A letter to Congressman Murphy on health care [guest essay]
by Ben L.
(also see his essay
America's Great Healthcare Denial of Service)
Dear Representative Murphy,
I would like to tell you my story, which is only a small horror story in the context of this wretched system of wasteful, greedy health care in the US. Hopefully, there is a tipping point where the people make their will known for a simple, effective system. Everyone should have access to care.
This year, my health care provider (HMO to PPO) changed from MVP to United Healthcare. Since then I am left to the wolves for fighting for benefits that they promised to me and then denied. I can see no mechanism that punishes them for the denials -- only their own benefit of stealing money from their members, from providers, from institutions.
I have Crohn's Disease. It is a chronic disease that requires medication to keep my condition from going into painful inflammation.
In October of 2008, I began trying to verify with United Healthcare (UHC) what my out-of-pocket expenses would be for covering Remicade infusions (for treatment of Crohn's Disease). After many phone calls, I received assurances in January of 2009 that the procedure would be coded and billed as an office visit and I would be responsible only for the co-pay. At this time I was coordinating services through Gastroenterology Associates of Northern NY in Glens Falls (through Dr. Michael Chase) as well as Glens Falls Hospital.
In April, I received a bill from Glens Falls Hospital for $1,677.09. This was for my first Remicade infusion for the year. The relevant UHC claim is [number].
A subsequent infusion was performed on 3/17/2009 and I again was billed using this different criteria. This time patient responsibility is set at $603.24 and UHC is now saying that this is the remainder of the maximum out of pocket expense for the year. (Although, actually I have been billed for $645 more because my gastroenterologist who I thought was in-network is out of network even though there are no local gastroenterologists in network, there is a different out-of-network out-of-pocket maximum than the in-network out-of-pocket-maximum -- this has subsequently been resolved after 3 appeals with UHC and another appeal through Tribune Company who actually self-insures the plan with UHC administering).
Although the hospital expenses appear to be a difference in how the billing is coded, I have not been given any direction or opportunity or redress to get them coded in a manner that is compliant with how I was described this process would work (and what my payment responsibility would be) as consistent with what I was told at the beginning of the year. For Dr. Chase’s bill, I was told that I would be able to obtain a waiver because there are no in-network gastroenterologists, but this has been refused in appeals with UHC.
I would like to get this figured out soon as I am getting a lot of bills that I do not feel I should be responsible for with “Past Due” and “Final Notice” on them. These bills in question are:
Glens Falls Hospital service date 1/20/2009 $1,677.09
acct# [number]
Glens Falls Hospital service date 3/17/2009 $603.24
acct# [number]
I am in the bad debt file over in the hospital and have 30 days to resolve the matter (pay the debt, set up a payment plan, etc.).
Please, please, please do something to reform this system, rife with abuse so people who are sick are not attacked by predatory corporations.Labels: health care, thieves
Local mill leading national polluter, says group
The Post-Star reports that Glens Falls' paper mill Finch Pruyn is
the nation's 6th largest polluter of cancer-causing chemicals, the leading polluter in New York state. According to the group Environment America, Finch
released into the Hudson River 26,541 pounds of carcinogens, the vast majority of which was formaldehyde.Labels: environmentalism, pollution
Conservative in politics, liberal with the truth
Perhaps it's no surprise that someone endorsed by Sarah Palin and Glenn Beck would, to be polite,
play fast and loose with the facts... especially after a campaign where he showed so little grasp of them. But maybe Hoffman ought follow Palin's advice (something the vice-presidential candidate never quite did) and "quit makin' stuff up."
Labels: elections
Guide to judicial candidates
Adirondack Almanack has
a useful guide to local judicial candidates for the state Supreme Court* as well as a link to a statewide guide.
*-The Supreme Court is actually the lowest level (trial) court in the New York state system and its justices are elected.Labels: elections, judges
"Stalinists" for "McHugh's heir"?
Over the weekend, the Republican-endorsed candidate for the special election in New York's 23rd Congressional district Dede Scozzafava
pulled out of the race. The race was provoked when GOP Rep. John McHugh was tapped by Pres. Obama to become Secretary of the Army.
Scozzzafava spent much of the campaign defending herself from a barrage of attacks by Glenn Beck, Sarah Palin and other far right national media types who backed her Republican-running-as-a-Conservative opponent Doug Hoffman. For his part, Hoffman was widely accused of
being a generic ideologue who knew very little about and talked very little of issues that affect the district. This was fueled by his decision to skip both public debates held during the campaign, the first of which he snubbed to get cozy with Beck on his show.
Hoffman and the national far right that backed and funded him weren't running against Scozzafava and Democrat Bill Owens, who most couldn't tell from Eve and Adam. These jihadists were crusading against infidel
RINOs and against satanic Nancy Pelosi. Democrats were no doubt licking their chops at this GOP self-cannibalization, hoping the party will become even more marginalized than it is now.
As
Adirondack Almanack pointed out, on the day of Scozzafava's withdrawal, Hoffman said warm and fuzzy things about the woman he spent months savaging. Hoffman had initially promised to accept the wishes of the GOP party bosses in the nominating process; then when they tapped Scozzafava to be the nominee, he renegged on that promise. That history didn't stop him from piously praising Scozzafava for putting the party ahead of her own personal interests.
But then the Republican Assemblywoman
endorsed Owens as the best man to represent the district's interests. As the only candidate in the race who'd ever actually had the job of representing the interests of any voters, her opinion wasn't insiginificant.
Suddenly Hoffman decided that
he and Dede were no longer BFF!!!... forever being an even shorter time in politics than in adolescence.
Reactions to the developments varied on ideological beliefs.
The New York Times' Frank Rich described
the national activists on Hoffman's behalf as "Stalinists." Anti-abortion blogger Bob Conner at Planet Albany says that the "pro-life" (read: anti-abortion)
Hoffman is the real heir to John McHugh on abortion.
Hopefully the voters of the 23rd (which do not include Rich, Conner or myself) will finally be allowed to make up their own minds without further meddling from outsiders.
Update: Planet Albany's Conner reports that top Republicans in the state Assembly are backing Hoffman. Controlling a whopping 26.7% of the chamber's seats, Assembly Republicans are no doubt the model of 'ideological purity = electoral success' that Hoffman and his far right backers are seeking to emulate.Labels: elections
Yes on NYS Constitutional Proposal #1
North Country Public Radio's blog has a piece on the two proposals to amend New York's state constitution that will appear on the ballot tomorrow.
Proposal #1 is a state land swap with the National Grid power conglomerate that would provide for more reliable electricity to the Tupper Lake area.
Proposal #2 would allow prisoners to voluntarily do work for non-profits.
The Watertown Daily Times decided to
endorse both proposals.
Proposal #1 was strongly
pushed for by local officials. But the move also has the broad support of the environmentalist community, getting the thumbs up from the
the Adirondack Council. Environmental groups support the swap because it would, in the Council's words,
avoid an environmentally disastrous six-mile detour through the woods... the detour would involve road construction through an old-growth forest, 95 streams and wetlands, and habitat for the endangered spruce grouse.Don't forget to vote on these proposals tomorrow. They're usually at the very top of the ballot.
Labels: elections
How the beautiful people live
Normally, I buy
The Post-Star at the newsstand every day, which may surprise readers of this blog, as I like to have something to read when I'm eating lunch. Sometimes if I'm eating dinner out, I'll buy a second newspaper. In the past, it's usually been the Albany
Times-Union, but I haven't bought that recently because of
the boycott against it.
I looked at the other papers. The Schenectady
Gazette covers issues outside my region of interest. I deemed
The Saratogian a poor use of my 75 cents (imagine a paper with less quality and content than
The Post-Star that costs 50 percent more). I didn't feel like paying 6 bucks and leg and two fingers or whatever
The New York Times is changing now. And there was no way I was giving a dime to Rupert Murdoch's
New York Post. So I ended up getting a New York
Daily News to read with my meatball sub. It's not the highest quality news organization but it has its entertainment value.
I was intrigued by a very unentertaining
story about wife-beating allegations against a prominent TV news anchor. The big shot warned the judge, "I've appeared on the cover of
The New York Times and
TV Guide... I covered the state attorney general and the chief judge of the court," before bragging about how he knew the state's recently retired top judge.
First, the wife called 911 to accuse her husband of beating her. Now that the case has gone to trial, she's claiming she lied because she was mad at him; recantations under pressure are not that uncommon in domestic abuse cases. Though she did admit in court that her husband called her a "dumb, stupid, project bitch."
One argument in her defense was revealing, though. In recanting, she claimed that it was actually a day laborer, not her husband, who assaulted her, but that she couldn't remember his name.
"You don't ask a laborer his name," she explained. "You ask a laborer to work."
I don't quite get why showing a laborer the basic human dignity of asking his name is so taboo, why it goes without saying that she'd never do such a thing. But then again, I'm not part of the glitterati.
Labels: arrogance
