Fighting the Insurance Company – Example of

After My Son Suffered a Traumatic Brain Injury, I Was Told Insurance Would Cover His Medical Bills. I Was Dead Wrong.

When RJ was discharged from the ICU after three weeks, he was transferred to a rehab facility. After he got there, they called me on the phone and said, “Your insurance company called and said RJ’s rehab benefits are up on Friday.”

I said, “No, no, no, no. That’s covered. I was told by my insurance company that this facility is covered for at least 60 days and possibly more. We have more time.”

But all I had was a voice on the phone. Without written proof, without the summary plan description, I couldn’t prove it. So when the rehab facility got another call from my insurance telling them these benefits had lapsed and I couldn’t prove otherwise, I went to the facility and I asked, “Where am I supposed to take him? He’s in a coma.” I remember a social worker telling me I could look into foster care.

Months passed, and I still couldn’t get the summary plan description. I kept calling my insurance company, and they’d be telling me my benefits, and I’d say, “You’re giving me information that you’re looking at. Give me, like, a screen grab of your computer screen.” But they wouldn’t do it. They kept telling me it was being “revised.”

I did some research, and I found out that under a law called ERISA—the Employee Retirement Income Security Act of 1974—I was entitled to the details of my insurance policy.

So I called an ERISA lawyer and told him the situation, and he said, “I can help you, but you’re going to have to give me a retainer of $30,000.”

Stephanie Peirolo
First told at a show by the Moth, the live storytelling group, at the Neptune Theatre in Seattle

Readers digest: https://www.rd.com/true-stories/survival/when-insurance-stops-paying/

Stephanie Peirolo is executive director of the board of the Health Care Rights Initiative, a nonprofit providing advocacy and navigation services for patients and caregivers. This story was excerpted from All These Wonders.

Here Are the Urban Highways That Deserve to Die – City Lab

On one side of Interstate 980 in Oakland rise the new glass skyscrapers of the city’s Uptown neighborhood, home to a bustling entertainment district and Silicon Valley’s spillover tech startups. On the other lies West Oakland, a “food desert” where two-thirds of residents live below the poverty line.

West Oakland residents should be able to benefit from the growing number of amenities available in Uptown, since they technically live in walking distance. But crossing the 560-foot-wide interstate and two frontage roads is a daunting task. It’s a prime example of one of America’s most divisive freeways—literally.

CLAIRE TRAN APRIL 3, 2019
https://www.citylab.com/transportation/2019/04/urban-worst-freeway-without-future-teardown-demolition-list/584707/

The Philosophy of an Epoch, Unknown Assumptions – Alfred Whitehead Quote

“When you are criticizing the philosophy of an epoch, do not chiefly direct your attention to those intellectual positions which its exponents feel it necessary explicitly to defend. There will be some fundamental assumptions which adherents to all the variant systems within the epoch unconsciously presuppose. Such assumptions appear so obvious that people do not know what they are assuming because no other way of putting things has ever occurred to them. With these assumptions a certain limited number of types of philosophic systems are possible, and this group of systems constitutes the philosophy of the epoch.”

Alfred Whitehead, Science and the Modern
Open Library

Hypothetical example – Everything is about Growth. The assumption that growing the GDP is a universal imperative, or that it’s an inherent good. 

In Utah, some public workers are able to fly to Canada or Mexico to buy their medication at a steep discount – WBUR

Utah is pioneering an alternative for its state employees to address soaring prescription drug prices.

The Pharmacy Tourism Program, a part of the Utah Public Employees Health Program (PEHP), allows certain members with high-cost medicines to fill their prescription in Vancouver, Canada, and Tijuana, Mexico, where medication comes at a much lower cost. The initiative even pays for members’ flights.

WBUR

Non U.S. millenials having same problems as the American ones?


US milliennials (roughly 22-37 yrs of age) are facing heavy debt and low pay which prevents or delays them from buying homes (or other large purchases) and starting families compared to their parents, are other countries experiencing the same or similar economic issues with this age group? from NoStupidQuestions

“In the UK almost identical situation.
I’m 43 I own my house and pay £600 pcm mortgage.
My colleague is 34 rents a house on the same street. Pays £900 pcm rent.
He’s fucked. Totally fucked.”

“In Finland, not as bad, but trending towards that. Pay is dragging behind the increasing cost of living, because we need to remain competitive in EU internal and global markets, which apparently can only be done with wages. Not by for example, making Finland more friendly to startups and small and medium sized companies, and entrepreneurs.”

reddit

‘We can’t afford healthcare’: US hospital workers fight for higher wages

Hospital and healthcare workers across the US are launching union drives and organizing protests in order to win higher wages and better working conditions, saying their industry exploits them and leaves them often unable to afford healthcare, despite working in the sector.

According to the SEIU, there are about 50,000 low-wage hospital workers throughout the Chicago metro area and about 10,000 are currently represented by the union.

LeChrisha Pearson, a single mother and certified nursing assistant for eight years at Chicago’s Mount Sinai hospital, was one of about 400 workers at the hospital who organized a union in June 2019, and threatened to strike in November 2019 before winning a contract that would raise wages for all workers to $15 an hour.

She works two to three jobs, including as a delivery driver for Uber Eats, to make ends meet while working full-time at the hospital.

Michael Sainato, February 17 2020, Guardian

In the News – Shouldn’t workers be doing better in this booming economy?

Despite unemployment at a near 50-year low, a soaring stock market and the longest expansion in US history, the recovery hasn’t yet reached these millions in economic hard times, say these analysts.

Even as wages overall are rising, about 50 percent of US workers received no pay raises last year, according to Bankrate. And in real terms, some say average salaries are stagnant.

“Today’s average inflation-adjusted wage in America has the same purchasing power that it did in 1978,” Liam Hunt, a market analyst at SophisticatedInvestor.com, told The Post. “That’s despite macroeconomic growth in terms of GDP, salary increases for the highest bracket of income earners and rapidly rising home costs,” he added. “In a growing economy, we should see real wage growth, though we haven’t.”

John Aidan Byrne, February 22, 2020, NY POST

‘Glass House’ Chronicles The Sharp Decline Of An All-American Factory Town

Lancaster, Ohio, the home of the Fortune 500 company Anchor Hocking, was once a bustling center of industry and employment. At its peak following World War II, Lancaster’s hometown company was the world’s largest maker of glassware and employed more than 5,000 town residents.

Though Anchor Hocking remains in Lancaster today, it is a shell of its former self, and the once thriving town is beset by underemployment and drug abuse. Lancaster native Brian Alexander chronicles the rise and fall of his hometown in his new book, Glass House.

“People are genuinely struggling,” he tells Fresh Air’s Dave Davies. “The economy of the town is struggling, not because there’s high unemployment, [but] because the employment that there is all minimum wage, or even lower than minimum wage.”

Fresh Air, February 6, 2017. NPR

For Her Head Cold, Insurer Coughed Up $25,865

Alexa Kasdan had a cold and a sore throat.

The 40-year-old public policy consultant from Brooklyn, N.Y., didn’t want her upcoming vacation trip ruined by strep throat. So after it had lingered for more than a week, she decided to get it checked out.

Kasdan visited her primary care physician, Roya Fathollahi, at Manhattan Specialty Care, just off Park Avenue South and not far from tony Gramercy Park.

The visit was quick. Kasdan got her throat swabbed, gave a tube of blood and was sent out the door with a prescription for antibiotics.

NPR, December 23, 2019

The system at work.

An Algorithm That Grants Freedom, or Takes It Away

Across the United States and Europe, software is making probation decisions and predicting whether teens will commit crime. Opponents want more human oversight.

He didn’t realize that an algorithm had tagged him high risk until he was told about it during an interview with The New York Times.

“What do you mean?” Mr. Gates, 30, asked. “You mean to tell me I’m dealing with all this because of a computer?”

In Philadelphia, an algorithm created by a professor at the University of Pennsylvania has helped dictate the experience of probationers for at least five years.

Interesting article in the Times:
Cade Metz and Adam Satariano, NY Times

This kind of reminds me of this book:
A Philosophical Investigation, by Philip Kerr

LONDON, 2013. Serial killings have reached epidemic proportions—even with the widespread government use of DNA detection, brain-imaging, and the “punitive coma.” Beautiful, whip-smart, and driven by demons of her own, Detective Isadora “Jake” Jacowicz must stop a murderer, code-named “Wittgenstein,” who has taken it upon himself to eliminate any man who has tested posi­tive for a tendency towards violent behavior—even if his victim has never committed a crime. He is a killer whose intellectual brilliance is matched only by his homicidal madness.

Amazon

“Educated Fools” – Thomas Geoghegan, The New Republic

In fact, the college graduates who are now the base of the party have moved working people out of the old neighborhoods. I think here of my own city—Chicago—where the members of the City Council whom columnists from Ben Hecht to Mike Royko used to mock now have more degrees than reporters of Hecht’s generation had. Here’s the finding of a new study from the University of Illinois at Chicago: In 1970, one half of Chicago by census tract was “middle-income”—that is to say, the people who made up the old working-class machine vote, most of them without four-year college degrees. Now that “middle-income” group is just 16 percent. The bungalows in those formerly middle-income neighborhoods teeming with high school graduates now belong to high-tech entrepreneurs and investors in hedge funds.

Thomas Geoghegan, New Republic

Apartments for rent in Denver: What will $1,100 get you?

Listed at $1,005/month, this studio apartment is located at 1431 Humboldt St. South.

In the apartment, you can expect a dishwasher. Amenities offered in the building include a resident lounge and on-site laundry. Pet owners, take heed: This property is both dog-friendly and cat-friendly. There’s no leasing fee required for this rental.

Walk Score indicates that the surrounding area is a “walker’s paradise,” is convenient for biking and offers many nearby public transportation options.

hoodline

Should Coal Miners Learn To Code? Slashdot discusses

During a campaign event on Monday, U.S. presidential candidate Joe Biden “suggested coal miners could simply learn to code to transition to ‘jobs of the future,'” reports Newsweek:
“Anybody who can go down 300 to 3,000 feet in a mine, sure in hell can learn to program as well, but we don’t think of it that way,” he said… “Anybody who can throw coal into a furnace can learn how to program for God’s sake…”

Many Twitter users criticized Biden’s comments as reductive. “Telling people to find other work without a firm plan to help them succeed will never be popular,” communications professional Frank Lutz wrote… Congressional candidate Brianna Wu tweeted that she was “glad to see the recognition that you don’t need to be in your 20s to do this as a profession,” but also called Biden’s suggestion “tone-deaf and unhelpful.”

Long-time Slashdot reader theodp notes the response this speech got from New York magazine’s Sarah Jones: “Please Stop Telling Miners To Learn To Code.” And in comments on the original submission, at least two Slashdot readers seemed to agree. “Not everyone can code and certainly not every coal miner or coal worker,” wrote Slashdot reader I75BJC. “Vastly different skills.”

Slashdot reader Iwastheone even shared a Fox News article in which rival presidential candidate Andrew Yang argued “Maybe Americans don’t all want to learn how to code… Let them do the kind of work they actually want to do, instead of saying to a group of people that you all need to become coders.”

But is there something elitist in thinking that coal miners couldn’t learn to do what coders learned to do? It seems like an interesting question for discussion

Slashdot

Thousands of Google’s cafeteria workers have unionized

The workers who voted to unionize earn wages that start at around $35,000 a year, according to a source familiar with the matter. And they say they don’t receive all the same benefits such as retirement plans that are standard for full-time Google employees. Their move to organize represents a symbolic pushback against the status quo of growing economic inequality in Silicon Valley, where all but the top 10 percent of income earners have seen their wages decline from 1997 to 2017.

 

Shirin Ghaffary, vox

10 assorted things from the 2010s

2010
the iPad is released

iPad (/ˈaɪpæd/ EYE-pad) is a line of tablet computers designed, developed and marketed by Apple Inc., which run the iOS and iPadOS mobile operating systems. The first iPad was released on April 3, 2010.

wikipedia


2011
The budget deficit is an ongoing problem

April 18 – Standard & Poor’s downgrades its outlook on long-term sovereign debt of the United States to negative from stable for the first time in history, citing “very large budget deficits and rising government indebtedness” as for why it did so. A statement from Standard & Poor’s explained its reasoning; “We believe there is a material risk that U. S. policy-makers might not reach an agreement on how to address medium- and long-term budgetary challenges by 2013; if an agreement is not reached…this would…render the U.S. fiscal profile meaningfully weaker than [its peers]”.

wikipedia


2012
Voters vote to make Marijuana Legal for Recreational Use

Colorado Amendment 64 was a successful popular initiative ballot measure to amend the Constitution of the State of Colorado, outlining a statewide drug policy for cannabis. The measure passed on November 6, 2012, and along with a similar measure in Washington state, marked “an electoral first not only for America but for the world.”

wikipedia


2013
NSA Shenanigans Exposed

June 9 – The Guardian and Washington Post disclose former Booz Allen contract employee Edward Snowden as their source for the intelligence related information recently published. Both published stories revealing the existence of PRISM, a program they say allows the NSA to extract the details of customer activities — including “audio and video chats, photographs, e-mails, documents” and other materials — from computers at Microsoft, Google, Apple and other internet companies.

CNN


2014
US stance regarding Cuba changes somewhat:

President Obama made a landmark announcement in mid-December declaring that the U.S. would begin restoring diplomatic relations with Cuba by re-opening an embassy in Havana and softening the travel restrictions on the long-banned country.

ABC News


2015
Pharma Bro Martin Shkreli jacks up drug price x 56

On September 17, 2015, Dave Muoio of Healio, an in-depth clinical information website for health care specialists, reported on a letter from the Infectious Diseases Society of America and the HIV Medicine Association to executives at Turing, questioning a new pricing for Daraprim. The price of a dose of the drug in the U.S. market increased from US$13.50 to US$750 per pill, overnight, a factor of 56.

wikipedia


2016
Prince and Bowie die
( see also: John Oliver – Fuck You 2016! )


2017
There is an eclipse

A total solar eclipse (nicknamed “The Great American Eclipse”) is visible within a band across the entire contiguous United States of America, passing from the Pacific to the Atlantic coasts.

wikipedia


2018
Electric scooters become ubiquitous in Denver
Adios 2018


2019
Last season of Game of Thrones
See also sexposition:

In visual media such as television and film, sexposition is the technique of providing exposition against a backdrop of sex or nudity. The Financial Times defined sexposition as “keeping viewers hooked by combining complex plot exposition with explicit sexual goings-on”. Its purpose, according to James Poniewozik, is to divert the audience and give characters something to do while exposition is being delivered, which is what distinguishes sexposition from merely gratuitous titillation.

Mobile Phone Tracking – The Times Looks Into

The Times Privacy Project was given access to a data set with more than 50 billion location “pings” from the phones of more than 12 million Americans across several major cities. Each piece of information came down to a set of coordinates in time. The result is a tapestry of movement laid across a city grid — like the computer game SimCity, only real.

Americans would never consent to a government directive that all citizens carry a device that broadcast, in real time, their physical location and archived that information in repositories that could be shared among powerful, faceless institutions. Instead, Americans have been lulled into doing it voluntarily by misleading companies.

If a mobile phone is turned on, chances are its location is collected in a spreadsheet somewhere. What does it feel like to see that archive? We went to Pasadena to find out.

NYTIMES

In the News – December 24, 2019

Boeing’s fired CEO could walk away with a $60 million golden parachute
https://www.cnn.com/2019/12/24/tech/boeing-ceo-dennis-muilenburg-severance/index.html

Travis Kalanick severs all ties with Uber, departing board and selling all his shares
https://www.cnbc.com/2019/12/24/travis-kalanick-to-depart-uber-board-of-directors.html

Hunter Biden owns massive home in swanky Hollywood Hills, court docs reveal
https://nypost.com/2019/12/24/hunter-biden-owns-massive-home-in-swanky-hollywood-hills-court-docs-reveal/

Adam Gase on not caring about fan criticism: ‘I’m rich as f–k’
https://www.nydailynews.com/sports/football/jets/ny-adam-gase-jets-fans-20191224-aqdwksbo5nditexjl65gvdb6ye-story.html

 

I Got Paid to Improve Rich Kids’ Personalities on Their College Applications – VICE

A lot of what we did is write Common Apps and sort out how we were going to make these students look good. The tough part was that this sometimes involved fabricating activities, or for lack of a better word, “passions.”

The fact of the matter is that these kids don’t have passions, so they are trying to do what others did with the test scores and buy their way in. Trying to fake passion is hard. It’s upsetting that people would pay good money rather than trying to cultivate it themselves.

For instance, there was a kid who ran a 5K for a hospital that was near the school he wanted to go to—a very elite school. I spun that to say he was involved in volunteering at that hospital. They really don’t check that kind of stuff, as long as it’s somewhat believable.

vice

How I Get By: A Week in the Life of a McDonald’s Cashier – VICE

Cierra Brown estimates her commute to work would only take about 25 minutes if she had a car. That’s part of the reason she returned to McDonald’s in January: Her car had broken down and she needed money. But at McDonald’s, Brown only earns $9.50 per hour as a cashier, which barely helps cover rent and is far from enough to solve her vehicular woes. Without a car, one of Brown’s main headaches is getting to work. Her typical bus commute to McDonald’s takes as long as two hours each way.

By the time she starts work, she’s already tired. When she gets home, she’s exhausted.

“That is where a lot of my headache comes from,” she told VICE.

At 29, Brown works approximately 40 hours a week, splitting her time between a McDonald’s in Durham, North Carolina, and a food-service gig a local hospital. “It’s still not enough,” she said. Both jobs are part-time, and she doesn’t receive health insurance through either employer. She can’t afford insurance on her own, either. That’s a problem since Brown is diabetic, and she has to pay for her medical expenses out of pocket. She’s trying to do all she can on her own—she receives no food stamps or other assistance, she notes—but it rarely feels like she’s doing enough.

“It’s really rough right now,” she said.

vice