Recent blog entries certainly have run long, haven't they? Honest, I swear I'm writing as concisely as I can, but maybe there's room for improvement. So let's try to take a stab at dealing with two complex issues very quickly.
Medical Billing Shenanigans
A few months ago I was temping for a while, and had no health insurance. Then I tripped over my own feet and fell on asphalt, scraping the hell out of my hand. (And I'd been the only one not drinking!) A couple days later it was infected, and I had no choice but to go to the emergency room at St. John's Hospital in Santa Monica. They did just about the simplest procedure possible, cleaning out the wound and putting on a bandage and giving me prescriptions for antibiotics; and then they charged me $766 for it (plus another $183 for the prescriptions). I called their billing department and negotiated a 30% discount, if I would pay immediately, which I did by credit card because that was the only monetary option I had left.
A few days ago, after nearly four months of silence, the hospital sent me a new bill. For the entire supposedly-discounted amount. Now I have to go through the whole argument all over again, and am awaiting their call back in the next round of this.
A few years ago, someone I know went through a similar problem with a hospital billing department, as they claimed that her insurance didn't cover something that she knew it did. Her insurance company, of course, was no help, and she had to resolve the dispute herself, to prove to the hospital that her coverage was adequate just as they should have known it was. During all this, she was also undergoing debilitating chemotherapy treatments.
All of which leads me to wonder: is there some quiet corporate policy at hand here? Disregard your agreements; change your practices; find ways to charge patients more money than they should pay. Yes, you will often find the people like my friend and I who are willing and able to argue the point and demonstrate the rightness of our position; but there will also be some percentage of people who don't argue, who simply see a bill and pay it; some percentage of people whose language skills aren't so good; some percentage who are sick and simply can't summon up enough energy to put up a fight. Put enough of these sorts of people together and you've got a nice little revenue stream going.
Paranoid conspiracy theory? No, I really don't think it is. Not all the time, anyway.
New Orleans: The New Atlantis?
People are gonna hate me for saying this, but I think New Orleans is doomed. Louisiana's governor just ordered the complete evacuation of the city, and colossal efforts are underway by the U.S. Army Corps of Engineers to at least plug the levee breaches that occurred yesterday. There is all the usual rhetoric about how the heroic citizens of New Orleans will recover and rebuilt, but I can't help thinking that it's a lost cause.
The online magazine Salon yesterday ran a very timely piece excerpting the first chapter of John McPhee's The Control of Nature. (A book that just happens to be on my Amazon Wish List, in case anyone wants to send me a belated birthday present.) In it, McPhee wrote about the absurd lengths the city of New Orleans had gone to in order to stave off the inevitable. "Every drop of rain that falls on New Orleans," McPhee writes, "evaporates or is pumped out. Its removal lowers the water table and accelerates the city's subsidence. Where marshes have been drained to create tracts for new housing, ground will shrink, too. People buy landfill to keep up with the Joneses."
In this book written in 1989, McPhee goes on: "As sediments slide down the continental slope and the river is prevented from building a proper lobe--as the delta plain subsides and is not replenished--erosion eats into the coastal marshes, and quantities of Louisiana steadily disappear. The net loss is over fifty square miles a year."
I've never been to New Orleans and have no sentimental attachment to it. Once I flew over the city, and changed planes at the airport, and as I stared out the window of the plane at all those canals and dikes and levees, at all that water snaking around absolutely everything, I wondered why on earth anyone would want to put a major city there. Now, in the wake of the storm, with everything I'm seeing, I think the only sane decision is to declare the city a goner, and to let it slowly disappear into the silt and water. The New York Times disagrees with me, running a staff editorial today (subscription required) that declares "New Orleans...is one of the places that belongs to every American's heart--even for people who have never been there." I don't for a second argue that it isn't one of America's great cities; I just don't think there's any practical way to keep it viable, given its geographical challenges. It's a horrific shame to lose such a unique city with its old-world atmosphere, but I'm sure Pompeii was a great loss as well, once upon a time.
With the city emptying out, and repair estimates extending over months, I'm simply saying that this might be the best time to face up to the realities and declare the city a loss. Because otherwise, some year there will be another hurricane, and the damage will be even worse, and when exactly do you declare an end to it all?
No comments:
Post a Comment