Since when have "patients and doctors" had control in the US?

I certainly don't remember that when I lived there and I've yet to hear any stories today that suggest anything has changed. John just wrote about yet another faceless bureaucrat at Blue Cross who is dictating his health care. Health care in America today is most definitely dictated by insurance companies. This is the only bottom up process most have ever seen. Read the rest of this post...

Mark Sanford to South Carolina: Get over it

Mark Sanford thinks his constituents need to move on:

"I'm looking forward and I think the people of South Carolina are ready to do the same," Sanford said, adding to the media: "I'm going to move on with my life. The question is will you?"

Yeah, that's the question, isn't it? Sure. Read the rest of this post...

Your tax dollars at work

Against you. Would it have been too much to ask Washington to block such spending?

As Congress spent much of the last three months looking at ways to tighten regulations on financial institutions, some of the biggest recipients of the government's $700 billion bailout increased their spending on influencing legislators.

"While these companies continue to count their taxpayer cash, they're using their lobbying against critical financial reform," said Ed Mierzwinski, consumer program director at Public Interest Research Group. "Anywhere but Washington, you would think this was the Saturday morning cartoons."

Trade groups also have ramped up their lobbying and the consequences already are being felt. House Financial Services Committee Chairman Barney Frank, D-Mass., has delayed a panel vote on legislation that would create a consumer finance protection agency widely opposed in the financial sector.

Let's hope Frank does the right thing and shuts down Big Finance. Read the rest of this post...

The profit motive: In health care and in politics

We're getting a lot of feedback and information from people who know a lot about health care. I got the post below as an email from a health care expert who I've known for years. The person told me I could publish it, but without attribution. Trust me, this person knows of what they speak.

The profit motive is powerful. And, the health care industry, including the insurance companies, sure know how to manipulate it:

Research conducted over the past 20 years has demonstrated unequivocally that standard pharmaceutical industry practices --- which include paying for meals, trips, conferences and courses for doctors, their office staff and families --- has a big influence on the prescribing habits of doctors, sometimes in ways that are not in patients’ best interests. Despite regular reform proposals from editors of influential medical journals and occasional media attention, little has changed in practice.

Obviously, this continues because both doctors and the pharmaceutical industry consider that the status quo is in their best financial interest. Doctors benefit from the gifts, meals and trips, while the pharmaceutical industry benefits from the added profits derived from expanded market share.

Which brings us to our legislators. The Washington Post today reported that members of Congress key to health reform, including Senate Finance Committee Chair Max Baucus, depend on contributions from the very industry that profits from our broken health care system. It seems that one in five dollars in campaign contributions Senator Baucus received between 2003 and 2008 came from the health care industry and its lobbyists, while just one in ten dollars came from contributors in his home state.

When confronted with research evidence showing how physicians’ interactions with the pharmaceutical sales force influence prescribing, doctors respond by insisting that they personally are not affected, even though they suspect the average doctor might be. We see the same kinds of responses from the politicians, who tell us that their own views are not biased by the relationships they develop with insurance and drug industry lobbyists at big-ticket fundraisers held in private settings.

It is hard not to suspect that the financial relationship between industry and Senator Baucus explains why a public plan option --- much less a single-payer approach--- has been taken off the agenda of the Senate Finance Committee, even though polls show nearly three quarters of Americans would like to see a public option included in reform. And even though they --- and we --- are in desperate need of a reform plan that would simultaneously rein in costs while expanding coverage.

One reason lawmakers can’t finalize a bill before the August recess is that there is no way to do what their patrons demand --- ensure robust industry profits --- while controlling costs and expanding to access to health care. An additional few weeks or few months of reflection will not change that basic fact, although it will buy time in which advocates of reform can find common ground, expand their ranks, and spread misinformation to sway public support.

Those who oppose campaign finance reform on free speech grounds don’t seem to appreciate that the concentrated interests of the few always outweigh the diffuse interests of the many. Unfortunately for all of us who would like to see meaningful reform enacted, it looks as though the powerful minority is poised to demonstrate that lesson for us once again.

Read the rest of this post...

Traditional media has to debunk the birthers

The absurdity knows no bounds. Today, Taegan noted that CNN's Lou Dobbs had joined the crazy birther movement. Dobbs did it on his radio show, not CNN, but he's most identified with CNN. Most of the birther crowd has been hanging out at FOX, but Dobbs joined in.

Also today, actually on CNN, Rick Sanchez went after the birthers in a big way. I watched it live and it was fantastic. I couldn't find video, but Rachel Weiner at Huffington has a report:

It's a "completely unfounded story," Sanchez said, and then repeated himself for emphasis. "There's something strange about even having to do this story," he said, but so many people believe it that "it needs to be addressed."

Lou Dobbs should watch CNN every now and then.

Jed posted a clip of Chris Matthews eviscerating one of the whacko GOP members of Congress, John Campbell from California, whose been pushing legislation on the birther issue. After telling Campbell "what you're doing is appeasing the nut cases" and "you're verifying the paranoia out there" and "you are feeding the whacko wing of your party," Matthews did get the Campbell to admit that Obama was born in the U.S. It's absurd that Republicans are so obsessed with this. But, it says a lot about the state of the GOP these days:


The real authority on this matter is Snopes.com. Read the rest of this post...

Michael Steele's insurance plan for his kids: “Don’t break anything, because Daddy can’t afford to fix it”

Via Greg Sargent:

Steele even confessed on the stump that this led him to tell his kids to take extra care with their health, according to an October 2006 WaPo article:

He told an audience in a recent speech that his family went without health insurance for three years.

“Don’t break anything, because Daddy can’t afford to fix it,” he recalled telling his sons then.

Steele, presumably, now has insurance, so his family doesn’t have to be quite so careful. Yet in an internal memo obtained by HuffPo, the RNC says it will “engage in every activity” to slow down a proposal that could give insurance to people who currently have to hope their kids don’t “break anything” because they “can’t afford to fix it.”

Knowing how bad it is to not have health care, why would Steele want to kill reform? But that's the GOP agenda. And, that's really sick.

Via Think Progress, Steele isn't even sure what kind of insurance he has right now. One's health insurance has to be very good for one not to even worry what kind it is. I'm pretty sure Michael Steele doesn't spend much time haggling with insurance companies over co-pays and denied coverage. The insurance company is too beholden to the RNC. Read the rest of this post...

My whopping $32 emergency room visit in the land of socialized medicine

This afternoon I went to the emergency room of the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts in Paris, France. It's a hospital that specializes in eye problems. I had to have emergency eye surgery on the spot. With the national debate on health care raging in Washington, it seemed timely to share my story.

I wrote earlier today about yet another hellish experience with CareFirst Blue Cross Blue Shield last night. I just arrived in France for my annual house-sitting for Chris and his wife Joelle, and I noticed that I was having some eye problems - specifically, a marked increase in floaters, including an incredibly large one and some new dark ones I'd never seen before in 40 years of having floaters. I have some experience with floaters, since two years ago when they last struck I went to a retina specialist and found out that I had a small hole and a small tear in my retina that needed to be fixed immediately, lest they lead to a full retinal detachment, that can lead to blindness. My sister suffered an all out detached retina, so it runs in the family.

Judging by my history of retina problems, and knowing the signs to look for, the marked increase in floaters set off warning bells, and I called Blue Cross, my insurer to inquire what my coverage was while abroad. They were total idiots. I explain that conversation in the post I link to above. Suffice it to say, Blue Cross first told me I was covered wherever I went, then a second employee told me I would only be covered if I went to an emergency room, but not if I stepped foot out of the emergency room for emergency care.

Shrugging off the utter confusion that was the advice I got from Blue Cross, and their implied threat not to cover me if the emergency room sent me to a specialist for emergency treatment, I went to the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, a local hospital here in Paris that specializes in eye conditions.

On first impressions, the place is no great shakes. It looks like a hospital a bit trapped in time - perhaps circa 1960 - and certainly doesn't compare to the gleaming fortresses that air American hospitals.

But.

Once you get beyond the cosmetic weakness, the French lived up to their reputation as the best health care system in the world, and the costs are cheap as dirt to boot.

I walk into the emergency room, wait ten minutes to speak to the woman at the "accueil" (or welcome desk). She takes my info for five minutes, then sends me to the cashier to pay in advance for my emergency room visit. I got to the cashier and explain that my American insurance is requiring a detailed break down of the costs, including how much for each aspect of the treatment (the doctor's fees, the medicines, etc), or they won't reimburse me. The woman behind the counter tells me all they have is the charge on the bill, 23 euros.

23 euros?

That's 32 bucks. You'll easily pay $800+ for a basic-level emergency room visit in the states. I think I stifled a laugh.

Rather than worry about Blue Cross' sure-to-be nightmare on trying to get my 32 bucks reimbursed, I went back to the emergency room waiting room and waited my turn. The sign on the wall said to expect a two hour wait, but the lady at the accueil said it would probably be more like an hour.

It was 20 minutes.

"Monsieur Aravosis," the very cute, very young dark-haired French doctor said from behind a glass wall. "Oui," I responded, raising my hand and pausing the copy of "The Last Starfighter" playing on my iPhone.

Julien, as my doctor would come to be known, asked me what was up, looked at my eyes with your standard eye-doctor eye-gazing contraption, and then had me do the standard eye test. He put some letters up on the wall and asked me to read them aloud. I asked, do you want me to say them in French? So I tried in French, kind of forgot how to say "H," and thank God there were no Js or Gs or he'd have had me pegged as blind for sure (J and G in French are pronounced the exact opposite of what they are in English), but apparently I passed. Doctor Julien then handed me some small print to read, to test my bifocal vision, I guess. I laughed - it was in French. I speak French, but still, judging my eyes by the French I read from the miniscule font on a small card while seated in an emergency room in a foreign country worrying about going blind, it just seemed awful funny. Doctor Julien then dilated my pupils, and told me to wait a bit (in fact, he gave me the medicine and had me dilate my own eyes, one drop in each eye with two different medicines, every ten minutes).

A funny thing happened while waiting for my eyes to dilate. An older man was seated across from me, maybe in his late 60s, and another doctor came out and asked him if he could help him. The older man said he was with the patient inside the other room. The doctor responded, "oh, are you his husband, or his father..." The old man responded, "he's my son." Both the doctor and the old man took the suggestion of the old guy's gay-ness in stride as if nothing happened. I imagined my own father if the emergency room doc were to ask him if he and I were a couple.

After fully dilating, Doc Julien sat me down, took another look, and confirmed that I had a rather large tear in my retina. I needed immediate laser surgery to cauterize the tear, or it would likely lead to a fully detached retina, major surgery, and possibly blindness.

You don't have to hit me with a 2 x 4.

I told Julien I'd do the surgery, then asked him "you are a doctor, right?" He laughed and said yes. I then asked, you've done these before? All the time, he said. So we went to the room with the laser and Julien and another doctor took me through 45 minutes of living hell. Not hell because of their skills or the facilities or the equipment. Hell because someone has their hand on your eyeball for 45 minutes, while zapping your eye with a really hot laser that hurts like hell. Definitely not for the feint of heart. But it had to be done.

After clutching the desk in front of me for an hour, worrying that I might accidentally blink and slice my eyelid in two like some James Bond movie reject, it was over. Julien and the other doctor explained that I had to come back in a week, that there was still a risk that the cauterization might not work, and that if that happened, I could be facing a detached retina. Lovely.

Julien then told me to look out for any flashes of light, dark spots in my vision, or loss of vision in a portion of my eye. If any of that happened, I was to come back to the emergency room, immediately, regardless of the hour - they had specialists on staff 24 hours a day, seven days a week.

We went upstairs, Julien made my appointment for next week, gave me the eye drops to dilate myself at home before coming in. Another woman told me that the emergency surgery, with two doctors working nearly an hour, was going to cost me a grand total of 100 euros, or 140 dollars (really only 100 dollars if the exchange rate weren't so out of whack). Added on to the basic emergency room visit and consult fee of 23 euros (32 dollars), that meant my emergency room visit and emergency room surgery came to a grand total of 172 dollars.

I started to leave, then turned around and suddenly realized I hadn't paid the $140 for the emergency surgery. Do I pay the cashier, I ask the woman behind the desk? Nah, she tells me - just pay it next week when you come back for your check up.

And that, my friends, is the "nightmare" that is "socialized medicine." We should all be so lucky.

PS For comparison sake, I believe my emergency room visit for slicing the tip of my finger off cost around $800. They simply cleaned out the wound and bandaged it up, no stitches. Read the rest of this post...

Rachel on the creepy, secretive "C Street" HQ for GOP members of Congress

Rachel has been talking about the secret "C Street" house frequented by some of the most right-wing of the GOP loons in Congress. It's creepy.

Visit msnbc.com for Breaking News, World News, and News about the Economy

You'll learn about Congressman who discuss the "totalitarianism of Christ" and "discipling." I think we're going to hear a lot more about this C Street house. Read the rest of this post...

Its not the uninsured, stupid

I was reading Dana Milbank's piece today, mentioning how if health care reform does not pass, millions of uninsured will have to wait till another time, and it got me thinking that, yet again, Democrats and their supporters need to stop talking about health care reform as if it were only meant to help the thousands of uninsured. For the rest of America, that sounds like a welfare bill that doesn't benefit them. Here's why I think so.

Our country is in the greatest economic crisis since the Great Depression. Most of us weren't around back then, so this is the biggest, scariest economic situation we've seen in our lifetimes. The biggest concern many of us, probably most Americans, have is surviving the next few years with our homes, our families, and our lives, in tact. While an economic crisis is the very time we should be most worried about the most unfortunate among us - e.g., those without health insurance because they're too poor, unemployed, or because plans are simply too expensive - those are the people that the majority of Americans, I believe, care least about at this time.

Why? Because in times of crisis you worry most about yourself and your own family. When you're worried about paying your own mortgage, you don't think "hey, maybe if I spend a little more money I can help some stranger halfway across the country." But that, I fear, is how too many health care advocates are spinning reform. As some trillion dollar program that won't benefit the majority of Americans at all, but rather, as a program for the unfortunate. And while Americans can be generous to those less fortunate during times of plenty, I don't think it's the wisest way to woo someone whose 401k has lost nearly half its value in the past year.

Most people have had problems at some point with their health coverage, or they know someone who has. It shouldn't be rocket science to get people concerned about how paltry their own health coverage really is, especially when their jobs (i.e., health care) are far from secure, and far too many of us are only one serious disease away from bankruptcy.

When times are tough people get selfish. It's time to appeal to their greed, not their charity. Charity, I fear, went out the window half a 401k ago. Read the rest of this post...

Senate voted to strike funding for F-22

By a margin of 58 - 40, the Senate just passed an amendment to strike funding for the F-22 fighter jet. Senators Carl Levin (D-MI) and John McCain (R-AZ) offered the amendment to the Dept. of Defense authorization.

Obama has threatened a veto of the Defense bill if it included the F-22 funding. That bill also includes the Matthew Shepard Hate Crimes Act, which passed as an amendment last week. So, this was a positive development on that front and could clear a major hurdle.

Yesterday, CQ Politics told us this would be a "showdown" vote. And, it was expected to be a very close vote. Instead, funding for the F-22 was dumped by an unexpectedly wide margin.

UPDATE: Obama just made a statement on the F-22. He's quite pleased by this development. Read the rest of this post...

Obama's poll numbers heading south, but GOP's are worse

It's a mixed bag. The GOP is still disliked even more, but it's still not good news for Obama's numbers to be dropping. Some of it is inevitable - the honeymoon is over, as it were. But Joe and I have worried for a long time that Team Obama's disinterest in wooing political friends and allies, mixed with their penchant for cutting deals with Republicans, might create a dual problem for them in the polls. First, Democrats and moderates might become disillusioned, while Republicans will never vote for him anyway. And second, all the accommodating to the mushy middle might create an appearance of weakness, of directionlessness. Obama and his team sometimes give the impression that they think they're so popular, they don't need to fight for their agenda (or keep their promises). But in politics, no one is popular forever. Read the rest of this post...

The hypocrisy and double standard of Rep. Mike Ross and his fellow Blue Dogs

In just a few paragraphs, the Kaiser Health News does what most of the traditional media has failed to do. This article explains how Rep. Mike Ross is obstructing health care reforms that would help his own constituents. He claims to be worried about bankrupting the country, while many American families already go bankrupt because of health care expenses. But, Blue Dog worries about health care expenses don't extend to their own efforts to increase funding for rural hospitals.

Many people in and around this economically depressed town can’t afford insurance, even as the battered economy has made it harder for employers to provide coverage for workers. They're looking to Washington for help, and Ross, a conservative Democrat with a strong voice in the debate over health care legislation, says he’s on their side.

Yet Ross stands ready to try to block passage of a House bill that, its supporters say, would provide exactly what Arkansas needs: guaranteed insurance and a wider choice of coverage at competitive prices.

Ross’ position reflects the conundrum confronting many lawmakers, including many he helps lead as head of the fiscally conservative Blue Dog Coalition's health task force. Even if large numbers of constituents might benefit, many of the Blue Dogs generally oppose the $1 trillion bill because they say it’s too costly and doesn’t solve other health care problems in the their mostly rural areas.

"What we’re talking about is containing the cost, slowing the rate of growth of health care down where it can grow at the rate of inflation,” Ross said in an interview, “because if we don’t, it’s going to bankrupt this country.”

Unless changes are made, Ross and six other Blue Dog members of the Energy and Commerce Committee say they’ll vote against the bill this week, bucking party leaders eager for House passage by the end of July. In the hard bargaining taking place, the Blue Dogs are demanding guarantees that the legislation won’t add to the federal budget deficit and would protect small businesses in their districts from employer mandates that would drive up their operating costs.

Yet at the same time, the Blue Dogs also are seeking changes in the way rural hospitals and doctors are reimbursed for their services, which could substantially drive up Medicare and Medicaid expenditures.

Oh, those Blue Dogs. The traditional media loves them. And, they love all the attention. But, they're hypocrites who are selling out their constituents. Funny how they're all about cost-savings, except when they're not.

Also, Ross and his fellow Blue Dogs really should read this article in today's Washington Post: GOP Focuses Effort To Kill Health Bills. Republicans want to kill health care reform. They want to ruin Obama's presidency and damage the Democrats. Ross and the Blue Dogs are doing the GOP's dirty work. Read the rest of this post...

Blue Cross tells me they will, then won't, cover my emergency visit to a French doctor today

As much as I write on a blog, and have done a lot of television and public activism, I'm actually quite a private person in some ways. I never really wanted to talk about my various health care problems on the blog because, well, it's just not something one does, the way I was raised. Not any more. To the degree Joe and I can help advance the health care debate in our own small way, by sharing our own personal stories of people who supposedly have "good" insurance, then so be it.

Today is the day I visit the emergency room of a hospital in Paris devoted to eye care. (I just arrived in Paris to do my annual house-sitting for Chris and his wife Joelle while they're on vacation.) You see, I'm at risk for a detached retina. Highly myopic. Hitting my mid-40s. Lots of floaters. And my sister already had to have emergency surgery for a detached retina a few years back, then lay on her stomach for 2 weeks - I believe she got like an hour a day to walk around - while her eye healed. It's all very risky, for your vision, but the alternative is most certainly going blind.

So, a few years back, I went to a retina specialist in DC and, lo and behold, he found two small holes/tears in my retina. He did laser surgery, on the spot, to cauterize the tears (let me tell you how fun that was), in the hopes that it would stop them from progressing to a full-blown detachment. I now regularly go to him for check ups, including one last week, before the recent symptoms.

So, this whole detached retina thing is serious business. That's why, when I noticed a marked increased in floaters in my right eye the other day, including a very large one (like I've never had before) and several small black pin points (also have never had that type before), I got worried. I remember my doctor, my sister, and all the the literature telling me that you should always be on the look-out for two things: flashing lights; and/or a marked increase in floaters. I've got one of the two. I called sis, and she confirmed, it's time to get to a doctor, pronto. You see, with retina problems, you don't feel pain. You don't feel anything. Your retina could start detaching, you might notice some symptoms, but you'd otherwise feel fine. And if you don't do anything about it, in a few days you could be permanently blind.

So, being the good guy I am, I got on the phone last night and called CareFirst Blue Cross Blue Shield in the states to find out if I even have coverage here in France, what that coverage is, whether they have specific doctors I have to/should go to in order to get the best coverage, and whether I even need to get pre-approved from them.

Big mistake.

The first lady at BlueCross was very nice. I told her what was going on with my eye, and she told me that I absolutely positively have coverage. Just go to a doctor, they'll cover it as they do at home. Wow, I thought, and I've been knocking Blue Cross lately - this is pretty good. She then told me that they had an international service, Blue Cross Worldwide that would help me find a doctor and all that good stuff.

I was seriously impressed, and told her so. I told her about the last time I'd called them with a health problem from Paris. I had had a cold or flu that had settled in my chest and gone on for over six weeks. I needed a chest x-ray to make sure it hadn't turned into pneumonia. Called Blue Cross to find out if they paid for it in Paris, and got a half-hour long runaround from a very nice woman who had no idea what she was doing, other than reading me written instructions that may or may not have applied to my case. In the end, after the woman had told me that my x-ray would, and then wouldn't, be covered (she asked me if my French doctor was "in plan" - I told her, "I'm in Paris, do you have doctors in plan here?" - she wasn't sure), I hung up and went anyway (and as the fee was 60 bucks, I didn't even bother submitting it to my insurance).

When I told this story to the nice lady at Blue Cross yesterday, to show her how a year ago no one even knew they had an international service, she was genuinely surprised, and told me "you know, you should have submitted that x-ray for reimbursement."

Not so fast, Nice Blue Cross Lady. Because within an hour I'd be passed to Not-so-nice Blue Cross Lady who would tell me the polar opposite.

You see, the original Nice Blue Cross Lady passed me to Even Nicer Blue Cross Lady at Blue Cross World Care. Nicer was going to help me get a doctor, and told me that my coverage would depend on which doctor and all that, and that she'd be happy to assist me in talking to the original Blue Cross folks to determine whether they have any in-plan doctors in Paris, etc. Well. That's when we discovered Not-so-nice blue Cross Lady. NSN, as we'll call her, was an expert at mono-tonally reading sentences on a computer screen. With Even Nicer lady still on the phone with me, NSN told me:

We cover "emergency care, urgent care services only."

Great, I thought, imminently going blind at the age of 45 has to be consider an emergency, or at least certainly urgent, right? Even Nicer Lady concurred, saying something like, well this is clearly an emergency.

That's when Not-so-nice jumped back in:

"We only cover service rendered on an emergency basis or in an urgent care emergency room," she told me.

What's an urgent care center, I asked? It's an urgent care center, where you go for urgent care, like we have them in the states, she said. Yes, just switch the order of the same words and it would all suddenly make sense. Maybe next time she could just read the same words louder.

In her best, somewhat annoyed, somewhat bored, computer simulated voice, NSN was telling me and the Even Nicer lady that I would only be covered for emergency room visits.

What?

I said, but the lady before just told me that any visit would be covered, for anything. She even told me that my visit to the doctor a year ago to get a chest x-ray would have been covered, and scolded me for not submitting it. How is it that now I'm only covered for an emergency room visit?

"We only cover service rendered on an emergency basis or in an urgent care emergency room," she told me again.

Right, but what if I go to an emergency room and they tell me, wow, you're retina is about to detach, you need to go see our specialist right away, and he's down the hall, not in the emergency room itself - so you won't cover that?

"I already told you, we only cover service rendered on an emergency basis or in an urgent care emergency room."

So, if the emergency room people send me anywhere outside of the emergency room to be treated, I'm not covered.

"Sir, I just read you what it says, I can only tell you what it says."

Yes, God forbid my insurance be able to actually tell me under varying scenarios what my coverage is and is not.

The thing is, why did the first Blue Cross representative tell me that my visit to the eye doctor, any eye doctor, would be definitely covered? Why did she tell me that my chest x-ray for last year, which was not done in an emergency room, would have definitely been covered? Why does Blue Cross's own Web site imply that their customers do in fact have some kind of international medical coverage, not unlike the in-plan out-of-plan coverage we have at home? From Blue Cross's own Web site:

If you need non-emergency inpatient medical care, you must call the BlueCard Worldwide Service Center. The Service Center will facilitate hospitalization at a BlueCard Worldwide hospital or make an appointment with a doctor. It is important that you call the BlueCard Worldwide Service Center in order to obtain cash-less access for inpatient care except for your usual out-of-pocket expenses (e.g., deductible, coinsurance). The Service Center is staffed with multilingual representatives and is available 24 hours a day, seven days a week.

At this point, I'd had it with Not-so-nice Blue Cross lady and told her to go away. She was not amused. Well neither was I. Even Nicer Blue Cross lady, obviously feeling bad about what she had just witnessed, was quite apologetic.

I explained to her - so, my eye might be going blind. Rather than go to a retina specialist, you want me to go a general emergency room, where they may or may not have a retina specialist to take a look at me. The risk being that we might not catch the detachment in time, I might go blind, and then we'll be facing $50,000 in surgery when I get back, which Blue Cross WILL cover, all because they won't cover a trip to a specialist while I'm abroad.

Again, Nicer was sympathetic. She agreed that maybe we should try a third Blue Cross expert back home in the states to see if I got a different, third answer as to whether I'm covered. While waiting 20 minutes for that person to come on the phone, my phone disconnected.

Again, let me reiterate. I have "good" health insurance. I pay nearly $420 a month for a PPO because I didn't want any of that "socialized medicine HMO garbage" when I started having to pay for my own coverage. I thought paying the extra money guaranteed that I'd be getting better coverage.

What I got was a company whose left hand doesn't even know what its right hand is doing. A company that can't even tell me if I am or am not covered when I'm in a situation where I have to go to a doctor.

We're to believe that this isn't the equivalent of "socialism," where some faceless bureaucrat rations out care, telling you what you can and can't get treatment for, to hell with what you really need, to hell with any chance of appeal? How could a government plan be any worse? At least with a government plan I can appeal to my member of Congress when the insurance provider starts playing games like this.

For all intents and purposes I have no insurance. I have a crap shoot. Not only are the details of my plan unknowable, but they appear to change with the luck of the draw, depending who answers the phone that day at Blue Cross' 800 number, spin the lucky wheel, headquarters in hell.

So today I'm dragging my happy ass to the eye speciality hospital - I learned how to say "horse shoe tear" in French - and, at the suggestion of Chris' wife, rather than making an appointment, I'm going to the emergency room, since that's the only treatment Blue Cross covers, and since even the Nicer Blue Cross lady agreed with me that being in imminent danger of going blind definitely qualified as an urgent emergency.

Stay tuned for Part II of this saga, my experience with the French emergency room culture. And then will come Part III: Submitting the reimbursement to Blue Cross, and them telling me that my visit wasn't, I bet, urgent.

UPDATE: I got back from the hospital, and had to have emergency eye surgery. Read about that tale, from the land of socialized medicine, here. Read the rest of this post...

Roubini: 'recovery is going to be subpar'

On the upside, Dr. Doom does see the US leading the way out of the global recession. In the near term though there's little to be excited about as unemployment grows and growth is severely limited. Roubini also gets behind the second stimulus which appears to be in the queue (or at least under serious discussion) for late 2009. The Democrats are going to need to show progress on the economy heading into 2010 or else the elections could turn ugly. Some of the states hit the hardest by unemployment were states that went for Obama but it's going to be a battle to hold those close states without some level of success. CNBC:

When asked about the economy Monday, Roubini said, "We may be out of a freefall for the financial system," said Roubini. "We have seen the worst in that sense. But in my view there is a sluggish U shaped recovery that might go into a W double dip if we don't fix the problems in the economy."

On a second stimulus: "I think there will be another one toward the end of the year. We need to have more shovel ready labor intensive infrastructure projects. We'll need it."

On investing in today's markets: "A "Stay away from risky assets. I think from now on the surprise will be on the downside in areas like commodities."

Read the rest of this post...

Tuesday Morning Open Thread

Good morning.

In the first few months of George Bush's administration, Congress passed a $1.3 trillion tax cut. All the Republicans lined up behind their party's leader -- and many Democrats went right along. That started us on the path to record deficits. And, while the richest of the rich surely benefited, most Americans aren't better off eight years later.

Now, we have a Democratic president who is trying to solve the health care crisis. All the GOP members of Congress have lined up against Obama (with maybe, maybe, one or two exceptions.) The GOP effort to kill reform is abetted by Democrats.

Democrats won recent elections because they promised to solve the problems left over from the Bush/GOP years. Do it. Bush got his party on board to enact the tax cut agenda he ran on -- and Bush really didn't even win in 2000. Why won't Democrats enact the health care reform agenda Obama and most of them ran on?

These are things that really drive me crazy... Read the rest of this post...

Saudi nationals seeking asylum in UK

The move by ten more is following the story yesterday about a Saudi princess who sought asylum on the basis of facing death by stoning if she returned. (Her baby also would have faced the death penalty as well since the child was born to a man other than her husband.) It would be interesting to see how the US would react to a wave of Saudi nationals seeking asylum. Would the US do the right thing or would they not want to offend the Saudi family?

Immigration and asylum experts said last night that asylum cases from women fleeing the kingdom were very rare. But Keith Vaz, chairman of the Commons Home Affairs Select Committee, said of the case: "This is the kind of person that our asylum laws are designed to protect. A woman and her unborn child should under no circumstances be sent back to a country where it is likely that they will be harmed. I welcome the decision made in this case."

New figures released by the Home Office also showed that a further 15 Saudis were refused asylum by the Government last year. There are no details about the sex of each of the applicants nor for the number of asylum applications received this year.

Mr Vaz called for more information to be made public about claims from Saudi Arabia. He said: "This is a country with a questionable human rights record. It is important to make clear the number of people who are fleeing similar treatment."

The princess's case is one of a small number of claims for asylum brought by citizens of Saudi Arabia which are not openly acknowledged by either government. British diplomats believe that to do so would in effect highlight the persecution of women in Saudi Arabia, which would be viewed as open criticism of the House of Saud and lead to embarrassing publicity for both governments.

Is "death by stoning" really any less embarrassing? Read the rest of this post...

Teen pregnancy and syphilis up sharply during Bush years

Oh those traditional family values. If only there were a few more purity balls, all of this could have been avoided. And some have the nerve to say the Bible was better than using science.

Teenage pregnancies and syphilis have risen sharply among a generation of American school girls who were urged to avoid sex before marriage under George Bush's evangelically-driven education policy, according to a new report by the US's major public health body.

In a report that will surprise few of Bush's critics on the issue, the Centres for Disease Control says years of falling rates of teenage pregnancies and sexually transmitted disease infections under previous administrations were reversed or stalled in the Bush years. According to the CDC, birth rates among teenagers aged 15 or older had been in decline since 1991 but are up sharply in more than half of American states since 2005. The study also revealed that the number of teenage females with syphilis has risen by nearly half after a significant decrease while a two-decade fall in the gonorrhea infection rate is being reversed. The number of Aids cases in adolescent boys has nearly doubled.

The CDC says that southern states, where there is often the greatest emphasis on abstinence and religion, tend to have the highest rates of teenage pregnancy and STDs.

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Be advised: Anti-gay marriage group also opposes civil marriage for straights

The anti-gay circus has arrived in Maine. But, the latest all-male anti-gay group is not content with just fighting same-sex marriage. No, they're also opposed to any marriage performed at City Hall -- without God. (Watch the video.) Read the rest of this post...

One small step...

I remember watching the first walk on the moon forty years ago tonight -- back in the summer of 1969. I was eight, almost nine. My sisters and I got to stay up extra late because it was just such a huge event. My mother made jello (which, for her, was quite an effort.) And, my grandfather, an Irish immigrant who was 80 at the time, kept pacing around the living room. He just couldn't believe it.

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