American health insurance fine print: wait one extra day for surgery after an accident and price goes up dramatically

by philg

Here’s a fun story on the health insurance system that America’s most brilliant technocrats have created…

Woman falls on Christmas (Tuesday) morning and breaks her collarbone. Blue Cross pays 100 percent of the cost of emergency care following an accident. $0 deductible. ED doc says will likely heal on its own. First available consult with an orthopedic specialist is Thursday morning. After a bit of deliberation, it is decided that surgery to insert a plate may be helpful. This will cost the insurer $30,942 ($35,080 “rack rate”). Had it been completed within 72 hours of the emergency visit, it would have been covered completely. Due in part to the holiday and a question about whether the break could heal adequately on its own, the surgery was not done until the following Monday, outside of the 72-hour window (one business day beyond, or maybe not even that if we subtract out Christmas).

Although the procedure is exactly the same, now the insurance customer must pay 15 percent of the total: nearly $5,000!

So the insurance company that you might think would want to encourage patients to step back and consider whether an offered intervention is useful instead gives them a huge financial incentive to sign up for whatever physicians put on the menu during the first 72 hours!

(The good news is that any customer who memorizes the 165-page 2018 benefits document would be well aware of this 72-hour cliff (don’t forget to read the 176-page PDF for 2019, though!).)

Related:

  • “A $20,243 bike crash: Zuckerberg hospital’s aggressive tactics leave patients with big bills” (Vox), in which the government-run hospital tries to get $24,074 for a $3,831 (market price) visit because “the hospital’s focus is on serving those with public health coverage — even if that means offsetting those costs with high bills for the privately insured. … ‘Our mission is to serve people who are underserved because of their financial needs.'” (the woman involved in the bike accident never had a choice to go to a hospital that was in-network for her Blue Cross)
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Can public school teachers be credible social activists?

by philg

Here’s the public Instagram feed of the teacher at a suburban Boston-area school (one of her thankless tasks is molding the 12-year-old mind of a friend’s daughter who previously caused mayhem with a feigned nut allergy). The feed is primarily for communicating with her students and their parents and many of the items are titled “Homework” and contain instructions such as “Just answer the Part 1 Questions! Please DO NOT do the figurative language on the back!”. Some non-homework material has made its way into the feed lately though…

(clumsily redacted in MSFT Paint for some privacy!)

This public servant, whose union has ensured her a total comp of well over $100,000 per year (salary, benefits, and pension), has apparently attended a “Teaching Social Activism Conference”. But with median hourly wage in Massachusetts down around $23 (was $22.81 in May 2017), or $46,000 per year on an annualized basis, can she credibly teach Social Activism? She and her union are directly acting to increase inequality by taking money from people who earn median wages to put it into the pockets of folks who earn above-median wages.

[The other parts of this feed are also interesting. The teacher exhorts her charges to “do something great for your community in honor of Dr. King”. Yet she teaches in a nearly all-white suburb thanks to the miracle of two-acre zoning minimums. African Americans are welcome as long as they can afford $1 million for a vacant lot and $30,000/year in property tax on a completed house.

There is an LGBTQ+ meeting on “Pink Days” in a 7th grade classroom sponsored by the Sexuality and Gender Alliance. Where does that leave 12-year-olds who want to gather around the topics of sexuality and gender but don’t identify as “LGBTQ+”? (maybe the “+” includes cisgender heterosexuals?)

Finally, the Instagram feed reveals that “Google Classroom” is heavily used. Americans will be Google users from cradle to grave? Will Google automatically flag K-12 heresy as a service to the young? An AI on a Google server will read one of the assigned essays on refugees and mark any passages in red that are not appropriately sympathetic and welcoming?]

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New term for an older gentleman paying a young woman’s bills: “money laundering”

by philg

“Political operative who was dating alleged Russian spy Maria Butina indicted” (CNN):

The money laundering portion of the indictment notes a $20,472.09 payment from one of [the old bald guy’s] accounts to American University in 2017, when [the young long-haired woman] was attending graduate school there.

Another $9,000 in payments were directed to a recipient whose initials are listed as “M.B.” in the indictment.

That’s what it is called!

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Healthy cannabis becomes poisonous marijuana at an elementary school

by philg

“At least a dozen elementary students exposed to marijuana gummies, police say; mom arrested” (CNN, 2019):

More than a dozen students at an elementary school in Cleveland were admitted to the hospital after being exposed to gummy candy that police say contained marijuana.

Fifteen children, ages 5 to 9, were tested for drugs and released from Rainbow Babies & Children’s Hospital at University Hospitals Ahuja Medical Center, said Katelyn McCarthy, a media relations strategist at the hospital.
She said that a couple of the children complained of stomachaches.
The police report noted that one of the children tested positive for a mind-altering chemical found in marijuana called tetrahydrocannabinol, also known as THC.

“When young children consume them, they can result in severe symptoms, including dizziness, excessive sleepiness and, in rare circumstances, impair their breathing,” [the toxicologist] said.

It’s key to safely store marijuana products far from where children can see them, said Dr. Suzan Mazor, director of toxicology for Seattle Children’s Hospital and a toxicology consultant for the Washington Poison Center, who was not involved in the Cleveland case.

Also, “make sure to have the poison center phone number on hand for caretakers, grandparents: 1-800-222-1222,” said Mazor, who is also an associate professor of pediatrics and emergency medicine at the University of Washington School of Medicine.

Previously in CNN:

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New York Times won’t divide by total population

by philg

“‘This Is Our Land’: Mineral riches should make Congo prosperous. Instead, they fuel corruption, which has kept the people poor and compromised elections.” (New York Times, Jan 26, 2019):

Between 2010 and 2012, Gécamines and other state companies sold stakes in several of Congo’s most valuable mines for at least $1.36 billion less than their market value, …

Some $750 million due to Gécamines by corporate partners between 2011 and 2014 could not reliably be traced to the company’s accounts, the Carter Center also found. The anticorruption watchdog Global Witness said that more than $750 million in mining revenues paid to Congolese state entities were lost between 2013 and 2015.

The front page lead-in to this story is “Why isn’t Cobalt Making Congo Rich?”

The journalists apparently never considered the question “What if we divide these numbers by 87 million?” (Congo estimated 2019 population, which the CIA says is growing at a rate of 2.3 percent annually)

Suppose that we accept the worst case analysis in the NYT article. A total of $2.1 billion has been stolen from the people of Congo. How “rich” would they have been if not for this theft? That works out to $24 per person.

Readers: What accounts for the reluctance of the media to admit that, even in a perfectly administered situation, a large population cannot get rich off a handful of cobalt mines?

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Theranos was an immigration and H-1B story

by philg

Bad Blood, the authoritative book on the rise and fall of Theranos, describes American- and British-born engineers and scientists being fired for saying “the goal is too ambitious” or quitting when realizing this. Who replaced them? According to the book, almost all immigrants from India, either folks who’d recently completed a degree in the U.S. or coming over on H-1B visas, all managed by Ramesh Balwani, Elizabeth Holmes’s boyfriend.

During the “grand fraud” stage of Theranos, therefore, it was a primarily immigrant show except for the young impresaria.

[I’m going to guess that neither Mr. Balwani nor any of these engineers and scientists make it into the children’s book First Generation: 36 Trailblazing Immigrants and Refugees Who Make America Great…]

The money to fuel the craziness of Theranos seems to have been all domestic. Walgreen’s kicked in $100 million(!) as an “innovation fee” and then loaned the company another $40 million, according to the book. The credulous yet imperial CEO Steve Burd (Wikipedia shows him hanging out with Barack Obama) drained huge amounts of Safeway shareholder cash to help Theranos. The idea in both cases was that Theranos devices were supposed to be placed in these retailers’ stores.

If the end result is a tech staff that is mostly Indian, I wonder if the Silicon Valley location makes sense. Why not have all of the engineers and scientists work from Bangalore or Delhi? Instead of 8 people sharing a two-bedroom apartment in Menlo Park, each of those 8 workers can enjoy his or her own comfortable house (rent for a 3BR apartment in the center of Bangalore is about $570/month (source), 1/10th the price of Menlo Park (source)). What’s the advantage of bringing H-1B slaves over to toil on a Silicon Valley plantation compared to running the tech farm in India?

(Another interesting aspect of the book is learning just how much room there is for human error in traditional medical lab tests, e.g., in the handling of reagents. Elizabeth Holmes was not wrong in thinking that a fully automated process could potentially be more reliable.)

Related:

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MIT and the Saudis

by philg

Recent email from the MIT President:

Last October, following the assassination of journalist Jamal Khashoggi, I asked Associate Provost Richard Lester, who oversees MIT’s international activities, to reassess MIT engagements with Saudi entities.

The report explores the full range of competing factors to consider, including faculty autonomy, the social and scientific value of the work we undertake with Saudi people and entities, the challenge of working in a nation so out of step with our commitment to inclusion and free expression, and our community’s deep sense of revulsion at actions of the Saudi regime.

Ultimately, the report concludes that if MIT faculty wish to continue their current engagements with colleagues, students, and public and private research sponsors in Saudi Arabia, they should be free to do so, as long as these projects remain consistent with MIT policies and procedures and US laws and regulations.

Nothing of substance changes, in other words. In the long run, however, virtue as defined by MIT will prevail:

The present moment is testing that position. When I agreed to host the Saudi state delegation at MIT last spring, I shared the hope of many in the US and around the world that the visit and official engagement were an important part of an ongoing process of reform and modernization.

Saudi Arabia needs to be “reformed” and modernized, in MIT’s official opinion. It is just a temporary setback that some of these Saudi state officials went straight from learning about MIT’s commitment to inclusion and free expression to planning the murder of the unfortunate Mr. Khashoggi?

Saudi Arabia faces an unusual demographic moment: More than half of Saudi citizens are younger than 30

How is this relevant to the question of whether MIT works with governments that assassinate the inconvenient? The killing of Mr. Khashoggi should be ignored because he was 59 years old and can be readily replaced by folks who are half his age? (And his intended bride, for whom he ran the risk of entering the Saudi consulate to gather some divorce documents (BBC), was 36 years old, so also outside of the demographic that MIT considers important.) The killing of Mr. Khashoggi would have to be taken a lot more seriously if the median age in Saudi Arabia were 40 (as it is in Singapore)?

Regardless of their age, it turns out that some Saudis are “worthy” because they share MIT’s principles (the others are “worthless”?):

I hope we can respond to present circumstances in a way that does not suddenly reject, abandon or isolate worthy Saudi people who share our principles and are doing good work for themselves, their society and the world, particularly if MIT faculty wish to continue the engagement. … Are there further steps we can take to make sure that our engagements are not only in tune with but advance MIT’s values, including equality and free expression?

One of MIT’s principles, as previously articulated by President Reif, is to employ both a “Director and Assistant Director of LGBTQ Services”. So this puts MIT principles at odds with the law in Saudi Arabia (though maybe not the reality, according to this Atlantic article, which says “Sodomy is punishable by death in Saudi Arabia, but gay life flourishes there.”) The only “worthy” Saudi people, therefore, are those who reject traditional Islamic belief and align themselves with what a non-Muslim or apostate MIT administrator might believe? (speaking of apostasy, it is punishable by death in Saudi Arabia)

Is this letter essentially saying that coastal American values are superior to Saudi values as embodied in their laws? MIT must labor under a White Man’s Burden to engage with the Saudis until they agree to adopt our values? How is that consistent with a commitment to inclusion?

Related:

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Middle school students assigned books about and by People of Color

by philg

Received from a teacher by a parent of a local 7th grader:

We will be reading March together as a class for our next unit and additionally students will be working cooperatively in book clubs for books that are about and by People of Color.

I asked “So they can pick any book written by or describing a Virginia Democrat?”

It seems that the answer is “no.” The letter continues with

Today in class the students had the opportunity to preview the book club books and rank their top choices.

So students can’t stray from the approved list and pick the autobiography of Clarence Thomas, for example, or Economic Facts and Fallacies by Thomas Sowell:

Government spending is often said to be beneficial to the economy, as the money disbursed is spent and re-spent, creating jobs, raising incomes, and generating tax revenues in the process. But usually if that same government money had remained in the hands of the taxpayers from whom it came, they too would have spent it, and it would still have been re-spent, creating jobs, raising incomes, and generating tax revenues in the process. This again is usually at best a zero-sum process, in so far as the transfer of money is concerned, and a negative-sum process in so far as high tax rates to finance government spending reduce incentives to do all the things necessary to generate economic activity and the prosperity resulting from it.

Poetry by Kanye West is presumably also excluded, though it might be interesting to hear a class discussion of “Gold Digger”:

Eighteen years, eighteen years
She got one of your kids, got you for eighteen years [23 in Massachusetts]
I know somebody payin’ child support for one of his kids
His baby mama car and crib is bigger than his
You will see him on TV any given Sunday
Win the Super Bowl and drive off in a Hyundai
She was supposed to buy your shorty Tyco with your money
She went to the doctor, got lipo with your money
She walkin’ around lookin’ like Michael with your money
Shoulda got that insured, Geico for your money
If you ain’t no punk
Holla, “We want prenup! We want prenup!” (Yeah!)
It’s somethin’ that you need to have
‘Cause when she leave yo’ ass, she gon’ leave with half [maybe closer to 0% after subtracting litigation costs?]
Eighteen years, eighteen years
And on the 18th birthday he found out it wasn’t his?!

The official list would also keep students from asking whether Chinese Nobelists such as Gao Xingjian and Mo Yan qualify as “of color” (of the wrong color?).

Personally I would love to see a student with the temerity to demand In Full Color: Finding My Place in a Black and White World, by Rachel Dolezal.

Readers: Does it help Writers of Color to put them in a February ghetto and tell students they can read books on white subjects by white authors the rest of the year?

Exciting Update: I got hold of the list! (Kanye West is not on it!).

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