Someone Heard!

 

I considered Xanax before taking my new phone to be activated, but I stuck to deep breathing.  The greeter at Toledo Verizon sported scruff not smooth cheeks, but he had the same hipster glasses and non-committed friendly demeanor as his Buffalo brethren. I eyed the crew around the service desk and felt old and technologically irrelevant. 

Inhale.

I took out my (print) New York Times and read an article about how Facebook was responsible for the Egyptian overthrow and another that predicted price increases on practically everything. To my right was a large poster for the iPhone which Verizon just began offering. There was a map of the state of Ohio that bragged about Verizon’s coverage versus AT&Ts. I thought wistfully of AT&T before it was deregulated, when phones worked everywhere, and a $25 bill was shocking.

Hold.

A young woman called my name and introduced herself; she seemed pleasingly untrendy; not a script-spewing corpoclone. The goal, I reminded myself, was to activate the replacement phone, not complain about being forced to buy a new one.  But when Jackie reviewed my account and saw its stillborn warranty she said something I never expected from a cellphone provider: Let me see what I can do for you. Then she offered the unthinkable: A replacement. On the spot. Free.

My heart skipped a beat until I remembered that the Buffalo Verizon rep said my third-party-issued replacement was non-returnable. I relayed this information. In the worst case, Jackie said, you can sell it on Craigslist, but you should give the vendor a call anyway. Would you do it for me, I asked. She did. They said they’d take it back.

Release.

Actually it took a while to get thru to the third-party-vendor. The call was dropped; an incorrect PIN entered; a system “down.” While waiting, Jackie juggled other customers, both on her phone and at the counter.  At one point, she asked a colleague to take my case as she had an appointment waiting. No, I thought, don’t leave me. But the colleague slacked off her request, quoting company policy. “I know how to do my job,” she told him. Go Jackie. Thank you god-I-don’t-believe in for not giving me the colleague in the first place.

If you need a recommendation, I'm in, I told her. She asked if I’d fill out an Internet evaluation. Absolutely; you’ve earned yourself a five. The scale goes to ten, she said. Okay, how about 11?

Someone at Verizon actually heard me. Wow. For just a few minutes, I’m hopeful about the future of the American corporation. Ma Bell is dead, it won’t be long till I’m reading  (what remains of the) NYT on a tablet, but at least there are a few helpful individuals out there.

Sigh.

Can You Hear Me Now?

My phone died last Friday when I was in Buffalo visiting my father (who’s improving, but still miles from recovery). One minute I can communicate anywhere, and the next I'm mute.

The next morning I hike out to Verizon Buffalo. The phone is under a year old so I expect if it can’t be fixed, I’ll get a replacement.  I’m calm as Anne, a tech rep with the clear skin, sleek bob and black geek glasses of every 20-something Verizon spokesperson, tells me she can’t find a pulse.

Okay, I say, set me up with a new one.

Let me find you a salesperson, Anne says. That’s not necessary, I smile, another Blackberry is fine.  That’s when Anne informs me my phone isn’t under warranty. Of course it is, I say, I bought it last March.

Anne tells me it that doesn’t make a difference: the day I bought the phone I changed billing responsibility from my then soon-to-be-former spouse to myself and this action, performed during the same transaction, invalidated the warranty.

You’re kidding, I respond. You mean if I’d changed the name on the account BEFORE I gave a credit card number, the warranty would be in place, but since it happened in the opposite direction, my warranty is voided? It’s Verizon policy, she insists. Pretty deceptive policy, I reply. Anne doesn’t twitch a facial muscle as she directs me to the showroom.

Maybe this is a blessing, I think: a Droid or an iPhone would be nice. According to the tag, a Droid is $129 with a two-year contract. That's reasonable, I tell the salesguy. Except that’s not the what it costs. What it costs is $600 unless I buy a two-year plan. No problem, I say; I’ll add two years to my existing plan. No, he says, you need to buy a new two-year plan. You mean I have to pay off the remaining 13 months on my not-working phone AND buy an additional two-year contract for this phone? That’s right, he says, also without a hint of sympathy.

But wait. I remember I bought insurance on the phone; in fact this is the reason I didn’t get an iPhone from the get-go—they don’t offer insurance. I relay this information to Anne and she says I should feel free to make a claim. I’m making a claim now, I say. No, she tells me, the insurance is through a third party called Asurion. But feel free to use any of the phones in the showroom to make the claim. And by the way, expect an $89 deductible.

I phone Asurion and the generated voice tells me to make a claim online. I open my laptop (a Verizon rep gives me a password after I balk at his suggestion that I use Starbuck’s signal) and start the process. Did I drop the phone? No. Did liquid spill on the phone? No. Is the phone cracked or broken? No.

In that case, a screen says, call us.

I call and talk to a live person. I explain the situation. So the phone wasn’t dropped, wet or broken? No. It just stopped working. Oh, the rep says, than we can’t cover a replacement. She explains that I wouldn’t expect my auto insurer to cover the costs of a new auto if my old auto just stopped working, would I? I’d only expect them to cover costs incurred in an accident.

I bought a new Blackberry that for reasons still unclear has to be mailed to my home. I plan to make one hell of a fuss when I take it to Verizon to get it activated, but I’m sure that fuss will be wasted on the clear skinned 20-something who waits on me. At this point I’m just hoping he’ll be able to transfer my contacts, which Anne says is not likely considering the phone’s power defect.

You didn’t back your contacts to your computer? she asked. I couldn’t figure out how to do it and when I asked Verizon for help, they told me to contact Blackberry. Blackberry didn't offer live person assistance and Blackberry online was so confusing I gave up.

Ah, she said as she turned back to her cohort of attractive technicians.

Verizon hears me loud and clear. But it's not about hearing, it's about helping, and that's where their signal falls short.

A Refund

The $62 charge for copying my 56-page medical history to send to a potential health care insurer (to use to up my premium) has been forgiven. This is the message from a Promedica director who in the same conversation advised me that $62 was a “fair and equitable fee schedule adopted by Michigan and Ohio in concert with multiple legal groups.”

“Nobody did anything illegal or inappropriate,” she informed me. According to the Ohio Revised Code, “physicians can charge for copying medical records.”

Indeed they can. They can charge up to $2.83 a page and it’s absolutely legal.

“I understand,” I replied, “but because something is legal, doesn’t mean it’s right.  Because you can, doesn’t mean you should.”

That’s “an interesting question,” the director admitted, and for a second I imagined her thinking it through from a less corporate perspective. But no. “Promedica prefers to “err on the side of standards,” she followed-up, suggesting that the “protocol” of photo reproduction does not come cheap: an employee to feed pages; paper; ink; the machine lease. Indeed that’s why Promedica in Toledo chooses to subcontract copying to a firm from Atlanta, Georgia.

Imagine the cost of the airfare.

But no, that’s unlikely. The firm in Georgia no doubts subcontracts to an individual with superior copying technique near-er by. Toledo to Atlanta then back to Toledo. How many people does it take to screw in a light bulb?

I asked the director if I could borrow my medical record and make a copy. I have access to a fast-speed copier, I told her. It would take five minutes and cost four cents a page: $2.24, a savings of over $59.

She told me that would not be legal. Promedica want to be sure that the contents of patients records are copied “appropriately.”

I thanked her for forgiving my fee (which apparently Promedica will remit out of its own pocket to the company in Atlanta).

I remain unconvinced there is any connection between legal and appropriate, legal and fair, legal and equitable.

Because they can, they do. And will continue doing.

Dear Marcy: A Letter to My Congressperson

Congresswoman Marcy Kaptur

1 Maritime Plaza # 6
Toledo, OH 43604-1881

Dear Ms. Kaptur:

I am writing to ask you to do everything in your power to make sure the healthcare bill is not repealed. More accurately, I’m writing to ask you do everything in your power to make the bill stronger, to work our way toward a single-payer, not-in-it-for-profit system.

I am a fit, healthy middle-aged woman. It takes 500 hours of work-income for me to cover my healthcare premiums and deductible.  This is my story:

Because of divorce and a bad economy, I recently lost employer and group coverage, and experienced a deep income drop. I am presently employed on an hourly basis at Owens Community College. Owens offers no benefits.  As a writing and ESL tutor, a job to which I bring two Masters degrees, I make slightly over $16 an hour.

In an attempt to defend against potential financial emergency, I asked my insurance agent to search for a reasonably priced healthcare policy. The least expensive plan she identified is an HSA product offered by Anthem Blue Cross, for which I must pay premiums of $315/month plus a $2500 deductible. Based on experience with former providers, I expect that when I actually try to “use” my policy, there will be plenty of non-covered exemptions.

But to step back, let me point out that the rate originally quoted by Anthem was $253/month. Then my medical records were scoured, and I was determined to have “Hyperlipidemia,” high blood cholesterol. Indeed, by current standards, my "bad cholesterol" is three points below "target." That said, I exercise daily, weigh at or below my target weight, have never smoked and could be the poster child for healthy eating.

Dare I suggest that my diagnosis of Hyperlipidemia is based more on profits than proof? About four years ago, according to my physician, the JNC 7 lowered target lipid levels. This opened up a huge new market for the manufacturers of statin drugs and put doctors at malpractice risk for not prescribing them. That said, many studies contest the correlation between statins and heart disease, especially for people with no other risk factors.

For a short period, I let my physician prescribe a statin, but since my lipid count before JNC 7 would have been considered “normal,” and because I have no other risk factors, and because the fewer drugs a person needs, the better for her body and her wallet, with my doctor’s agreement, I decided not to continue these pills.

Still, even though I am not on a statin (or any other drug), Anthem continues to deem me a risk. Or at least Anthem uses that reasoning to justify the upcharge to my premium.

Dare I also suggest that the pharmaceutical companies and insurers are the reason healthcare is so expensive?  That said, insurers rates are, in theory, “regulated” by the government, as are many other costs relating to healthcare.

Another story: In order for me to even apply for this (or any) insurance policy, I needed to submit five years of my medical coverage. To do this I was forced to pay $62 to have that record copied and mailed to Anthem. Because this is an even longer story, I will leave the enclosed letter to Dr. Lee Hammerling, the CMO of Promedica, to speak for itself. Please note that the Ohio legislature has been blamed by at least one Promedica employee for these excessive copying charges.

Ms. Kaptur, I am outraged at the state of healthcare in this country. I am outraged at the cynicism and greed of insurers, pharmaceutical companies, and so many other auxiliary “providers” of health care products and services.  I am outraged that healthcare is a profit-driven business and that the executives of so many of these businesses (not to mention their lawyers, lobbyists and affiliates) make millions of dollars while refusing and reducing services and coverage. I am aghast that so many Americans worry about the “socialization” of healthcare, and think the system is working. I used to live in Germany; the healthcare was straightforward, caring and effective. What I would do to be under a “socialized” system again.

Soon only the elite–as in how much money one has, not how much education or talent one possesses--will have sufficient healthcare.  I used to be elite. It does not take long to lose that status.

As Martin Niemoeller said:

First they came for the Socialists, and I did not speak out --
Because I was not a Socialist.

Then they came for the Trade Unionists, and I did not speak out --
Because I was not a Trade Unionist.

Then they came for the Jews, and I did not speak out --
Because I was not a Jew.

Then they came for me -- and there was no one left to speak for me.

Please. Do what you can to assure that we are on the road to a single-payer healthcare system. Get the greed out of the system. Educate those individual who think what we have works. I will do what I can to help.

Both Sides Now

The pleasant-looking lady above is named Betsy Morgan. Until 2009 she was CEO at the Huffington Post. A couple weeks ago she accepted a similar job for Glenn Beck’s online enterprise, The Blaze, perhaps equally well-appellated, The Flame.

Asked how she could make the about face from a left leaning pub to one that tilts 179 degrees opposite, Ms. Egan is quoted in the New York Times as saying, “I am a very apolitical person. I’m a business person, who is absolutely fascinated by brands.”

“Glenn has built for himself quite an enormous brand,” and the purpose of The Blaze is to “leverage the huge loyalty of that audience,” she told a Forbes blogger.

Uh huh. Brands used to be things like Coke, Raid, Kibbles and Bits. Enterprises whose logos contained Fraktur-fonted nouns like Post, Times, Gazette used to be known as newspapers. The former were launched to sell stuff of interest to the public. The later were expected (at least lip-servicedly) to serve the “public interest.”

Brands were about “lifestyle.” Papers were about lives. Brands were about showing off. Papers were about telling what. Brands were sold. Papers were edited.

Morgan’s job for Beck will be to “curate.”  Dare I say: “How Brooklyn!”

Brand people talk a lot about “passion,” as do incendiary media types, and this includes Huffington as well as Beck. But passion no longer implies loyalty to a cause, it means to monetize. I don’t think “monetization” was a word in newspaper stylebooks until recently.

Execs jump from Coke to Pepsi, from Apple to Microsoft, without the slightest thought of loyalty. Why should I fault Ms. Morgan for doing what’s expedient, for playing both sides. (Ms. Huffington, herself in the monetization business, no doubt agrees.)

I need to get with the program, to realize there is no such thing as public interest anymore, just what excites passion or oh-c’mon-let’s-call-a-spade-a-spade, What Sells. Mary Matalin and James Carville set the stage for hypocro-politics two decades ago.  Betsy Morgan no doubt admires them both.

Saving Seymour

Until he was in his mid-80s, my Dad was a sexy raconteur able to amuse dinner partners with tales of youthful exploits and mature successes. Then he developed a rare skin condition which his dermatologist treated with Prednisone, not an ideal drug for a chronic ailment in an elderly individual—and at 88, he fell victim to steroid myopathy, a condition in which muscles weaken and atrophy from steroid exposure.

This was last October. An ambulance was called to my parent’s flat to lift Dad off the dining-room floor and since then he’s hasn’t been able to walk, let alone stand or sit without assistance. For a month and a half he was transferred between ICUs, hospital beds and rehab facilities where interventions made his condition worse—he fell out of bed; was administered medications that shouldn’t have been administered, and not given those he should have received; notes in his file went either unread or misinterpreted; medical/social work personnel rotated in and out; diagnoses/decisions were made out of context. The list goes on and on, incompetencies atop incompetencies, even when intentions and personnel meant otherwise. 

Dad’s case, I fear, is repeated in every hospital, rehab and skilled nursing home in this country.

It is not news that Healthcare as practiced in Show-Me-The-Money America is, unequally, hyper-bureaucratically administered.  I am not expressing original thought by saying a single payer, no-incentive-for profit (not to be confused with the current legal definition of non-profit; so often a tax loophole) is the first-step to remedying this. Advocates of keeping the Healthcare system as is say it works. These advocates probably haven’t yet tried to keep a “loved one” from dying in it. Even if a patient has “coverage,” he remains a cost to be contained.

Here are just a few bureaucracies/convolutions/circles of hell we’ve encountered.

Once a patient is registered in a rehab/nursing facility he no longer has contact with his primary care physician. Ie, when a patient is at his frailest, he can no longer see the doctor who understands the context of his illness (probably a combination of pathologies). 

At best, the patient will have a daily pop-in by a “freelance” doc who, upon seeing, signs of medical distress, will return the patient to the hospital because rehab/nursing facilities are not in the business of providing medical care and the last thing he wants is to have his butt exposed to a liability suit. Freelance docs are supposed to read recommendations/patient synopses from primary care physicians, but they can overrule these—in Dad’s case, we were informed that the medication prescribed by the primary care physician to wean Dad off steroids was “very expensive” and as such, the rehab doc did his best to prevent its administration.

Once a patient is outplaced from a hospital to a rehab/skilled nursing facility (even a dirty, urine-scented, one-star-out-of-five-stars facility like the one Dad was moved to), he cannot transfer out without first taking a three-day detour back to the hospital.  (This is, like all else, a reimbursement issue.)

According to a New York State ombudsman contacted re my Dad’s case, it is SOP for rehab/nursing facilities to start a patient in rehab than downgrade them to skilled nursing—when this happens, the provider is, by law, allowed to offer lower reimbursement. It is also SOP for a patient to be moved from skilled nursing to “custodial care”-- for which the provider is entitled to provide NO compensation (or at least according to the “coverage” agreement of Dad’s plan.)

The list goes on and on but it’s fair to say that this is not a system cares about  patient recovery. Financially, is more expedient for patients to die, especially patients scared and occasionally irrational because under-respected and no doubt chip-on-their-shoulder freelance docs have, by omission or commission, administered the wrong drugs. “Your father has dementia,” we were told by a particularly negative member of this class. Saying my father has dementia is like saying Healthcare is not an oxymoron.

The past several months have been a roller coaster of Kafkzesque twirls and Grapes of Wrath suffering, but through the unrelenting persistence of my sister-in-law, a woman of keen legal mind, impressive research skills, and don’t-you-dare-treat-me-like-that confidence when talking with Healthcare gatekeepers and providers, my father will soon (without the three-days-needed in hospital stay) be moved from the urine-scented nursing facility in which he’s been a “resident” since mid-December.  His recuperation will continue in a three-star rated suburban facility in which we hope he’ll make increased progress.  It’s too early to tell, but I for the time being, I think he’s been granted a reprieve from purgatory.