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Monday, October 26, 2009

When Will Rational People Take Back Conservatism from People Like Rush?

For those who missed it:

Rush Was Punked: “Obama Thesis” Hoax

http://buzz.yahoo.com/buzzlog/93122?fp=1

The evidence just keeps piling up, doesn't it? Of late, there's the ongoing lies about the MIT report on climate change and the refusal by some to stop misquoting and misrepresenting it. Now this. The level of desperation and complete lack of ethics and integrity is awesome.

I'm thinking that self-described "conservatives" ought to be getting more than a little nervous. Conservatism is rapidly becoming synonymous with fanaticism. Unless rational people take back the cause and start to ostracize lunatics and liars like Limbaugh, Beck, O'Reilly, Coulter and all the rest, your ranks are going to continue to shrink. Those people aren't journalists or news people, they're commentators. Actually, they are snake oil salesmen. They know how to make a buck from a gullible audience!

I know, I know. I'm running the risk of offending someone by implying that listeners of Rush, Fox News, and the like are gullible. How about naive? Overly trusting? Seems tame, actually, to some of the names I've been called. Besides, I'm not name-calling. I'm just offering my observations and describing them in general terms.

Look, Rush's only talent is to spin. At the end of the day, that's all Fox News does, too. Yes, I do watch it. Not with any devout regularity, mind you. Mostly on Sunday mornings as I tend not to watch very much TV.

Slogan or not, Fox News does not report and let you decide. They comment and try to make you feel like you're some kind of an idiot if you don't see it their way, too.

And Rush's mea culpa (http://mediamatters.org/mmtv/200910230019) is the real coup de grace. He's caught red-handed and has the audacity to try to reframe his being caught in his own trap of misinformation and commentary as unimportant and even ok. People have lied about him. And....and... and........besides.......he knows what's in the president's heart and mind even if the so-called story he was reporting isn't true.

Doesn't this tell any thinking and rational American that Rush and people like him have zero credibility? None. Nada. Zilch.

So, I'll say it. To all the Dittoheads out there - wake up. Your emperor and his court - all the "beacons" of neo-conservatism - have no clothes. They are entertainers. They are hucksters. They do and say anything that makes them money. And they make tons of money the way all money is made in media - from advertisers who, in the case of conservative talk radio and neo-con news outlets, want to reach what I think are probably the most gullible people in America - O'Reilly Factor watchers, Beckheads, the Savage Nation, and listeners of EIB.

If what I've written offends anyone, I am sorry you feel that way but I'm not sorry for saying it. If you're interested in helping me to understand why we should admire and respect nut cases like Rush, Beck, Savage, or the next layer of lunacy lorded over by Hannity, O'Reilly, Coulter and anyone else associated with conservative commentary or news, then I'm happy to have that discussion.

Just don't go all weak-kneed-nanny-nanny-boo-boo-Keith-Olbermann, ok? K.O. is simply the liberal mirror image of Beck. He knows how to make money by telling people what they want to hear, too.

Thursday, October 8, 2009

Truth about CFLs

I received an email recently attacking "liberals" (not sure why they were singled out) for thinking we need CFLs and questioning their safety, so I did a little checking.

1.) Invent a reason for a revolutionary light bulb when none is needed.
  • CFLs use up to 75 percent less energy than incandescents
  • Each CFL can save up to $30 in energy costs over its extended lifetime
  • If every American home replaced just one light bulb with an ENERGY STAR® qualified bulb, it would save enough energy to light more than 3 million homes for a year, more than $600 million in annual energy costs, and prevent greenhouse gases equivalent to the emissions of more than 800,000 cars.

Is there something wrong with saving money on our electric bills while burning less coal to produce that electricity?


2.) Invent a light bulb that requires a f***ing HAZMAT team to haul it away..
  • recycle them properly by wrapping them and dropping them off for safe disposal at a CFL collection site like Home Depot or Ikea, which also recycles batteries and other toxic household products.

I think we all have Home Depots or Ikeas within reasonable driving distances, and when was the last time any of us actually were clumsy enough to break a light bulb anyway? These bulbs last for years. When one does burn out, add it to your trip to recycle centers with glass, plastic jugs and bottles, newspapers, plastic grocery bags, metal and aluminum cans, and anything else that can be recycled.


3.) Invent a light bulb whose toxicity if broken in your home will f***ing kill you!!!!!!!!!!
  • According to the EPA, the amount of mercury contained in each bulb is an average of about four milligrams, which is roughly equivalent to an amount that would cover the tip of a ball-point pen. By way of comparison, older thermometers contain about 500 milligrams of mercury. It would take approximately 125 CFLs to match that amount.
  • Given the amount of energy and fossil fuels incandescents burn over their short life span, they emit more mercury (and other toxic chemicals like sulphur and nitrogen oxide) into the atmosphere than energy-efficient CFLs.
  • Thanks to technology advances and a commitment from the members of the National Electrical Manufacturers Association, the average amount of mercury in CFLs will continue to decrease as time passes.

It doesn't seem like 4 milligrams would be deadly even if you somehow could extract all of it and somehow get it inside your body.

Compare that with all the additional pollution pumped into the environment by coal fired power plants to generate all the additional electricity needed to burn so many more incandescents versus the average 7 to 12 year lifespan of a CFL, and clearly the more deadly approach is the status quo.


Sources:


Just in case anyone cares about the facts. ;-)

Tuesday, October 6, 2009

Medicare Denials Higher than Commercial Insurers?

Here's the version of the email recently sent to me:

According to the 2008 Health Insurance Report Card (PDF) released by the American Medical Association, the “carrier” with the highest percentage of denials is . . . Medicare.

Metric 12—Percentages of claim lines (i.e., records) denied

Description: What percentage of records submitted are denied by the payer for reasons other than a claim edit? A denial is defined as: allowed amount equal to the billed charge and the payment equals $0.

Source: NHXS

Payer

Count of records

Denied records

Percent of

claim lines

denied

Date range

Aetna

637,239

43,317

6.80%

03/01/2007 – 3/10/2008

Anthem

250,070

11,546

4.62%

03/01/2007 – 3/10/2008

CIGNA

263,728

9,060

3.44%

03/01/2007 – 3/10/2008

Coventry

20,487

590

2.88%

03/01/2007 – 3/10/2008

Health Net

4,975

193

3.88%

03/01/2007 – 3/10/2008

Humana

143,026

4,142

2.90%

03/01/2007 – 3/10/2008

Medicare

6,938,431

475,566

6.85%

03/01/2007 – 3/10/2008

UHC

1,127,691

30,177

2.68%

03/01/2007 – 3/10/2008

My first reaction was to spend a few minutes simply looking at the table provided and thinking about what it meant. It was:

"So you're going to split hairs between Medicare and Aetna over 0.05% while Medicare processes 10 times as many claims and almost 7 times as many claims as the next largest processor, UHC?

That's something I call "reframing", (redacted friend's name), but I do appreciate the attempt.

Besides, statistically wouldn't it be fair to assume that the processing of the largest number of claims would yield the greatest likelihood of more denials?"


What's more telling on closer examination of the report card is that the commercial insurers are less efficient, less forthcoming with information, and more responsible for wasteful overhead than Medicare ever could be.

For example....

...CIGNA and Humana don't even reveal the date they receive a claim (Metric 1)

...while Medicare's median response time of 14 days (Metric 2) is among the longest, it's no longer than CIGNA and only one day longer than Aetna and Humana

NOTE: The "median" means the middle value, or the value at which there are an equal number of values above and below the median value. Think highway median dividing two sides of the highway equally. The "mean" is the arithmetic average. Further review of the details of Metric 2 show the following mean values:

Aetna: 13.81 days

Medicare: 13.83 days

CIGNA: 19.57 days

Humana: 21.85 days


...the coup de grace seems to me to be "Metric 5 - Contracted payment rate adherence" defined as, "On what percentage of records does the payer’s allowed amount equal the contracted payment rate?"

Medicare is 98.12%. The next closest is Coventry at 86.74%. Humana is 84.20%, Aetna is 70.78% and CIGNA is 66.23%.


Now I'm no expert, but it looks to me like commercial insurers don't seem to score very well at even paying what they contracted to pay. Some of them are getting what we called in school "failing grades."


And some of us think the big, bad government can't do things right? Please.


So if someone sends you something similar and wants to split hairs between Medicare and Aetna over 0.05% while Medicare processes 10 times as many claims as Aetna and almost 7 times as many claims as the next largest processor, UHC, then feel free to remind them that that is called "reframing the discussion." It's what people do when they want to cherry pick data, present it out of context, and without proper comparison to related data that forms the broader and more accurate picture.


Finally, the definition of "denial" seemed a bit unclear to me. I'm still not claiming to fully understand all of this but here is what it looks like to me.

Medicare's top reason for denying a claim (27.8%) is, "Claim/service lacks information which is needed for adjudication." Looks to me like something we call in the business world "cockpit error." Someone in the health care provider's office seems to have failed to fill out the form completely and/or correctly.

The carrier with the next highest percentage of denials, Aetna, has as it's top reason for denying claims (65.7%), "Payment adjusted because the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated."

Again, I'm no expert but I've raised 2 kids, have power of attorney for my aging mother, and have reviewed my fair share of claims. I think what this means - 2/3 of all their denials - is that they have made their plans and the processing of claims so complex as to result in 2/3 of denials being essentially a duplicative claim. No need for reform there, right?

CIGNA's top reason for denying claims (37.6%) is simply, "Deductible Amount." Again, I wonder how it is that just over 1/3 of all the denials end up being this. Could it be that CIGNA's plan definitions, processes, and claims processing are so confused and confusing that 1/3 of all denials are because the patient and health care provider claims administrator can't tell that the claim is part of a deductible? I don't know; just speculating.

So before anyone starts reframing the discussion and dissecting and distributing misleading or self-serving information, ask questions, do some homework, and challenge the assumptions and conclusions.

I'm on the record as supporting single payer. If this report card is any indication of how that might work under a government-run program, I'll gladly pay higher taxes instead of insurance premiums to companies that have never proven and still can't prove that they can do a better job.

---
"Everyone is entitled to his own opinion, but not his own facts."
Daniel Patrick Moynihan