Saturday, April 19, 2008

Blog #32 A pinch of Orwell, a spoonful of Carroll

Well, the State of Texas sure as hell bit off more than it could possibly chew when they raided that Polygamist Retreat near San Angelo and took all the women and children into detention? All on the basis of a single telephone call from a supposedly sixteen year old girl who they have not been able to find since. They soon released the women, but lawyers from all over the state have come in droves to defend the rights of these 416 children who have been forcibly removed from their parents and put into foster care on the strength of that one telephone call. Can you say PANIC? Of course, the caller had used the magic words, forced into marriage upon puberty, young girls being forced to have sex with older men. And adding a layer of hysteria not previously known in the state of Texas, child protection services are fighting having to give the boys back to their parents claiming the boys were being trained as perpetrators in future child molestation. How is that for legal fantasizing?

Good luck to all in that Orwellian, Lewis Carrollian disarray. Word from San Angelo reports that the first days proceeding could be summed up in one world: chaos, as hundreds of lawyers fought Texas Child Protective Services attorneys tooth and nail on every legal point. Within minutes after state District Judge Barbara Walther took her seat, at least 250 attorneys kept her hopping, challenging everything from the fact that all the children's cases were being heard in one proceeding instead of separate ones to whether an investigator could read from her notes. Despite the absurd atmosphere, Susan Hays, a Dallas attorney for a 2-year-old FLDS girl, thought Walther was handling the pressure well. "I think the judge is doing an unbelievable job," Hays said.

The tours of the living quarters given to CNN showed them to be quite drab and sterile and made you pity the child who has to live in them, but on the other hand these are the children of these parents, and they have been forcibly taken away from them by charges completely unsubstantiated. I guess the occupants can thank their lucky stars that the state of Texas didn’t go in with tanks and guns blazing, as had happened in February 1993 against the Branch Davidian compound near Waco. It makes you wonder, though, just how “free” we are really allowed to be in our so-called “free country.”

Friday afternoon brought a temporary resolvement of the program. Of course the judge ruled the children will remain in the custody of the state until dna testing can reveal each child’s parentage, and then each case will be decided individually. This ruling comes despite testimony from the state’s star witness, Dr. Bruce Perry (who counseled children who survived the Branch Davidian disaster), that the majority of the children would not face immediate sexual or physical harm if returned to their parents. “And also the children, older girls excluded, would likely be more damaged by being placed into foster homes as opposed to returning to their parents,” Perry said. "The traditional foster care family would be destructive to these kids," Perry told the court. “Attending public school and exposure to modern ways would be overwhelming for children raised behind high walls in a deeply conservative, highly authoritarian sect.” But the judge ruled against the parents anyway, at least in the short term. Why? Because the whole Texas house of cards might collapse if she had ruled against the CPS.
And the lucky Texas Legislature. They are going to get the chance to figure how to pay for this debacle, whose legal costs will soar into the stratosphere.

And then came the final straw from Colorado Springs, Colo. Police there Wednesday arrested Rozita Swinton, a 33-year-old black woman. She was charged with falsely reporting abuse to authorities in connection with a polygamist incident in Colorado Springs two months ago. She reported the incident in a child’s voice, and Texas authorities say Swinton is a person of interest in their search for the girl whose call prompted them to raid the Yearning for Zion Ranch in the first place. And so it may well turn out that the second most intrusive disruption of a religious sect in the state of Texas may well have been founded on complete, unmitigated fraud. Who would have thunk it?
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Well folks, I hate to have to report this but the cost of staying alive for the chronically ill just took a sharp turn upwards. It happened very quietly, as do most things which change our lives for the worse. It all boils down to this, health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds, even thousands of dollars for prescriptions for medications which may either save their lives or at the very least slow the progress of serious diseases. The full report is at:

“With the new pricing system, insurers abandoned the traditional arrangement that had patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, an amount which can run to thousands of dollars a month. The upshot of all of this means that the burden of expensive health care can now affect insured people, too. No one knows how many patients are affected, but hundreds of drugs are being priced this new way. Drugs that are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without.”

“Insurers say the new system keeps everyone’s premiums down at a time when some of the most innovative and promising new treatments for conditions like cancer and rheumatoid arthritis and multiple sclerosis can cost $100,000 and more a year. But the result is that patients may have to spend more for a drug than they pay for their mortgages, more, in some cases, than their monthly incomes. The system, often called Tier 4, began in earnest with Medicare drug plans and spread rapidly. It is now incorporated into 86 percent of those plans. Some have even higher co-payments for certain drugs, called a Tier 5.”

“Very interesting,” says the german accented voice in the old LaughIn series. I had my own personal brush with the high price of a drug when I was diagnosed as having chronic myeloid leukemia back in 2002. This was determined after a (painful) bone marrow sample was taken. It turns out that the only drug that successfully treats this form of leukemia is called Gleevec and costs $3,000 for a monthly dose. Of course this was out of the question for me in my financial state. The doctor’s office gave me an application form to apply for assistance, but upon reading it it turned out that I was ineligible because I had Medicare. My son Joel, the doctor in residence, gave me the idea of going to the Veteran’s Administration hospital in Houston to apply for assistance there. He went with me, and we found out that indeed, my Army Air Force service was verified in the VA’s computer system, after all of these years I had even remembered my army serial number correctly, 18228386. Joel was convinced that the VA would get me this miracle drug, $3,000 a month be damned. I have to admit that I was skeptical, but what the hell, it was certainly worth a try.

However, it turned out that I was to never find out. The VA oncologist took another bone marrow sample, and upon further deliberation he determined that I did not have leukemia after all. Later I received a refund check for $54 from the physician’s group of which the doctor who originally misdiagnosed me was a member. Whether this was a refund for my part of the misread bone marrow scan I have no way of knowing. Needless to say $54 did not even begin to approach the inconvenience of having been improperly diagnosed in the first place. However, I cheerfully deposited the check, no questions asked. It is not often you get a refund from a medical facility which had misdiagnosed you, though perhaps I was hasty and should have had the check framed on my wall for constant viewing and worshipping.

In my unprofessional and highly personal opinion I believe that the entire “for profit” system that American medicine is built upon is wrong. Health care should never be for profit. It should pay its practitioners a living, of course, but they should not be allowed to make a killing. However, as we have noted before, the only entity which has muscle enough to change the system is the federal government. And as long as Republicans have a thread of power they will never seek so drastic a change. They honestly believe, no believe is too mild a word, they worship a “for profit” system.

And so while other countries have state run health systems (Canada, England, France, the list goes on) we in our so-called free America think we have the best system in the world, albeit that 30 to 40% of us can’t afford care under the system. And one serious accident or illness can bankrupt a family. We pass along fantasies that have Canadians coming over to America for health care to avoid the long wait they would have in the Canadian system. But we don’t tell about the American citizens who manage to cross the border and access the Canadian system (Michael Moore’s excellent movie “Sicko” documented one such case), and we don’t deal with the fact that the quality of America's health care rates far lower than that in most other industrialized countries.

And of course, we do not face up to the basic problem of a “for profit” system, Health Care Providers can only make money by taking in premiums and then denying care. There is no other way for them to profit under a system that has driven up hospital care to such heights. And although most Americans are stuck with having to deal with the American system in their health care, at least many Americans have discovered that ordering their prescription drugs online from Canadian pharmacies allows them to avoid their outrageously overpriced American bought equivalents.

A recent survey we reported on found that for the first time a majority of American doctors are favoring some kind of government run health care system, admitting for the first time that our present system isn’t serving their patients very well. It is so necessary that the Democratic Party, should it win the presidency and substantial majorities in both houses, retool the health care industry from scratch, preferably dropping the term industry and substituting it for a term more consistent with the hippocratic oath administered to all physicians. Nomenclature that emphasizes service and care.
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One of the most difficult things we modern day consumers have to deal with are the telephone representatives of companies whose products have failed us. It is no simple task to talk such a trained company representative out of something you think is fair, but which the company initially refuses to 0ffer. The most interesting advice I have ever read in handling of service personnel comes from a blog called the Consumerist. In the interest of those who might have to deal with such a representative I would like to reprint it here.

“Still think using the Geek Squad might be a good idea? That's what reader Nicole thought when she took her laptop in for a warranty covered repair. The laptop was sent off to a service center, "repaired", then sent back. She immediately noticed it had the same exact problem and sent it back 48 hours later. This time, she was told the warranty wouldn't cover it, as the Blue Screen of Death was now being caused by water damage. Nicole pointed out that there wasn't water damage the first time it was repaired for the exact same problem two days ago. Geek Squad responded by quoting her $775 for the repair. She said that even though the manager was a very nice man and agreed with her, he said nothing could be done.

To which the all knowing Consumerist told her: “Nicole, don't buy for a second the idea that "no one can override the repair center." Unless you've got one of those special repair centers staffed by the Board of Directors themselves, there's always someone in a position of authority to countermand the grunts on the ground. They just don't want to talk to you. Luckily, you have access to the internet, a phone, and this lovely article on How To Mind Control Customer Service Reps. Keep dialing until you get someone who will listen." The article he referred to:

"Keep in mind, please, that these rules require that you keep a calm, even head, or at least the appearance and sound of one, and you must have the audacity not to ASK for anything. You will be rude, and you will seem to have entitlement issues. But you will get the job done.

“Here are the basic guidelines. The longer and more often you end up doing this, you will find yourself using your own language and tricks. Eventually, you will be able to determine within a few seconds whether the person you have on the phone is the correct person to speak to.

“If all of this fails and you happen to be female, try asking a male relative or friend to do it, following the same steps. It sounds wrong, but people respond to voices, and in today's society, a male voice will sometimes go farther. I am female, however, and if you have a strong enough tone and voice, in most cases, you won't need to resort to that.

“1. Always maintain a calm, collected tone. Keep your voice even, keep your tone low, and do not lose your temper. If you find yourself getting upset, place the person on hold for a moment, take a slow, deep breath, and pick the phone back up. If they have hung up on you, mention it when you call back.

“2 . Before you call, outline the situation for yourself, and decide how you want it solved. Write down several options you would be willing to accept, and keep the page in front of you when you call.

“3. Always get the name of the person who answered the phone, even if you speak to them for only a moment. Write the name down, as well as any other person you connect to. Keep notes of who said what.

“4. When you get a CSR on the phone, immediately ask to speak to a supervisor. When/if they insist that they can help you, keeping your tone low and even, state again that you need to speak to a supervisor. Not want, need. If they again insist, state in a clear and calm, low tone, that they WILL connect you to a supervisor, now. Do not yell, shout, or raise your voice or tone. "No. You are going to get a supervisor for me. Thank you. I'll wait." Say "thank you" immediately. Do not wait for them to answer your request first. If they again insist, hang up immediately. Call back. If you get the same person, make the request again, and if they again refuse, hang up, wait one hour for a shift change, and then call back. Do not give the initial person your name. They do not need it.

“5. Once you are connected with a supervisor, introduce yourself, and then inform the person that you have a situation that they are going to fix. Do not say "that you need to fix" or "that I want fixed" or "that I need fixed." You know they will fix it. "I have a situation that you are going to fix for me today. I appreciate your patience." If they say they will try, state again that you're sure they will fix it for you. "No, you'll fix it. Don't worry." Reassure THEM. It will confuse them enough that they will allow you to explain your situation.

“6. Explain your situation in a calm, even tone. Do not pause for them to respond until the entire situation/story has been told. Simply tell it as if you are dictating a letter. Once the entire situation has been explained, do not pause. Immediately give them the first option of how it should be fixed, in a simple, declarative sentence. "...this is the situation as it stands at this moment, and the reason I am calling. So what you will be doing for me today is ..." or ".. so what we need to do today is ..."

“7. If the supervisor insists that your solution is outside of policy, ask for the full policy. Do not accept "It's just not policy to do this." You want a full description of the policy. This does not mean twenty pages, faxed. A simple description of the section they feel affects your situation is what you need from them. IF they again simply say "It isn't policy to __", you say "That isn't a policy. What, exactly, is your policy in this situation?" If they refuse to give you the policy, ask for their supervisor, or a corporate number - if you choose to or must call corporate, refer to *A - however, this will most likely not be necessary. If they give you the policy, continue to step 8.

“8. Listen carefully to the policy, then scan your list for solutions that fall within it. If none of your solutions fall within their policy, inform them of your viable choices, and ask them how they are going to solve your problem. Do not ask if they will. Ask how. "So, how are we going to resolve this issue?" not "Isn't there anything you can do?" or "there must be something you can do." There is always something they can do. Do not ask. It is fact. If they inform you that there is nothing they can do, again ask for their supervisor or a corporate number.

“9. At this point the person should be working with you for a solution. Continue to keep a calm tone until you reach an acceptable solution
Be sure to refer to the person by name at least twice, to make sure they know you remember it. If they say they will call back, ask for their direct line. If they do not have one, again ask for their supervisor or a corporate number.

“10. You SHOULD now have a solution. Write down the details, making sure to read it back to the person on the other end of the line, and make sure to repeat their name, as well as writing it next to the solution that has been reached. If it is not an immediately solvable problem (returns, or delivery, etc) get a time estimate. "And this will be here by....". You can, at this point as well, ask for a direct line, in case you have issues and need to speak to them again. Then thank them for their time and hang up.

“11. If longer than the specified time goes past and the solution has not gone into effect, call the same number and ask for the person by name. If this person is unavailable or does not exist (there is always the chance) go back through your notes and ask for the person you spoke to immediately previous. Throughout this conversation remember to keep your tone calm and even. If the person you spoke to is unreachable, again, ask for a supervisor, and then immediately ask that supervisor for a corporate number. If the supervisor offers to help you, you may either attempt to work with this person, or simply call corporate.

*A - Calling Corporate
“12. Keep your tone even. Introduce yourself immediately and ask to speak to a person who can solve your problem. Use those words. "Hello, my name is ___. I have an issue. Please connect me to someone who can solve it today."

“13. When you are connected, introduce yourself again. Repeat step 6
More than likely, the person you are speaking to will either do what you've suggested, or will offer an alternative. At this point, if you continue to follow these basic guides, you should reach a solution fairly quickly. Remember to continue to escalate until you reach someone who will solve your problem.

“This works even if the problem is not your own, and you are dealing with the infamous Best Buy. I have a success story to share now. Currently living with me is my sister-in-law. She moved from Texas. A year or so before she moved to California, there was an issue with her computer. Her parents are fairly computer illiterate, but had purchased the PC as a gift for her, and therefore did it on their own. They purchased a floor model, and were not informed, and did not know to ask, that the OS disk was not included. They were not informed that they would need to make a boot disk themselves, and neither was my sister.

“Six months later, my sister's computer ran out of space, and she followed the on-screen instructions to free some up, running Disk Cleanup. Disk Cleanup removed essential files from the OS, causing the computer to brick. A full re-install was necessary. She called Best Buy and they told her it would cost over $100 to reload the computer. She called me in a panic, as she and her parents were living off her father's Army pension at the time and could not afford the fee.

“I called the Best Buy store's direct number, and asked to speak to a manager. I was told none was there. I waited one hour, and called back. This time I got Jose. I introduced myself and let him know that I was calling on behalf of a friend that was having an issue, and thanked him for solving it for me today. I then explained to him that my friend had been given a computer without an OS disk, and now needed to reload the computer, but had been told it would cost quite a bit of money. He informed me that she was told when the computer was purchased that she needed to create a boot disk. I informed him that she was not, and that he would need to reload the computer without charge.

He said he could not do that. I calmly pointed out that it is very bad policy to charge a customer for something he should never have done in the first place, and that the operating system was sold with the computer, and since the disk was not included, we basically had two options available to us - he could either issue her a free copy of Windows XP, or reload the computer free of charge. I asked him which solution he felt would be best for her. He told me that they could do neither, and I asked him how he would be solving it. He asked me to hold for a moment, then came back on the line, and told me to have her come in, and he would take care of it.

“I called my sister and gave her Jose's name and told her to ask for him directly once in the store, because he would be taking care of her problem. She and her mother went, and he met them. Again, they were informed that it would cost to reload the computer. The exact charge came to $97.53 with taxes. In a panic, my sister called me, and I told her that he was not going to charge her. She said he was. I asked her to put him on the phone.

“Here's the clincher - when faced with having to speak to me again, he quickly changed his mind and offered an acceptable solution to the problem: he would issue them a gift card for the exact amount, and they would use that to pay for the service. We all agreed to the terms, and he came back exactly two minutes later with a gift card for the exact charge, and handed it to the cashier.

“At no point did I yell, or in any way raise my voice. I did not threaten him, or mention lawyers or the business bureau. I simply informed him of what he would be doing, and he did it. While it took a bit of reinforcement, eventually he did come up with a solution that was both within his policy, and right by the consumer. This is not a 'talent', it is a skill, and by following these steps you can usually avoid the horrific experiences many consumers have.

Cheers to Lona, and thanks to her and The Consumerist for sharing that story. Dealing with technology telephone consultants has to be about the most unpleasant task imaginable. Usually you are kept waiting for many minutes, and by the time you finally get connected you are almost ready to abandon your quest. Read the advice above carefully. And good luck.
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And so another week’s blog fades slowly into the sunset. Who knows what ridiculous mahem will dominate our musings next week? But we invite you to return to find out. Meantime have a good week.

The Real Little Eddy

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