Yom Kippor Madman

Thursday, October 13, 2005

The Blame Game

My thirteen-year-old son, Jason was playing his new video game the other day when I came into his room. I reached over and kissed him on the head. At that very moment, his quarterback was tackled for a loss.

"It's your fault I got tackled," he said with a laugh. I laughed too.

Jason continued with his game, but now, every time he got tackled, or threw an interception, he yelled, "It's your fault, Daddy," with that same laugh or chuckle. Jason never learned how easy it was to kill a joke.

After about five minutes of his "blame game" I finally called to him, "You know, Jason, if you keep blaming people for your mistakes, some day you can become president."

We both laughed.

-Noah Greenberg

Buried by Paperwork

Health Care, Codes and Forms

"Even though the amount of paperwork a patient has to deal with might seem to be a lot, it would be much worse if there wasn't a unifying organization like a health plan easing that burden,"
-Dr. Alan Sokolow, chief medical officer at Empire Blue Cross Blue Shield in New York



Spoken like a true advocate of the current health care system and a true opponent of Universal health care. What Dr. Sokolow doesn't say is that his industry needs to keep this current system alive in order to stay profitable, viable and necessary. Let's face it, contrary to what Dr. Sokolow says. universal health care would actually make things better, and less complicated. For example, when someone files for Social Security, they don't need a "middle-man" with toms of paperwork to "make things easier", do they?


Come to think of it, you could probably make a lot of money betting that President "G"lobal "W"arming Bush and his "G"reed "O"ver "P"eople Disciples would love to make Social Security look more like a "for-profit" health care system and might even use the complicated paperwork and bureaucracy of the health care industry as a model for the future of Social Security.

"I'm the president's senior adviser on health information technology, and when I get an E.O.B. (Explanation of Benefits) for my 4-year-old's care, I can't figure out what happened, or what I'm supposed to do. I can't figure out what care it was related to or who did what."
-Dr. David Brailer, the National Coordinator for Health Information Technology in the Department of Health and Human Services (HHS)

Uh-Oh. This guy better start looking for a new job if he is going to "Dis" GW's buddies in the health insurance industry and their lobbyists.


When the guy who is in charge says "I dunno," what are the rest of US supposed to do?

As many of you know, my daughter, Bonnie, has had three operations in the past four months. Not a fun summer for a kid who just graduated high school. We now get bills, or statements, or invoices, or whatever you might want to call them in relation to her care. Although we belong to an HMO, Bonnie's doctors are non-participating. We are allowed out-of-network benefits, so we are covered... we think.

The neurosurgeons who operated on Bonnie took "assignment" meaning that they took what the insurance company gave them, less the deductible. The anesthesiologist said he took "assignment", but we still receive bills from him. There were a litany of doctors who stared at Bonnie while scratching their head, most of them during her second hospital stay resulting from a staff infection due to her first hospital stay. That also send US bills.

I receive these "Explanation of Benefits" with these huge dollar amounts and I try to make heads or tails out of them. I feel Dr. Brailer's pain.

"I understand the words of diagnoses and procedures, but codes? No. Or how things are paid or not paid? I don't understand that."
-Dr. Blackford Middleton, a Harvard Medical School professor

"Suppose you walk into a restaurant, and you don't get a menu, you don't get any choice of what food you'll eat, they don't tell you what it is when they're serving it to you, they don't tell you what it's going to cost. Then, weeks or months later, you get a bill that tells you all the food you ate and the drinks you had, some of which you remember and some you don't, and although you get the bill, you still can't figure out what you really owe,"
-Dr. Brailer

Then, you could add to that, Dr. Brailer. Weeks after that first bill comes, you get separate bills from the busboy, the dishwasher and the Maitre 'D all demanding payment, as well.

The biggest joke of all is this term:

"Usual and Customary"

Only the health insurance industry could come up with that one. Basically, what that means is if an operation costs $10,000 and you have a 30 percent deductible, you are responsible to pay $3,000 ( unless you have reached your maximum out of cost ceiling, which is the maximum amount that you are responsible for). The first thing that happens is you get a bill from your doctor that says "Even tough you may have insurance, you are still responsible for this (the invoice total) amount." You throw that bill away knowing you have the necessary health care coverage.

You next get an "Explanation of Benefits" letter from your insurance company. If you're lucky, it says "We paid this amount" and it points to a $7,000 figure, but we all know that almost never happens. More than likely it will pay a "usual and customary" amount, which can be hundreds, if not thousands of dollars less than the doctor's bill, and you are left either negotiating with your doctor or just shelling out the difference.

Here's what happens if you're unlucky. You get that same "Explanation of Benefits" that tells you the "procedure is not a recognized procedure, and is not covered". Most people take this chance to hyperventilate or just faint. If you were to call your insurer, they usually tell you something like "Don't worry, we send that to everybody when the doctor didn't fill out the paperwork correctly." Very reassuring.

In some cases, your doctor will take the money the insurer gives them, an "assignment." In some cases, they won't. And in some cases they say they will, but their "people" still send out bills with return envelopes and places for your credit card number expecting the difference.

"The number of bureaucrats between the point of service and the final cash reckoning is just incredible,"
-Dr. Thomas Delbanco, a Harvard Medical School professor of primary care medicine and a leader in the field of patient-centered care

Remember this: The more people that work for the insurance companies, the more people that have to figure into the overhead. The more people they figure into the overhead, the more they have to charge the patient for premiums. Everything works on percentages, so if an employee of Blue Cross earns $50,000 per year, like most businesses, you have to mark that up as overhead and thus, have to make a profit on that employee.

In "key-stoning", a business term whereby you try to double your cost, every dollar requires you to earn a dollar. Applying that principle to the health care industry, every dollar spent must become two dollars earned. The cost of that $50,000 per year employee earns that insurance company $100,000 net and $50,000 in profit. When that employee gets a raise to $55,000, the insurance company, in order to keep their percentages the same, now "earns" $55,000 by increasing premiums or reducing benefits, or both.

"You can't just be sick. You have to be sick and be drowning in paperwork."
-Ellen Mayer, who has a rare type of gastrointestinal cancer and requires constant monitoring through blood work, CT scans and PET scans

"It's comical, it's unbelievable. And I think to myself, 'What if I was an elderly person, or a single person? What if I wasn't healthy enough to handle it?' "
-Ms. Mayer

"Everyone is bogged down by this: the physicians, the hospitals, and ultimately it reverberates to the consumer,"
-Ron Pollack, executive director of Families USA, a health care advocacy group

"It is hard to describe what it is like to be confronted with mounds of scary claims and bills when you have a 2-year-old who is extremely ill, who needs constant nursing and doesn't have a great chance of surviving. And to sit in a hospital room, on hold with the insurance company for 30 minutes or more only to have your child start puking just as you get a rep on the line."
-Bonnie MacKellar, whose two-year-old son was diagnosed with a highly malignant nervous system tumor

"I'm paying through the nose for this premium, and when I go to the doctor it's a roll of the dice as to whether or not they'll pay it. It seems like it depends on the mood of whoever happens to be doing the claim that day, or on the phases of the moon."
-Mitch Mayne, a relatively healthy man from San Francisco

And that's the way they like it.

-Noah Greenberg

Why We All Do What We Do

I know it takes a lot of effort to compile Note From A Madman all week long. I and everyone who reads the newsletter is indebted to you and its contributors.

I do what I can by emailing my congressman, local news sources, making donations and phone calls. I swear I do my best to be a thorn in the side of those who are supposed to be working for me, the voter.

I implore my friends to do the same. Unfortunately so many of them feel like their efforts are wasted. Sometimes I feel the same. But if there is a chance I can make even the slightest difference in the way our country is run, or who gets elected, or if I can make someone listen, I feel it's my duty to do so.

I used to stick my head in the sand and tune out what was going on around me. To only pop my head out long enough to have a drink or two or three or whatever... and it didn't just stop at alcohol. I turned my life around nearly three years ago. When I did I was absolutely overwhelmed at what I saw and heard!

I have two sons 25 and 20 and someday (
God willing) I'll have grandkids. I would like to think that they could have the happy childhood I and my kids enjoyed. I know deep down if we don't take our country back from the greedy SOBs that are running/ruining it, my heirs don't stand a chance at a decent life. No matter how hard they work.

My signature line translates to "Only you can prevent forest fires" Well, there is a raging fire right now in this country. And it's spreading. Every man and woman who wants this country to prosper must fight however they can.

OTHERWISE it will burn and fizzle out.

Solum potestis prohibere ignes silvarum.

-Sean (Mr. Blue-Sky)

Bush Raises Taxes
Bush to Cut Health Care and Mortgage Tax Breaks

"Remember back in his first term when President Bush and the Republicans in Congress pushed through a bunch of tax cuts that went overwhelmingly to the richest sliver of Americans?

"Well now the Bush administration has figured out a way to help pay for it: RAISE YOUR TAXES

"Do you own a home? Do you ever use health care? Then Bush wants you to pay more.

"President Bush's tax reform panel, which is expected to send him its recommendations by November 1, is proposing to scale back two of the nation's most popular tax breaks, for home mortgage interest and employer-paid health insurance.

"Needless to say, middle-class Americans rely on the tax breaks to help them pay for their homes and to help them afford health care in an increasingly inaccessible system. Any cuts to those deductions would be devastating to ordinary
American families."
-From the DNC blog


I said in 2004 that Bush would find a way to increase taxes without increasing the rates. He'll claim he never increased taxes but in effect working and middle class people will get stiffed. The Republicans are fond of saying that rolling back tax rates on dividends would be a tax increase. So, how about eliminating deductions that most working and middle class people use. Isn't that a tax increase?

People have invested considerable money in their homes over the past 5 years. Eliminating the deduction for home mortgages will hurt. This may even burst the housing bubble for good and put the country into a recession. Even worst is eliminating the deduction business gets for sponsoring health care plans. That may actually cause millions of Americans to lose their health care. At the very least, their companies will drastically increase the employee's contribution to their health care plan.


Do the Republicans think that the health care crisis can be fixed by making it unaffordable except to the top income brackets? That seems like an insane idea.

If the Republicans follow through on these threats, they are begging Democrats to boot them out in 2006. The question is will they be arrogant enough to assume they can get away with this robbery of the American people without paying a political price.

-Robert Scardapane

The Trade Deficit and Other Stuff

The US trade deficit has grown to over $59 billion. That's a one billion dollar jump from July to August, or a couple of days worth of spending in Iraq. And, in keeping with the argument that foreign goods cost less, the Labor Department reported a 2.3 percent jump in import prices for the month of September. That number doesn't even include a 48.9 percent rise in gasoline prices since September of last year.

Let's put all of this in perspective:
We manufacture less, so we employ less people at good paying jobs
We buy more from other countries so we rely on them more
We borrow money from the countries we buy from, so we can "float" our money better
We export less which keeps US from being more financially solvent
We earn less that we had earned previously without increasing the standard of living of most of the countries who supply our goods
And now, our cheap imported goods are costing US more without US making more money

China now has an $18.5 billion trade surplus in relation to the US. That up 4.6 percent in just one month!

The labor department, practicing its very own version of the "spin" said that jobless claims "Fell" to just 389,000 last week. Of course that number didn't include the 75,000 people that filed due to Hurricane Katrina. That brings the REAL NUMBER up to 438,000, a considerable rise in unemployment claims. So either the Department of Labor felt that no one in the gulf coast areas of Louisiana, Mississippi or Alabama would have filed a new unemployment claim, or they simply don't consider those area part of the United States any longer.

I guess we have just 49 states now, excluding Louisiana.

It's a good thing for the Bush administration that disasters strike, natural or al-Qaeda made. That way they always have an excuse for our misfortunes.

-Noah Greenberg

Dobson, Miers and Lost Freedoms

Today, on American Family Radio, Focus on Family, James Dobson was interviewed and was quite anxious to tell the world, as well as whomever might subpoena him in the coming days, the following:

Rove called him on the phone, two days before the official announcement, and told him that President Bush was going to nominate Harriet Miers for the Supreme Court.

Dobson also claimed that Rove told him, in the same conversation, that most of the highly qualified candidates who had been on the list, had refused further consideration, because of the 'climate of hostility that the Democrats were creating.'

Dobson claimed that Rove assured him that Harriet Miers was an Evangelical Christian who had been attending a pro-life church for decades, and that perhaps Dobson should contact high ranking members of the Evangelical. . .uh. . . I mean Republican party and let them know, how effective a Supreme Court judge Harriet Miers would be.

Ken Starr, on the phone to the radio show, then chimed in with plenty of recommendation of Harriet Miers as an Evangelical Christian, of many years and a wonderful woman he had known for many years.

Much was made on the radio show of the fact that James Dobson is not only an Evangelical Christian leader, but also a psychologist.

I had to switch the radio station at that point, before becoming ill. But what disturbed me about this interview might surprise others.

Although I am adamantly opposed to abortion, and would overturn Roe vs. Wade, I am equally determined that no federal government should insert itself between me and my physician, or any other woman and her physician. Mainstream Republicans understand this but the NEOCONS are highly suspect. Tactics will only start with Roe vs. Wade, and not finish till we are all at the mercy of law enforcement (at the rate we are going with Bush's incessant insistence on military involvement in every aspect of lives, military law enforcement) when it comes to health care.

Further, the insidious way in which the 'Democratic hostile environment running off all the far more qualified candidates' was worked into the segment as propaganda worthy of WWII Tokyo Rose.

Even further, the fact that Karl Rove would make a surreptitious call, to a religious leader, to politicize by religion, a questionable candidate for the Supreme Court smacks of not only gossipy old woman tactics, but underhanded, conniving, manipulation of what should be a strictly Constitutional process, derived to provide the American citizens with a separation of powers of government. Or in other words, treason against government, as well as blasphemy against religion.

Any nominee who has to be leveraged into position with these tactics, by the likes of Karl Rove, who with dual citizenship in Germany and the US has questionable allegiance himself, could not possibly be what President Bush, Kenneth Starr and James Dobson, might claim, that Harriet Miers is capable of interpreting law, by the Constitution, rather than legislating from the bench. If it were otherwise, she would never have allowed this.

Last and of most tragedy, is the fact that a radio show, which purports to support families, which they need in these times, would spew such garbage onto a public, too overworked, underpaid and stressed to have the time to sort it out.

By the way, one other item I have uncovered about Harriet Miers.

She has allowed the illegal use of women in combat, setting precedence for drafting them into combat positions, indiscriminately with men. If the draft is reinstituted, the language has already been changed to include females.

Personally, I'm sure that there are some 'women' who would excel at combat. However, drafting the typical 18 year old prom queens (girls) and treating them as if they were on the same level as 18/19 year old boys, is going to get a lot of the boys killed in combat.

Drafting girls along with boys, will sunder our military, with pregnancies no one knows about till they are overseas, medical requirements of field med/evac units for a raft of female problems men just don't have. Birth control. Broken bones, which are smaller in females and do break with less stress. Equipment, and facilities for that every month, 3 to 9 day duration of cramps and bloat and backaches and necessary place of privacy to address feminine product changing. In combat?????

As a woman who would excel at combat, remembering what she was like till about age 35, you can trust that I know what I am talking about.

Ordinarily I would be pleased to have a woman on the Supreme Court, even with her lack of experience as a judge in particular, however this woman seems to be just another NEOCON, just as willing as the guys to be a part and party to the rise of fascism (and I'm beginning to believe, insanity) in our national leadership.

As for my daughters and me, all of us would fight to the death against an identified enemy, for the Constitutional rights we have, for liberty, for freedom. None of us will lift a finger to defend the policies of the Bush administration, which are corrupt to the core and result in death, destruction, and desecration.


I want to be with people
who don't do greed
who don't do scams
who don't do wars.
I want to be with people
who dance and sing
and love and play
where is this place
I want to be with people
who each have spoons
of three feet long
content to feed each other.
I want to be with people
who dance and sing
and love and play
where is this place


In response to, "Can any of you remember the last time a disease was actually 'cured?'", Victoria Brownworth writes:

Well, I know that neither of mine have been.

And that's just the problem. Even if one isn't sick, the drug companies still want you to take some sort of medicine, and they're willing to do or say anything to make that happen. Remember President Bush's "idea" to have pre-schoolers tested for their mental health? That was just another "G"reed "O"ver "P"eople party scheme devised by the pharmaceutical industry to get US to stuff more pills down our children's throats in order to pad their "bottom line." -NG

Just something going around a newsgroup I thought was worth sharing with all of you:

"If Texas didn't execute folks with IQs around 70 or below, they'd be hard put to find anyone to execute."

And in response to it, this:

"That's an unfair thing to say. Actually Texas treats it's Intellectually Challenged citizenry more equitably than any other state in the Union. In Texas they're as likely to executed a retarded person as to elect him governor."

-Thanks to Dennis and David

-In response to, "Would you want a President that believes in using torture to turn the military loose in our cities?", Rhian writes:

Actually, it would be a military who has been trained in Iraq, to control a hostile, armed, civilian population, a military who are by majority, on drugs (anti-depressants/mood elevators) a military whose troops have been trained in the use of torture, brutality, and who are inured to the sight of men, women and children blown apart by munitions, for over three years.

It would also be a military in various stages of broken loyalties to family, country and American values, a military which has been supplied by Command and Halliburton with free gas and foreign prostitutes while overseas.

It would be a military accompanied by Blackwater and other notorious mercenaries, some foreign nationals, that would be turned loose by the President, into our cities.

Today's Quote
So Much for "No Litmus Test"

"People ask me why I picked Harriet Miers." They want to know Harriet Miers' background. They want to know as much as they possibly can before they form opinions. And part of Harriet Miers' life is her religion.''
-"G"lobal "W"arming Bush

I heard as much as I care to hear. I am now dead set against Harriet Miers.

When the President says he picked a Supreme Court justice on the basis of religious belief there is something seriously wrong. All along this President claimed he picks judges based on whether they are strict constructionists. Now, he is using religion as a criteria.

I am not against anyone's religious conviction but in America using that as a criteria is simply wrong. Whose conviction count more than others? Do we give preference to Evangelical Christians over Catholics, Jewish, Hindus, Buddhists and Muslim people (sorry if I left anyone out!)? What about people who are agnostic? The last I checked people do have the right to be agnostic. What about knowledge of constitutional law? If all Bush can tout is her religious conviction, she is wrong for the job.

-Robert Scardapane

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-Noah Greenberg