Insurance

A Year in Retirement

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Published on the Doomstead Diner on March 13, 2016

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This week is the one year Anniversary of when I left the working world.  Not voluntarily, it was forced on me by an accident at work which I have detailed in numerous blogs and forum posts, along with at least a couple of rants.  Nevertheless, voluntarily or involuntarily the result is the same, I am "retired".

http://www.usnews.com/dims4/USNEWS/27f6743/2147483647/thumbnail/652x435%3E/quality/85/?url=%2Fcmsmedia%2F12%2F18%2Fc182a6924667bca09a4cd1bed6ff%2F140714-seniorgolf-stock.jpgFor the first 7 months of this retirement, it wasn't exactly bliss out on a Florida Golf Course.  Besides the physical issues stemming from the accident, I was under a lot of financial and emotional stress, since it wasn't clear when or even if I would have any income to pay my bills.  I wasn't eligible for Unemployment Insurance because I wasn't able to go to work of any sort.  In fact just getting out of bed is hard many days.  The insurance company representing my old employer "contraverted" the Workman's Compensation claim, which basically means they deny responsibility to pay up.  That case is still under litigation a full year later now.

The final source of support in this situation is Social Security Disability Insurance (SSDI), and for this it takes a minimum of 4-6 months to get processed, and then only around 40% of applicants get their bennies on the first round.  Another 40% get it on the second try, and then 20% are left twisting in the wind.  Finding out anything about what is going on with your application during the initial supposed 4-6 months is about impossible, so you just wait and hope for the best.  It's very stressful though as you watch your savings account dwindle paying your monthly bills, and this of course assumes you have such a savings account with enough money to pay all your bills for at least 6 months, which relatively few people have.

http://www.dumblittleman.com/wp-content/uploads/2011/06/Piggy_on_Money1.jpgThe blame for this lack of savings is often laid at the feet of the individual, but the fact is that unless you make a fairly high income, saving much money is quite difficult to do.  Every month you struggle to meet your regular bills, and then when minor disasters come up each year like an impacted wisdom tooth or the tranny on your 8 year old Toyota gives out, whatever savings you accrued to that point ends up being used to cover the small annual disasters you face.  If you lose a job for any reason and are unemployed for a few months, even if you get your UE Bennies it's not as much as you made in salary, so again you start dipping into your small pile of savings to cover that period.  Over 30 or 40 years of the typical working lifespan in the industrial era, I think just about everyone suffers 1 or 2 periods of unemployment.

Anyhow, fortunately for me as a Doomer I did have my Nest Egg, and I also have made it a point to live very cheap, I keep my bills low and stay out of debt.  An early experience in my life of amassing a fairly decent credit card bill for the time made me very penurious.  It was all of about $6000 and seems like Chump Change now, but at the time it was $6000 more than I had or even was worth in any assets.  All I had was a 7 year old Toyota Tercel 4WD Wagon, vintage 1983 worth about $1500, but they can't take your only transportation from you in a BK.  So I declared Chapter 7 Bankruptcy, the bank didn't even bother to show up at the hearing and I was out from under the debt.  I never went in debt again, in fact I never even held a credit card since then.

RE-BM-Camp3When my final BIG DISASTER occurred, I was not in the majority of people with less than 6 months of savings to cover bills, I had enough to cover more than a year.  While not being in immediate danger of becoming Homeless though, it was stressfull watching the carefully harbored digibits in the Credit Union account dwindle each month, and I busied myself making plans for what I would do if I reached a low enough threshold where I would have to give up my digs and go live in my RV.

A HUGE source of psychological comfort and relief for me during this dark time were my friends on the Diner, 4 of whom offered me a place to come and park my RV while trying to get everything sorted out.  These folks know who they are, and they have my eternal gratitude.  Don't let anyone ever tell you that you can't make true FRIENDS over the internet, you can.  True Friendship cannot be measured when times are good, you only know who your true friends are when times get rough.

3912-Finger-of-God-02Finally for me, after 7 months The Finger of God stepped in one more time to keep me going, I got my first SSDI check in November of 2015, and the digibits have been dropped in my Credit Union Account each month on the 4th Wednesday of the month ever since.  The Credit Union Account no longer dwindles, now it grows again, although not by too much each month.  My bills though are low enough though that SSDI covers them with a little bit to spare.

Many people look at SSDI recipients as "leeches" or the "Free Shit Army" as they liked to phrase it on The Burning Platform when I participated on that Temple of Libertarian nonsense.  Fact is though, SSDI wasn't "free" at all.  It was a mandatory Insurance Ponzi Scheme that I paid into for every year of my more than 40 year working lifespan.  Just like if you have Fire Insurance on your McMansion and it burns down, if you have faithfully paid your monthly premium you EXPECT to be paid off by the Insurance Company!  Of course they often try to weasel out on these claims, like the Workman's Comp Insurance company I am battling with is trying to do, but if your claim is valid you are ENTITLED to compensation!  "Entitlements" are used pejoratively, as though there is something wrong with being entitled to a pension after working 30 years on a GM Production Line?

https://www.bodyrock.tv/wp-content/uploads/2013/11/OldManWithCanes.jpgBeing approved as a Certified Cripple by SSDI also makes it possible for me to get an "Early Pension" from the Union I worked for for 17 years, back in the day.  When this comes through, it will add a bit more to the Monthly Mailbox Money I am ENTITLED to, because much like SSDI, my Union Dues were a REQUIRED monthly payment I had to make every month I was working in that industry.  So that will add to my buffer level when it does finally come through, although there are delays on that one because they want a copy of my Divorce Decree from 30 years ago, which of course I no longer have and now am trying to get from the NYS Dept of Health.  12-14 weeks on that one supposedly, we'll see.

After all of this, sometime in the next year, maybe by summer I hope to have the Workman's Comp case tied up and settled as well, to finish out the first couple of years of my retirement, which while pretty stressful and not too physically comfortable at least I GOT!  Moving down the road into the future, it becomes less and less likely that SS will hold up, that Pension Plans will hold up or that 401Ks and Stock Portfolios of "investments" will hold up too well either.  So all the Pigmen who were ENTITLED to a comfortable retirement by living off their investments also won't be doing too good.  Retirement as a whole is pretty much an industrial society concept, and in Ag Cultures and H-G cultures, once you past the point of being able to do SOMETHING the society valued, you died.

I in fact do have something to give back to the society which nurtured me, although it does not pay any money currently and actually costs me money to do, which is run the Doomstead Diner.  How many people the Diner reaches is an open question, but overall the numbers are pretty good across all the sites under the Diner banner. So I have a REASON to keep going, which is to write for the Doomstead Diner. 🙂

rantBesides their work, besides raising the kids who leave the nest, besides Hobbies like playing Golf in Florida or visiting National Parks, once retired many folks find themselves without purpose, and that is really what leads you into death.  This is a problem I do not have, every day there are new things to write about for the Diner, and in fact I usually am overloaded with projects I want to pursue.  Who can I get on for the next interview?  What topics to discuss in the next Collapse Cafe?  What is sufficiently PISSING ME OFF to rant on? What pictures to select for the latest rant?  I am bizzier than ever as a crippled and retired doomer than I ever was as a member of the for pay working world!  LOL.

So overall, although it is not the retirement I dreamed of in my youth, this is not too bad as retirements go.  I'd like to be in better physical shape of course, but at least my mental faculties are still in decent shape (although some Diners might dispute that. lol).  I'm still hopeful that things will improve some too once all the bureaucratic and legal nonsense is tidied up.  I'm in the midst of a debate with myself on whether I am physically capable of taking myself out on the road one more time to explore North America, to witness for myself the Collapse of Industrial Civilization as it manifests itself in communities around this land mass.  Or perhaps I need to just stay here in my little cave and keep writing until the Internet Goes Dark.  I don't know which one I will pick right now, but either way it is OK with me.  I lived a pretty interesting life in the Age of Oil, and I didn't compromise my principles very much to make it through either.  I certainly got a heck of a lot more than most folks who preceeded me got during their time walking the earth, and more than most folks who succeed me will get either.  So all in all, a pretty good go round on this trip in a Meat Package for me on Planet Earth.

I no longer worry about or fear death, although I hope not to have an extended and painful one.  I am ready to go into the Great Beyond any day, any time, and for this go round my legacy of the Doomstead Diner will stand until the Internet Goes Dark.  Not sure what legacies I left in previous iterations of my life in a meat package on Earth, although I am pretty certain of a few of them.  I know spiritually that I have always been a Nomad and always been a Freedom Seeker. I know that I have each time been anti-authoritarian and put the natural world above technological development.  I know that in every iteration, I have been an independent soul who cares about others.  I know this world will end, but souls are eternal in this universe and others.  I know that my soul, when it leaves this meat package this time, will find again another place to seek FREEDOM.

I was there once before, I am certain of it, Navigating the first cat rigged sailing canoe that made it to the Big Island of Hawaii.  I will be there again after this retirement is finished and I take my next trip to the Great Beyond.

http://pvs.kcc.hawaii.edu/images/graphics/kane_hokulea2.jpeg

Fear & Loathing in Portland

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Published on the Doomstead Diner on February 15, 2016

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As regular Diners know, I am still in the battle with the bureaucracies and insurance companies on my disability case, and later this morning I will be picked up at the digs by a cab to ship my decrepit ass down to Ted Stevens International  Airport, to be further Air Freighted to Portland for what the lawyers call an "IME", or Independent Medical Exam.  Said IME is paid for by the Insurance company for my old employer, so it's not REALLY independent of course.  ::)

 

 

After recording today's Collapse Cafe with Ugo Bardi, Steve Ludlum and Norman Pagett, I spent most of the rest of the day tidying up the digs and getting my travel bag ready for the expedition out of Alaska and back down to the Lower 48.  All Wrong Insurance doesn't have a local Alaska Neurosurgeon on their payroll, so they need to fork over for the travel and hotel to ship my sorry ass to Portland for this exercise in stupidity, totally unnecessary because all the evidence of merit is in the imaging already.  There is nothing this Pro from Dover could find that isn't in the MRIs, Xrays and CT scans.  However, they still look for ways to delay and to try and weasel out from under the massive medical bills accumulated here to date, along with paying off on the long term repercussions of the injury.

I packed a spartan bag of preps for me, mainly due to all the restrictions the TSA has for what you can carry on these days, and I don't want to wait around the baggage claim area for a bag of preps which in all likelihood I won't need.  Of course, I will be sorry if TSHTF while  I am in Portland and I don't have them, but I'll take the risk on this one.  It's only a 3 day trip, and how much can go wrong in 3 days, right?  :icon_scratch:  Even if there is a Bank Holiday declared on Monday while I am flying, the planes will still probably be flying for my return trip on Wednesday.  So I fully expect to make it back to my digs and am not real worried about this eventuality.

What I will use this free trip for is to get the latest on the air travel experience, since I haven't flown out of here in about 2 years, in fact I think my last trip out of Alaska was for the Diner Convocation in TX in April of 2014.  Also try to get some feel for what is going on in Portland, though I am not renting a car so won't be able to cruise around too freely.  All Wrong Insurance paid for cabs to get me to the IME and back to the hotel, and the hotel provides a shuttle to & from the airport.  So I will mostly be holed up in the hotel room.  Hopefully it is a fairly decent one.

I will broadcast live from the airports if possible, and maybe even while In Flight since these days it is possible to get Wi-Fi while you are in flight on Alaska Airlines.  Not sure on the bandwidth though, so whether it will handle audio and video is an open question.  Check in on the Diner Forum for links to Google Hangouts if you wanna chat while I am On the Road (or In The Air).

This is in theory the last of the hoops I need to jump through before the Workman's Comp case gets resolved.  I don't think there is anything left for All Wrong to use to delay resolution further, and the final hearing date for the case is set for the Ides of March, aka March 15th.  Hopefully, this chapter of my life will be tidied up by then, although I still have an ongoing issue with getting my pension disbursed which may take a few more months.

So, while the World Burns over the next few days, I will not be talking or writing much about that, but rather just doing a diary of my own shit.  If you're interested, drop in on the Diner over the next 3 days.  If not, you can take a break from Doom and go on a Picnic or something.  :icon_sunny:

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Days of Our Lives 3: D-Day Arrives!

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Published on the Doomstead Diner on August 28, 2015

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Death-Rattle

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RE-Age-28Today I go in to have my neck carved up by the Pros From Dover, after several months of trying to get costs hammered out, insurance hammered out, etc.  I was never really able to do that, and I go in for this operation without any real knowledge of what I will be billed for in the end.  I know I am supposed to have a $5000 Deductible and maximum out-of-pocket for the year around $1500 and 100% of the costs are supposed to be paid beyond that, except that is only for what the insurance company deems as "reasonable and normal" charges.  Needless to say, often enough the charges dropped on your tab are unreasonable and abnormal.  The cost of Spinal surgery is unreasonable and abnormal from the get-go, this will go well into the 6 figures.

Although it sticks in my craw, I am going in for this operation regardless, because my lawyer tells me I should, and I agreed to follow his advice when he took my case.  I don't really have a choice here other than to go forward with this, even without all the details hammered out.  I will be asked to sign an open end contract that I will pay whatever is charged that my insurance company does not pay, and I have no idea what this amount might be.

I wrote  what follows below as a script for an audio rant about a month ago, but after 2 tries I couldn't do the read of it without getting overly emotional, so I'm just going to post the script.

Greetings Doomfans, and welcome to another edition of the Frostbite Falls Daily Rant, here on the Doomstead Diner.

I decided to do Episode 3 of Days of Our Doom Lives as an Audio Rant, rather than another plodding text discourse on the failures in our current health care and legal systems. Mainly this is because there is tons of shit to write on in Collapse right now which is treated better with text and graphics, and my Personal Doom story doesn't need a whole lotta that shit. I'm doing just one text blog a week and one audio rant a week now, in an effort to not burn myself out on laptop time. So I have to pick and choose and do some rationing here. For those of you who have not been following this clusterfuck, a brief recap.

About a year ago I took a fall on the job and injured my neck. The symptoms from it started cropping up inside a week or two, at first just dull pain, and I wasn't sure where it came from. I thought maybe I just slept wrong or I was spending too much time in front of the laptop with bad posture. LOL. In a few more weeks, this escalated to EXTREME PAIN, to the point every day even at work I had to lie down with a heat pad on my neck to try to relieve it some. Eventually that pain subsided some, but then I got a NEW PROBLEM! My right arm became paralyzed, Not 100% paralysis, but enough to make the arm almost useless for many tasks, like shaving or wiping my ass for instance. Fortunately I am left handed, so I still can write with a pen sort of, but that isn't too good either. My keyboarding on the computer is a good deal slower these days than it used to be too, but at least I can still do that right now. So at this point, I know I need to find out what I wrong, except one small problem. NO MEDICAL INSURANCE at this time!

RE-age-28-backflipI also don't want to go down the Workman's Comp path at this time, because first off I hope it will get better, and second I don't want to leave my job either. So I wait it out and finally get some Insurance in January of 2015, and head in for the VERY EXPENSIVE testing necessary to get a diagnosis of the problem. Just to get fully diagnosed here cost somewhere in the neighborhood of $10K, between the MRI, CT Scan, Xrays and visits to a variety of Doctors, my primary care physician, a Neurodiagnostician and the Surgeon who is supposed to carve up my neck and try to stabilize the problem. Those preliminary visits are not done with yet either, because prior to going in for surgery, you have to have visits with the same pros from dover in the last month before the surgery, and I will tell you from experience these visits are a complete waste of time. All the information they need is in the imaging that was done. About the only thing important is to do a final Blood Workup before the surgery to make sure there isn't some thing that will make the anaesthesia a problem.

Anyhow, the whole biz led up to my leaving my working life about 5 months ago now, trying to get Unemployment Insurance, getting a Workman's Compensation case going and applying for SSDI, since nobody is going to hire a one armed guy who has trouble walking , bowel problems and tinnitis (ringing in the ears) for the type of work I do. Have I been able to get any sort of assistance from any of these agencies? Nope, as of yet, Zero, Zilch, NADA! I am fortunate I am a Doomer and have my own savings and preps, otherwise I would have been Homeless and dying as a Cripple on the streets of Palmer Alaska 3 months ago! I still may go out that way. Definitely do not count on Da Goobermint to help you through a crisis, even IF in the end you can win your case. By the time you win, you're DEAD!

The intervening months have been a nightmare of trying to negotiate the medical insurance industry, the doctors, the legal system and the Goobermint bureaucracy. I have received all sorts of interesting advice here on the Diner on how to approach this, and I have my own thoughts on it as well, but the only advice I really can follow is that of my Lawyer, because I made the promise when he took the case On Spec that I would follow his advice. He has 40 years experience trying this type of case, he doesn't take cases he doesn't think he won't win, and he tells me what I need to do. I am obligated to do that, and I live up to my word, always.

RE-newbornThis is not to say I myself have not spent many hours in Due Diligence, trying to find out all the costs, how they are paid, who will pay them, etc. It is close to impossible to do this, if not entirely impossible. Maybe you could do it if you had a few years of time available to make phone calls, negotiate automated phone trees and pass Snail Mails back and forth (Doctors don't do email), but I don't have the time for that, my lawyer tells me I need to have my neck carved up by the Pros from Dover ASAP. So, in spite of the fact I cannot get all these charges nailed down and how the coverage will be paid out, I did as I was told and I SIGNED UP for the operation, to be performed by the Alaska Pros from Dover who specialize in this type of operation. My date fore the operation: August 28, 2015, 3 days before my 58th birthday. 2-3 days Recovery time if you live through the operation, so with luck, I walk out of the hospital on August 31st, just as I left the hospital carried in the arms of my mother 58 years earlier.

I really do not expect to make it these days. But it doesn't matter to me, because I got everything tied up now, and everybody dies sooner or later. I already lasted a lot longer than I should have. In a certain sense, it is WORSE if I live through this thing, because then I got a whole lot of new shit I will have to negotiate, like trying to figure out how I will LIVE afterward, because I highly doubt I am employable anymore, even if there is some improvement over my current issues, and it seems unlikely there will be. It was a lot simpler back in the old days, when you got a real bad problem, you just died. Today, you have all these real cool means to keep you ticking, but SHIT they cost a lot of money! Is it really worth it to keep me ticking a few more years? Well, to me it sort of is, at least if those last few years are not lived as a Homeless Person on the streets of Palmer Alaska, but for society in general I can't see WTF the value is in this is? I personally would like to witness more of this Civilization Collapse spin down and write about it, but it sure will make very little to no difference in how it plays out. I spent the last 8 years or so writing about this shit, all I do now is chronicle the latest manifestations of of the clusterfuck, I had it pretty well figured by 2009. The Diner is the digest of all of that, and its up on the web now for as long as the web is up and running, on the Diner Legacy space.

RE-age-28-handstandI still have a couple of more hoops to jump through before D-Day on Aug 28. I have to go in AGAIN for a stupid pre-op with the Pro from Dover on Aug 11, where I will be pretty surprised if I even get to see HIM personally. Just more chats with the Nurses, PA and Billing folks. Then I have a Pre-Op with the Internist on Aug 24th, which actually does have some meaning, he will take the last Blood tests before the operation. Of course though, the charges for this visit will be outrageous. I had to schedule that visit within one week of the actual surgery, otherwise they would have had to do them all over again by the rules here. My own prediliction was to wait this out, see how the WC case turned out before signing up for the operation, even though there is substantial risk in that. Longer you wait on something like this, the more probable you get additional problems and damage. However, which is worse, dieing as a Quadraplegic or Freezing to Death as a Homeless Person? At least as a Quadraplegic you don't feel any pain on the way to the Great Beyond. My lawyer doesn't see it that way though, and apparently neither does the system he is negotiating for me and doing the Navigation. I have to follow his advice on this, so under the knife I go on August 28th. I got one more month here of Blogging to do, and I intend on making the most out of it. If I get a new lease on life and get off the table in somewhat better shape than I am now and can keep on blogging after that, that will be another Bonus. I've been on Bonus Time for years if not decades now. I should have been dead many times over already. I guess there may be some purpose in the grand scheme of things for me to stay alive a bit longer, and I will try to do that and value it if I get it. But if not, it was a wonderful run through the Age of Oil, and I got to see and experience plenty. I sewed up my Legacy, and I am ready for my meeting with the Grim Reaper. I will cross the Great Divide satisfied with my life and how I lived it.

And that's all the Doom, this time until next time, here on the Doomstead Diner.

Hopefully, I will make it through and just be offline for a few days to a week, and the other Diner Admins will keep the Diner running during that time.  I have up previously written material in the drafts that should publish automatically, if not Surly can drop in and get them published.

If I don't make it through, I have a Self-Obituary in the drafts which Surly can publish, but not for at least a week not hearing from me!  It went up briefly once by accident while we had the server problems, and I don't need another one of those clusterfucks, so I am not scheduling it to post automatically.  LOL.

OK, my friend should be picking me up in a few hours for the drive into Anchorage and I am going to try and get some sleep.  Hopefully I will check in with you all again a few days. If not, you know the Tag Lines.

SAVE AS MANY AS YOU CAN

SEE YOU ON THE OTHER SIDE

UPDATE: I MADE IT THROUGH!!! 🙂

I Spy Doom: Hospital Intro

Guerney Ride from Recovery Room

The Days of Our Lives: Episode 2

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Published on the Doomstead Diner on June 14, 2015

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Discuss this article at the Medicine & Health Table inside the Diner

Another Week has passed in the Last Great AdventureTM for RE, negotiating the Dysfunctional Health Care System of the Fascist States of AmerikaTM.

medical_billsAfter the visit this week at the office of the Pro From Dover who is supposed to carve up my neck and fix me up at some point, two NEW Projects emerged which I need to resolve before Signing on the Dotted Line for all the charges that are going to be pitched out for such a Surgery.

First thing is to get the Subrogation between the two Insurance Companies (my own Insurance and Workman's Comp Insurance) properly set up.  This has to happen because in the event I win my Workman's Comp case, all the bills that currently have been paid for by my insurance or myself will need to be reimbursed to me and my insurance company ex-post-facto.

Second thing is to nail down precisely WHAT the costs are for this operation?  All I have right now are the charges the main Pro From Dover drops on the Bill, but there are many more.  Anaesthesiologist, Neuro-Monitoring Dover Pro, Assistant Neck Carver Dover Pro, and the Hospital costs themselves.  There probably are other ones not yet identified too.

All of this we have been detailing out Inside the Diner in the thread evolving from Episode 1 so far.  Balance of this article comes from that thread.

From JDW:

Heh, you're not the only one, Micheal Snyder just published this:

http://theeconomiccollapseblog.com/archives/hospitals-are-blatantly-ripping-us-off

 

From Surly:


Right on time.

50 hospitals charge uninsured more than 10 times cost of care, study finds

From Eddie:

 I mentioned the story of how my son went to the ER in Del Rio to get checked out for a bit of heat stroke, right?

The actual treatment rendered consisted of starting an IV and giving one bag of fluids.

The bill? Ten thousand dollars. Seems they like to diagnose heat stroke using an MRI and a CT Scan on a healthy 24 year old.

From RE:

I just finished composing two emails to my Insurance company, which of course can only be sent on their proprietary server.  For "security" reasons of course.  ::)

However, a minute after sending them that way, I sent the same two emails to myself through two of my many email addys.  ;D  So I have my own record with the time and date stamps on them.

In addition, for the reading pleasure of the Diners following the Days of RE's Life Soap Opera, here are the two emails:

Note:  I have changed names and numbers for legal reasons in this version.  Changes are in BLUE  :icon_mrgreen:

First, on the Workman's Comp Subrogation issue:

I have spent the last several month undergoing diagnosis for an injury I suffered at work.

I was informed by the billing department of one of the doctors that the claim needed to be "subrogated", so I called up ALLWRONG Insurance a couple of months back to find out about this.  The representative on the phone told me there was nothing I needed to do, my claims were being paid.

I was informed again yesterday the claim needed to be subrogated, and that ALLWRONG Insurance said I had never called about that, which is not accurate.

The Insurance company for the Workman's Comp Claim is Mutual of Deceit.  The Claim Number is 666-FUCKYOU.

Further information regarding the case can be provided by my Lawyers Dewey, Cheatham & Howe.  They can be reached at (666) SHYSTER.
 
Please let me know when this has been properly handled.

Thanks for the fine coverage you have provided so far.  Without it, I would not have been able to get diagnosed.

Second, on the reimbursement rates for the Pro From Dover's list of charges:

I have been diagnosed with a neck injury and will need spinal surgery.

I have been given a list of 2 possible proceedures that might be undertaken, and the prices the Pro From Dover charges for this.  It does not include the charges from the anaesthesiologist or neuromonitoring doctor or the assisting doctor, just his own charges.  It also does not include the hospital charges.  I have not yet been able to get those charges.  However, we can begin with this.

I will list the codes for each proceedure and the prices he charges.

63081     $13,000
22551       $19,000
22554     $12,500
22846     $ 7,900
22585     $ 3,500
20931     $ 1,300
Total       $57,200

or

63081     $13,000
22554     $12,500
22846     $ 7,900
22585 x 2  $3,500 each
63082     $ 4,500
20931     $ 1,300
Total $46,200

Please send me the list of reimbursement rates from ALLWRONG Insurance on both of these sets, and the total reimbursement for each one.

Thanks for your help and fine coverage.
——————
I am going to get a LOT of Blogging material out of this!  :icon_sunny:

From RE:

OK, just fired off another email to try and get a Price Quote on the REST of the charges for this operation.

Doing this is not easy, because just FINDING an email address to send this mail to was difficult, but I did find one that was semi-appropriate in a pdf on the Providence Hospital website.

None of the Pros From Dover provide email addys, and everybody has their own Billing department.  If you have dealt with just ONE of these billing departments on the phone, you know you can't get jack shit in information this way.

Anyhow, here is my first attempt at trying to get the FULL LIST of charges for the operation by the Pros From Dover:

I have been Diagnosed with a neck injury I suffered at work, and will need Spinal Surgery to repair it.

The Surgeon at Providence I visited with is Dr. X.  He has provided me with his list of charges for the operation, but not the rest of the charges such an operation at Providence Hospital will accrue.

I need the list of charges from the following Doctors and Providence:

1-Anaesthesiologist charges (No Doctor Named)

2-Neuromonitoring Doctor (Dr. Q named)

3-Assisting Doctor to Dr. X (No Doctor Named)

4-Providence Hospital Charges for the Operating Room and Recovery stay at Providence

Estimated time in Surgery is 3 hours

This is the only email address I could find to try and get this information.  Please forward to the appropriate billing departments and have them reply to me if you cannot provide this information yourself at this address.

Thanks for your help.
—————-

OK, that is IT for today in trying to swim through this clusterfuck.

Now I am going back to DOOM!

From GO:

Realize it's easy to say but throw it out of your mind, it will add to your illness if you dwell too much on it.

There is no swimming through it, it's an endless river of pure evil extortion. Get the operation as soon as possible to get yourself well and deal with it later. The whole fucking country is in unpayable debt and bankrupt anyway, from students to senior citizens to the government. Something will have to be done to help out people in such an untenable situation sooner rather than later.

From RE:

Nope, will not do this operation until I get it all spelled out.

It's really a very good Test Case of many aspects of the system, besides the Medical Industry bullshit & Insurance Industry bullshit, you also have Unemployment Insurance (Epic Fail already), Workman's Comp (still under litigation) and  SSDI (still in bureaucratic paper shuffling).

I'm not going to get bullied into an operation that will bankrupt me before I am otherwise bankrupt anyhow.  Right now I can still write and I have a roof over my I head I can do it in and plenty of food to eat too.  When I have used up the last of my savings, THEN I will go in for the operation, if I'm still alive anyhow.

It's my LAST GREAT ADVENTURETM.

From GO:
Well, you certainly are the best judge of your own situation RE.

I was merely coming from the usual assumption that a medical condition untreated become worse and harder to deal with later on. But I'm no Doctor, that's for sure.

It's such an evil racket that it turns the stomach of honest normal people.  :'(

From RE:

Everyone "assumes" that "your health is the most important thing".  So no matter WHAT it costs, you're supposed to do it.

Really though, your Health is subsidiary to your Economic Well-Being.  If getting fixed up means GOING BANKRUPT, HTF am I better off?  I have a fixed neck but I am HOMELESS? This is an IMPROVEMENT?

The Med industry trades on the fact that sick & injured people will spend whatever it takes to get fixed up, rather than die or live as a cripple.  I WON'T pay whatever it takes, if whatever it takes will BANKRUPT me.  It's not worth it.

From JDW:

You know, RE, you may have trouble with your spine, but you definitely have BACKBONE.

Most people (myself included) would not do what you're doing, and that's why these businesses are able to get away with it.

From GO:

I hear you and think the same way RE. My idea is they know they can't get blood from a stone so it may be possible to work out a long term payment plan without ending up on a park bench.

Of course if you had a paid for home or they smelled assets they would bleed you dry. But a school teacher, on a modest salary, living in a rental and driving what they consider to be a shitbox is another matter. They surmise you are not rolling in dough They might want to grab every dime the could get from insurance and all the avenues you listed and then, after they maxed out all they could get there, saddle you with some leftovers and work out a monthly pay plan which allows you to continue without bankruptcy. A lot of legal firms offer an initial free consultation, perhaps you could get an idea with an inquiry.

Another idea is a legal aid society. a lot of colleges and schools offer free advice to people in financial trouble, the law students usually give ideas from that source and not actual lawyers.

I certainly understand what you are saying though, would do the same thing if in your shoes, just trying to offer some ideas. 

From RE:

Thanks for that JDW, but it's really not "Backbone" or "Courage" at work here, it's my LOGIC and CFS at work.

I just did a COST-BENEFIT analysis on the situation.

1- The operation is unlikely to restore my former spry and athletic self.  Damage done already is too great for that.  All it does is stabilize the situation some.

2- I am not likely to be fit for any type of work that I have experience with even after a successful operation which stabilizes it.

3- Being BANKRUPT and unfit for any type of work I have experience with leads to HOMELESSNESS if I cannot get my Bennies or a Settlement on the Workman's Comp Claim.

4- Finishing off my life as a Homeless Cripple is not how I would like to go to the Great Beyond.

So in this Game Theory exercise, I have only one valid option, which is to fight the system and hope I hold up long enough to make it through to the Other Side of it.

I'm not being "Brave".  I am just doing what makes CFS to me.

I will WIN!  I will make it through the Clusterfuck!  I have HOPIUM.  :icon_sunny:

I never QUIT!  I never GIVE UP!

It ain't OVAH till the Fat Lady Sings for RE, and she's not sung the final Aria yet!

From Monsta:

Logical it maybe but it still involves courage. The thing is we like to think of ourselves as rational human beings that apply logic whenever possible but the thing is when logic meets our primal desires it often fails. Our will to live is strong and quite often those logic decisions we make get overruled. It is partly this reason why we have the clusterfuck we see today. So in the end while your decision maybe CFS it still requires courage on the fact it takes balls to overrule your desire to live (you're primitive brain often does not make the distinction between good life and bad life). Also another desire that stops people is quite often people want to fit and not rock the boat and be a troublesome person. This is a fact that many companies play on when giving poor customer service; the lack of courage some customers have in speaking out.


And that is probable MORE than enough for Episode 2 of Days of Doomer LivesTM here on the Doomstead Diner. More coming down the pipe, to be sure.

RE

Hospitals Are Blatantly Ripping Us Off

Off the keyboard of Michael Snyder

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Published on The Economic Collapse on June 9, 2015

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Scam - Public Domain

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Most Americans are deathly afraid to go to the hospital these days – and it is because of the immense pain that it will cause to their wallets.  If you want to get on a path that will lead you to bankruptcy, just start going to the hospital a lot.  In America today, hospitals and doctors are blatantly ripping us off and they aren’t making any apologies for it.  As you will read about below, some hospitals mark up treatments by 1,000 percent.  In other instances, basic medical supplies are being billed out at hundreds of times what they cost providers.  For example, it has been reported that some hospitals are charging up to 30 dollars for a single aspirin pill.  It would be difficult to argue that the extreme greed that we see in the medical system is even matched by the crooks on Wall Street.  These medical predators get their hands on us when we are at our most vulnerable.  They know that in our lowest moments we are willing to pay just about anything to get better or to make the pain go away.  And so they very quietly have us sign a bunch of forms without ever telling us how much everything is going to cost.  Eventually when the bills come in the mail, it is too late to do anything about it.

How would you feel if someone sold you something for ten times the amount that it was worth?

Would you feel ripped off?

Well, that is what hospitals all over the country are doing every single day.  Just check out what one brand new study has discovered

Some hospitals are marking up treatments by as much as 1,000 percent, a new study finds, and the average U.S. hospital charges uninsured patients three times what Medicare allows.

Twenty of the hospitals in the top 50 when it comes to marking up charges are in Florida, the researchers write in the journal Health Affairs. And three-quarters of them are operated by two Tennessee-based for-profit hospital systems: Community Health Systems and Hospital Corporation of America.

“We just want to raise public awareness of the problem,” said Ge Bai of Washington & Lee University in Virginia, an accounting professor who wrote the study along with Gerard Anderson of Johns Hopkins University in Baltimore.

Does reading that make you angry?

It should.

They are greedily taking advantage of all of us.

Other studies have come up with similar results.  Here is one example

According to National Nurses United, U.S. hospital charges continue to soar with a handful of them, such as Meadowlands Hospital Medical Center in Secaucus, N.J., going as far as charging more than ten times the total cost — or almost $1,200 per $100 of the cost of care. Meanwhile, the hundred priciest hospitals in the nation were found to have this cost ratio begin at 765 percent, which is more than twice the national average of 331 percent.

Much of the time, we are being overcharged for tests, services and procedures that we don’t even need.

It has been estimated that the amount of truly wasteful spending in the U.S. medical system comes to a grand total of about $600 billion to $700 billion annually.  That means that wasteful medical spending in the U.S. each year is greater than the GDP of the entire country of Sweden.

And of course almost everyone has a story about an absolutely ridiculous medical bill that they have received.  In fact, if you have one that you would like to share, please feel free to share it at the end of this article.  The following are just a few examples that were shared in an editorial in a local newspaper

Have you heard about the little girl who required three stitches over her right eye? The emergency room sent her parents a bill for $1,500 — $500 per stitch (NY Times, Dec. 3). My neighbor recently spent six hours in the emergency room with bleeding from the mouth. He was on a blood thinner, needed several blood tests, and his heart was monitored. His hospital bill came to $22,000. A California man diagnosed with lung cancer chose to fight his cancer aggressively. Eleven months later his widow received a bill exceeding $900,000.

One of the most disturbing trends that we are witnessing all over the nation is something called “drive by doctoring”.  That is where an extra doctor that isn’t even necessary “pops in” to visit patients that are not his or “assists” with a surgery in order to stick the patient with a big, fat extra bill.  The following is from a New York Times article about this disgusting practice…

Before his three-hour neck surgery for herniated disks in December, Peter Drier, 37, signed a pile of consent forms. A bank technology manager who had researched his insurance coverage, Mr. Drier was prepared when the bills started arriving: $56,000 from Lenox Hill Hospital in Manhattan, $4,300 from the anesthesiologist and even $133,000 from his orthopedist, who he knew would accept a fraction of that fee.

He was blindsided, though, by a bill of about $117,000 from an “assistant surgeon,” a Queens-based neurosurgeon whom Mr. Drier did not recall meeting.

How would you like to receive a bill for $117,000 from a doctor that you had never met and that you did not know would be at your surgery?

This is how broken our medical system has become.

And of course this type of abuse is not just happening in New York.  It is literally happening all over the nation

In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives.

If you or a close family member has been to the hospital recently, you probably know how astronomical some of these bills can be.

And if you have a chronic, life threatening disease, you can very rapidly end up hundreds of thousands of dollars in debt.

If you doubt this, just check out the following excerpt from an article that appeared in Time Magazine.  One cancer patient out in California ran up nearly a million dollars in hospital bills before he finally died…

By the time Steven D. died at his home in Northern California the following November, he had lived for an additional 11 months. And Alice had collected bills totaling $902,452. The family’s first bill — for $348,000 — which arrived when Steven got home from the Seton Medical Center in Daly City, Calif., was full of all the usual chargemaster profit grabs: $18 each for 88 diabetes-test strips that Amazon sells in boxes of 50 for $27.85; $24 each for 19 niacin pills that are sold in drugstores for about a nickel apiece. There were also four boxes of sterile gauze pads for $77 each. None of that was considered part of what was provided in return for Seton’s facility charge for the intensive-care unit for two days at $13,225 a day, 12 days in the critical unit at $7,315 a day and one day in a standard room (all of which totaled $120,116 over 15 days). There was also $20,886 for CT scans and $24,251 for lab work.

The sad truth is that the U.S. health care system has become all about the money.

A select few are becoming exceedingly wealthy while millions go broke.  One very disturbing study discovered that approximately 41 percent of all working age Americans either have medical bill problems or are currently paying off medical debt.  And collection agencies seek to collect unpaid medical bills from approximately 30 million Americans every single year.

Once upon a time, going into the medical profession was a sacrifice and you did it because you wanted to help people.

Today, it is considered to be a path to riches.

If the U.S. health care system was a separate country, it would actually be the 6th largest economy on the entire planet.  Even though our system is deeply broken, nobody wants to rock the boat because trillions of dollars are at stake.  If it was up to me, I would tear the entire thing down and rebuild it from scratch.

So what about you?  How would you fix our broken health care system?  Please feel free to share your ideas by posting a comment below…

The Days of Our Lives

Off the keyboard of RE

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Published on the Doomstead Diner on June 10, 2015

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Discuss this article at the Medicine & Health Table inside the Diner

I'm taking a break this week from doing my usual Wednesday Audio Rant, because with all the shit going down with the Diner Crash and my personal  Health Crash issues, I just haven't had the time to get one recorded this week.

In its place, from Inside the Diner in a restricted forum for Regular Diners Only is today's tale of my latest visit with the Surgeon Pro From Dover who is supposed to carve up my neck at some point and slow the progress toward Quadraplegia and Inevitable Death.

It's a short snippet of the tale of the Amerikan Medical System, and how it fails to operate in any sane fashion.  Enjoy.  LOL.


From RE:

Another appointment with the Surgeon today.

(Note: The Image Below is NOT my Xray!  I can't use my own Imaging for Legal Reasons.  Suffice it to say that my issue is in the C4-C5 area but somewhat dissimilar to this one in some respects.  I can't go into that either.  Beyond that, an XRay doesn't reveal the scope of the problem too well.  For this you need an MRI and CT Scan.  KACHING!)

http://www.knowyourback.org/PublishingImages/cervical_rao1.jpgI handed them my Imaging DVDs at the Desk.  Waited about 20 min.  Got called in to go to an exam room.

I saw the intake Nurse who takes your BP and recent history of symptoms, then sat in the exam room for 45 min waiting for the Physician'a Assistant.

Physician's Assistant tells me again what I already know, condition is deteriorating, need Surgery Soon.  Taps my knees with the Mallet, has me try and lift my arms.  No can do with the right arm as usual.

Another 30 min wait and the Surgery Scheduler comes in and hands me basically the same paper as before with the Surgeon's Price List on it.  We discuss the same issues regarding how Insurance will cover it, and the Workman's Comp case.  I am told once again it needs to be "subrogated", which I tried to do after they told me that the first time, but was told by whoever it was I spoke to at the Insurance company that it wasn't necessary.  Said insurance company says I never called them, which is bullshit.  This time I am going to do it online in writing and take a record of it.

Wait another 15 minutes and the Billing Clerk comes in, with a list of Phone numbers I need to call to get Price Lists from Anaesthesiologist, Neuro Monitoring Pro From Dover who monitors nerve impulses as the Scalpel Pro From Dover carves up my Neck, and the Hospital itself that charges for the Operating Room expenses and any time you need to spend in recovery.

I never actually see the Surgeon himself on this visit.

So we are basically at the same place we were before, with the added Info that none of the 3 Pros From Dover are "In Network" for my Insurance company, so likely what will be covered is not what will be charged.

I will write the Insurance company tomorrow about the Subrogation bullshit, not up to it today.  I'll also give them the Codes and list of charges from the Surgeon to see what they will cover.

At this point however, I will not go in for Surgery until this economic nonsense is better defined.

From AG

From RE

BTW, for this "Consult" with the Surgeon (who I never actually saw), I was charged $650.

For the $650 I got:

10 Min with the Nurse taking my BP (Good today at 118/78  :icon_sunny:)
10 Min with the PA Tapping my knees and chatting with me encouraging me to sign up for surgery NOW!
10 Min with the Surgery Scheduler going over the same Price List as before
 5 Min with the Billing Clerk discussing Insurance issues
85 Min Waiting Time in the Exam Room Surfing the Net on my Smart Phone

What a fucking RACKET!

From GO

You are getting off easy.

I hate to add to your misery RE, but things are really bad, much worse than you have encountered so far.

They have drive by doctors now that no one requests who work hospitals and cases just like yours. People get bills for twenty and thirty grand from these pricks.

Max Keiser and others have done shows recently on these swill. Please check it out on various places on the web and do what you can to protect yourself from them. It is a con that is growing rapidly, and the bastards get away with it legally some how.  A sad situation.  :'(

From Eddie

Wow! That's ridiculous. Hard to believe. I believe it, but it's really outrageous. I can't believe any insurance company would pay that for a minute…so of course they stick it to you, since they won't. ONLY IN 'MERIKA.

From RE

Well, actually so far the Insurance Company HAS picked up the tab for this nonsense.

I met my Deductible and Max Out of Pocket for the year of $1500, within reason and my ability to pay.

So far, my total bills for all the diagnostics and consult are still under $10K (slightly).  This is still less than the $12K/year my Insurance costs, paid for by you the Taxpayer under Obamacare.  :icon_sunny:

However, I am 100% CERTAIN that once I rack up the 6-Figure costs for the Surgery, they will not be so generous.  LOL.

Even though I haven't got cost estimates from the other 2 Pros From Dover and the Hospital on their charges, I am pretty certain we are talking a $200K Bill here.

medical_billsNow, besides this, the Surgeon Billing Department on the way out wants YOU to pay the bill right then and there, then YOU negotiate with the Insurance company to get Reimbursed.  Needless to say, on both visits to the Surgeon for a Consult, I "forgot" my checkbook.  LOL.  So they billed the Insurance company in the end for the first one, which they paid up on.  No idea what will happen with this one.

Have I got off EZ here?  Yea, so far actually I have.  I did get diagnosed finally and it only cost me $1500 so far, max $2150 if the insurance company balks on paying the latest ridiculous bill.

Will I rack up $200K in bills without having it spelled out what is gonna be paid for here and what won't and by who?

HELL WILL FREEZE OVER FIRST!

I would rather get 2 nice years here of Retirement and then give myself up to the Bear than let these folks RAPE me!  I do not sign up for this fucking surgery until it goes onto the Tab of Workman's Comp insurance or I have already bankrupted my savings, THEN I will go in and have said surgery and declare Bankruptcy.

Will my condition deteriorate because I am not gonna do this?  Probably.

Then, if I finally do come through it I will file a Class Action Lawsuit against the Federal Goobermint, Workman's Comp and Social Security and the Insurance Companies for the delays involved in getting the Health Care I need.

I am going to go out FIGHTING!


So ends today's Ongoing Soap Opera with my Neck Injury.  This is sure to continue onward for MONTHS, if not YEARS if I don't Buy My Ticket to the Great BeyondTM before it plays itself out.

If nothing else, I am going to get a SHIT LOAD of writing material (and ranting too when I have some time to record) out of this.

LIKE SANDS THROUGH THE HOURGLASS, THESE ARE THE DAYS OF OUR LIVES

RE

 

RE’s Excellent Spinal Surgery Adventure

Off the keyboard of RE

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Published on the Doomstead Diner on April 15, 2015

Neck-Injuryhttp://api.ning.com/files/JJsOgcmxC3fUvCyoW4AAZFJDMAzgNJahfa-VpXyIPZyz8u-RVSppED4aCTmsoCQ3mhd9fShIkNSsnAALhnd1rjd-y-1T*hqn/billted.jpg

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Death-RattleAs regular Diner Readers are aware, I have been dealing for quite some time with Pain & Paralysis from a Neck Injury I suffered last year.  I did not have Med Insurance at the time, and have been waiting, hoping it would improve on its own.  It has not, it has become worse.  I finally got Insurance, and started making the rounds of the Doctors, beginning with my Primary Care Internist, followed by a visit with a Neurological Diagnostician and then finally today the visit with the Spinal Surgeon.

The issue is this: resultant from a fall I took on the job, the C4-C5 vertebrae in my neck were damaged. This has put pressure on the nerve bundle running down the  spinal column, and anyone who knows anything about this knows that when you have damage that far up, you’re not just in danger of becoming Paraplegic, you are on the road to Quadraplegia if you aren’t fortunate enough to die outright.

From SPINALINJURY.ORG

Vertebrae are grouped into sections. The higher the injury on the spinal cord, the more dysfunction can occur.

http://www.stemcureindia.com/images/spinal.jpgHigh-Cervical Nerves (C1 – C4)

  • Most severe of the spinal cord injury levels
  • Paralysis in arms, hands, trunk and legs
  • Patient may not be able to breathe on his or her own, cough, or control bowel or bladder movements.
  • Ability to speak is sometimes impaired or reduced.
  • When all four limbs are affected, this is called tetraplegia or quadriplegia.
  • Requires complete assistance with activities of daily living, such as eating, dressing, bathing, and getting in or out of bed
  • May be able to use powered wheelchairs with special controls to move around on their own
  • Will not be able to drive a car on their own
  • Requires 24-hour-a-day personal care

Low-Cervical Nerves (C5 – C8)

  • Corresponding nerves control arms and hands.
  • A person with this level of injury may be able to breathe on their own and speak normally.
  • C5 injury
    • Person can raise his or her arms and bend elbows.
    • Likely to have some or total paralysis of wrists, hands, trunk and legs
    • Can speak and use diaphragm, but breathing will be weakened
    • Will need assistance with most activities of daily living, but once in a power wheelchair, can move from one place to another independently
  • C6 injury
    • Nerves affect wrist extension.
    • Paralysis in hands, trunk and legs, typically
    • Should be able to bend wrists back
    • Can speak and use diaphragm, but breathing will be weakened
    • Can move in and out of wheelchair and bed with assistive equipment
    • May also be able to drive an adapted vehicle
    • Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment

I was warned first by the Neuro-Diagnostician that any further falls or whiplashing of the neck could send me over the edge in an instant.  The Spinal Surgeon confirmed this today, and is desperate to get me on the table to carve up my neck STAT!  However, the costs of this operation are Mind Boggling.  We’re talking $200K here at least by the time all is said and done.

So, the last month since leaving the job have been a non-stop NIGHTMARE of dealing with Goobermint Bureaucracies and Insurance Companies as I attempt to get this covered under our dysfunctional system.  To this point, other than having some of the early bills for Diagnosis which are none too small themselves  partially covered, I haven’t been able to get any Bennies at all to cover my loss of income.  I am living entirely off my savings at the moment.  I’ve got a Lawyer working on this, but it will likely be months before I see any resolution or Bennies.

This may well be the Last Great Adventure for RE, so to further be able to Chronicle it on the pages of the Diner, I have to “Come Clean” and drop one of the RE Mythologies, that I have piles of money.  I don’t, I’m a formerly Hard Working Middle Class Guy who managed to stay out of Debt by being Penurious, socking away some Savings and getting a small Inheritance when my mom died.  That’s my “Cushion”,  which if I didn’t have it I would be well on my way to Homelessness already.  I could last a few years with no Income with no Med Bills, but if I can’t get this covered it basically would wipe me out financially, and then what fucking good is having my neck fixed if I am completely broke?  I’m better off DEAD in this scenario.

The next step in the process here is a Friday “Pre-Hearing” with Workman’s Comp Alaska, where my Lawyer will begin the process of doing Battle  with the Insurance Company Lawyers, but which will end in a postponement for minimum 45 days because neither side has all the medical records yet.  The Insurance Company has of course “Contraverted” the claim, since paying out on this will cost a decent piece of change between the Med Bills and the Lost Income.  My Lawyer will attend the pre-Hearing for me, I don’t need to make another trip to Anchorage yet for this one.  I never enjoyed going down to Anchorage to begin with, but now when I know if I even stop short because a Moose is crossing the road that could instantly turn me into a Vegetable I don’t relish the drive into Anchorage at all.  I try to not travel much at all these days and spend a lot of time resting horizontal which takes away some of the Pain.  If I spend a lot of time on my feet moving around, by the end of the day my Head feels like it will literally EXPLODE with PAIN.

Then, next week I am scheduled for a C-T Scan at the local Matsu Regional Medical Center.  The Surgeon wants this scan in addition to the MRI and X-Rays I already got ($3000, KACHING!).  This additional Scan necessary to determine which of two types of proceedures he might end up performing, which I have details of but I will save for another post.  After that, I will try and schedule the Surgery and get it Pre-Approved by the Workman’s Comp Insurance Company.  If miraculously that occurs,  I should be wheeled into Surgery sometime in Mid-May at the earliest would be my best guess, but somehow I doubt the Insurance Company will sign off on $200K in bills that easily.

Meanwhile, although every day is somewhat tortuous in terms of pain and just doing simple tasks like tying my shoes  and getting dressed, I am looking at this as my Retirement at long last from the world of “School” and “Work”, neither of which I ever was happy about having to do even though I was good in Skule and for the most part enjoyed my work while doing it, whatever it happened to be in whatever era of my life, although there were a couple of jobs I didn’t like at all after doing them for a while, like teaching in the Public Skules.  What I always hated was the necessity and responsibility every day of HAVING to get up and do what was required of me to be an acceptable member of this culture.  The Retirement may not be very long here, but at least I got one a month long or so and counting now.  Many folks never get one, they die in Car Accidents on the way to work.  or they sign up to be a Brave Soldier, and get their Ticket to the Great Beyond TM from an IED in Beirut before they make it out of their 20s.  Or they get Cancer young; or they get Hazed and Abused on the net and Hang themselves as Teenagers; or the numerous other ways people end up dying long before they ever get the chance to “retire”.

Anyhow, now if I don’t show up here one day Unexpectedly in the near future, Diners will have a better idea of what happened.  I HAVE made provisions for the Diner to continue on at least for a while after I cross the Great Divide, though I doubt it will last all that long.  In the grand scheme of things though, nothing lasts all that long and everything dies, even Species and even Planets.  I’d like to last a bit longer, and I hope the Planet and Homo Sapiens do also.  Ka inside the Diner asked what the purpose of living is without Individuality? What is the Purpose of  Honeybee living, or of a Flower?  It is self-reflexive, the purpose of living is just to live.  You do so for so long as you can, experiencing what we call life, and then you are Dust in the Wind.

SEE YOU ON THE OTHER SIDE

RE

I Consider Myself…the Luckiest Doomer…on the Face of the Earth

Off the keyboard of RE

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Published on the Doomstead Diner on February 19, 2015

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Today, Doom arrived at my Doorstep.

As regular readers of the Diner know, a while back I suffered a partial paralysis of My Right Arm, which I have been dealing with for the last few months.  I actually did a Rant on the problem shortly after it cropped up.

Here’s the transcript for those of you who prefer to read rather than listen.

Typical current RE Sleeping Position

Typical current RE Sleeping Position

Greetings Doomfans, and welcome to another edition of the Frostbite Fall Daily Rant, here on the Doomstead Diner.

For today, I am going to leave the world of Global Doom once again to talk about personal Doom. This goes along the lines of it’s a Recession when your neighbor loses his job, it’s a Depression when you lose yours.

I remain amongst the fortunate folks in the world of Collapse for the most part, no debts, money in the Bank, still employed, live in a nice still uncollapsed neighborhood etc. However, I have health problems, most of which are my own fucking fault for taking lousy care of my corporeal package for the last 50+ years. Well, actually I took pretty good care of myself for the first 35 or so, but slacked on this stuff for the last score or so of years.

I mentioned in a prior rant my issues with PAD, peripheral artery disease which has made my legs less than world class for running the marathon, or even walking to the dumpster to dispose of some of the waste from my life. This has been an annoyance for a while, but overall hasn’t made life that difficult for me.

A couple of weeks ago though a NEW problem cropped up, which appears to be neurological in nature, though I am not 100% sure of this or what exactly is causing it, though I have some pretty good ideas on it at this point, after dealing with it for the last few weeks.

The etiology of this latest issue is one day about 3 weeks ago or so I noticed some pain in my right arm. The next day, ENORMOUS Pain at the base of my neck. The day after that, I could barely move my right arm.

I hate the whole med industry, so refused to go to the Doctor. I figure at the time its a pinched nerve in my neck, maybe some CRACKING from a chiropractor will fix it up. I had good luck with a chiropractor once before, so even though these guys don’t have a great rep overall I figure this is worth a try again. The first session gives me some minor relief, but the next session does nothing. I cant see continuing having my head and back cranked on like this if I can’t perceive releif after the torture session.

So now I do finally talk to an MD, a friend of mine, casually about this issue. He informs me I can have a whole HOST of problems possible here, from a Stroke to Lung Cancer. So now I am SURE I am gonna die soon. He also lets me know there is no way to make an absolute diagnosis without getting not one but probably 2-3 CT scans of the tissue in my arm, my neck and my torso. The TESTS alone here are probably $3-4000, and they won’t cure any of these problems either.

If I DO find out I have Lung Cancer, what’s the prognosis there? Very low survival rate if you got the BIG C in your breathing apparatus. In the med solution to this issue, you gotta go through Radiation and Chemothrapy, and even after all of that most folks don’t make it more than 5 years best case scenario. Not gonna do this no matter what.

If I find out its a STROKE, also not much can be done. These things either heal over time or they don’t. Your brain and nervous system either find a work around to the problem or not. Physical Therapy can help here, but you don’t need a Physical therapist to help you with this, all the info for this is available Online on what to do.

So now I decide to be my OWN Doctor, and go researching to try to figure out WTF is wrong with my Right Arm based on all these symptoms, and after a couple of days of this I get what I consider the most likely answer, I have something called”Cervicogenic Headache”, just a real bad version of this. It hits the lower neck vertebrae, and comes basically from Bad Posture and doing stuff like hunching over your laptop 8 hours a day writing about DOOM. LOL.

So now I figure I am not really dieing of Lung Cancer, I’m just a CRIPPLE for some indeterminate period of time until I can Rehab my way out of this or not.

Until you have actually LOST the use of one of your arms, you don’t realize how much this screws up even simple things you do all the time like wipe your ass or shave. I happen to be (fortunately in this case) Left Handed but even so I have traditionally wiped my ass with my Right Hand and put the shaving Cream on my face with this hand also. I already have had to re-educate myself to wipe my ass with my LEFT hand instead, and spread shaving cream on my face with this hand also. This hasn’t been too hard overall, but there are other more difficult things I have to find work arounds for while I Rehab here, or not.

My Cameras and my Car are two main ones. Did you know all Cameras are Right Handed? The Shiutter Button is always on the right side of the camera. If you only have use of your LEFT hand, you can’t hit the shutter button to take a pic, Try it with your camera. Fortunately here I don’t have TOTAL loss of the Right Arm at the moemnt, it’s just real weak through many positions. If I hold the camera up with my left hand, I can essentially rest my right hand on the camera and my finger still works to press the shutter button. LOL.

Similar with the car. The Transmission Lever is operated with your Right Arm, what I did to adapt here is use my Left Arm to lift my Right arm up to hold the lever, Dr. Strangelove style and then pull on my right arm with the left one to shift it into Drive. LOL,.

Putting on your clothes, tieing your shoes, buttoning your shirt, zipping up your fly, EVERYTHING is a challenge here without a fully functional right arm! Fortunately, I did not lose complete use of it, just partial, and more fortunate than that I appear to be getting incremental improvement as days go by here, though it is mighty slow overall and I don;t know if I will ever get back complete use of this limb.

I keep my Left Fingers crossed the Left Arm doesn’t go down the route of the Right one before I can get it working OK again. As of now, I can adapt, even though many things are difficult to accomplish. Similar loss in the Let arm would make that impossible though.

On the upside, I can still keyboard with both hands, though a lot slower now. Also got no problem ranting into a microphone attached to a wireless headset, though it is a bit of a challenge to get the damn headset onto my head to begin with.

Basically at this point I am a Living Metaphor for the Industrial Economy, falling apart one piece at a time, held together with duct tape and bailing wire.

That’s all the Doom, this time until next time, here on the Doomstead Diner.

RE

I didn’t see a doctor about the problem until just recently, since I was without insurance and just to get it diagnosed was going to cost a small fortune, much less any of the possible techno-fixes depending on exactly what the cause of the problem is.  Well, not completely accurate, I have a friend who is an ER doctor, and I talked with him about it, and we looked at some crappy X-Rays of my neck the Chiropractor took which didn’t really show much.

I considered also going to an Accupuncturist after the Chiropractic did nothing, but finally passed on going down that route also.  Visits there weren’t too cheap either, though a good deal cheaper than a visit to the Internist to get started on this thing.  I finally got some new Med insurance though, so a few weeks ago it was off to the Internist for the first appointment in the Big Med Industry.

From my chats with the ER Doctor, I was aware of a few of the possibilities here.  Possible trauma to the Spinal Cord, possible blockage at the Brachioplexus from a tumor, possible forms of peripheral neuropathy.

For my initial visit with the Internist, $500 not including the Blood Tests, which I am not sure how much they charged for those yet.  He did a few squeeze tests and the old fashioned ping your elbows and knees with a rubber mallet trick, and found enough wrong that he recommended I see the Spinal diagnostician in Anchorage.

I saw her the first time 2 weeks ago, and she did a few more tests, but without an MRI and Chest Xray and a more comprehensive set of nerve tests, making any kind of diagnosis wasn’t possible.  $1000 for this visit.  So I was scheduled for my BIG DAY today of the full 9 yards of Techno Medicine, XRAY, MRI in the morning then the nerve tests in the afternoon.

The XRAY was EZ and fast, then off to the MRI Tube.  You don’t want to be claustrophobic in these things, and I wondered while in there how some of the Large Size people we have in Amerika can even FIT into one of them.  I asked this question after finally getting out, and the answer is they have special Jumbo MRI units for the Big People.  LOL.

A few rules while getting your Neck Scanned, don’t swallow your spit or move your tongue while the RACKET is going on, it can blur the image.  You have your ears plugged up and pads over the ears, but it’s so loud when the machine is running that the sound travels right through your bones and into your ears that way.  Also, don’t need a bathroom trip, which I started getting concerned about around the 20 minute mark inside the Electronic Coffin.  Fortunately, I made it through the full 30 minutes without pissing the demeaning Hospital Gowns they make you wear for these things.  I avoided any claustrophobia feelings by keeping my eyes closed the whole time and pretending I was taking a nap.

Cost for this adventure, around $3000 for both, then I had a couple of hours for Lunch and upstairs in Tower A of Providence Hospital for the Nerve Tests.

After once again undressing and donning another Hospital Gown, the nerve Test Specialista came in, and we had a Discussion first about what was now possible in the panoply of things that could be wrong with my nervous system.

First, a RELIEF, the Chest XRAY showed my Lungs were clear, we could rule OUT the Big C of Lung Cancer. 🙂

Then came the BAD NEWZ.  What could not be ruled out based on the symptoms and initial tests was ALS, Amyotrophic Lateral Sclerosis, aka,  Lou Gehrig’s Disease.  She was going to have to run through full conductivity and needle testing to see if this was the cause or not.

At this point of course, my Heart is Pounding, my Brain is Racing.  I KNOW the progress of ALS, it remains an incurable disease and if it is what I got, then I got MAYBE a year or two left before my motor neurons progressively deteriorate and eventually I choke to death on my own spit, after a few months where I can’t feed myself.  I mention to the doctor that if I got ALS, I would rather die fast here.

So now it is time to do the nerve testing, and folks, this is positively Medieval stuff, I imagine they do versions of it with higher amperages at Gitmo, but even at the low end here of the Shocks, every one makes you JUMP and grit your teeth if you don’t wanna be a baby and scream.  The Needle stuff is even worse than the electrode stuff.  I am not sure which was worse, this or the day I had my Teeth pulled by the Dentista, it’s a Pain Tossup there.

https://www.bvu.edu/resize_image?path=/dotAsset/201210.jpg&w=628I was reminded of my Science Cabin biology experiments on Frogs that I caught at Summer Camp.  In those days, nobody was worried about being Cruel to Frogs, so all you did before disecting them was “pith” the brain of the frog so it wouldn’t jump around on you when you dissected it, but the nerves still worked, you could make legs move with a little jump start from a 9V battery, etc.  In this case, I was the Frog.

It took about an hour of this shit for Dr. Frankenstein to work her way all the way from my toes to my hip on my right leg, then from my fingers to my shoulder on my right arm, then finishing me off with tests of the neck muscles.  I am a limp rag at this point but move my decrepti ass off the table and back to the consulting chair for the DISCUSSION.

GOOD NEWZ!

It’s probably NOT Lou Gehrig’s Disease, if it is it is very early stage and with new medicines coming down the pipe, I might have a few years left before I choke on my own spit. 🙂

Now the BAD NEWZ!

The main problem appears to be in the Spinal Column between the C4-C5 vertebrae, this apparent from the MRI.  I apparently have an extremely narrow channel for the nerves going down through my neck, this is probably congenital and then exacerbated by Age as bone spurs develop on the vertebrae and can put pressure on the spinal cord.  Normal Channel width around 10mm, Spinal Specialists begin to be concerned around 7-8 mm, mine is 5mm.  Accckk!

Then there is the DAMAGE.  There is trauma and scarring of the tissue where I whacked my neck in a fall I took just prior to all this shit going down.  It’s very precarious, and the Doc WARNED me I need to wear I cramps on my shoes for Ice and Snow, make sure there is nothing to trip over, don’t whiplash your neck in any way because…at the point where this is affected, if it gets any more pressure I will be a QUADRAPLEGIC!

This is a GOOD result for a QP trying to rehab. I’ll spare you the depressing videos of QP being fed by helpers and getting his bed pan cleaned of excrement and being turned over so he doesn’t get Bed Sores.

Is there HOPIUM here for RE?  Of course there is, modern medicine is AMAZING!

My next stop is with the Spinal Surgeon, where any chance for fixing this up lies in having at least two of my neck vertebrae fused, along with trying to grind off some of the bone spurs and damaged spots to open the channel a bit for the nerves to operate the way they are supposed to.  Said operation of course has its own set of risks, they probably have to go in from both the front and back of the neck to try to fix it, and the recovery period is LONG.

I’m not sure I even WANT to go through this shit.  I haven’t figured out yet what I am going to do.

On the upside, it is very liberating in a way, I no longer have to concern myself with Prepping anymore, I am a fucking goner no matter what here, even if modern medicine can keep me ticking a while, in a SHTF scenario I am DEAD in short order.

If I just stay careful here, maybe I can last a while longer with just a malfunctioning right arm, write a few more blogs and record a few more rants before I turn into a vegetable.  All I ask here is that when the messages from my Brain shut down to my Fingers to further keyboard out the Doom here on the Diner, you Diners send in Dr. Kevorkian if I cannot off myself at that time.

To conclude, I DO consider myself the Luckiest Doomer on the Face of the Earth.  I had a great run through the Age of Oil, living by my own set of rules and making only the compromises necessary to make to get along.  I had enough time and woke up to the nonsense going down early enough that I was able to write down just about everything I could think of to examine the history and how we got here, and how we might work out of this very ugly situation.  Also, much like Lou Gehrig, I am glad to have been associated with the people who have helped me in creating and building the Diner.  A great bunch of Doomers.  Love you guys.

RE

Duct Tape Politics

Off the keyboard of James Howard Kunstler

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Originally Published on Clusterfuck Nation  November 4, 2013

 Duct-tape_Moving_Van

 

 

 Duct Tape Politics

The ObamaCare website rollout fiasco, joined by the bait-and-switch “You can keep your current insurance (not)” tempest, obscure the fundamental quandary about so-called health-care in America: that it is a gigantic racket structured to allow countless layers of grift and counter-grift. The end product of all that artifice is that medical care costs twice as much in America as any other civilized country, and that it has to be operated by a cruel and despotic matrix of poorly coordinated bureaucracies that commonly leave people more disabled financially than the diseases that brought them into the system.

     ObamaCare was designed to work like a giant roll of duct tape that would allow the current cast of characters in charge (Democratic Progressives) to pretend that the system could keep going a few years longer. But it looks like it has already blown out the patch on the manifold and is getting ready to throw a rod — which duct tape will not avail to fix.

    I had three major surgeries (hip, open heart, spine) the past year and paid attention to the statements that rolled in from my then-insurer, Blue Shield (the policy was cancelled in October). These documents were always advertised as “this is not a bill” and that was technically true, but it deflected attention from what it really was, a record of negotiated scams between the “providers” (doctors and hospitals) and the insurance company.

      There was never any discussion (or offer of discussion) of the cost of care before a procedure. When asked, doctors commonly pretend not to know what their work costs. Why is that? It’s not to spare the patient’s feelings. It’s because sick people are hostages and both the doctors and the hospital management know they will agree to anything that will get them through the crisis of illness. This sets up a situation that allows the “providers” to blindside the patient with charges after the fact.

     My hip “revision” operation was necessary because my original implant was a defective (“innovative” circa 2003) metal-on-metal joint that released metal fragments into my system and it had to be removed. The stated charge for replacement part — a simple two piece bearing made of metal and plastic, about the size of tangerine — was $14,000. Blue Shield “negotiated” the price down to about $7,000. If you go to the websites of any of the manufacturers of these things, you will not see any suggested retail or wholesale price. The markup on these things must be out of this world. Cars come with four ball joints that carry roughly the same time warrantee, and they come with a staggering array of “extras”— engines, transmissions, air-conditioning, seats, air-bags, and radios. The pattern was similar for the other surgeries and what they entailed. I ended up paying five-figures out-of-pocket. Lucky for me that I saved some money before this all happened. I don’t have kids so I haven’t been paying extortionate college tuitions during my peak income years.

     All the surgeries I had required hospital stays. For the hip op, I was in for a day and a half in a non-special bed (no fancy hookups). The charge was $23,000 per day. For what? They took my blood pressure nine times. I got about six bad meals. The line charge on the Blue Shield statement said “room and board.” It would be a joke if this extortion wasn’t multiplied millions of times a day across the nation. Citizen-hostages obviously don’t know where to begin to unravel this skein of dreadful rackets. If you think it’s possible to have a productive conversation with an insurance company rep at the other end of the phone line, then you’re going to be disappointed. You might as well be talking to a third-sub-deputy under-commissar in the Soviet motor vehicle bureau.

     This ghastly matrix of corruption really only has two ways to go. It can completely implode in a fairly short time frame (say, five years, tops), or we can, by some miracle of political will, get our priorities straight and sweep away all the layers of racketeering with a single-payer system. The evidence in other civilized countries is not so encouraging. England’s National Health Service has degenerated into a two layer system of half-assed soviet-style medicine for the proles and concierge service for the rich. France’s system works more democratically, but the nation is going bankrupt and eventually their health care network will fall apart. The Scandinavian countries have relatively tiny populations. I don’t know, frankly, how the Germans are doing.

     Here in the USA, you can make arguments for putting a greater share of public money into a single-payer system. For instance, if we redirected the money spent on our stupid military adventures and closed some of the countless redundant bases we run overseas. That would be a biggie. Given the current choke-hold of the military-industrial complex on our politicians, I wouldn’t expect much traction there.

     You can argue that nobody complains about government spending on the highway system, so why should “the people” complain about organizing a medical system that really works? Obviously, there’s no consensus to make that happen. Too many doctors want to drive BMWs. Too many insurance executives and hospital administrators want to make multi-million dollar salaries. Too many lobbyist parasites and lawyers are feeding off that revenue stream. Too many politicians with gold-plated health insurance coverage don’t want to change the current distribution of goodies. End-of-story, as the late Tony Soprano used to say.

       It’s the old quandary of fire or ice… which way do you want to go? Since I’m interested in reality-based outcomes, my bet would be on implosion. In any case, several of the other systems that currently support the activities of our society are scheduled for near-term implosion, too. That would be the banking-finance system, the energy supply system, and the industrial agriculture system. As those things wind down or crash, you can be sure that everything connected with them will be affected, so the chance that we could mount a real national health care system is, in my opinion, zero.

      The ObamaCare duct-taped system will go down. The big hospitals, HMOs, insurers, pharma companies will all starve and shrivel. Like all things in the emergent new paradigm, they will reorganize on a small and much simpler basis. Everyone will make less money and high-tech medicine will probably dwindle for all but a very few… and for them, only for a while. Eventually, we’ll re-set to local clinic style medicine with far fewer resources, specialties, and miracle cures. There will be a whole lot less aggravation, though, and people may die more peacefully.

     Finally, there’s the pathetic American lumpen-public of our day itself, steadily committing suicide en masse by corn byproducts, the three-hundred pounders lumbering down the Wal-Mart aisles in search of the latest designer nacho. What can you do about such a people, except let fate take them where it will?

 

***

James Howard Kunstler is the author of many books including (non-fiction) The Geography of Nowhere, The City in Mind: Notes on the Urban Condition, Home from Nowhere, The Long Emergency, and Too Much Magic: Wishful Thinking, Technology and the Fate of the Nation. His novels include World Made By Hand, The Witch of Hebron, Maggie Darling — A Modern Romance, The Halloween Ball, an Embarrassment of Riches, and many others. He has published three novellas with Water Street Press: Manhattan Gothic, A Christmas Orphan, and The Flight of Mehetabel.

Healthcare Hiccups

Off the keyboard of RE

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Published on the Doomstead Diner on November 3, 2013

Discuss this article at the Economics Table inside the Diner

Inside the Diner this week I FINALLY got a bug up my butt to write about the CLUSTERFUCK that is the Affordable Health Care Act, AKA Obamacare.

I have basically ignored this piece of legislative insanity here on the Diner, it is fundamentally a Derivative Problem of a Failing Monetary System, and bogging down blogging on it when I am quite sure it will collapse along with the monetary system supporting it seemed unnecessary to me for a long time here.  However, the Integral Part it played in the Kabuki Theatre that played out in the most recent Debt Ceiling stand-off motivated me to take a look at the various problems and failings in the methodology chosen to try and get Every Amerikan access to “Affordable” Health Care.

I will start this examination with a paste from inside the Diner of my Original Post Obamacare Online Fiasco, followed by a few Pithy Comments from some of the Diners.

From RE:

I’m going to have to write a Blog Article about the complete INSANITY of the so-called “Health Care Marketplace” that was supposed to be integrated by Healthcare.gov for getting everybody Insured for Medical Issues, but for tonight for the Diner Regulars I want to drop on a few initial thoughts on this Clusterfuck.

First, the IDEA of getting everybody “covered” in some sense for Health issues is obviously important.  All Men are NOT created Equal if one guy can get a New Heart when his ticker stops working right and another cannot.  If your access to the best Medical Care is dependent on your economic status in the society, obviously being POOR makes you Less Equal.

At the same time, providing exceedingly EXPENSIVE medical care to EVERYBODY is on its face impossible.  Given the typical income of most people, the exceedingly EXPENSIVE Drugs and Proceedures modern medicine is CAPABLE of cannot be offered to EVERYONE.  Insurance does not solve that problem.  All insurance does is distribute out risk, but if everyone is at risk and eventually everyone comes down with some disease that takes expensive care to maintain life.  This comes as a result of aging no matter WHAT.  Does not matter how well you take care of yourself, EVENTUALLY you will need the same medical care that somebody who does NOT take care of themself does.

Look at the Smoking Issue.  If you are a Smoker, they tack on a huge premium because you are more at risk for Heart Disease, Emphysema etc earlier in your life.  But if you live long enough, you’ll STILL come down with the same diseases!  Long as you will provide the same level of Medical Care for 80 year olds as 50 year olds, it does not MATTER if you smoked or not, eventually you will need the same level of medical intervention.  EVERYBODY gets sick and dies eventually.  EVERYBODY.

No distinction is made on Age as far as any of this stuff is concerned, and this is the fundamental problem.  If you made a distinction on Age, you could say at age 50 say you would give a Life Saving Operation to a non-Smoker as opposed to a Smoker, since the NS took better care of himself.  If you make no such distinction, the non-smoker will get the same diseases just a few years later in life and the same expenses incurred in keeping him ticking.  He poays premiums a few years longer, but the premiums do not cover the costs on an actuarial level.  If they did, you could just save money to cover your eventual health issue that WILL come down the pipe eventually.

The next issue is the insane COMPLEXITY involved in this exercise, they based it all on the ability to create a Google-like massive database that could handle MILLIONS of people seeking Health Care options.  Insane really, even Google evolved over the last decade or two to become the behemoth it is, it did not develop overnight.  They have many vendors all contributing glitchy software to this thing, and it is a fucking MESS.  Very few people that the system targets could negotiate it even if it worked properly!  Not only do you need a functioning laptop with good Java Script capability, you yourself have to be literate enough to negotiate the mess.  Most people who have a laptop just use it to surf Amazon for buying crap or surf for Porn, they do NOT engage interactively with even basic software.  The difficulties many people have just negotiating the SMF we run the Diner on is an example of this, and SMF is WELL DESIGNED software!

In reality, Health Care has to be SIMPLIFIED, not COMPLEXIFIED, and the services you can get need to be limited to what the society as a whole can afford.  REQUIRING everyone to buy insurance is plain NUTS!  How is any price “affordable” if you are already maxed out paying rent, buying groceries and transportation costs to get to the workplace, assuming you still HAVE a job?  Forget the car, in NYC these days the Public Transport of the Subway is up to $2.50!!!!  I was not alive when it was a Nickel, but in my youngest years is was 15 cents, and last price I paid still doing Subway commutes was around 35 cents.  Today, to get to and from work on the Subway would cost you minimum $5.  I shudder to think what the cost is these days on the LIRR.

So what is gonna HAPPEN here with “Affordable Health Care”?

First off, the objectives of getting Millions of Uninsured people on the Insurance Roles by Jan 2014 is NOT gonna happen. The computer system is too fucked up to begin with, and even if it wasn’t most of the people this is directed at can’t afford “Affordable” Health Care at ANY PRICE.  If I currently cannot meet my bills, I sure am not going to sign up for an additional Monthly Bill even IF threatened with fines or Jail, and Jailing people for not paying their required premium is just a joke.  Talk about increasing your Prison Population!  LOL.

In a large society, availability of Health Care SHOULD be a right of the Citizen of such a large society.  It should not be dependent on your personal means as an individual.  However, we cannot AFFORD large societies anymore.  We cannot afford complex Health Care of the Wealth Care system anymore either.  If you get sick and there are not basic remedies that can help you, you DIE.  Take good care of yourself, eat healthy, avoid Radioactive Fallout, maybe you last a decent amount of time here.  Getting your Femoral Arteries rotor rootered out with Lasers and Ultrasound as I did a couple of years ago is not gonna be an option too much longer.

Forget Medical Care of this type.  When you get sick enough, you die, end of story.  If you are young enough and WANT to live long enough to see the whole biz crash big time, eat well, exercise and avoid radioactive fallout zones.  Personally I am past this period of living.  I’m a dead man walking waiting for some real nasty consequence of not taking good care of myself for 57 years, and Obamacare will not Save Me.

A plane trip to a Brazilian or Indian Hospital might though, for a year or two more.  :icon_sunny:

RE

From Surly:

Quote

In reality, Health Care has to be SIMPLIFIED, not COMPLEXIFIED, and the services you can get need to be limited to what the society as a whole can afford.  REQUIRING everyone to buy insurance is plain NUTS!  How is any price “affordable” if you are already maxed out paying rent, buying groceries and transportation costs to get to the workplace, assuming you still HAVE a job?

Single Payer, or “Medicare for everyone” would address much of that, but single-payer was off the table from the beginning of hearings. Advocates of single payer were forcibly ejected and otherwise prevented from making the case, let it become part of the public record.

Plenty of evidence and links here.

Recall that this was at a time when Dems controlled both houses of Congress. Thus, feel free to lay the blame at the feet of the people responsible: the Democrats. Perhaps the realized that the insurers were so strong that they would crush any proposal which threatened their sugar-tit. Or perhaps they were afraid of waking up with a horse’s head in their beds. Or, maybe they just liked it that way. Check out the video; and may Max Baucus roast in hell.

“We need more police…”  “Hahahaha…”

Funny stuff. Not.

 From Uncle Bob:

Taking an across the board general approach, theres a shrinking tax base and healthcare is paid for by deficit spending. But heres where there is a lot of waste:
1 procedures on palliative patients. Ambulances and beds tied up too much, as well as just not allowing people to die with dignity. Its all about money, they buy lotsa drugs.
2 Drug addicts. Again, ambulances and beds especially in psych wards. Also most likely to abuse staff.
3 Extremely overweight. Problems of their own making end up taking too much of the pie.
4 Disability. While I agree things such as wheelchairs and other technology and care options improve quality of life most times, there are also massive costs for profoundly disabled patients such as Cerebral Palsy and achieve nothing really. A “coordinated care” monthly meeting will have numerous service providers and professionals present all getting paid to achieve not much. I Sat through so many for no real reason when an email to several recipients should have sufficed.

Tighten up those areas and increase funding to Paediatrics and Mental Health. Many psychiatrists and psychologists are effectively prostituting their professionalism because they are paid by the insurance co’s and dance to their tune. When you are paid by medicare you are more independent and more likely to report  objectively. Its fine for medicare to fund 2/3 of consultation for a limited number of appointments for those without insurance (an ever increasing number now), but many people cannot afford the 40 or 50$ out of their  pocket to make up the Scheduled Fee, and they should not have scheduled fees, they should have a scale based to some extent on what patients can afford.

From Eddie:

To make universal care work, several things need to happen.

One is that people have to “age out” at some age. Perhaps 75 would be about right. This would eliminate much of the huge amount of waste we spend on dying elderly people in their last year of life. Is that the same as a “Death Panel’? No, because it would take the judgment out of the process. People would just have to accept that there are LIMITS on what we can pay.

Secondly, we would need to limit the care we give to barely viable premature children, who run up huge bills before their 1st birthday, and then burden the system for the rest of their lives. This is harsh, but right now what we do is completely crazy and based on emotional decision-making.

Thirdly,we would need to go to single payer, and then relentlessly prosecute doctors ( and hospitals) who try to game the system.
Or make the practice of medicine a government salaried job, so that no motivation would exist to steal from the system.

No huge online marketplace needed. Cost reduced by maybe 75% from where we are now.

Boom, I just fixed the system for ya.

Unfortunately, none of that will ever happen.

From RE:

Indeed, the first thing to cut off is the End of Life Extend-a-Care where many if not most of the huge bills get racked up.  This of course does not play well with the aging demographic of the society.  Then the insane neo-natal care for barely viable infants needs to be axed, but this does not play well with Right-to-Lifers and people who generally like Babies and think they all should be taken care of, no matter how badly malformed they are.

You have the problem of Inequality if Rich people can just BUY the services others cannot afford, so essentially you have to make it illegal to purchase health care outside the system.  The equivalent idea to this is to just make Health Care a Goobermint service, paying the Docs and Nurses through Taxation.  This of course is way too “Socialist” and besides Libertarians would have a COW.  It also would basically collapse the Pharmaceutical company scam kicking back Money to docs to prescribe their medications.

So, none of the above possible fixes will happen, and basically when the monetary Ponzi of perpetual debt issuance collapses, the whole Medical Industry goes with it.  You may still be able to see a Doctor if you have a Chicken to trade for his House Call, but he won’t have any medicine unless he is out there picking Medicinal Plants himself.  He won’t have a CT Scanner or even an X-ray machine.

How FAST will it drop down to this level?  That remains to be seen, but it will get there in the bye & bye for sure.

From Uncle Bob:

About 15 yrs ago I was in the dept of Family & Children’s Services and responsible for supervising Social Workers. From a remote aboriginal community of Full blooded aboriginals an alcoholic woman had birthed a profoundly disabled child, Lee-Shaun Wurramurra and had made a decision to let him die. The do-good SW’s saved him and he lived in constant agony his fingers and toes curled and knotted  eyes rolled somewhere in their sockets, and limbs  twisted as well with tension, in nappies  for life, groaning and dribbling and needing to be rolled over etc.

The FCS and hospital SW’s entered him for the  Chief Minister’s (like a governor) Bravery Award, which he was awarded. While the SW’s were tut tutting about how horrible his natural family had treated him to leave him dying.

The point I make here is that aside from the huge cost in $, it is highly debatable whether the western ideal is in fact more humane IMO.

And RE youre wrong thinking having the govt fund medication shuts down the pharmacos bribery scam. It still goes on unabated. PBS = Pharmacuetical Benefits Scheme eg RU486 1700$ abortion pill available for 1$ No insurance required, taxpayer funded.

 From RE:

The point I make here is that aside from the huge cost in $, it is highly debatable whether the western ideal is in fact more humane IMO.
Highly debatable for sure, but the Christian concept here is that ALL life is “Sacred”, and whatever it takes you are supposed to try to keep any person born living out of the vaginal canal ALIVE as long as you can, no matter WHAT.

The example of Stephen Hawking is often used here as an example of a Genius with extreme physical disability who would not live without extreme intervention of high tech medicine.  Value of his contributions to understanding Physics notwithstanding, how many such people can a society keep living?

If I lose my legs to the PAD, should *I* be kept living on SSDI?  I don’t think so.  Time to take my trip to the Great Beyond.

Quote

And RE youre wrong thinking having the govt fund medication shuts down the pharmacos bribery scam. It still goes on unabated. PBS = Pharmacuetical Benefits Scheme eg RU486 1700$ abortion pill available for 1$ No insurance required, taxpayer funded.
Well, in theory you squash this kind of kickback also.

From Lucid Dreams:

Forget Medical Care of this type.  When you get sick enough, you die, end of story.  If you are young enough and WANT to live long enough to see the whole biz crash big time, eat well, exercise and avoid radioactive fallout zones.
RE
Well I eat well (all whole foods cooked at home with the occasional trip to a Mexican joint), and I exercise well, but avoiding radioactive fallout zones is going to be difficult.  Only way to do that would be to have a bug out machine big enough for my family with very expensive radiation detection equipment.  The cheap shit doesn’t pick up the real small radioactive particulates…at least that’s my understanding.  At any rate that would require money, which I don’t have.

Far as the Obamacare bull shit, my wife and two kids have medaid, I am uninsured due to making too much money (although I’m not even employed so figure that shit out…they said it was because we “own” a home…so if you have a mortgage that you can’t pay, and you move in with family and rent your house, you make too much money for medicaid).  My wife, on the other hand, does make some money and qualified (I think it’s cause she was pregnant at the time and she’s in a glitch of state gov incompetence right now).

My plan with this Obama care shit is to do nothing.  Fuckem.  Maybe they’ll show up and try to cart my ass off to prison…good luck with that.  They’d have to catch me with my pants down, cause I’d grab a bugout bag and disappear into the woods.  They ain’t takin’ me away from my family on account of fascism.  At that point they would be taking me to prison for not having a job is essentially what it would boil down to.  At that point I get violent if need be because the revolution will have been long past due.  You can’t take people to prison for doing nothing wrong (well you can, but not in an open and democratic society).  What we have is a clusterfuck society with a clusterfuck government whom is incapable of dealing with reality.

My healthcare plan is the plants I grow, and am going to be growing, in my yard.

When I need healthcare…guess I’ll just be fucked won’t I :-\

So, here you see a nice cross-section of Opinion on the various problems faced in trying to get EVERYONE access to Health Care at an affordable price, which is basically impossible since the absolute COST of Health Care has gone out of reach for everyone except the Uber-Rich.  Insurance does not reduce the absolute cost, it merely distributes out the risk across all the people in the Insurance Pool.  Since everybody is going to get sick and die at some point, if everyone has access to expensive proceedures to keep them ticking, EVERYONE will rack up a huge bill at SOME point in their life.

Obamacare doesn’t make any of the proceedures undertaken these days to keep people alive any cheaper.  It just mandates that everyone drop into the Insurance Pool, and if you are too poor to afford the Insurance, Da Goobermint will Subsidize your Premium.  Then it purports to make this whole signup proceedure possible for ALL AMERIKANS by loading up a BEHEMOTH WEBSITE called a “Healthcare Marketplace”.  Has a nice “Free Market”, “Capitalist” ring to it, no?  This of course is pandering to the FEAR OF SOCIALISM!  God Forbid we Socialize Medicine like the Hosers in Canada or the Brits in Jolly Old England!  EVERYBODY KNOWS those systems don’t work!    Long waits for treatment, substandard care yadda yadda are all always brought in here as failings of Socialized Medicine, and some of those Critiques are Valid also!

Let us get back to some REALITY here, how the Health Care Conundrum affects REAL PEOPLE, like you, me and my Sidekick on the Collapse Cafe Monsta666, who just got released from Hospital over in the UK after suffering a Heart Attack in his 20s!

If it was not obvious to you that the Single Payer, Socialized System that the UK is running does a better job of distributing Health Care to Young Brits than the nonsensical insurance Scheme of Obamacare does before this, I hope you can see it now.

Is it PERFECT?  Hardly, but it is not the CLUSTERFUCK Obamacare is, basically pandering to the Insurance and Pharmaceutical Companies. Besides that and thousands of pages of legal mumbo-jumbo in the act is a sorry-ass online system for sign up about nobody can negotiate, which apparently now is supposed to be FIXED by the very same Obama-sam Cronies that set it up in the first place!

Until we get complete crash here, your best bet for Health Care at an Affordable Price?  A Plane Ticket to India and Cash on Hand.  For lesser illnesses which Drugs might ameliorate, cross the border into Mejico and buy them on the cheap.  Otherwise, eat well, stay away from GMO foods and take some Vitamins if you wanna try to live a bit longer than average.  If you are already past average, make your peace with your Maker and prepare for the trip to the Great Beyond if you get really sick.

RE

Counterpoint: Obamacare and Free Market Solutions

Off the keyboard of Eddie

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Published inside the Doomstead Diner on October 7, 2013

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The Affordable Healthcare Act really doesn’t represent a government takeover of healthcare, nor does it represent what the John Lounsbury claims in Obamacare and Free Market Solutions, that it is ” a step toward eliminating major sources of waste in health care.”

What it represents is possibly the nail  in the coffin of healthcare as we know it, at least as far as healthcare delivered at the level of service we have been led to believe we deserve. It really represents an almost  complete corporate takeover of healthcare by the insurance industry.

They (insurance corporations) now have the best of both worlds. The government has mandated that ALL citizens will pay them a premium (albeit a subsidized one for the poor), and the government has handed them the reins with regards to determining HOW to allocate the money.

The expected result is that (a) the insurance companies will make out like bandits and (b) the actual providers of care (doctors) will get screwed, and (c) the patient will be taught to accept a lower level of care.

It’s a David vs. Goliath fight, and it’s already all over but the crying. Goliaths always win in the real world.

http://americanvision.org/wp-content/uploads/2012/11/Obamacare-cartoon.jpgThe truth is that single payer would be a far more efficient system than the one we are about to receive. So-called “managed care” is really a shell game perpetuated by insurance companies, one in which the rules for getting paid are constantly changing, fees are constantly being downgraded in an arbitrary manner, and under which systems that work are abandoned and replaced by ones that funnel more money to the middle man.

Don’t get me wrong. I greatly favor a healthcare system in which the patient is the “economic arbiter of his own healthcare”. I just think the author is naive about the chances of that happening.

In my opinion, if patients were paying for their own care, they would demand a lot less of it than what they are getting now. Nobody would sit quietly and let the doctors do a coronary bypass on their aging parent if they had to pay a hundred thousand dollar deposit up front instead of Medicare being billed.

It’s true that significant waste exists in a system that charges 100K for a bypass, but the fact is that “managed care” is the way it works already for most people. Medicare and Medicaid are already administered under this type of system, although
the real payer is the government, paying for it with money BORROWED from  future generations. Under this type of “management” doctors have already seen their payments drop, private insurance premiums are exorbitant and getting worse, and the insurance companies….are making RECORD PROFITS.

The real coup of Affordable Care is the expected extraction of a premium from young healthy individuals who don’t need much healthcare. This will (supposedly) help cover the old folks. The system already represents an unaffordable burden for the taxpayer, and is projected to increase in cost  logarithmically over the next several years. Forcing young people in this country to pay insurance premiums really amounts to increased taxation, and on the demographic group that can least afford it, and who are already on the hook to pay far more than their fair share in the years to come.

Deficit spending is paying for Medicare/Medicaid now, and those deficits will increase substantially under Affordable Care. The premiums collected from those not now in the system won’t cover the shortfall.

Whatever care gets delivered, somebody has to pay for it. Although inefficiencies do exist, putting the insurance corporations in charge of healthcare does only one thing. It creates a very big, expensive middle layer of management, that does little to contribute to patient care, but skims much of the premium dollar.

Insurance companies have a tried and true way of making money. They take the premium, give the patient the lowest level of service he will accept, and then  try to screw the doctor completely out of getting paid. The insurance companies already own the hospitals. They would like to own the doctors too. They are pretty close, because they set the fees. And they are the final arbiters on whether or not to pay. Sweet deal, for them.

Any doctor who has been around the block would greatly prefer a single payer system. We had that with Medicare/Medicaid for a long time, and it more or less worked. At least claims usually got paid, albeit at a reduced fee compared to private pay. Now it’s a total crap shoot. Doctors are forced to deal with as many as 50 or more corporate entities when they bill for services. Each company has it’s own arbitrary rules designed to delay and obfuscate payment, and some are known to NEVER pay a clean claim without a fight. Yeah, that creates efficiency…NOT!

elephant-in-the-roomThe elephant in the room really is Peak Oil. The real problem is that we no longer have the abundance that cheap oil provided, and no system of healthcare can possibly be conjured that will be sustainable…without greatly limiting certain services that are now deemed sacrosanct.

Eventually all this top-down “efficiency” will pass away. Healthcare will be 100% local and will vary according to local abundance and the ability of people to actually pay for the service. I don’t know how long that will take, but it will happen.

In the meantime, don’t look for the new system to reduce your taxes, raise your level of care, or empower you to change anything.

Prepare to be assimilated.

http://mbtimetraveler.files.wordpress.com/2013/03/borg1.gif

Obamacare and Free Market Solutions

Off the keyboard of John Lounsbury

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Published on Global Economic Intersection on September 23, 2013

obamacare-toon

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Note from RE:

With this article, the Diner welcomes John Lounsbury from Global Economic Intersection to the list of Cross Posting Bloggers featured on the Diner Blog.  John is an old friend from days back on the Raging Debate website, where I also first got together with Jim Quinn of The Burning Platform.  Steve Hansen who works together with John on GEI also is a veteran of the Raging Debate, which ended up spawning quite a few Collapse Bloggers of varying types in the end.

John’s blog Global Economic Intersection is quite comprehensive, covering economic topics from many perspectives and publishing numerous articles of interest every day for Kollapsniks to wade through.  A highly recommended read for all Diners.

A funny thing happened on the way to the forum hospital:  Socialized medicine was passed into law and free market implementation broke out.  Liberals have proclaimed the 2010 Patient Protection and Affordable Care Act to be the first step in establishing truly universal care for all Americans – in their view it is a step down the road to single payer “socialized medicine“.  And this is exactly why many conservatives criticize it as a “government take-over of health care“.

rights-gone-flash-380px

Follow up:

This observer now sees Obamacare as a government enabled and subsidized free market health care insurance system. What is happening is a progression toward an ideal that this observer argued for in 2009 here and here. The consumer (the patient) is becoming the economic arbiter of his own health care insurance implementation. This is a step toward eliminating major sources of waste in health care. As I said in 2009:

If the patient is negotiating for service with his own money, we will have the most effective and affordable control of fraud and unnecessary treatment possible.

Corporate Sugar Daddies

Since the middle of the last century the traditional source of health care has been employer provided insurance. Employees have generally liked that arrangement – they had a major economic factor (their health care costs) magically paid for by their corporate sugar daddy. Someone who was paid $50,000 a year in salary never considered the cost in dollar terms of his comprehensive coverage as part of his compensation, even though it might have been as much as 20-40% of taxable salary. Few recognized that the $50,000 salary they received was actually part of their larger compensation – they were also receiving the equivalent of another $10,000 to $20,000 a year in tax free medical benefits.

This employee was receiving his compensation in two forms:  $50,000 in taxable cash and $10,000 to $20,000 in untaxed services.  The employee probably paid a great deal of attention to how he spent the cash; he paid very little attention to how effectively he “spent” the services portion because he wasn’t viewing that as part of his income.  He rather viewed it as a “benefit” that flowed like nectar from the gods.

Even as employee contributions to health care have been implemented over the past two decades the perception of company paid health care benefits as part of total compensation in a dollar context has not been on the minds of most employees. That is all changing very rapidly because of Obamacare.

How Much Will Government Costs for Health Care Increase?

The CBO (Congressional Budget Office) seems to know the answer: The government will pay a lot more, rising to 8% of GDP by 2038 (up from 4.6% in 2012).

However, how health care costs will accrue to the government in the future is subject to much uncertainty and the CBO’s current projections could be either too high or too low. From a recent GEI News article:

One study finds that small increases in employer provided plans could shift millions of people into the public insurance exchanges and shift the supplemental support for premium payments from companies to government.

Another study finds that costs of Obamacare accruing to the government could result in enormous pricing power for the consumer and hence reduce the cost of government subsidies. The study also concludes that the cost savings could be impacted by continued political resistance. Those politically active in “fighting” Obamacare may achieve the opposite of their stated objective; they may reduce the cost savings that could otherwise be achieved and thereby increase government expenditures, according to researchers from the Brookings Institute and Georgetown University.

The shift of health care costs from corporations to employees and government is picking up speed. GEI News recently reported the movement of corporations away from group health plans for retirees:

Corporate benefits for retiree health care have been shrinking for years but the latest changes appear to be accelerating the process. Late last month GEI News covered the shifting pattern of employers moving from sponsored group plans to use of private insurance exchanges where employees shop for individually tailored coverage with corporate support of part of premium costs through donations to HCAs (Health Care Accounts). The changes are especially common for retirees.

Corporate giants who are making this change include General Electric (NYSE:GE), IBM (NYSE:IBM), DuPont (NYSE:DD), Caterpillar (NYSE:CAT) and Time Warner (NYSE:TWC) which made the announcement today (09 September 2013). GEI News covered details of the IBM change in the article last month.

The answer as to how much government costs for health care will increase over the next 5, 10 and 20 years is not one for which a reliable estimate can be made at present. The playing field is changing in a revolutionary way.

Private Insurance Exchanges are NOT Obamacare

What corporate headlines are reflecting is not a shift from corporate group plans to Obamacare. The private insurance exchanges that are rapidly expanding have been operational on a smaller scale for a number of years. They are just now becoming major players as large corporations shift their retiree health plans from corporate sponsored group plans to the new format. And, even though just a month ago survey results indicated a much lower active interest in the insurance exchange format, now the use of exchanges for active employees is suddenly in the news. Just last week Walgreen announced it was shifting its 160,000 employees from a company group plan to individual purchase on a private exchange.

The public exchanges opening for registration of applicants next month under Obamacare are newcomers to the exchange platform concept. As time goes on the efficiencies of the older private exchange system and the public exchanges can be compared and operational costs can be reduced. Eventually there may be just a single set of insurance exchanges with a merger of public and private structures.

Winners and Losers

Any time big changes are made there will be winners and losers. In many cases the same parties may be both winners and losers – it’s called a process of trade-offs. Some of the winners:

  • Corporations will be better able to cap and plan for health care benefit costs.
  • Employees will no longer be captives to a health care benefit shackle tying them to one employer.
  • Insurance companies will gain millions of new premium payers greatly increasing their revenues.

Here are some of the losers – the list looks similar:

  • Corporations will have to compete more vigorously to staff their most demanding positions because talent will be more mobile.
  • Employees will no longer have a “sugar daddy” paying for their health care.
  • All seeking health care coverage will have to put forth effort to get the best individual coverage.
  • Insurance companies will be subjected to more competition for cost effectiveness as tens of millions of customers shop for the most cost effective coverage.

Bottom Line

The “socialized medicine” legislation known as Obamacare may unleash private market forces that will be cheered by today’s opponents and are probably feared by many present-day proponents. The cost curve for health care may be bent and the CBO projections may turn out to be way off the mark. Remember federal surpluses “forever” (2000) and trillion dollar deficits “as far as the eye can see” (2009)?  The CBO has a record of projecting poorly from past records into the future.

Rather than the first step to socialized medicine with everything offered through central planning, we may be seeing the first step toward distributed health care determined by 150 million consumer housholds. Which path has the greater likelihood of resulting in the most efficient delivery of health care and the best chance to “bend the curve”?

Single payer may offer a path to holding down the growth of health care costs.  But couldn’t 150 million payers also curtail that growth?  And which process has the best chance of optimization for each household?

An Aside to Ron Paul

Ron Paul recently reviewed Obamacare and concluded it was merely a waypoint before we got a single payer.  He criticized the Obama administration as “corporatist” and criticized the structure of the health care delivery system.  Mr. Paul suggested that the most efficient system would be for everyday health care to be paid for by patients directly, with insurance used only for coverage of catastrophic events.  This aligns with my arguments more than four years ago.

However, I propose a glass half full view of Obamacare and suggest it could be a step closer to our shared view. Mr. Paul views the glass as half empty and envisions a future moving away from the free market forces I suggest may hold sway.

 

Bayman Beachfront Blues

Off the keyboard of RE

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As most people are aware by now,  most of the damage caused by Sandy came along the shoreline due to an impressive Storm Surge over a very long stretch of coast, one of the most densely populated coastlines on any continent.

Numerous iconographic Beachfronts were hit, the Boardwalk in Atlantic City basically destroyed and I suspect the newly renovated Coney Island Amusement Park did not fare much better.  The beach in the Rockaways where I made Sand Castles as a kid was hit hard, and many homes and biznesses in this aging beachfront community were simply washed out to sea.

Sandy didn’t just hit the poor and the middle class though, she was equally destructive of the multi-million dollar Mansions in the Hamptons where the Masters of the Universe go to play each weekend, sutffing themselves with Canapes and 500 year old bottles of Pinot Noir while they stuff the noses of Ford Models with coke prior to doing Channel Stuffing they practice on the Stock Market during the week.

Although there is no Beach on the Southern Tip of Manhattan Island, it’s not much more above sea level than the typical Beach is and also went under water for several hours, long enough to fill some Subway Stations and Tunnels with seawater, along with the basement Safes of some Securities firms holding $trillions$ in Stock Certificates in them, with some estimates putting the value of this Toilet Paper in the $36T range.

Hindsight is always 20-20 Vision of course, and after the fact here all the talk is about how to Build it Bigger and Better for Next Time, robust enough to fend off the worst that Mother Nature can throw out.

In terms of Large Public Works Projects, some impressive ones are being bandied about.  One is to build a huge underwater Seawall around lower Manhattan and the Port of NY/NJ that would deflect most of the energy of a storm surge.  Said Seawall would have some breaks in it that Tanker Ships could pass through.

This of course is similar to the Dykes built around the Netherlands holding back the Sea there, and overall on the engineering level this is some pretty impressive stuff for sure.  In the Dutch case though, the Dykes were built up over many Centuries of time and the marshy areas which were reclaimed were not very deep.  Although I am sure with modern heavy equipment, lots of Fuel and GOBS of Money the Army Corps of Bozos probably could build something like this it sure would not happen overnight, even if they do Print new Debt Money to do it.  The estimate on cost I read for this brainstorm is around $6B, but I am sure that estimate is made with the assumption Oil stays at $100/barrel for the decade it would take to complete it.

Thing is here, while this might prevent the worst Storm Surge from overrunning Wall Street, the deflected water is going to go somewhere, likely the Jersey shore to the left and the Brooklyn shore to the right.  So they will end up WORSE off after it gets built.

Another somewhat more reasonable Infrastructure Improvement I read about was to put Storm Doors on all the vulnerable Subway entrances and Air Vents and create “plugs” or “corks” to stuff in the ends of tunnels which exit into low lying areas.  Apparently Bangkok has such a system in place which allowed their subway system to keep running even during the regular and heavy flooding events they have been subject to the last few years.

Again though, nobody really explains where all the MONEY is going to come from to make all these improvements or how it would ever be paid off if you issue Debt to do it.  In the case of the Subway improvements, how high do you have to hike the Fare the Straphangers pay to actually pay this stuff off and then maintain it?  The subway system is ALREADY subsidized heavily, by you guessed it BROKE Goobermint.  The reason the system never gets Upgrades is BECAUSE it doesn’t pay for itself already.

Although little Newz is trickling out from the devastated Beachfront communities along the Jersey Shore and Long island, the pictures alone tell you that the rebuild costs are Unimaginable, and Goobernator Chris Christie has already said it will be “a long time” before these communities get their lights back on.  He should have added, “if ever”.

So, SHOULD people actually be LIVING so close to the shore in such vulnerable spots to the destructive Power of Mother Nature?  On the surface Common Sense says no, but there are many reasons why MOST of the population of Homo Sapiens does in fact live close to the shore.

First off, going right back to Ancient Civilizations which first used Boats for fishing and then trade, a large portion of the population has always made its living from the Sea.  So you naturally get towns and cities forming up at locations where boats can port up in relative safety, and in fact the Port of NY/NJ is one of the best protected harbors in the whole world on a geographic level.  That is WHY the Dutch dropped the settlement in New Amsterdam at the bottom of Manhattan Island.

Prior to the Railroads, once you got interior to a land mass to any great degree, any trade goods from other places became quite scarce and expensive.  Evne once you HAVE Railroads though, you need to have substantial numbers of people at the terminal end near the Seaport.  Still, you probably could organize it so only a Skeleton Crew of people are at the shoreline, and most of the people are far enough inland that they won’t get nailed with a Storm Surge.

The problem here is that people LIKE the Ocean.  they like swimming in it, surfing on it, tanning on the beach and Ogling the Girls in their Bikinis also.  Recreation is BIG BIZNESS, and there are Seaside Resorts in just about every Country and Island in the WORLD, and Seaside Communities that grow up around them to service the Tourist trade.  For some places like Hawaii, this Recreational tourist Trade is pretty much the only real economic driver they have, you just don’t earn all that much FOREX growing Pineapples and Macadamia Nuts.

Even for pitiful and aging Seaside Communities like Atlantic City, the Boardwalk and the Beaches are what set it apart from the Indian Reservation Casinos and Las Vegas.  In terms of Tax Revenue, it was a main source for New Jersey and that revenue is not coming back anytime too soon, and not until NJ spends a small fortune to do a rebuild.  Can they ever recoup what the spend in Taxation of a refurbished Atlantic City?  Highly unlikely of course.

Probably the most important econonomic driver for our Industrial Societies centered along the coastlines are all the Refineries and offload points for Tankers carrying the Crude from underneath the Desert Sands of Saudi Arabia and off the shore of Brazil and Venezuela.  The VLCC Super Tankers require specialized deepwater ports like the LOOP to function, and moving heavy unrefined crude through pipelines from them is costly on EROEI.  The closer you can make the Refinery to the offload point for the crude, the more profitable it is.   So you have many FSofA refineries near the shores of Lousiana and Texas, and on the Jersey shore also.  You need workers for those refineries who live nearby them, and again communities sprout up in vulnerable locations.

Trying to move all this infrastructure away from the shorelines is an impossibility as long as you want to maintain this sort of Industrialized culture, and overall most people who live inside such societies want them to continue onward as they have known them.  They want Lights On in their McMansions, they want Running Water in their Toilets.  They want the I-pads, Plasma TVs and SUVs too, but they at LEAST EXPECT that they can live in a heated home with running water.

While it does appear that the NY Shity Subway System has been brought back online for the most part, underplayed in NEWz Reports to date is just how much OTHER infrastructure has not been brought back yet.  As the Major Financial Hub of the Empire, Wall Street is the first one to consider on the Economic Loss level here.  Even though CONedison has brought Power back to Lower Manhattan, MANY Coomercial and Residential Skyscrapers can’t accept that power.  Why?  Because their basements were not hardenned against such a massive Flooding even tlike the Subways are, and most of their Electrics and Heating mechanisms are housed in their BASEMENTS, which in many if not most cases WERE Flooded Floor to Ceiling.  These include buildings like 125 Maiden Land &  55 Water Street, which houses offices for companies like S&P and services like UNICEF and Planned Parenthood:

At 125 Maiden Lane in Lower Manhattan, a 17-story building not far from the East River, a disaster recovery company official involved with work on the building said that it would be months before it could reopen. Like many other buildings in the vicinity, he said, it was flooded and would need new transformers, boilers and other equipment.

Tenants include the United States Fund for UNICEF and the International Planned Parenthood Federation.

 

At 55 Water Street, where Standard & Poor’s has offices, the “restricted use” sign listed “severe flooding in basement, no fire alarm, no power, damaged face brick at loading dock.”

On Sunday night, water gushed from hoses that snaked inside the shuttered towers. Workers scrubbed and mopped lobbies.

Brookfield Office Properties, which operates One New York Plaza near Battery Park, where Morgan Stanley is a tenant, estimated that it would be three to six weeks before the building reopens.

These towers are not all strictly Bizness either, some are residential, often housing Eledrly people:

Many of the residential buildings in Lower Manhattan without heat house significant populations of elderly people, including Smith/Vladeck Houses and Southbridge Towers, a Mitchell-Lama building, according to Julie Menin, former chairwoman of Community Board 1.

A rapid Cleanup for many of these buildings is unlikely, because besides the damage to the electrical and heating systems, they also  have been contaminated with Oil and Gas Seepage from Sunken Carz:

Because cars and other vehicles were submerged, gasoline, oil and other chemicals poisoned the waters that entered the buildings. As a result, the buildings themselves will have to undergo special cleanups before people are allowed in. These cleanups could take weeks.

Precisely where the Management Companies for these buildings is getting the MONEY to do this Cleanup remains unclear.  Also unclear is whether Commercial or Residential Tenants inthese buildings will continue to pay Rent/Mortgages on spaces they can’t Work or Live in.

Larger companies in NY Shity have Multiple Office Spaces distributed through many Towers, so these companies are no doubt shuffling people around to some other spaces they have “doubling up”.  For the smaller companies though, they have to quickly find alternate locations to workout of, or else go Outta Biz.

So beginning with Wall Street on the Economic Level, you have huge hits here in 3 areas, Clean Up cost,  Insurance Liability and Payout and Lost Tax Revenue.  Those spaces don;t come cheap, and there are a lot of them “underwater” here now, around 400 large buildings in this Nabe “Yellow Tagged” by the Department of Buildings as Unsafe.

While Individually  not as costly, the AGGREGATE cost of all the Residential and Comercial Real Estate that went Underwater on Long Island and the Jersey Shore, along with the Brooklyn, Queens and Staten Island Real Estate is likely much GREATER than even the cost of Out-of-Service Wall Street buildings.  An important factor to consider is how many people will continue to Pay Mortgages on housing and commercial structures which either no longer EXIST, or have been declared so Unsafe as to be Uninhabitable now.  Would YOU keep paying your mortgage on a McMansion so damaged you cannot live in it anymore?  Many if not most of these folks will eventually here walk away from these Properties.

Calculating the precise total here of lost revenue, lost taxes and cleanup costs is basically impossible at this point, and true Numbers as they come in will certainly never be reported.  The $50B “estimate” for damage here is a crock of shit, it is WAY higher than that, even NOT taking into account the possibility of $Trillions$ in Securities being “lost” in some Basement Safes.

One thing you can be certain of as the Money to Rebuild is distributed out, it will NOT be distributed out to the Individual Homeowners and Small Bizmen who lost their homes and livelihoods here.  The Money will be distributed out to Well Connected Corporations, Big Bizmen & Contractors with good Political Connections who get Cleanup work.  A bit of this will Trickle Down to J6P Construciton Worker who has been UE for a while and now will have Cleanup work for a few months, but once done those jobs will disappear as fast as they appeared here.  Those New Jobs are more than balanced out by the many people who LOSE their jobs here because their workplaces no longer EXIST at all, or the companies they work for are not on the Gravy Train to get the Big Loans to “rebuild”.

What many people on the Jersey Shore and Long Island just found out is that you CAN’T expect that Electric Power and Heat for your Biz or Domicile will remain in place, just as a whole bunch of people found that out when NOLA got hit by Katrina.  If you are not Well Connected enough to get the Big Money Handouts from Da Federal Goobermint to “rebuild” you are basically SOL here.  I am quite SURE S&P will be floated a $100M or $1B Loan from Helicopter Ben to repair THEIR Building, I seriously DOUBT  Emilio or Mohammed gets a $100K loan to repair his Bodega.

So across the board here, we at the very LEAST are looking at a version of Jimmy Kunstler’s Long Emergency, and incremental Spin Down of the quality of life for MANY formerly Middle Class people in the NY Shity Nabe.  Staten Island is QUINTESSENTIAL “Middle Class” Working Man territory in NY Shity, probably half the NYPD, Sanitation Department and NYs Bravest Firefighters live on Staten Island.  These are not “Welfare Leechfucks”, they were hard working people who bought into the Amerikan Dream, now turned Amerikan Nightmare.  Now they ALSO are the Underclass, and will be left Hung Out to Dry as the Big Money is passed out to Big Corporations in the Capitalist system to “rebuild”.So it has always been here in the FSofA, since Alexander Hamilton openned the First Bank of the FSofA, since Andrew Jackson tried to “Kill” the Second Bank of the FSofA and since Paul Warburg and Nelson Aldrich SUCCEEDED in resurrecting said Banking System for the Illumati on Christmas Eve of 1913 with the passing of the Federal Reserve Act after Secret Meetings on Jekyll Island.  Anyone who believes that “Freedom” & “Dmocracy” have EVER existed inside the borders of the FSofA is seriously deluded, victim of 300 years of solid and continuos BRAIN WASHING.

The thing is, once the Coastal Shities fail, the Interior Shitieshere in the FSoA will also FAIL,  though not necessarily from the direct attacks of Mother Nature from Hurricanes and rising Sea levels with bigger Storm surges.  They will fail as the energy supplies they need to operate fail to reach them from the coastline.  They will fail as the huge ports which service the Container Ships are damaged and destroyed by Mother Nature.

Here in Alaska the Port of Anchorage is aging and decaying, it hasn’t been rebuilt or even maintained all that well since the Big Quake in ’64.  Next decent quake we get there, it’s all rubble and I seriously doubt will be rebuilt.

The small Fishing Boats and Kayaks will last a while longer though, and people will still live and work near the Sea, from which ALL LIFE comes, until the Sea itself has life no more.  A dangerous place to be for sure as Mother Earth becomes more Geologically and Atmospherically unstable, you never know if you picked the WRONG day to go out Dip Netting the Kings when the run and a Tsunami comes your way here on the Ring of Fire.

If you do see the tide run out real fast though, drop the dip net, drop the fish and RUN LIKE HELL for the High Ground.  At least it slopes up pretty quick here in most places and you can get up 30 meters pretty quick.  Not so true on Long Island, where you gotta get inside a good mile from the shoreline to be up more than a few feet above Sea Level.

Anyhow, you can second guess all you like all the people who lived once on the Jersey Shore and in Coney Island and Rockaway Beach and on Fire Island too, but who will live there no more even if they did escape with their lives this time.  While you are at it, you might also second guess all the folks who live in Tornado Alley on the Texahoma border.  Not to mention all the folks who live in the Flood Plain of the Mighty Mississippi.  Not to mention all those folks living on top of the San Andreas Fault or in range of Sparks from tinder dry Forests in New Mexico and Colorado.  Wherever you are, eventually the Odds catch up with you, and you never know the day the Big Show will Come to a Theatre Near You.  The odds don’t appear to be improving here either, apparently 500 year floods now arrive 2 or 3 times a decade, and we get a new “Freak” event all the time like “Derechos”, “Haboobs” and “Frankenstorms”.

Perhaps the most IMPORTANT Second Guessing to be done here is WRT the Nuke Plants distributed out worldwide in ALL of these vulnerable locations.  Nuke Plants need a HUGE amount of Water for cooling, so they are always nearby major rivers or near the coast.  The cities and Ag Land these Nuke Plants provide energy for quite often are over geological fault lines and/or subject to drought or flooding.  There is nowhere “safe” to put something that has toxins that will last for Millenia, on a Millenial Timescale just about EVERY neighborhood gets hit with some kind of major disaster.

All Nuke Plants need to be Decommissioned, and all the spent fuel collected and sequestered off where it can do the least damage, perhaps in Antarctica or perhaps by sinking it into a subduction zone around the Marianas Trench, but it MUST be moved BEFORE, not AFTER the disaster strikes.

Will we have to sacrifice the Lights and the Flush toilets?  Most probably so, but at least perhaps then we will survive as a species and eventually come up with some better ways to manage the resources of the Planet we live on, and which gives us ALL life.  Its the only one we got, and we ain’t making out to any Exoplanets anytime too soon either.

RE

Katrina & Isaac: Anniversary Issue

Off the Keyboard of RE

Discuss this article at the Geological and Cosmological Events Table inside the Diner

As Isaac bears down on NOLA on the 7th Anniversary of the landfall of Katrina, I though it would be a good idea to make a comparison of these two Hurricanes.  Above you see one of the last of the radar images taken before the Outer bands of Katrina made landfall, one of the most perfectly organized Cyclonic Storms of all time.  Well, at least what we have Satellite Imagery of anyhow.   Below is the most recent Satellite Image of Isaac I can pull up with a permalink:

As is obvious, at this stage of the game, Katrina was a much more Organized Cyclonic Storm, and packing much higher wind speeds as well.  Katrina was at this stage between Cat 3-4, and the Doomsday scenario was that she would continue to strengthen to a Cat 5 before landfall.  That did not happen, she in fact weakenned to around a Cat 2 at landfall.

Isaac by comparison is just barely making Cat 1 wind speeds now, and may strengthen to a Cat 2 before landfall.  In the end the wind speed differential between the two storms on landfall probably will not be more than 20-30MPH.  What should be remembered however is that the damage and loss of life Katrina caused was not a result of high wind velocities, it was a Flooding Event caused by failure of the levee system in a neighborhood that has much of its land below Sea Level.  What is above Sea Level is only barely so.

The main question here is whether with the improvements made since 2005 by the Army Corps of Bozos the levee system will hold its integrity this time?  One suspects the ACoB has positioned more Troops and more Heavy Equipment along the levee system to plug any levee breaches as soon as they occur.  Imagine a few hundred Little Dutch Boys equipped with Caterpillar Back Hoes and Daiwoo Front End Loaders here ready to Spring into ACTION to stick a Finger in the Dyke hole.

This is a Water Level and Pressure problem overall, which can’t really be predicted by any model since you don’t know precisely how much water vapor the system holds, and how much it will drop how fast at any given spot once the system is over land.  That in turn depends on Ground Level Temperatures and Upper Air temperatures above the system itself.  If it is getting overlaid by cooler and drier air above as it rolls ashore, that is what will spawn Tornadoes, and if any one of those Touch Down on a Levee or Lock along the Mighty Mississippi, you definitely get a breach.

To get some idea of what the comparative  Water situation might be like, let’s look at the respective Storm Tracks  of Isaac and Katrina roughly One Day before Landfall.  First, Isaac:

Now the Storm Track for Katrina:

As you can see, both storms are making landfall at just about precisely the same location, but the Angle of Attack is different.  These models 48 hours out are quite accurate, so we can pretty much assume this is how it will go.

Because of the Attack Angle, the Storm Surge which could hit Lake Ponchartrain from Isaac could be bigger than that of Katrina, it depends there on the precise timing of landfall and High Tide.  Also depends on the absolute Speed the storm center is moving, and if you look at the chart, Isaac is not moving as fast as Katrina was at the same relative time.  This means a longer time period with high wind speeds over the water, which translates to more water piling up in higher waves.  The current strom surge is predicted to be about 12 feet, but IMHO there is a significant Error Margin there, probably +-6 feet depending on the time of day Isaac actually hits.

Levee Breach in NOLA, Katrina 2005

Now, overall as opposed to last time with Katrina, IMHO the Army Corps of Bozos is probably prepared to go the full 9 yards to keep the levee system intact,  insofar as their equipment will allow them to do that anyhow.  They also have had 7 YEARS to plan for such a scenario, so if they haven’t figured out how to keep it from occuring again here, they are going to look like, well, BOZOS.  If NOLA Floods AGAIN here, that Big Shity is about Done, Outta Biz.

Lousiana Offshore Oil Port (LOOP)

Next main issue here is the Oil Patch, the LOOP and Refineries and Pipelines streaming out from southern LA.  If you remember back to 2008, the damage caused by Gustav and Ike made a mess of this system, and Gas prices spiked up about $.75/Gallon.  That was when Gas was running around $2/Gallon.  If Isaac causes anywhere near the amount of ancillary damage to the whole Oil Production system that Gustav and Ike did, given we also have all the Shit Going Down with Iran and the rest of MENA and total global production capacity is MORE compromised now than in 2008, a hit to this portion of Global Oil Supply now probably drives up the GasDiesel Price $1/Gallon.  That moves it from near the $4 range in the FSoA to around the $5 mark.  The Automobile Industry is already in Collapse now, the “New” GM is on the verge of ANOTHER Bankruptcy.  $5/Gallon Gas puts the Final Nail in the Coffin for Happy Motoring here in the FSofA, and guarantees full blown Recession again, no matter how much Funny Money Helicopter Ben dishes out to the TBTF banks.

Hurricane Damaged oil Platform, Port Fouchon

Beyond those Physical Problems is the Debt Problem, which overall now is an Order of Magnitude or perhaps two greater than it was in 2008.  In the interim time, big Insurers like AIG and Lloyds of London have basically gone BK and are on Goobermint Life Support.  Goobermints that themselves are in deep Debt Problems even without another “Natural Disaster” induced Oil supply problem.  Any projections at all made for the various Industrial Economies to work their way out of the Debt Problem all depend on GROWTH, which is pretty hard to accomplish if Mother Nature keeps taking out your Industrial infrastructure every few years.  Mortagages for instance are issued out on 30 year cycles, and these days you have some Goobermints issuing out Bonds of 50 year durations!  If what you bought with a 30 year Mortgage gets DESTROYED in 7 year increments, the DEBT remains, the COLLATERAL does not.  No McMansion to Repo if it got washed down the Mighty Mississippi and out to sea of course.  Similarly, repairing a damaged Refinery every 7 years is a very pricy deal overall.

So, what is the DANGER as far as Isaac is concerned?  Is it the likelihood of another Flooding Event of the Magnitude of Katrina in NOLA?  Not really, though that would cause not only Economic Havoc but Political Havoc as well here in the FSofA.  If NOLA Floods, you can GUARANTEE Obama-sama loses the Election.  He’ll look like as big a BUFFOON as Dubya did during Katrina.  Romney will be all over that one.  If it does NOT Flood, Obama-sama will crow about how well HE prepared for this as opposed to the poor job done by Dubya, so that enhances his re-election possibilities.

Where the real DANGER though lies is in another “Black Swan” hitting an already very fragile Economic system and Energy Delivery system on the verge of collapse from many other directions not present in 2008 when Gustav & Ike hit the Oil Patch of the GOM.  Greece wasn’t on the verge of being ejected from the Eurozone in 2008.  Spain wasn’t coughing up 7% on its Bond Issues in 2008.  Helicopter Ben wasn’t Doing the Twist and Super Mario Dragon  wasn’t creating Schrodinger Money from Nothing in 2008 either.  A perturbation in the House of Cards created here now has a much more powerful Knock-On effect than it did in 2008.  The system is simply less resilient to SHOCK.

Can you really call this a Black Swan though?  It is not, because Black Swans are not predictable, whereas this one was completely predictable, within a timespan of a decade anyhow.  Another Hurricane hitting this stretch of the GOM is completely predictable now over such timespans.  If the Oceans churn them up at a given rate, you will get a given number hitting the GOM and at least one of them each decade will hit on NOLA and the LOOP or the Houston Ship Channel.  It is GUARANTEED.  How many times can you rebuild this stuff, issuing out still MORE debt to do so?

If Isaac turns out to be a Big One for damage to the Oil Infrastructure of the GOM and Lousiana, this may be the last time.

To finish this 7th Anniversary of Katrina and the oncoming Marriage betwen Isaac and NOLA, let us review an Independent Documentary of  Katrina’s effects and consequences from one competely INSANE Storm Tracker.  That this dude’s SUV held up long enough for him to make his ESCAPE is nothing short of MIRACULOUS.

RE

Knarf plays the Doomer Blues

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