the poverty threshold for a one-person household. Based on these numbers alone, 100 to 400 percent of the federal poverty level for a single person would be $12,071 to $48,284. However, this person may or may not be eligible for a premium tax credit.

Please be aware that your subsidy eligibility may be impacted by the state you live in due to Medicaid expansion decisions and other savings programs available there.[1] Furthermore, state benchmark plans (i.e., the second lowest cost silver plan) can also impact subsidy amounts and eligibility.[2] You can estimate your premium tax credit using online calculator tools such as the one available through healthedeals.com.

* The New York Times editorial board weighs in  on declassifying the now secret 6,700 Senate Torture Report and Senators Levin and Rockefeller ask Obama, who they quote as saying:  “one of the strengths that makes America exceptional is our willingness to openly confront our past, face our imperfections, make changes and do better” to do the right thing.

 

In praise of a dead dictator

A Castro supporter on the radio just now spoke of free medical care and higher education for all Cubans.  Typical.

Any free market American Exceptionalist will plainly see these things for what they are: shameless Communist apologist propaganda.   In a free market things like health insurance and  higher education are best left to free enterprise.  

Literacy, another of the dead dictator’s alleged legacies to the people of Cuba, also, highly overrated in the age of smart phones.

Worst from an American Exceptionalist perspective: in Castro’s Cuba, nobody born entitled to makes a dime on health care or education.   SAD.

One reason Trump is President-elect, why most Americans hate their government, and why they hate others, as well

I voted for Barack Obama twice, holding my nose the second time. “All presidents disappoint”, Bill Moyers reminded his viewers during the euphoria (for many) when Obama was elected the first time.  Moyers’ reminder was one of the most sobering, and prophetic, I can recall.  Obama, smooth, thoughtful, droll, sensitive, has disappointed more than any other president in my lifetime.  

For but one example of my disappointment, let’s have a peek at his signature achievement, The Patient Protection and Affordable Care Act, popularly known as Obamacare, the program the president-elect has vowed to repeal as soon as he’s inaugurated.  

I am the only person I know who is directly affected by the outgoing president’s masterful compromise with the massive health care corporations who need to remain as lucrative as ever.    I speak of the workings of the PPACA with bitter personal familiarity unmixed with statistical satisfaction of any kind about things like the possible long-term altering of medical care cost vectors.  

The law was a hasty compromise with what was sorely needed to prevent tens of thousands of preventable American deaths every year.  It was written, by industry insiders, to ensure, above all else, that the private insurance and drug industries would remain as healthily profitable as possible.  

Written by wealthy health industry lifer Elizabeth Fowler (check out the great five minute Bill Moyers clip at the bottom of the link) who worked, during a brief sabbatical in ‘public service’, for the most handsomely paid (by the Health Insurance and Pharmaceutical industries) man in government, Montana Senator Max Fucking Baucus.  

Baucus apparently admitted never having read the bill, stating that it would have been a “waste of time” to do so, because only an expert could understand its 2,700 pages (NOTE: the author of the linked Washington Post article, no friend of Mr. Obama’s, is a professor at the ‘Antonin Scalia Law School’ whatever the devil that infernal place is).   A somewhat less biased account of Baucus, with a passing note on his ambivalent role in the crafting and passage of the PPACA, is here.

One learns from the Grey Lady article that Baucus is the scion of a “prominent and mostly Republican” Montana ranching dynasty who always “marched to his own drummer” as he did, one assumes, when accepting Obama’s appointment as ambassador to China rather than face sure defeat in a re-election bid as Montana Senator after three and half decades on the job.  

Baucus took over the lead role shepherding through the PPACA when Ted Kennedy died.  Baucus is known (albeit not well) for these right-wing, business-pleasing votes, as well as for taking millions in campaign contributions from concerned health industry lobbyists:

In 2001 Mr. Baucus defied Tom Daschle, then the Senate Democratic leader, by co-writing President George W. Bush’s tax cuts, setting off screaming matches between the two Democrats. In 2003, Mr. Baucus broke ranks to support a Medicare prescription drug benefit that Democrats viewed as a giveaway to drug companies.  (source)

You can google either of these characters, Baucus or Fowler, to read their sordid bios.  One can admire the way Ms. Fowler danced through the revolving doors, and made millions while serving her fellow health industry executives, without applauding, or even cracking a smile about, the sickening health care law she lovingly crafted for Mr. Obama’s signature.

Anyway, I’m just worked up because I got “an important notice” from the New York State of Health in the wee hours of the morning. It arrived at 3 a.m., certainly the most effective hour to send such crucial health insurance-related news that likely impacts a patient’s immediate health insurance coverage.  It read: 

A notice has been sent to your inbox in your account. This notice tells you important information you need to know about your health coverage for you and/or your family.

You must log into your account on the NY State of Health website to read the notice.

The careless motherfuckers at New York’s Obamacare “marketplace”, The New York State of Health, contacted me last year, with an almost Josef Goebbels-like sense of mischief, on Christmas Eve and Christmas Day to inform me I would be ineligible for health insurance until March 1, 2016, at the earliest, and gave me seven (7) days to provide all tax forms and a full, written explanation of why I should be given health insurance at all.

 

Almost lost in my inbox, I took a moment just now to log into the accursed site and read this:

Screen shot 2016-12-04 at 3.04.34 PM.png

IMPORTANT NOTICE:   Today is December 4th, please come back AFTER December 15th to keep your insurance up-to-date and in place for 2017.  On, or just after, December 15th you will then have up to 24 hours — provided our servers, often overloaded just before our short, arbitrary registration deadlines, do not crash– to provide all required updates within that short window in those leisurely days before Christmas, or lose your insurance coverage until, the earliest, March 1, 2017.  

Or maybe not.  Nobody you speak to at New York State of Health, after a wait of no more than 25 minutes, will have the definitive word on what’s what.  The only thing you can rely on regarding the New York State of Health is not getting reliable information.  Take heed, though, and take that to the bank, bitch.

I’ll be eagerly following Barack Obama’s career as a private sector public speaker.  I am confident that my man will break all existing earning records for corporate speaking.  He’s that good.