One to make you happy, one to make you mad

Her Reaction At The End (: from r/aww

Plastic rubbish being dumped into the Amazon river from r/videos

Another video (same location).  I note there is a cement block ramp at the dump site, so this is being done with some local governmental approval.

It never seems to end...

The title of the Vanity Fair piece says it all:

As Deficit Explodes, GOP Demands Emergency Tax Cut for the Rich

[Ted Cruz is] currently devoting his efforts to a much more important cause: demanding another tax cut for the rich, this time without Congress’s approval.

In a letter sent to Steve Mnuchin on Monday, the senator from Texas urged the Treasury Secretary to use his “authority” to index capital gains to inflation, a move that would almost exclusively benefit the mega-rich. Claiming, falsely, that the United States economy “has experienced historic levels of growth as a result of Congress and the current administration’s policies such as the Tax Cuts and Jobs Act,” Cruz insists that it is now crucial for the Treasury Department to adjust capital gains for inflation “so that everyday Americans can continue to enjoy better lives and livelihoods.” And by “everyday Americans,” he of course means (but doesn’t say) the spectacularly wealthy.

Missing from Cruz’s call for Mnuchin to use “executive authority” to end this “unfair” treatment of taxpayers, which was signed by 20 of his Republican colleagues, is the fact that, according to the Penn Wharton Budget model, a whopping 86% of the benefit of indexing capital gains to inflation would go to the 1 percent (and reduce annual tax revenue by an estimated $102 billion over a decade). Perhaps seeking to address this criticism, Cruz claimed that changing how capital gains are taxed “would…unlock capital for investment, increase wages, create new jobs, and grow the economy, benefiting Americans across all income levels.” In other words, he’s arguing that the executive branch should give the super-rich another tax cut and it’ll benefit everyone because of trickle-down economics which—checks notes—has never actually worked. Including in the case of the 2017 Tax Cuts and Jobs Act

... Trump has reportedly “told confidants...that he remains deeply invested in making the change,” and his National Economic Council chair, Larry Kudlow, has been pushing for it since he was hired. Also, as Bloomberg points out, “Trump is looking for issues to win favor with voters and donors during his 2020 reelection campaign,” so perhaps the rich will get another well-deserved break.

I can't help but be reminded of the Russian oligarchs raping their country.  What I fear is that this ongoing uncontrolled expansion of the deficit will place the newly-elected Democratic president and Congress in the position of having to raise taxes, perpetuating the trope that they are the party of tax and spend.

I'll close comments for this post.

List of school shootings in the United States

"Prescription drug prices are out of control"

That's not news, of course.  But a longread at PhillyMag provides some insight into the bureaucracy and some ideas.

I’m on drugs for multiple sclerosis and have been since 2004. MS meds are what are called maintenance drugs, meaning you take them daily or weekly from the moment of diagnosis till death or untenable side effects do you part. They’re also some of the most jaw-droppingly expensive drugs on the market. Today, in 2019, the four different name-brand medications I’ve been prescribed at different points in my treatment list for between $75,816 and $98,899. Per year. Prices are indeed high. And they’re going up fast.

Like everyone else, I’d been hearing the drumbeat: The cost of prescription drugs was out of control. But because the insurance plans I’ve been on had decent-enough prescription drug coverage — my meds had generally cost me a co-pay in the $100-to-$150-per-month range — I’d been shielded from the issue. And a few years back, I discovered that if you ask, some drug manufacturers will actually pay your co-pays for you. So I was getting drugs that listed for a decent annual salary for the cost of my modest-by-comparison health-insurance premiums. I didn’t know who was paying how much of those prices — honestly, they seemed too absurd to be real. All I knew was that it wasn’t me.

But as I sat in the conference room for my company’s annual benefits presentation last December, I got a cold dose of reality — and became another of the millions of Americans incensed by the skyrocketing prices pharmaceutical companies charge for their products and the byzantine, competition-squelching health-care system that allows those prices to escalate unchecked...

Thanks to secret negotiations, the prices that pharmaceutical companies list are different from the prices for your insurance company, which are different from the prices for your pharmacy. America’s health-care system is the most expensive and pointlessly complicated in the world...

Fact 7: Nobody outside of this system knows what’s happening inside of it. And the fact that we know so little suggests that it’s in the best interests of all involved to keep quiet.

Fact 8: Pharmaceutical companies claim, rightly, that developing drugs is an expensive business, and that for every drug that eventually makes it to market, there are untold failures.

Fact 9: And yet we also know that pharmaceutical companies are some of the most profitable businesses on the planet...

Fact 10: As a result, everything happens in a black box, and as any NTSB investigator will tell you, nothing good comes out of black boxes. The whole system is a vicious circle of plausible deniability. In the face of criticism, any one entity in the supply chain can, and often will, point to the others and say, essentially, “Not it.”

Way more at PhillyMag.

Why you had to calculate your own taxes

Excerpts from an article in Vox:

Congress is set to make it illegal for the IRS to create free tax preparation software, software that could save millions of Americans from wasting their money on TurboTax, H&R Block, and other tax preparers currently profiting from the IRS’s failure to help taxpayers.

ProPublica’s Justin Elliott reported that the Taxpayer First Act, sponsored in the House by Democratic Rep. John Lewis (GA) and Republican Mike Kelly (PA), and in the Senate by Finance Committee Chair Chuck Grassley (R-IA) and Ron Wyden (D-OR), would prohibit the IRS from creating an online tax preparation system that would compete with TurboTax and H&R Block...

The IRS could prepare taxes automatically for the vast majority of Americans for whom it has all the required information. The bill, Elliott reports, would bar the IRS from the much more moderate step of creating software that competes with TurboTax...

It is a huge scandal that Congress has not yet instructed the IRS to automatically prepare taxes for the vast majority of Americans. The IRS has all the information required to do that for all but a few taxpayers, and the main reason it hasn’t to date is lobbying by companies like TurboTax and H&R Block...

In a way, creating a free online tax preparation program, as this bill would ban the IRS from doing, is the absolute least the federal government should be doing for you. There is little preventing the IRS from preparing tax returns on its own for most Americans...

If I’m not itemizing deductions (like 70 percent of taxpayers), the IRS has all the information it needs to calculate my taxes, send me a filled-out return, and let me either send it in or do my taxes by hand if I prefer.

This isn’t a purely hypothetical proposal. Countries like Denmark, Sweden, Estonia, Chile, and Spain already offer “pre-populated returns” to their citizens. The United Kingdom, Germany, and Japan have exact enough tax withholding procedures that most people don’t have to file income tax returns at all, whether pre-populated or not. California has a voluntary return-free filing program called ReadyReturn for its income taxes...

So why hasn’t return-free filing happened yet? Well, as the current fight in Congress suggests, the short answer is lobbying, and in particular lobbying by companies like Intuit...

Worldwide slaughter of pangolins - updated

From a report at The Guardian:

The true scale of the slaughter of pangolins in Africa has been revealed by new research showing that millions of the scaly mammals are being hunted and killed.

Pangolins were already known to be the world’s most trafficked wild mammal, with at least a million being traded in the last decade to supply the demand for its meat and scales in Asian markets. Populations of Asian pangolins have been decimated, leaving the creatures highly endangered and sharply shifting the focus of exploitation to Africa’s four species...

A total ban on the international trade in any pangolin species was passed by the Convention on the International Trade in Endangered Species in September. But Ingram said the enforcement of both international and national laws had to be increased to prevent African pangolins following their Asian cousins on the path to extinction.

The demand in Asia for pangolin meat and scales as delicacies and supposed medicinal uses is a major factor in cross-border trade but a significant proportion of African pangolins are eaten locally. Ingram said that measures are also needed to develop alternative livelihoods for African hunters of pangolin...

More from Wikipedia:

The pangolin trade is centuries old. An early known example is in 1820, when Francis Rawdon, 1st Marquis of Hastinges and East India Company Governor General in Bengal, presented King George III with a coat and helmet made with the scales of Manis crassicaudata [low-res photo at the link]. The gifts are now stored in the Royal Armouries in Leeds.

The pangolins are boiled to remove the scales, which are then dried and roasted, then sold based on claims that they can stimulate lactation, help to drain pus, and relieve skin diseases or palsy. As of 2015, pangolin scales were covered under some health insurance plans in Vietnam.

The scales can cost more than $3,000/kg on the black market.

GIF of a pandolin.

Reposted from 2017 to show this image of a shipping container with the remains of 36,000 poached critically-endangered pangolins:

They sailed into a Singapore inspection port by shipping container, the vessel marked “frozen beef” and bound for Vietnam. Inside, customs officials found the sacks, packed and piled from floor to ceiling. They overflowed with the product of a wildlife smuggling operation so vast, yet so niche, it had conservationists worried about the extinction of an animal that most people haven’t even heard of yet...

Restaurants buy pangolin meat, which is considered a delicacy, an off-menu item that a well-heeled customer might order when trying to impress. Those seeking the new cure-all buy the scales, which are used in traditional medicine to treat everything from rheumatism to cancer, even though there is no known science that supports their remedial properties. And the fashion industry has shown interest in the skin, its diamond pattern making for an attractive leather design. It’s scale-to-tail consumption.

More information at the Washington Post (whence the embedded photo, credit Getty Images, cropped for size)

A thousand dead dolphins on French beaches

 
As reported by France24:

“There’s never been a number this high,” said Willy Daubin, a member of La Rochelle University’s National Center for Scientific Research. “Already in three months, we have beaten last year’s record, which was up from 2017 and even that was the highest in 40 years.”

Though Daubin said 90 percent of the fatalities resulted from the dolphins being accidentally captured in industrial fishing nets, the reason behind the spike this year is a mystery...

Autopsies carried out on the dolphins this year at La Rochelle University show extreme levels of mutilation. [note the severed dorsal fin in the photo]

Activists say it’s common for fishermen to cut body parts off the suffocated dolphins after they are pulled up on the nets, to save the nets...

It claims many of the trawlers they watch in the region don’t activate the [dolphin-] repellent devices, fearing they will scare off valuable fish as well, and only turn them on if they are being checked by fishing monitors...

She cited scientists who predict that the current rates of fishing will likely drive the dolphin population to extinction.

Why is stuff like this allowed to exist ?

Good day to you.

My name is [redacted], a renowned Togo based lawyer. I am writing in connection to your late relative who died along with his wife and only Son in an auto accident.

I have contacted you for the repartration of his money valued at sixteen million five hundred thousand dollars and the also the claiming of his estate. Get back to me for more clarification; Looking forward to hearing from you

Yours faithfully, [redacted]. 

I redacted the name in order to not give the scammer any publicity. We have all received emails like this, and any sensible person recognizes it as fake.  In fact my understanding is that scams like this are intentionally written in this floridly bogus style so as not to accidentally entrap any sophisticated computer users, their targets being only the totally naive internet users and those with mental impairments.

As the son of an elderly mother who had advanced dementia, it annoys me that this type of material continues to exist.  I understand that much of it arises overseas in places beyond the jurisdiction of the American court system, but I can't believe that no mechanism exists to shut it down or punish the malefactors. 

Anti-vaxx enabling physicians

Despite a California law passed after the 2015 Disneyland measles outbreak that got rid of the "personal belief" vaccine exemptions for children entering school, pockets of low vaccination rates have developed in the state. A number of counties are reporting rates lower than 90 percent, the number needed to achieve herd immunity, which occurs when enough people are vaccinated against an infectious disease to protect others in the community who are not.

That is likely due to a surge in medical exemptions— a doctor's note allowing a child to go to school without the required vaccinations, according to research published October in the journal Pediatrics. In some schools the medical exemption rate is as high as 20 percent, according to the California Department of Public Health.

California parents opposed to vaccinations have found a way around the law, with help from doctors willing to write medical exemptions for kids who don’t need them. The Pediatrics study found some medical exemptions were being given with inadequate justification, such as “family history of allergies and family history of autoimmune disorders.”..

The study revealed that the exemptions were being generated by doctors who don’t normally treat children and were “coming from physicians who were charging fees.”

While some doctors appeared to charge a single fee for a permanent exemption, the researchers discovered that some were giving temporary exemptions, say for three months at a time, and then charging a new fee for each additional exemption...

Richard Pan doesn’t mince his words when he talks about the doctors “selling” exemptions: “The thing we need to recognize is that many of the physicians who have broken their oath, they’re doing it for their own pocketbook. It’s not based on their expertise. They’re monetizing their license,” he told NBC News.

There are of course perfectly valid indications to not be vaccinated, primarily based on impaired host immunity (bone marrow transplant, chemotherapy).  But these doctors are gaming the system for personal profit.  More at NBC News.

Mommy, what's a "double Irish, Dutch sandwich"?

"The double Irish with a Dutch sandwich is a tax avoidance technique employed by certain large corporations, involving the use of a combination of Irish and Dutch subsidiary companies to shift profits to low or no tax jurisdictions. The scheme involves sending profits first through one Irish company, then to a Dutch company, and finally to a second Irish company headquartered in a tax haven. This technique has made it possible for certain corporations to reduce their overall corporate tax rates dramatically."

Example provided by Reuters:

AMSTERDAM (Reuters) - Google moved 19.9 billion euros ($22.7 billion) through a Dutch shell company to Bermuda in 2017, as part of an arrangement that allows it to reduce its foreign tax bill, according to documents filed at the Dutch Chamber of Commerce...

The subsidiary in the Netherlands is used to shift revenue from royalties earned outside the United States to Google Ireland Holdings, an affiliate based in Bermuda, where companies pay no income tax.

The tax strategy, known as the “Double Irish, Dutch Sandwich”, is legal and allows Google to avoid triggering U.S. income taxes or European withholding taxes on the funds, which represent the bulk of its overseas profits. 

Google responds that they comply with tax laws.  True.

Two commentaries on the American health care system

First, from Common Dreams, the argument that a single-payer system is possible and affordable:

Contrary to the doom and gloom of the latest healthcare spending numbers for the US—$3.5 Trillion overall annually, $10,739 per person, now exceeding 18% of GDP while providing worse outcomes, lower quality and shorter life expectancy than any other industrialized country—the Pollin study shows we can guarantee healthcare to all US residents by improving Medicare, and expanding it to everybody...

The study answers the proverbial question—“But how do we pay for it?”—by utilizing the existing public sources that account for 60% of current financing, eliminating commercial insurance premiums, co-pays and deductibles, and replacing those with a combination of payroll taxes substantially less than employers are paying now, an upper income tax that makes the wealthy pay their fair share, and a sales tax on non-necessities...

It’s important to note that these savings are not available under a multi-payer system, under a system of Medicare buy-in, or via proposals that keep tens of millions of workers in commercial insurance plans.  In such schemes, the administration costs for providers do not substantially decrease; 20% of the tax subsidies to buy insurance are wasted on overhead, marketing and profits; the leverage to set rates is not as strong; and individual purchase (“buy-in”) undermines the social insurance model that spreads costs...

More at the link.  But way more entertaining is a rant at McSweeney's:

"Welcome to America General Hospital! Seems you have an oozing head injury there. Let’s check your insurance. Okay, quick “heads up” — ha! — that your plan may not cover everything today. What’s that? You want a reasonable price quote, upfront, for our services? Sorry, let me explain a hospital to you: we give you medical care, then we charge whatever the hell we want for it.

If you don’t like that, go fuck yourself and die..."

I"ll put the rest below the fold because the language gets a bit "salty" -

The Federal budget deficit continues to grow. No end in sight.

As reported by the Wall Street Journal two weeks ago:

Federal revenues were essentially flat in the budget year that just ended, despite stepped up economic growth, strong hiring and rising wages for workers, according to new estimates from the Congressional Budget Office that show the effects of last year’s tax law. Government spending rose 3% in fiscal year 2018, pushing the budget deficit to $782 billion, up from $666 billion the previous fiscal year, CBO estimated. As a share of gross domestic product, the deficit totaled 3.9% in fiscal 2018, which ended Sept. 30, the third consecutive increase. The deficit would have been even higher if not for shifts in the timing of certain payments...

On the spending side, federal outlays rose 3% in the fiscal year, due to rising costs for Social Security, Medicare and Medicaid, as well as higher interest payments on the public debt and higher military spending.

The WSJ article was based on the Congressional Budget Office's "snapshot" report.  This week the Treasury Department released the final fiscal-year report...

... showing that the deficit for FY 2018 increased to $779 billion, a $113 billion (or 17 percent) increase from FY 2017. The deficit is 3.9 percent of GDP, also up from 3.5 percent in 2017...

The $113 billion increase in the deficit comes from largely flat revenue coupled with increasing spending. Revenue was up only $14 billion, or 0.4 percent. This revenue growth rate is the eighth lowest in the past 50 years, and the seven lower years either coincided with a recession or tax cuts/expiring tax increases enacted shortly after a recession...

Outlays were up $127 billion over FY 2017. Interest was the fastest growing portion of the budget, increasing nearly 24 percent since last year. Other areas of spending growing significantly were Social Security (4.5 percent) and defense (5.6 percent). Defense spending grew by a more rapid rate than recent years due to this year's budget agreement that increased the defense spending cap substantially...

Recent legislation is responsible for the deficit increase. CBO estimated that the tax law would cost $164 billion in FY 2018, which would account for more than the entire deficit increase. The spending deal (the Bipartisan Budget Act of 2018) was estimated to cost $68 billion, which would account for about 60 percent of the increase. Other deficit increasing legislation in FY 2018 added $32 billion to the 2018 deficit. These estimates suggest that if none of these laws were enacted, the deficit would have declined to about $515 billion this year. The tax bill and the spending deal are expected to cost more next fiscal year ($228 billion and $185 billion, respectively) as the deficit is expected to reach nearly $1 trillion.

For Fox ache - is there no adult anywhere in Washington who is willing to address this problem.  It seem to me these numbers have hardly been mentioned in the news, because everyone is so busy reporting on Kavanaugh hearings and hurricane damage and the Khashoggi murder and the midterm forecasts.  And the baseball playoffs.  And... squirrel !!!

Embedded image from the second link.

Borderline behavior

 
Excerpts from an article in this month's Harper's:

Laura Sandoval threaded her way through idling taxis and men selling bottles of water toward the entrance of the Cordova International Bridge, which links Ciudad Juárez, Mexico, to El Paso, Texas. Earlier that day, a bright Saturday in December 2012, Sandoval had crossed over to Juárez to console a friend whose wife had recently died. She had brought him a few items he had requested—eye drops, the chimichangas from Allsup’s he liked—and now that her care package had been delivered, she was in a hurry to get back to the Texas side, where she’d left her car. She had a three-hour drive to reach home, in the mountains in New Mexico, and she hated driving in the dark.

Sandoval took her place in the long line of people waiting to have their passports checked by US Customs and Border Protection (CBP). When it was her turn, she handed her American passport to a customs officer and smiled amicably, waiting for him to wave her through. But the officer said she had been randomly selected for additional screening. Sandoval was led to a secondary inspection area nearby, where two more officers patted her down. Another walked toward her with a drug-sniffing dog, which grew agitated as it came closer, barking and then circling her legs. Because the dog had “alerted,” the officer said, Sandoval would now have to undergo another inspection.

She was taken to a fluorescent-lit, windowless room inside the port of entry office. Two female officers entered and announced that they were going to search her for drugs. They patted her down again, but found nothing. At that point, Sandoval assumed they would release her, but instead they told her they were going to conduct a strip search. The officers put on latex gloves, picked up flashlights, and asked Sandoval to remove her clothes and bend over so they could look for signs of drugs in her vagina and her rectum.

By the time they finished, Sandoval had been detained for more than two hours in the stifling room. Her passport and cell phone had been confiscated; her husband and children had no idea where she was. Sandoval begged to be released. “I was shaking and I was in tears,” she told me. Saying nothing, the officers put her in handcuffs and led her to a patrol car waiting outside. They left the international bridge and drove north into Texas. Frightened, Sandoval asked the officers if they had a warrant for her arrest. “We don’t need a warrant,” one of them replied...

Sandoval, whose name has been changed to protect her privacy, told me that after the officers forced her into the squad car, they drove her to University Medical Center, a public hospital in El Paso. The officers found an empty room and shackled her to the examination table. A nurse entered and asked her to swallow a laxative so they could observe her bowel movement. Then a group of doctors came in. Sandoval pleaded with them to let her go. “A nurse told me to calm down,” she said. “That this was something they did anytime Border Patrol brought people in.” One of the doctors conducted a vaginal and rectal search using a speculum and his hands. “The agents kept saying that they knew I had drugs,” Sandoval told me. Still not satisfied, the doctor ordered an X-ray and a full-body scan. Again they found nothing...

Sandoval tried to forget about what had happened to her. She figured it would be too costly to fight the government. But then the bills from the hospital started to arrive. For the cavity searches, the X-ray, and the CT scan, the hospital was charging her $5,488. [she had refused to sign a consent form]

The article continues at Harper's.   I'm going to close comments for this post.  Posted because some people don't realize what's going on in this country.  Just to emphasize - this lady is a legal American citizen.  The only "probable cause" was someone's interpretation of a dog's behavior.

And these CBP agents operate not just at the border itself, but for a hundred miles inside (see the map at top), where two-thirds of all Americans live.  Some "roving patrols" extend twice that far.

In 2008, Patrick Leahy, a senator from Vermont, was stopped at a temporary immigration checkpoint in New York—125 miles from the border. Agents ordered Leahy to get out of his car and asked him to prove that he was a US citizen. When Leahy asked under what authority the Border Patrol agent was acting, the agent pointed to his gun and said, reportedly, “That’s all the authority I need.”...

[Beto] O’Rourke’s opposition to CBP’s sweeping powers stems in part from his own encounter with border agents. In 2009, he and his two-year-old son were detained at a checkpoint more than seventy miles from the border while agents pulled his truck apart. “They don’t have to explain why they’re holding you,” he said, “and you’re not given the right to an attorney.” O’Rourke told me that he and his son were held in a cell for close to thirty minutes before they were allowed to leave. “It was a strange feeling to be held against my will and to have my car searched,” he said. “I hadn’t committed any crime. I hadn’t even crossed the border.”..

Sandoval said she was glad to hear that the hospital had changed its policy, but she still worried that CBP would subject others to similar treatment. She has not been back to Juárez. “It’s not because I’m afraid to go to Mexico,” she told me. “I’m afraid of coming back to my own country.”

There's more at the link.  Sad.

Plastic in the environment - updated

Source.

In response to an anonymous comment ("ahhh....photoshop") this morning, I searched for and found a video of an equivalent turtle (p.s. Amy, you are hereby warned...) :

YouTube link. 

In 2009 I posted an item at Neatorama entitled "Death by Plastic" with photos of albatross and seabird carcasses engorged with plastic; among the 30+ comments were several claiming that the stories were fake and the images contrived.  I don't know whether there are some people who actually don't believe these things happen, or whether they just get personal satisfaction out of making troll comments.

That same year I also posted this indescribably horrifying video of plastic heading out to sea from a Romanian river.  I'll keep posting these items, because what humans are doing to our oceans is nothing short of criminal.

Reposted from 2011 to add this report that Carlsberg is now gluing beer cans together:

Carlsberg beer cans are to be stuck together with glue as it becomes one of the first brewers to abandon plastic rings.

The Danish firm said the move, which has been heralded as a world-first, to attach its multi-packs with adhesive will reduce the use of plastic to package products by 75 per cent.

After a three-year development process, Carlsberg insists the dots of glue bonding its new "Snap Packs" are strong enough to withstand journeys from shelves to homes, yet sufficiently brittle to break when twisted.

Wherein I rant about the financing of American healthcare

This morning I'll post yet another example of a healthcare financing debacle.

There are undoubtedly thousands upon thousands of these, the vast majority of which don't reach the public eye and are suffered quietly by the powerless victims.  This story about a myocardial infarction successfully treated with stents was posted by Kaiser Health News:

Patient: Drew Calver, 44, a high school history teacher and father of two in Austin, Texas.

... [as he was recovering from his MI and the stent placements], Calver asked whether his health insurance would cover all of this, a financial worry that accompanies nearly every American hospital stay. He was concerned because St. David’s is out-of-network on his school district health plan. The hospital told him not to worry and that they would accept his insurance, Calver said...

And then the bills came.

Total Bill: $164,941 for a four-day hospital stay, including $42,944 for four stents and $10,920 for room charges. Calver’s insurer paid $55,840. The hospital billed Calver for the unpaid balance of $108,951.31.

Medical Treatment: Emergency room treatment followed by four days in the hospital, most of it spent in the cardiac unit. During surgery, four stents were implanted to clear a blockage in his left anterior descending artery, the source of so-called widow-maker heart attacks, because they are so frequently deadly...

Surprise bills occur when a patient goes to a hospital in his insurance network but receives treatment from a doctor that does not participate in the network, resulting in a direct bill to the patient. They can also occur in cases like Calver’s, where insurers will pay for needed emergency care at the closest hospital — even if it is out-of-network — but the hospital and the insurer may not agree on a reasonable price. The hospital then demands that patients pay the difference, in a practice called balance billing...

This case “illustrates the dangers that even insured people face,” said Carol Lucas, an attorney in Los Angeles with experience in health care payment disputes. “The unfairness is especially acute when there is an emergency and the patient, who might ordinarily be completely compliant, has no say about the facility he winds up in.”..

St. David’s charged $19,708 apiece for two Synergy stents made by device giant Boston Scientific. Two other stents used were far cheaper.

The $20,000 price tag represents a significant markup of what U.S. hospitals typically pay themselves for stents. The median price paid by hospitals for the Synergy stent was $1,153 over the past year, according to the nonprofit research firm ECRI Institute.

Every now and then I allow myself to rant about matters that drive me to distraction, including health care financing in this county.  I spent over 30 years in academic medicine, and I have immense admiration for the people who actually provide the hands-on healthcare in this country, especially the nurses and therapists.  The problems arise from the vast army of administrators, coinsurers, financial analysts, billing clerks, chart analysts, insurance adjusters, collection agencies and others who feed off an ever-expanding and ever-more-complex web of regulations and policies.

There is no need for cases like the one detailed above to occur.  The system doesn't need to be this complex.  Even the people who administer the system realize it is fucked-up, but they don't have the power to make changes in a bureaucracy that is extraordinarily complex.

Look what happened in this case after the story was publicized:

UPDATE: Monday, shortly after publication and broadcast of this story by Kaiser Health News and NPR, St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.”  

Got that?  They graciously offer a "discount" from $109,000 to $800.  Because someone took the time to bring this story out of the darkness and expose it to daylight.


I don't care whom you vote for this November - Republican, Democrat, Independent - but please for the love of God and in the name of common sense, vote for someone who will totally gut this system of health care finance. 

And don't accept the lame alternative of a politician who assures you that under his/her proposal "everyone will have health insurance."  This case - and tens of thousands of untold ones - illustrates why that is an inadequate alternative. 

It doesn't have to be this way

Discussion thread at LateStageCapitalism.

See this post at BoingBoing for more discussion of the cost of universal health care.

Dirtball

YouTube link

Rear dashcam documents a driver intentionally swerving into puddles to splash pedestrians.

Via the Videos subreddit, where the discussion thread includes some readers' experiences.

Addendum:  A tip of the blogging cap to reader David Laidlaw, who found that the van driver was fired.

Arizona lawmaker thinks he's above the law

As reported by Fox News:

Mosley was pulled over on March 27 for driving 97 mph in a 55 mph zone in La Paz County, according to Parker Live. In a video obtained by the website, Mosley was caught telling a deputy that “legislative immunity” prevented him from receiving a ticket for his speeding.

The lawmaker admitted to the deputy he was going 120 mph and sometimes hits speeds of 140 mph.

“Yeah, this thing goes 140. That's what I like about it,” Mosley said.

Mosley was not given a ticket, according to The Arizona Republic. Driving over 85 mph on Arizona highways is a Class 3 misdemeanor, however, which usually results in a fine.

"Please Mr. postman... "

Yes, I know it's a difficult job.   Carriers work long days (our mail occasionally isn't delivered until after 6 p.m.) driving sometimes dodgy roads in unpleasant weather.  But it's so very frustrating when they seem to give up.

One Friday I was expecting a package that required my signature, and the tracking number said "Out For Delivery," so I did some chores near a window to monitor street traffic.  I saw the postman arrive, linger momentarily at the mailbox, then continue down the street.  When I walked out to the street I found in the mailbox the dreaded note: "SORRY WE MISSED YOU..."

There was no way I wanted to wait until Monday and then have to drive to the post office, and I knew that she would be coming back on the other side of the street, so I went across and waited for her return.

She smiled and said "Oh, my goodness.  How lucky for you that you got home when you did..."

Now I leave notes on the mailbox.


More than you need to know about "Please Mr. Postman"

Whale autopsy

 
Behold the state of our oceans.

A whale has died in southern Thailand after swallowing more than 80 plastic bags, with rescuers failing to nurse the mammal back to health. The small male pilot whale was found barely alive in a canal near the border with Malaysia, the country’s department of marine and coastal resources said.

The whale vomited up five bags during the rescue attempt.