Harder Faster Longer (For Less Pay)

Today's Must Read is from the New York Times. It invites us to be less productive. This sounds like a slacker motto––unhelpful, uncooperative, lacking in the team spirit which is so fashionable these days in workplaces––but consider this: the way we measure productivity requires workers to work longer and harder and better for less pay each year. That's how managers meet their benchmarks. That's why 40 years of productivity gains have been paid upward, not to the workers achieving them. How is that fair?

The same harder/faster/longer ethos has crept into our schools. Each year schools and teachers and students are expected to achieve higher marks, the way a business is expected to. But it's fundamentally stupid and impractical. Teachers start over every year with new kids, at roughly the same level as the kids who came before. Yet the gains of the past year are used to compound the expectations.

I am not adept at figuring compound interest, but I figure that with a yearly rise in student achievement of say 2%, compounded annually, measured over the past 40 years since I was in school, that kids today have to be ten times or a hundred times smarter, quicker and more knowledgeable than they were in 1972. Are their brains larger? I've not noticed it. But the work load is much larger. The kids burn out quicker too. The teachers are teaching 45 in a class on the same pay and lower school funding measured against inflation.

This is what happens when you invite businessmen to run your society. They turn up the speed on the machine and pocket the profits or bank them in the Caribbean. That is the model being sold this year by the Republican Party. It's the package they been selling us for four decades. It burned our economy out in 2007 and 2008, but they're still driving the car.

Kicking the Poor: An American Pastime

Barbara Ehrenreich has a trenchant and disturbing piece in this morning's Guardian. It is a well-reported piece, thoroughly footnoted and linked to sources of further information. So why is it labelled "opinion" rather than published as fact? (And why did Ehrenreich have to cross the Atlantic to get it published?) Fact editors have to be extra careful not to lay blame. Fact reporting is one more thing under the thumb of the advantaged. Journalism, which once took appropriate pride in discomforting the comfortable, is now especially careful not to offend. It's one more advantage in the powerful system of Accumulated Advantage and Disadvantage.

This journalistic caution has increased as the comfortable class has narrowed and grown comfortable beyond the dreams of avarice. Their comfort must not be disturbed, and reining in these systems that prey on the poor might result in the comfortable having to pony up their rightful share of public costs. The rich might have their puny taxes increased if we stopped hitting up the poor for the costs of being poor.

The bizarre injustices Ms. Ehrenreich describes here are positively Dickensian, but in a time so rich with injustice, too many of our best writers devote themselves to chronicling the struggles and ennui of the moneyed, the leisure classes.

Romney the Violent Bully Boy

This story from the Washington Post doesn't surprise me. It's very well reported, thoroughly documented and sourced. It paints an unattractive picture of Mitt Romney, the child of privilege who enjoyed using his advantaged position to humiliate others.

Romney's manner is quiet, gentle, modest (except when he takes credit for the successful auto industry bailout that he vehemantly opposed) but once you know about the companies he's broken up for scrap, the thousands he's fired after taking their pension funds, the dog on the roof, you begin to wonder if the Romney you see is a fake.

These disturbing accounts of his bullying behavior in high school add another layer to our understanding. And Mitt wasn't just a rowdy follower in this behavior. He was the leader. He was the one bent on violently humiliating the non-conformist, the less popular, the vulnerable. Romney, the governor's son, sought out and went after the vulnerable individual with a gang of his bully boy friends. For those who were there the memory is very fresh, very disturbing.

It begins to form a pattern. Romney adjusted the manner of how he did it, but his venture capital career worked to the same model: find the vulnerable and take advantage. Seek out weakness and exploit it without mercy or consideration. It's called predatory behavior.

The boy is father to the man.

How Money Has Drained Values Out Of The Public Conversation

I read this interview in Guernica magazine with the Harvard professor and author Michael Sandel. I urge you to read it. It got me thinking.

What's curious, and can't really be explained, is how the very rich and their Republican helpers use money to measure all things in our society, emptying the public conversation of ethical and human issues, and yet, at the same time, manage to claim the moral high ground, even the "Christian" high ground, assuming everybody agrees Jesus was a Republican and favored rich people over the poor. Assuming God is afraid of science or feels threatened by intelligent life on earth.

It only works this way because an immense money advantage enables Republicans to tilt the game, dominate the airwaves (which they already own) and browbeat Americans into doing what they're told. We worry about devaluing the dollar or losing America's stellar credit rating, meanwhile the big money boys have sucked the intelligence out of the public discourse, dumbed everything down to the level of non-science, a six thousand year-old earth and an economy guarded magically by fairies and elves, but not, heaven forbid, regulated.

Stupid is as stupid does, sadly.

Pay Or Die

We are at our most vulnerable when we are sick or in pain or afraid of dying. Somebody decided this was a good moment to demand payment up front. Pay or continue hurting. Pay or die. Health problems already put our lives and our finances in jeopardy. It's sick to hit up the vulnerable for money prior to helping them. It seems a lot like extortion to me. Demanding money with menaces. You'll read in these reports from the Minnesota Attorney General (reported in the StarTribune) that they also threatened the sick with harm to their credit rating. In company emails they mocked the poor who needed help and bragged about turning the screws on them. Fairview Hospitals, founded to help Minneapolis's poor and sick Norwegians, is the hospital system where these egregious practices were in effect. The aggressive bill collection firm is Accretive, from Chicago.

"Marcia Newton of Corcoran was one consumer who saw Accretive's tactics firsthand. Although she is fully insured by Blue Cross and Blue Shield of Minnesota, she says she was told by a Fairview admissions clerk that she needed to pay $876 upfront as her share of a $9,000 procedure to insert tubes in the ears of her 3-year-old son. But when Newton received her insurance statement, she learned that the procedure cost $4,200 and her share should have been $200."

She says she spent two months fighting with Fairview after her credit card was overcharged by nearly $700.

"If I hadn't read that explanation of benefits from my insurer, I would have thought I paid my money and was done," said Newton, a certified public accountant with an MBA. "A lot of people who couldn't have afforded it would have gotten ripped off."

Patients arriving in Fairview emergency rooms with serious conditions and in pain were subjected to strong-arm collectors and pressured to pay before being helped.

Internal e-mail from a collector at Accretive's Kalamazoo, Mich., office "I make the deadbeats feel like s---, talk nicely to women who sound education/have money, and am firm with dumb f----. If they say something stupid, I make sure they know they've said something stupid."

Another collector's response to the above message "Thanks. I went through the hospital notes and this is what pisses me off the most. The patient is pissed because Medicaid didn't cover this and told the hospital that she is never going to pay this. There are some attorneys who aren't skilled enough for an actual practice that work for these stupid fricken non-profit organizations who help the poor in Detroit. Now we have to waste our time to deal with this low-life patient and some dumbass attorney all because this patient didn't show up to the DHS office to renew her benefits. Ugh. I'll make sure they get a call though."

A collector's response (the same day as the earlier messages) after learning a lawyer had left a message on behalf of a particular patient "Mrs Smith, my name is ______ and I'm the Financial Counselor (Admitting Rep) at [Fairview]. According to your insurance company you have a deductible of $100 and a 10% co-insurance. Based on a 3-day stay, your estimated amount due is $440. How would you like to pay for that today? We accept cash, check, debit or credit card."

Pay up front or you won't get treated, was the message patients got from Fairview:

One story, related by a physician who deplored the collections practices: "...a breast-cancer survivor was ushered into a small room with a billing officer who told her she had some unpaid bills to pay. She said, 'What bills? I have paid all my bills." The man told her she hadn't received the bills yet, but still had to pay them. When she refused, the man pleaded that it would look bad on his record..."

The NYTimes also covered the story.

There was an strange and absurd defense of Pay or Die from the Strib's "conservative" opinion writer Doug Tice, suggesting we should be forced to pay for emergency care up front like we do fast food...

And a thoughtful humane counterpoint by Paul Olson, also in the StarTribune.

This story points up the difficulties of hospitals and doctors, locked in a system of private insurers in an economy where patients increasingly cannot afford insurance. The best answer is universal healthcare via single payer, a government solution like Medicare, which is cost-efficient and beloved. Let the doctors treat their patients and let the patients get the help they need without worrying about finances on top of ill health.

But Republicans demanded a private insurance solution. Obama passed his Affordable Care Act with their input, chiefly the inclusion of an insurance mandate, something the ultra conservative Heritage Foundation proposed in 1989. But once ACA reached the floor of the Congress every Republican voted no, repeatedly. And now it is this Republican demand, the mandate, (which isn't some Communist invention––George Washington insisted on a health insurance mandate for merchant seamen when he was president) which the Republican court challenge is using to scupper the whole reform. And a return to financial and healthcare peril for anyone who has the bad luck to get sick.