The Widdershins

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Who pays the bill?

Good Day Widdershins!

MB has had some real life issues come up
so I’m subbing for her today.

Welp, the Super Bowl is over and as chat and I used to say, we’ve entered the Dark Times now as far as football is concerned.  However, we survive.

What we may not survive is how insurance companies treat us when we may have to use the services of the emergency room.  Basically they now have decided that unless you have diagnosed yourself, performed an M.R.I. on yourself with your own imaging machine that you keep out in the garage and truly have an emergent condition under their own list of diagnostic codes rules and, in the case of Anthem, they probably won’t cover your claim for an E.R. visit.

A list of codes from Missouri is significantly longer, with more than 1,900 diagnostic codes that could indicate non-emergency visits. The list includes multiple types of “unspecified injuries” and “chest pain on breathing.”

(snip)

In other states, the list of diagnosis codes remains confidential. Georgia insurance regulators have asked Anthem to provide a copy of that state’s list, but so far, that hasn’t happened.

The link above is a link to a Vox article describing what happened to one woman in Kentucky Who had Anthem Blue Cross.

Brittany Cloyd was doubled over in pain when she arrived at Frankfort Regional Medical Center’s emergency room on July 21, 2017.

“They got me a wheelchair and wheeled me back to a room immediately,” said Cloyd, 27, who lives in Kentucky.

Cloyd came in after a night of worsening fever and a increasing pain on the right side of her stomach. She called her mother, a former nurse, who thought it sounded like appendicitis and told Cloyd to go to the hospital immediately.

Hell, if my mom was a former nurse and told me that I would be heading to the E.R. too!

At the E.R. the doctor and staff did a CT scan and ultrasound.  They determined that Cloyd had a case of ovarian cysts.  They gave her a prescription for pain meds and an order to followup with her gynecologist.  And ya know…most of us don’t have that CT machine and ultrasound to do our own tests before heading to the E.R.

However that wasn’t good enough for Anthem Blue Cross and they denied Cloyd’s claim leaving her to pay a $12,000 bill.

What Anthem suggests other than a visit to the E.R.

Anthem discovered a really neat way to start denying E.R. claims when they received them.

Anthem has begun denying coverage for emergency room visits that it deems “inappropriate” because they aren’t, in the insurance plan’s view, true emergencies.

The problem: These denials are made after patients visit the ER, sometimes based on the diagnosis after seeing a doctor, not on the symptoms that sent them, like in Cloyd’s case.

Now, I’m not a doctor nor a nurse but I do believe when you present to the E.R. the docs and nurses will get the symptoms you are having and then start the process of ruling out or ruling in what the problem or issue is.  However, it’s much easier and cheaper (!) to go by what the discharge diagnosis turned out to be.

Vox wanted to interview someone from Anthem but after initially agreeing to an interview Anthem backed out and just gave them a written statement.  (which is bullshit btw)

Renee Hsia, a professor of health policy studies at the University of California San Francisco and practicing emergency physician said:

“If you look at insurance claims data, you have diagnoses but you don’t have what the patient came in with,” Hsia said. “It’s not fair to expect the patient [to come] in knowing their diagnosis. If they did, they wouldn’t come in and wait for ours.”

Oh and that little flyer thing above that Anthem included in some folks’ bills?  It a crock.  In my local area, urgent care places close at 6:00 p.m., they aren’t open “nights”.  So if I have chest pains after 6, do I wait until the next day when they are open or do I call 911 and go to an E.R.?  And pardon me, but the Teledoc?  I’m having chest pains and I’m going to video conference with a doc?  Uh no and besides they charge either $40 or $45 bucks and then they would say “go to the E.R.”.

At least Brittany got satisfaction on her claim.  It only took two appeals and then Vox getting into the situation.

John Rogers, president-elect of the American College of Emergency Physicians said “Hospitals are starting to talk to patient advocacy groups, asking whether they’re aware of the situation,” he said. “We’re starting to sit down with legislators to say, ‘This is happening, we don’t think it’s a good idea, and these are other, better solutions.’”

Good luck Dr. Rogers.  Going up against the big health insurance companies will be a long, difficult slog.

Open thread of course.

I couldn’t bring myself to write about tRump and his calling the Democrats “treasonous” because they refused to kiss his ass applaud his S.O.T.U. address.  You’ll find out about real treason very soon Donald.

 

 

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Good morning Widdershins.

This week has been rough. On Tuesday and Wednesday Republicans passed the Money Redistribution Act. Not a single Democrat voted for this travesty that will gut whatever is left of the American middle-class. But Republican centrists, those honorable people likeSusan-collins-e1465230869154.jpg Susan Collins and Lisa Murkowski – heroines of the ACA repeal fiasco – showed once again that when it really comes down to it, they are as dishonorable as every other Republican. Both sold out the American public for a handful of dollars; actually, when I say a handful I mean a huge handful for themselves and their corporate overlords. Susan Collins, when told that McConnell would not honor his promise to her about the ACA mandate, lashed out at the media:

“I believe that the coverage has been unbelievably sexist, and I cannot believe that the press would have treated another senator with 20 years of experience as they have treated me,” she told reporters in the Capitol. “They’ve ignored everything that I’ve gotten and written story after story about how I’m duped. How am I duped when all your amendments get accepted?”

A certain female former Senator, Secretary of State and almost President might laugh at Collins’ self-pity. The GOP tax bill for all intents and purposes repeals ACA. Collins voted to repeal it after claiming she wouldn’t. Because McConnell promised her something he has no intention of delivering. If she truly thought he would – she may not look it, but Susan Collins was born yesterday.

In other news, the New York Times continued to demonstrate why they are – as I like to say – the rotting corpse of a once great news organization. Just a few short weeks ago they suspended their star White House reporter Glenn Thrush after stories came out that multiple women were accusing him of harassment and assault. On Wednesday Dean Baquet announced that Thrush would be back at the paper, just not covering the White House.

“While we believe that Glenn has acted offensively, we have decided that he does not deserve to be fired,” Baquet said in a statement. He said Thrush will receive “training designed to improve his workplace conduct,” and that Thrush is undergoing counseling and substance abuse rehabilitation on his own.

This is galling, especially when you consider that the Times previously wrote op-eds calling on Al Franken to resign. (Which he did and just announced that he will be gone atmaxresdefault.jpg the end of the year.) Thrush, one of the star male reporters who helped craft the narrative in 2016 that Hillary Clinton was unlikable and not trustworthy, was proven to be a misogynist. Perhaps considering the Times’ coverage, especially Baquet’s political coverage, one should not be surprised. But appalled and disgusted, yes. Or as Brianna Wu tweeted:

Dear . The issue with Glenn Thrush isn’t that he behaved “offensively.” It’s that he got drunk, sexually assaulted women he worked with, and then DESTROYED THEIR PROFESSIONAL REPUTATIONS with colleagues to cover his ass. How can you keep that in your newsroom?!

Perhaps more than any other paper, the New York Times has been responsible for normalization of Trump and White Supremacy, and the destruction of Hillary Clinton. If anyone still has a subscription to it, I urge them to cancel it. (Also worth noting Arthur Sulzberger, the publisher of the Times, announced his retirement from the paper effective December 14th. His place as the head of the paper was taken his son, A.G. Sulzberger. Because, well, of course.)

Memes.com

Good Monday, all. As I was toodling around the interwebz trying to find something inspiring to write about, I came across this article about an organization called “Care2,” which has been around since 1998, has over 41 million members, and is considered a pioneer in the field of online activism.

A couple of things that stood out for me:

  • Online petitions actually do help. According to the article, they’re a great tool for showing that a cause has a large number of supporters, as well as leading people to take next steps, such as calling or writing their Congresscritters.
  • The normalization of outrage is dangerous to the Resistance. We are understandably and justifiably exhausted from the constant stream of crayzee coming from Drumpf, but, we can’t let it go by. We can never accept his behavior or his Residency. All we can do is say no, no, a thousand times no, and keep saying it!

That’s all the positivity I have for you today. If you want to leave on a happy note, stop reading, because what’s coming next will not make you smile.

While the Orange Jumpsuit has resolutely golfed his way through the crisis in Puerto Rico and the Virgin Islands, tweeting madly about the mayor of San Juan and the NFL’s standing or kneeling during the National Anthem, the Thugs in Congress have quietly found a way to take health care away from 9 million children and pregnant women. Because you know, that’s what those heartless f*cking bastards live for.

Congress just allowed the Children’s Health Insurance Program, which provided low-cost health insurance to 9 million children, to expire.

If action is not taken soon to restore the funding, the effects will become obvious in schools across the country, with many of the children in the program unable to see a doctor for routine checkups, immunizations, visits when sick and other services.

The program, created under a 1997 law passed with bipartisan support during the administration of President Bill Clinton, provided coverage for children in families with low and moderate incomes as well as to pregnant women. It was instrumental in lowering the percentage of children who were uninsured from nearly 14 percent when it started to 4.5 percent in 2015. It was last reauthorized in 2015 and was due to be renewed by Sept. 30, 2017.

The program is a bargain. It only cost the federal government $13.6 million last year. Some of the moneys are paid from state budgets, which makes is structured a bit like Medicaid. Perhaps that’s why the deplorable Thugs hate it so much, although my personal theory is that since it was Hillary’s baby, they’re letting it expire from spite. I said the same thing to Paul Begala on Twitter.

I like Paul Begala, but I really, REALLY don’t want to hear anything more about how Republicans are “actually” good and decent people who “should speak up.” They don’t speak up because they are TOTALLY FINE WITH WHAT DRUMPF IS DOING. If you support the Republican Party, you support the Party of Death. They do not give a flying f*ck if the entire country turns into Mordor; a hot, stinking, war-addicted, slave factory where they rule with iron fists over a squabbling, bloody, ignorant populace afraid of the light. The people like the Kochs, Mercers and Adelsons feel they are immune from it all; that their money insulates them from whatever disasters they perpetrate on the environment and on the American people. They don’t need government health care, you see, so no one else deserves it. They don’t need clean air because they can afford to seal themselves up in a bunker and filter it all out. They probably think they can survive a nuclear holocaust, which, cockroaches that they are, just might be true.

Seriously, doesn’t Sheldon Adelson look like the Portrait of Dorian Grey? He is the very embodiment of corruption.

It makes me even more viscerally ill that a lot of these right-wing f*cktards are Jewish. They are sending millions and millions to people like Steve Bannon and Alex Jones, who preach the exact same anti-Semitism that got 6 million Jews killed from 1941-1945. How dare they empower this kind of racial division masquerading as “right-wing populism” – another phrase I never want to hear again? What a bunch of sociopaths. The holes inside them can never be filled with money, but much to the detriment of America and those who love her, they’ll never figure that out.

What can we do about all of this? Well, we can tweet, and sign petitions, and march, and make sure our Congresscritters know exactly how we feel about everything they’re doing. And we can also take comfort in the fact that the Democrats have flipped 7 seats in special elections this year…and the Republicans have flipped none.

According to the Cook Political Report (and our friend Janicen), the elections to watch are the ones in Virginia.

As those elections show, Democratic voters are hyper-motivated right now. But their chances fall as turnout rises. On June 20, Republican Karen Handel defeated Democrat Jon Ossoff in Georgia’s 6th CD after a $50 million contest that generated 56 percent turnout. The very same day, Democrat Archie Parnell came within three points of a shocking upset in a South Carolina race that attracted a fraction of the money and generated 19 percent turnout.

Virginia’s House of Delegates races are a better proxy of what’s to come in 2018. Turnout won’t be too hot (as in Georgia) or too cold (as in New Hampshire). It will be driven by the governor’s race, which better approximates what a midterm turnout looks like.

Moreover, there are plenty of vulnerable GOP Virginia delegates sitting in districts where Clinton outperformed Obama. Republicans like Dels. Jim LeMunyon (67th), Scott Lingamfelter (31st) and Tag Greason (32nd) all fit that bill – just as there are plenty of House Republicans sitting in districts where Trump is uniquely unpopular. Their races will test voters’ inclination to send a message to Trump regardless of whether they know and like the local GOP candidates.

Let’s keep an eye on these races in particular.  Election Day is 11/7/17. Things could get very, very interesting.

This is an open thread.

Good Monday, all. It has been another busy, crazy weekend. First things first: we need to keep calling our Senators (and for those of us in blue states, calling Susan and Lisa, as I fondly call them) – to make very, very sure that they don’t pass Graham-Cassidy.

Senator Susan Collins: (202) 224-2523

Senator Lisa Murkowski: (202)-224-6665

You can also call McMaverick: (202) 224-2235

And Brillo Pad Paul: 202-224-4343

As for the rest, where do I even begin? While no one would ever defend the media’s horrific treatment of Our Girl, Hillary Clinton, I will say there is a YUGE challenge in trying to keep up with the non-stop sh*storm our Presnit unleashes every single day. I even heard a couple of women talking about it in the nail salon today, and they were not kind. I’m pretty sure they were Republicans, too, being white, of a certain age, and in Croton-Harmon, Noo Yawk (FYI, I live in the more down-market town slightly north). “Why doesn’t he stay out of private enterprise?” asked one. “Why doesn’t someone take that d*mn phone away from him?” asked the other. Neither one had an answer, but it was clear they were absolutely disgusted. “There’s something so wrong with him,” the first one concluded, shaking her head.

Yes, there is. And to attempt to chronicle the madness would take much more time than your intrepid MB has…so here are some thoughts I have about the latest scandals. It will be a lightning round. Here goes…

There are four defining characteristics of the GOP in the Drumpf era: Corruption, white male rage, narcissism and high crimes and misdemeanors. If I were the media, I would put each scandal into one of those frames to make it easier to digest and understand.

It would look something like this:

Corruption

  • Attempting to remove health care from 32 million Americans so the Kocks and Sheldon Adelson will open their checkbooks and spend hundreds of millions of dollars to get them re-elected
  • Proposing a $1.3 million tax cut for themselves and their friends under the guise of “tax reform”
  • Private jets for Cabinet secretaries
  • Staying at Drumpf properties for 33% of his very short term so far, and continuing to make money from them
  • Refusing to disclose his tax returns
  • Buying fake news ads on social media

White male rage

  • #MAGA
  • Stephen Bannon, Sebastian Gorka, etc. etc. etc.
  • Breitbart and Fox News
  • Condemning black football and basketball players for peacefully protesting racism, while opining there are “very fine” Neo-Nazis and Klansmen after they killed a young woman and two law enforcement officials in Charlottesville
  • Build The Wall
  • Lock Her Up
  • DACA rollback
  • Muslim ban
  • Transgender ban in the military
  • Deportation force
  • Birtherism
  • Not sending aid to Puerto Rico immediately – because they are “brown” American citizens

Narcissism

  • Drumpf’s obsession with (ahem) size
    • Hands
    • Rallies
    • Victory in 2016
  • His need to destroy everything related to any person or institution he lost to at one point (which is, like, a lot of people, because he is a LOSER. Sad!!!!)
  • His need to always claim a win, even though…see above
  • His constant need to be praised, stroked, and told he is the best at everything

High crimes and misdemeanors

  • Russia, Russia, Russia
    • Firing of Sally Yates and James Comey
    • Trump Tower, Moscow
    • Wikileaks
    • DNC hacks
    • Voting database hacks with no acknowledgement and no action to prevent them from happening again
    • “Voting fraud” commission as an excuse to purge more voters from the rolls

I am exhausted! I don’t know how Rachel Maddow does it. I hope I’ve given you enough to talk about today, Widdershins.

This is, as always, an open thread.

You think we’re buying that crap?

 

A good morning to you Widdershins!

Just a little something since DYB’s Wednesday post was so wildly successful.

So Frankencassidy Bill of Louisiana and Lady Lindsey of South Carolina would have you believe that their plan to abolish the A.C.A. is about giving Americans a “better choice” for healthcare.  And they would accomplish this by creating “block grants” to send to the states and the states would take care of healthcare and health insurance for their residents.  I call bullshit on it.

Here’s what NPR had to say about this atrocity.

Here’s what it does:

Graham-Cassidy essentially deconstructs all of the major programs created by the Affordable Care Act, gathers up the money and hands it over to states to run their own health care programs.

It gets rid of both the subsidies that help people buy individual health insurance policies and the reimbursements to insurance companies for offering price breaks on copayments and deductibles to the lowest-income customers.

It rolls back the Obamacare Medicaid expansion that was adopted by 31 states and Washington, D.C., and it eliminates the Basic Health Program that was created under the ACA and implemented in New York and Minnesota.

All the money that currently goes to those initiatives would instead be distributed to the states as block grants that would particularly benefit those states that did not expand Medicaid earlier and those states with lower health care costs.

There’s a huge graphic there that breaks down how the A.C.A./the House plan/First Senate bill/and Graham-Cassidy affect various groups.  Check it out.

Another thing is the fact that yes this sends money to the states and their legislatures to create some type of health care program for individuals and to manage their medicaid programs.  Now…take a look at this graphic of who controls the state legislatures in the country:

Now do you really think those red state legislatures are going to be very concerned about individuals with pre-existing conditions or keeping the guaranteed essential benefits of the A.C.A. plans?  Puhleeze!

And here’s another little sneaky thing the dynamic duds will accomplish: (again from the NPR piece)

Graham and Cassidy say their plan restores fairness to a system where currently more than a third of the money spent on the Affordable Care Act goes to just four states: Massachusetts, Maryland, New York and California.

[snip]

Timothy Jost, a professor at Washington and Lee University School of Law who wrote a widely used textbook on health law, says the proposed change also has political benefits for Republicans.

“In general, the legislation would over time move money away from states, predominantly Democratic, that have expanded Medicaid and aggressively pursued enrolling their lower income populations in Medicaid and exchange coverage,” he wrote in a Health Affairs blog post. “Money would move toward states, predominantly Republican, that have not expanded Medicaid.”

To quote someone famous:  “Aye, there’s the rub”.

And the biggie of all the biggies in the Repubs wanting so hard to push this deal simply comes down to money that their Lords and Masters say they want and they want it from the A.C.A.

The Kock Brothers (and yes I meant that) and the rest of their ilk have simply said their checkbooks are closed to the Repubs until they accomplish something.  And the something is a big, fat tax break for them courtesy of the money saved by getting rid of the A.C.A.

At a weekend donor retreat attended by at least 18 elected officials, the Koch brothers warned that time is running out to push their agenda, most notably healthcare and tax reform, through Congress.

One Texas-based donor warned Republican lawmakers that his “Dallas piggy bank” was now closed, until he saw legislative progress.

“Get Obamacare repealed and replaced, get tax reform passed,” said Doug Deason. “Get it done and we’ll open it back up.”

Dave Brat, a Repub from Virginia said:
“If we don’t get healthcare, none of us are coming back,” he said in a brief interview. “We said for seven years you’re gonna repeal Obamacare. It’s nowhere near repealed.”

It’s the same for tax reform, Brat said: “We don’t get taxes through, we’re all going home. Pack the bags.”

So there you go:  It’s all about the “dollahs” to the Repubs.

Speaking of dollahs to Repubs, I saw this on nola.com about Frankencassidy Bill and how much he has raked in through contributions:

https://www.opensecrets.org/news/issues/healthcare?type=P

If you look at the top of the heap there’s old Bill from La. raking in the most.

Lastly, here’s Jimmy Kimmel’s round 3 on Frankencassidy and his crappy piece of legislation:

Give ’em hell Jimmy!

And as far as Frankencassidy and Graham, well:

As usual, this is an open thread.

 

 

 

 

 

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There was a moment during the previous Trumpcare vote, when John McCain made his dramatic entrance and gave the melodramatic thumbs down, when Democrats spontaneously burst into applause. And minority leader Chuck Schumer angrily waved for them to stop, which was almost like someone hit the “mute” button. Schumer must have known that Trumpcare was not yet dead and gloating was premature. Sure enough, Trumpcare is back. And it is actually closer to passing now than it was back then. Lisa Murkowski, who with Susan Collins so resolutely stood against it then, is wavering now. It is impossible to read McCain’s intentions. His maverickness has always been an illusion. Will he waver until the last moment and deal Trumpcare another deathblow so he can bask in the glow of public praise? Or will he do his usually hyper-partisan right-wing thing and do what he has always done: vote right along party lines? Who can tell.

There’s a moment in Hillary Clinton’s book “What Happened” where she mentions that at the inauguration McCain came up to her and hugged her, and had the same horrified expression on his face that she had. I’m sure this happened, but I’ve always been fascinated by how politicians can do and say such awful things to one another – and then talk about each other’s integrity. McCain’s behavior towards Clinton has been vile for many years. From Benghazi and emails through the entire campaign. And yet, Hillary considers him a friend. I know this sort of thing has been the gold standard for bipartisanship (fight during the day, share dinner and drinks at night), but when so much it at stake, how do politicians separate their personal feelings? How do they compartmentalize watching people do horrible things and go grab a smoke after? How does one continue to respect a man like John McCain?

Speaking of vile and no respect: Bernie. Yesterday socalannie posted a tweet from Sasha Stone, founder of the entertainment website awardsdaily.com.

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That’s a perspective on Sanders and his Revolution I hadn’t appreciated until Stone articulated it. And suddenly, so much of it makes sense. Bernie is the alien from “Aliens,” a parasite with acid for blood that latches on to a host because it can’t survive on its own, and then eats its way out through the chest cavity. It lays eggs (Bernie’s loyal minions like Nina Turner and Susan Sarandon), who do their own damage by killing their own hosts. And the cycle continues. Of course Sanders’ revolution is against Democrats. He and his believers have dedicated more time to attacking Democrats than Republicans and Trump. And they are doing it by infiltrating the party and are now eating their way out. Sadly the Democratic party is allowing it. Last week Sanders managed to bully a lot of leading Democrats, like Kirsten Gillibrand, Corey Booker and Kamala Harris into supporting his single payer plan, a plan each and everyone one of them knows has zero chance of passing. And a plan that they announced just as the newest version of Trumpcare, conceived by Lindsey Graham, began to dig its way out of the grave. Sanders convinced Democrats to take their eyes off the undead with the usual promises of magical unicorns. Even Bernie Bro Matty Yglesias tweeted that October 1 – the day after reconciliation of ACA repeal ends – would have been a better day to introduce single payer. Now it’s impossible to tell if ACA will survive. And no, contrary to what Bernie Bros maintain, death of ACA will not lead to single payer.

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On the plus side, NY Times’ Glenn Thrush announced he quit Twitter. Sayonara baby.

What’s your minds Widdershins? This is an open thread.

Good Monday, Widdershins. I hope you had a good International Women’s Day. I saw quite a few women wearing red at my client site last week in honor of “A Day without a Woman.” It was inspirational. I think there are several more actions planned from the organizers of the Women’s March, so stay tuned!

Now to the title of my post. This comes from some research I’ve been doing on the human brain, and the way it works to keep us alive and protect us from threats. This won’t be a super-science-y piece – more of a meditation on the state our country is in, and how it’s possible for sub-human cretins like Drumpf, Bannon and their minions to win even one vote, much less 60-odd million.

As I’m sure many of you know better than I, there are older, more primitive parts of our brains that only exist to make sure we quickly and instinctively respond to threats. From an evolutionary perspective, these parts of the brains are extremely important. They initiate the “fight or flight” response, which actually also includes a “freeze” as well, giving us microseconds to decide either to go to war, or to retreat.

After millions of years of evolution, we actually developed the capability to process these responses and evaluate them. Ah, the frontal lobe! Human beings develop this part of the brain in young adulthood. At least, some human beings do.

…It organizes responses to complex problems, plans steps to an objective, searches memory for relevant experience, adapts strategies to accommodate new data, guides behavior with verbal skills and houses working memory. Its orbitofrontal circuit manages emotional impulses in socially appropriate ways for productive behaviors including empathy, altruism, interpretation of facial expressions. Stroke in this area typically releases foul language and fatuous behavior patterns [bolding mine].

My argument today is that Drumpf and his supporters have either not developed their frontal lobes, or they have developed them, but are unable to use them. Their amygdalae are in charge, causing them to respond unthinkingly to perceived threats without the calming influence of the orbitofrontal circuit. This inability to counter the constant screaming of “Danger, Will Robinson!” makes them extremely susceptible to manipulation by other like-minded people, who deeply understand the constant state of anxiety in which these primitive brains exist.

In other words…they are stupid. And because they’re stupid, they’re evil.

Read the rest of this entry »


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Blog Archive

April 2018
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Kellyanne Conway’s new job

So similar

Take the kids to work? NO!

That moment when *your* pussy gets grabbed

You go gurl! h/t Adam Joseph

“The” Book

Nice picture of our gal

Time till the Grifter in Chief is Gone

Hopefully soonerJanuary 21st, 2021
2.7 years to go.

Mueller Time!

Wise Words from Paul Ryan

Heroine of the Resistance

B-I-N-G-O!

Only the *best* politicans bought by the NRA

Marching for their lives

Perfect Picture

Perfect Name For Him h/t Daily News

Scary a.f.

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