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With no single national calamity to focus on this week, theSunday New York Times brings us mélange of Big Journalism on Important Topics, the general drift of which leads us to wish we'd stayed in bed. For starters, there's another must-read piece by Elizabeth Rosenthal, whose specialty is digging into just why the American medical system manages to be the world's most expensive even though it doesn't actually cover everyone. No, not even under Obamacare, imagine that. This time out, Rosenthal looks at the phenomenon of surprise extra fees in hospital bills, which can come from seemingly anywhere. As reimbursement rates from both Medicare and private insurance have been cut, hospitals have been bringing in high-priced, out-of-network specialists to help with tasks that often used to be done by residents or other hospital employees. Take, for instance, Rosenthal's lead example of Peter Drier, a guy who had back surgery that he thought he'd planned for financially, but which resulted in bills from both the surgeon he knew would do the operation (and who readily accepted Drier's insurance reimbursement, about $6,200), and an "assistant surgeon" who charged just under $117,000 and would not negotiate on the cost:


In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives.

The practice increases revenue for physicians and other health care workers at a time when insurers are cutting down reimbursement for many services. The surprise charges can be especially significant because, as in Mr. Drier’s case, they may involve out-of-network providers who bill 20 to 40 times the usual local rates and often collect the full amount, or a substantial portion.

“The notion is you can make end runs around price controls by increasing the number of things you do and bill for,” said Dr. Darshak Sanghavi, a health policy expert at the Brookings Institution until recently. This contributes to the nation’s $2.8 trillion in annual health costs.

Insurance companies are fighting back with lawsuits, but they also sometimes just eat the extra costs, as they did in Drier's case, which of course just encourages the bastards. Rosenthal offers example after example of little tricks that lead to higher costs -- almost always services provided by out-of-network providers, of course. Out favorite: "The person in scrubs who walks a patient to a bathroom for the first time after hip surgery may turn out to be a physical therapist billing $400." Also, to help offset cuts in insurance reimbursements, lots of medical groups are turning to consulting outfits whose entire business is offering "advice on how to increase revenue through 'innovative' coding, claim generation and collection services."

Hello, children, can you say "single payer"? PLEASE?

In other stories, the Times brings us a story about a Syrian terrorist group called Khorasan -- another offshoot of al Qaeda --that is possibly more of a direct threat to the United States than ISIS is because unlike ISIS, which is mostly interested in taking and holding territory in Iraq and Syria, Khorasan is more focused on attacking the Great Satan. Get ready to hear wingnuts freaking out every time they hear a Spanish speaker say something about being in love.

There are also a couple of interesting Life During Wartime pieces by reporters on the ground in Ukraine, where a lot have civilians don't care whether Ukrainian or Russina forces win, but would like to not have shells falling on them please, and in Iraq, on the boundary between territories held by the Iraqi government in Kurdistan and by ISIS forces. There, while a lot of the movement is of refugees trying to get away from ISIS, there are lots of people who still go back and forth, like Thamer Hasan, a professor who lives in a town controlled by ISIS but still commutes to Kirkuk University College of Education in Iraqi-held territory:

A trip that once took 15 minutes in his own car now took two to five hours by way of a series of short taxi rides and long waits at various checkpoints on both sides of the border.

This seems like as good a place as any to mention that earlier this weekend, we ran across a piece about the great wingnut thinker Michael Savage, who explained that dealing with ISIS would really be quite simple -- just drop a few tactical nuclear weapons into Iraq and Syria to take out the estimated 10,000 to 15,000 ISIS fighters. Oh, sure, maybe a few million civilians like Professor Hasan and his family would be wiped out, too, but there's an excellent precedent:

President Truman didn't care about collateral damage when he dropped the bombs on Hiroshima and Nagasaki.

Of course innocent Japanese women and children were killed, but it also saved a million American lives and another five years of war.

That was the calculation when we had a real man in the White House.

Wonkette's favorite domestic insurrectionist, Larry Klayman, thinks nuking ISIS is a nifty idea too.

Back in reality-land, if you'd like to rinse out your brain with something nice, you could read this cool piece about the rediscovery and restoration of an untitled 1913 movie that was the first feature film to have a black cast. starring the greatest black Broadway star of the day, Bert Williams, the unedited footage would have been the basis for a 30 to 40 minute romantic comedy:

In it, Williams vies with two other suitors for an elegant lady, played by Odessa Warren Grey. Featuring domestic scenes, gatherings at a social club and a carefree day at a fair, the film has some racial stereotypes but also gives a glimpse of everyday activities. Here, the characters dress in high fashion for a ball and they take their children to the fair, where the grown-ups blithely ride the carousel. Williams and Grey have several tender exchanges.

The movie contains other gems. An elaborately staged ball scene in which the cast performs the Cakewalk is the longest early record of black vernacular dance on film, the curators said. Behind-the-scenes footage shows Williams’s ever-present blackface being applied. Even the kiss between Williams and Grey could mark a first example of such affection for black characters on film, said Ronald S. Magliozzi, the organizer of the exhibition and an associate curator in MoMA’s film department.

And just to break your heart a bit, it's likely that the movie was never finished because while it was in post-production, Birth of a Nation became a huge hit, which probably made the studio give up on the Williams movie, since audiences of 1915 were clearly in the mood for heroic Klansmen saving the South from rascally blacks. Or white actors in blackface, in that case.

There's also this tease for film buffs: "The reels were part of a collection of 900 unprinted negatives that came from the defunct Biograph company in New York." Makes you wonder what else might be in there.

On to the terrifying Style section! In keeping with tradition, there's a profile of a successful, thoughtful woman, relegated to "Fashion and Style" because woman, duh. Amy Cuddy is a "social psychologist and associate professor at Harvard Business School" who did a TED talk in 2012 about “power poses;” that presentation has become the second most-viewed TED talk of all, making Ms. Cuddy rich and famous and much sought-after for speaking engagements. It's like Posture Pals plus a TED Talk!

We sat up a bit straighter while we typed this. And her story actually is pretty cool, especially considering that she almost died in a car accident when she was 19 and suffered a brain injury:

and though she worked her way back to academic excellence at graduate school at Princeton, she suffered acutely from impostor syndrome.

She was so afraid to give her first-year talk as a Ph.D. student, she told her adviser she was quitting. Instead, she feigned confidence all the way to the faculty of Harvard Business School. “Fake it till you become it” is her rallying cry.

Hey! That works in blogging, too! We think.

On to the social advice guy, who fields a question from "Eli" in New York who wonders what to do with "a huge carton of Chinese cigarettes" that a Chinese grad student gave him as a thank-you for a small favor. Eli doesn't smoke, and nobody Eli knows smokes, so, he wonders, "Would it be so wrong (albeit unhealthy) to give these cigarettes to the homeless?"

Happily, social advice guy isn't going to waste time playing nice, ad so we include his answer in full (the last line is a reference to another letter from a terrible human being):

That is the single worst idea you have ever had, Eli — and I include the time you used steel wool to buff your mother’s car. (Sorry, that was my brother.) Do not give proven cancer-causing agents to homeless people. They are not human junk drawers. Even if you found a homeless person who smoked, or could sell the cigarettes, you would be creating unhealthy incentives. Throw them away; buy the homeless guy a sandwich, instead. (Give the ciggies to parents who don’t invite your children to their children’s birthday parties.)

And let us peruse the Columnists, too, shall we? Frank Bruni has written another column that's mostly just a summary of a book he liked, and so the hell with him. Nicholas Kristoff is wondering why Alicia Keyes is nekkid except for a peace sign painted on her pregnant abdomen, and he wrote a column about her explanation of it, too, we think. She wants to start a peace army, and if they're going to be nekkid, we have no problem with that. Get ready for laments about Sending The Wrong Message and Keyes somehow being racist against whites, too, because she said that the shooting of Michael Brown was a bad thing.

Thomas Friedman is glad that Scotland didn't vote for independence, because "Had they not, it would have clipped the wing of America’s most important wingman in the world: Britain." And also he thinks pluralism is good, because just look at how awesome America is, even with all its mixed cultures and "all the strengths that come from being able to act together":

As I’ve asked before: Who else has twice elected a black man as president, whose middle name is Hussein, whose grandfather was a Muslim, who first defeated a woman and later defeated a Mormon? I’m pretty sure that I will not live long enough to see an ethnic Pakistani become prime minister of Britain or a Moroccan immigrant president of France. Yes, the unrest in Ferguson, Mo., reminds us that we’re still a work in progress in the pluralism department. But work on it we do, and I’ll take the hard work of pluralism over the illusions of separatism any day.

Yay, pluralistic us! And for once Friedman's look-at-all-the-places-I've-been act isn't entirely loathsome, even if it's just another mishmash of his flat world that will be saved by innovation and creative mashups. For a Thomas Friedman piece, it is actually quite almost-readable.

Ross Douthat looks at ISIS and Syria and comes to the amazing conclusion that there are no good options, for which we thank him; he points out that relying on "the moderate opposition" to Bashar Assad and ISIS involves no end of wishful thinking, and ultimately ends up at the surprisingly non-warhawky conclusion that containment and attrition against ISIS is probably more realistic, if nowhere near as emotionally satisfying as imagining we can just kill them all:

But neither does it require magically summoning up a reliable ally amid Syrian civil strife, making a deal with the region’s bloodiest dictator, or returning once again to ground warfare and nation-building in a region where our efforts have so often been in vain.

It does not traffic, in other words, in the fond illusions that we took with us into Iraq in 2003, and that hard experience should have disabused us of by now.

But some illusions are apparently just too powerful for America to shake.

Crikey, we are agreeing with Ross Douthat again? Just wait -- he'll write about loose sexual mores again and things will be back in balance.

And finally, Maureen Dowd spends some time on Willie Nelson's tour bus, and thank god, the contact high doesn't lead to the stupidest column ever. Does she flatter herself with comparisons to the genial Weedman? Duh:

When Willie Nelson invites you to get high with him on his bus, you go.

The man is the patron saint of pot, after all, and I’m the poster girl for bad pot trips. [Wonkette link substituted for Daily Beast link, cuz we're better -- Dok Z]

It seemed like a match made in hash heaven.

Why, yes, that's a perfect match, if you think that matter and antimatter should try dating sometime. It's actually a pretty good read, mostly because, hey, Willie Freakin' Nelson, despite Dowd's insistence on putting herself at the center of things:

I needed a marijuana Miyagi, and who better than Nelson, who has a second-degree black belt in taekwondo and a first-degree black belt in helping Norml push for pot legalization?

Still, Nelson did mention her disastrous pot-candy experience in Rolling Stone -- “Maybe she’ll read the label now!” -- so MoDo is clearly Always On His Mind. She asks him what went wrong, and thanks to Willie Nelson, Maureen Dowd is vindicated, because Willie doesn't care for edibles since the dose is often less predictable than with a good ol' joint.

Not only that, Willie Nelson makes a fine Explication Device for MoDo to set to rest some ugly rumors about her, really:

Eager not to seem like a complete idiot, I burbled that, despite the assumption of many that I gobbled the whole candy bar, I had only taken a small bite off the end, and then when nothing seemed to be happening, another nibble.

Nelson humored me as I also pointed out that the labels last winter did not feature the information that would have saved me from my night of dread.

Now, however, Colorado and Washington State have passed emergency rules to get better labeling and portion control on edibles, whose highs kick in more slowly and can be more intense than when the drug is smoked.

It's really quite generous of Mr. Nelson to grant her the chance to explain herself to us like that.

There's more, mostly incidental; stuff -- Willie 's not a fan of Jerry Brown's fears "that a nation of potheads would threaten American superiority," and he doesn't really remember whether he smoked a joint on the roof of the White House when he visited during the Carter presidency.

Did he also indulge in the Lincoln Bedroom?

“In what?” he replied, mischievously. “I wouldn’t do anything Lincoln wouldn’t have done.”

So there you have it -- in a time of civil war, Willie Nelson might suspend habeas corpus. That's where weed will get you, America.

Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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