Showing posts with label Health Care. Show all posts
Showing posts with label Health Care. Show all posts

Thursday, August 29, 2013

Wal-Mart Joins the Parade

OK—so they did it.
It’s a little late for me, since Wal-Mart laid me off over two years ago, but it will be great for the rest of the gay and lesbian associates who are still clinging to their job. Now, those associates can put their husbands, wives, domestic partners on the health plan.
What happened? Did a great liberal wave sweep through the corporate home offices in Bentonville, Arkansas?
Nah—it happened as Mr. Fernández said it would. It got too complicated, for one thing, to figure out what state allowed for domestic partners, what state allowed for marriage equality, when one state would institute marriage equality. Oh, and what to do about a married gay guy living across the river in Minnesota but working in a store in Wisconsin?
That was one thing. The other thing? Talent—and how to attract it. OK, retail is not like academia, which arguably has a higher percent of gays and lesbians than retail. But you’d be surprised—I was—by the number of LGBT folk in high positions in Wal-Mart. And how do you attract a key person away from Costco when Sam’s won’t put her or his partner on the health plan?
That—if memory serves—was also the gist of a letter sent to the Wisconsin legislature by the University of Wisconsin Board of Regents. Yes, the UW’s History Department has traditionally been very strong. But several high-powered historians had turned down the UW to go teach at Harvard, since Massachusetts was the first state to allow gay marriage, and remains in the vanguard.
Or what do you do when you’re transferring an employee from Massachusetts to Mississippi? His compensation package is going to change, if he can no longer put his husband on the health plan.
Lastly, and Wal-Mart admits it—they held out until the very end. Of the 30 top retailers, only two (Publix and a chain I’ve never heard of) are not offering benefits to same-sex couples.
I wish there were any pleasure in this for me, since I battled for several years to put Raf on the health plan. Instead, he paid several thousand dollars more to be covered under Cobra, when his old job folded. And he is now paying several thousand more from his old job to cover me, since my job folded, and Raf’s current employer—like Wal-Mart—doesn’t allow him to put me on the health plan.
But it’s hardly the money issue that makes me so sour on hearing this news.
I defended the company when I worked for it, for nearly 10 years. Does it pay its workers badly? Yes—and with the exception of Costco—so do all the other retailers. Does it have a disproportionate number of part-time workers? Again, no more so than the rest. Does it fight tooth and nail against unions? Absolutely.
We would have, in fact, seminars on what legally we could say to employees on the topic of unions. No, we couldn’t threaten to fire either individuals or close the store if an employee advocated for unions, or if the store joined one. But we could explain the company policy, which went something like, “Wal-Mart has the open door policy, which is a way to assure that management and workers communicate and come to an agreement.”
Well, I used that policy to press Wal-Mart to put Raf on the health plan. And, be fair, I was listened to, treated respectfully, and told “no.” Be more fair—the policy only promises that you’ll be heard, not that you’ll get what you want.
The problem I have is the strong-armed tactics. Ten current and former employees were arrested in front of the Washington DC offices of Wal-Mart, recently. And even worse, some 60 or 70 associates have been fired or disciplined for traveling to Bentonville during the annual meeting to protest conditions in the stores.
And Sam Walton would be reeling in his grave at the thought of employees risking their jobs to bus into Arkansas to raise grievances, while the top management was having what is essentially a huge party. Why? Because the Walton family owns about 60% of the stock. So yeah, they have to have an annual meeting—big deal.
Oh, and that 60% of the stock? That’s equivalent to the amount of money owned by the bottom 40% of the American people.
So would Sam Walton be at the party, or would he be outside, listening.
No question in my mind….      

Thursday, August 22, 2013

On Becoming a Footnote

OK—it’s 11:22 in the morning and what have I done?
Well, it must have been the fatigue following the exertion of becoming, with Mr. Fernández, a footnote in the legal history of Puerto Rico—that must be what’s operating, here.
It was in 2008 that, on a cold December morning, Rafael and I walked into the Cambridge City Hall to get married. Had we made an appointment? Of course not. So the secretary sighed, and called the justice of the peace, Margaret Drury, down to marry us.
Every trip to the altar—even when there’s no altar—is a long one. In our case, it was physically a long trip; I had spent the early part of the week in Wisconsin with my mother, who was recovering from open-heart surgery. I had flown out of a huge snowstorm, missed a flight in Miami, gotten back home, confirmed our flights to Boston—and discovered that Expedia had botched one leg of the journey. We eventually flew to New York, and took the bus to Boston. And then the snow began—the storm I had flown out of from Wisconsin I had bussed in into Boston.
I was still on edge on the day of my marriage—it had seemed unreal, somehow. But I had told my boss, the director of Human Resources, that I was getting married—and to whom. She asked how long we had been together, and I told her: twenty five years. “It’s high time,” she said. Later, meeting her in the crowded lunchroom, she kissed me, wished me a good trip, and bustled off to wash her hands. Glancing over her shoulder, she called out, “and congratulations on…the other thing!”
And so we referred to our wedding as “the other thing,’ throughout the trip.
I had told her, because I knew perfectly well what I was going to do: ask the company to put Raf on the health plan. He was between jobs—and his Cobra payment was a couple hundred dollars easily over what I would pay to put him on my company’s health plan.
So I found myself, after we returned, with my boss and the president of the largest company on the island—Wal-Mart Puerto Rico—arguing that if we had a statement in the Employee Handbook stating that we didn’t discriminate on the basis of sexual orientation, shouldn’t gay spouses be included in the benefits? “I think you should,” said the president.
It was the first time anybody had raised the issue to him.
Was it easy to do that? No—my hands were wet, my mouth was dry, I was in the classic fight or flight response.
I also knew that I would do it, that I was right, and that if I didn’t do it, I was letting the next generation down. Drag queens fought in Stonewall for me, and if they can fight cops with Billy clubs, I could talk to a Colombian man in a small office in Puerto Rico.
My request was denied, of course, on the grounds that my marriage was not legal in Puerto Rico. OK—so I wrote requesting reconsideration from Bentonville. Oh, and I wrote a letter to the executive vice president for Human Resources for the entire company.
This is called rattling the cage, and somebody has to do it.
Bentonville never replied, so I sent a certified letter. That got a response.
So it became a tradition, in those last years of my time there—I would formally petition to put Raf on the health plan, and present my marriage certificate.
“What do you want me to do with this?” my buddy Karen would ask.
“Oh, just send me the same letter you sent last year,” I’d say.
“Ay, Marc….”
If the Internet were working, I could tell you who said, “courage is a muscle that becomes stronger with exercise.” Recently, I came out to a room full of strangers, blurting out, “Sweetheart, I’m your husband, not your friend,” after Raf, about to read a poem of my mother’s, referred to me as a friend. The whole room laughed—look, how threatening is a roomful of poets?
So it was natural to me, to protest when a notary public, in preparing a deed for an apartment I bought, referred to me as soltero, or bachelor.
“No, I’m married in the Commonwealth of Massachusetts,” I said.
We went around about it; he explained that legally, I was a bachelor. We signed; I went home and had a drink. The lawyer went home and lost sleep.
In Puerto Rico, property sales are handled by a notary public, who must be as well a lawyer. So the notary public got it into his head—he knew he had to do something. The next day, he called the professional association that rules over the notaries, and asked them the question: what to do about a marriage legal in one state but not in Puerto Rico?
“It was great—they all took the question very seriously, and very respectfully,” said Tony, to give the notary his name.
Even the head of the association, with whom Tony finally ended up….
“Your job as a notary is to record the facts, not judge on the legality,” the director said. “You have to amend that deed, and state that Marc and Raf were married in the Commonwealth of Massachusetts. And they both have to sign it….” The director went on to speculate—what happens if Puerto Rico is obliged to recognize all marriages from other states, including same-sex marriages?
So we did, but not before asking Tony if they the notary association had ever had the question put to them.
“No,” he said, “they had been waiting for it, but it had never come up. They’re actually thinking of writing a memo to all the notaries on the island, directing them to do what we’re doing. So yours will be the first gay marriage recorded on a legal document in Puerto Rico.”
“You really should spread the word around,” said Johnny, when I called to tell him the news. “There could be other gay people who need to be aware that their marriages need to be recorded….”
So I have!

Tuesday, July 9, 2013

La Madre de las Estafas

Well, it’s starting to look as if Mr. Fernández is right.
“It’s the damn Spaniards,” he’d say, when I asked him why, in Puerto Rico, spectacular frauds are committed to the accompaniment of shrugs and yawns. Our secretary of health, who formerly was the medical director and executive vice president of Triple-S, recently awarded a juicy (think it was $200 million) contract to a health provider—and guess who it was?
Triple-S!
But wait, cried the secretary, it’s saving us 43 million!
Sure, but Triple-S has declined to accept liability—leaving the government stuck if any Triple-S patient sues. The previous health provider—Humana—had accepted liability.
The Trinidadian writer V. S. Naipaul once propounded a theory—corruption was the national sport of Trinidad and Tobago. As proof, he told the story of a concert promoter, who came to town promising an extraordinary gala of unbelievable names—the greatest singers of Europe and America would be there. He published lavish ads, he spoke on radio, he showed pictures of himself with Sinatra and Carlos Gardel. He sold zillions of tickets and then….
Those points of ellipsis kinda tell the story, right?
OK—you saw that coming. But what might surprise you is the reaction—all of the Trinidadians walking around the next day shaking their heads and saying, “wow, that guy was great! Hey, that was the best scheme I’ve seen in YEARS! Totally cool!”
That said, let me whip out my pistol and shoot myself in the foot. Because, as you can see in the video below, the Spaniards themselves are anything but amused by the estafa or con that got practiced on them—a con perpetrated by the Spanish government.
If you’re living in the United States, you may not be aware of how dire the situation in Spain is. Unemployment is around 25% (unofficially), but unemployment of Spanish youth is nearing 50%. The economy has contracted wildly, and Spanish banks, which had expanded aggressively, were hit hard. So they needed cash, and fast.
Into this picture steps Rodrigo Rato, whose last name means what you think it does, and who cooks up the perfect scheme.
Rato came from money, and has made money his profession. He got an MBA from Berkeley, went on to become first deputy prime minister of Spain, and later served as managing director of the International Monetary Fund.
In 2003, Rato was vice president of the government minister of the economy, and he was facing bad news: the banks had to be shorn up. So what did he do?
He legalized a practice, and allowed banks to begin selling preferentes, a financial instrument that you and I—assuming you’re as dumb about money as I—don’t want to touch.
In fact, it’s hard to see why anyone would, except under very special circumstances. Essentially, you’re lending money to the bank, but have no voting rights, no say in the corporation, no guarantee of interest, and no rights to withdraw your money. Oh, and you’re pretty much last on the list of debtors to get paid. In short, you’re giving your money away, and hoping that you’ll get something back. I’d only do that if I controlled 51% of the company….
They are called high-risk investments for a reason, and that makes it all the more galling that the banks began to sell the preferentes to the very people who should never have bought them—middle aged or older modest savers who put all their money into these investments.
You can argue—they should have known better, they should have read the fine print. Confession—I am writing this in an apartment bought through a mortgage which was only given to us after we signed well over twenty documents, not one of which we read. And Mr. Fernández has an MBA, to boot.
Right, so if we—with our twelve years of higher education—were infernally stupid and trusting, who can fault the elderly Spaniards, who listen as that nice bank manager they’ve known and trusted all those years calls them up and tells them about a really great deal. 7% interest!
They fell for it. But it’s not just that the banks had sold them a questionable investment—one writer alleges that the banks had in fact set up subsidiaries in paraísos fiscales (don’t have to translate, do I?) The only thing the subsidiary did was to collect the money and ship it off to the main bank, but the fiscal paradise was considerably sunnier for the bank than the small investor, trying to retake his money. The bank, in short, was in the Cayman Islands; the investor was on the street.
Quite literally on the street, with their whistles and pots and pans, as well as hand-written placards. Thousands of protestors; perhaps a million people out 80% of their money. And then, according to El País, the police responded to the protests, fining the organizers for various supposed infractions to the peace.
El País also reports that the Supreme Court has just told one large Spanish bank (BBVA) that it has to return almost 300,000 Euros plus interest to a couple who had invested in preferentes. And that the bank had the obligation to assess the couple’s financial status and acumen.
Seems pretty obvious, doesn’t it? Oh, and what happened to Rato, who legalized this particular fraud?
Forbes named him worst CEO of the year in 2012.

Wednesday, July 3, 2013

So Where Is Everybody?

So where is everybody?
That’s what a friend, José, wanted to know. He’s up on the news, he reads all the island’s newspapers every day; then he reads The New York Times for national and world news. Like me, he’s a news junkie; also like me, there are writers and journalists in his family.
And journalists, as I heard in exhausting detail—OK, I confess it. When the old man was lecturing on the importance of a free and objective press, I tuned him out, those many years ago. Look, does any 15-year old hang on his father’s lips?
Now, of course, it’s different. I see him, in my mind’s eye, listening on Tuesday nights to the City Council meetings, which were broadcast over the radio. Jack, my father, was probably the only guy who ever listened, but that was OK. If only one guy listens, but then goes and writes a blistering editorial in the newspaper the next day—well, the system works.    
There’s a real question, however, if the system works down here. The island is mesmerized by the capture of la viuda—the widow—who is in fact quite a merry widow. Here’s a pic….
Well, I confess it, I spent several hours of my life yesterday poking about and hanging with the widow as well. But today, la viuda is still splashing around on the front page of the New Day; I, however, am moving on.
“No, José, no. It can’t be….”
He swore it was. And then he told me the story.
In 1993, our governor, who was by the way a pediatric orthopedic surgeon, instituted a health plan. Essentially, he did away with the socialized health system and spent the money giving it to private insurers. The system continues to this day, said José, with 1.6 million patients.
“What,” I squawked at José, “are you telling me that half of the island is on the government’s health plan?”
Yes.
The island, for the purpose of the health plan, is divided into 8 regions, and various health providers are asked regularly to submit bids. Thus, it was no surprise when the new providers were announced last Thursday. What was the surprise?
Is that a big deal? Well, the doctors aren’t too happy. Here’s one:
“Tanto pacientes como médicos estamos a merced de esta organización, llámese como se llame. Le da un poder de casi $2,000 millones a una sola empresa, le da más que eso, le da una arrogancia sin límites. Va a disponer de pacientes, de clase médica, como le da la gana”, afirmó el doctor Eduardo Ibarra, presidente del Colegio de Médicos Cirujanos.
 (“Patients as well as doctors are at the mercy of this organization, call it what you will. It gives the power of almost 2 billion dollars to one enterprise, more than that, it gives unlimited arrogance. They can do whatever they want to patients and doctors,” stated Dr. Eduardo Ibarra, president of the College of Medical Surgeons.)
 “Preocupa grandemente que se conceda casi un monopolio de los servicios de Salud a Triple S. Sobre todo, se ha señalado constantemente que el secretario de Salud, Francisco Joglar Pesquera, ha tenido serios conflictos de intereses con dicha compañía y que esta contratación no abona a la confianza pública sobre dichos procesos de contratación”, afirmó el expresidente de la Comisión de Salud.
(“I worry greatly that this concedes almost a monopoly on the services of Health to Triple S. Above all, it’s been shown constantly that the secretary of health, Francisco Joglar Pesquera, has had serious conflicts of interest with this company and that this contract does not meet the public’s trust about the process of awarding contracts,” the former president of the Health Commission stated.)
Conflict of interest?
“What’s that all about?” I asked José.
Senior Vice President and Medical Director for Triple S.
“What?” I’ve gone beyond squawking, now I’m just squeaking.
“Yes,” said José.
I’m dumbfounded.
“This is blatant.”
“Don’t worry,” said José so seriously that I knew he was joking. “Joglar took himself out of the whole process. He recused himself, and gave it all to his sub-secretary. Then he went into his office, shut the door, closed his eyes and covered his ears. And when the sub-secretary knocked on the secretary’s door five minutes later, Joglar was just as surprised as the rest of us. So it was fair. See?”
Oddly enough, the essential health of the political system of the United States is that people are pissed off. We’re angry, frustrated, and—some of us—almost explosive. But that’s good—all that energy and foment can lead to change.
“Los pillos,” people say, with a shrug of the shoulders, a glance skyward.
The thieves.
Speaking of our elected officials as thieves is dangerous. It implies a cynicism, a consent to be stolen from, an apathy that nothing can change. And that means, of course, that nothing will change.
José was right….
Where is everybody?

Wednesday, April 3, 2013

Wednesday Morning Rant

What’s going on here?
Susan sent me Maureen Dowd’s column, which featured one of the creators of “Will and Grace”—which apparently was a television show—as being disgusted and heartsick at the Supreme Court. He felt—didn’t we all?—that we were all in a sort of time warp; five of the justices are all back in the fifties, the rest of us have moved on.
Well, I can see that—but only out of my right eye. My left eye went cloudy, last Thursday, just in time for the Easter weekend. Of course my ophthalmologist wasn’t working, so I spent the weekend being intermittently worried—was it an infection? Cataract? Worse, was it macular degeneration, which had robbed my mother of her vision, and really of her joy in life, those last hard years?
Well, I don’t have to worry, or rather I do. It’s a cataract, and the procedure is simple. It takes ten minutes to do the surgery, 24 hours to recuperate, and no more of those hideous eye patches. Amazing, really, the innovations in eye surgery.
Wait, did I say, “I don’t have to worry,” somewhere up there? Wrong—I do. This afternoon I will spend substantial amounts of time calling an insurance company, trying to figure out how to fund this operation. “Lucky you,” you say, “lots of people don’t have insurance.”
And indeed, I am lucky. But it may be just general irritation or an inbred tendency to see the glass as half-empty, because it does occur to me—I’m somewhere in the middle of the lucky gradient. Other people with insurance simply sail in, flash the card, and the operating room doors open by magic.
I only have insurance, you see, through Raf and his former job. Since his company closed he was allowed to retire, and qualifies for the health plan. And yes, that health plan allows him to put a same sex spouse on the plan. Raf’s current employer does not. So I have an excellent insurance plan that—since the company is located in the US—nobody on the island accepts.
And I live—a bit tangentially, but still live—in the richest nation on the planet. And that nation, currently, has no national health plan, and so throws its marginalized into a terrible position. At 56, with a college education and good people skills, I can easily figure out how to manipulate the system—rigged as it probably is against me. (“It does occur to me,” I said to John grumpily yesterday, “that the insurance industry is the only business I can think of which charges its customers an enormous amount of money so it can pay people to say ‘no’ to its customers….”)
Right, so Canada and Norway and most of the developed world have figured out how to dispense health care—we have not. And in nine states I am legally married, and in 41 states plus the territories I am not. And now, we will have to wait around until June to see what will be, in all likelihood, a half victory.
And yesterday, I read an interesting statement when looking for something to blog about. “The history of farming,” an article stated, “has been inherently open-source.”
Say whaaa…?
Translation—nobody owned, until agribusiness came along, a seed. That was the whole point—you grew whatever it was and ate 80% and saved the rest for the next year and that’s how it was for millennia. Now, farmers are the pawns of the seed / fertilizer / herbicide company, and we are suffering or about to suffer a massive jolt to our health—physically, environmentally, economically.
And the Supreme Court, in one sweeping decision that nobody much noticed, was the body that changed “open-sourced” agriculture to corporate agribusiness.
The Supreme Court, who last week worried that homosexuality was newer than cell phones. And yet these guys, so worried about making a “sea change” socially, had no problem completely shifting the foundations of what we put into our mouths?
I go back to wondering, at times, whether men should really be allowed. Yes, we do some things very well. Yes, I’m a guy myself. Yes, I have worked in almost all-female environments and yearned for a nice, testosterone-driven guy.
But maybe it’s time to recognize—agriculture was for millennia a female activity. The men were out there hunting; the women were in the field. And more than that, they were sharing information, swapping seeds, observing how plants grew and why. The essence of agriculture celebrates some traditionally feminine traits—cooperation, patience, nurturance.
Hunting is a guy thing, as is—let’s be honest—business. I worked in the biggest company in the world, and yes, it paid lip service to diversity. But any woman who was going to get seriously ahead was going to have to have bigger balls—sorry!—than the guys. It was about competition, winning, going for the kill.
You know, I don’t accept the Supreme Court being “behind the times.” Not being able to say the word “gay,” but always using “homosexual.” Asking how many states allowed gay marriages, and comparing being gay to cell phones.
That’s bullshit, and an insult. Dowd’s friend may be heartsick….
…I’m pissed.

Friday, January 11, 2013

Now Then

Well, having dispatched our puppet—La Comay—to wherever it is he went off to, what’s next? We have, as we used to say corporationally (OK, computer, businessly? Companally? Does ANYTHING make you happy?), many opportunities down here. One person in seven is using drugs. Murder rate is over a thousand a year. Forty eight percent of the population is living below poverty level.
‘Well, at least we have absolutely no problems with snow removal,’ I thought on the morning trot, after having glanced at the New Day’s front page. Gobierno irá contra los padres, announced the headline. The Government Is Going After the Parents?
Hunh? Why? What have they done?
It started when our new governor visited a school two days ago, and discovered that very few of the parents had bothered to pick up their children’s report card, much less attend parent / teacher conferences.
How few?
A Department of Education spokesperson says only 30% of parents pick up the grades.
So the government gave the parents un halón de orejas or an ear pulling. It’s a common Puerto Rican chastisement. And now, they’re hitting where it hurts.
It seems that parents get all kinds of benefits from the state—plan 8, that’s the apartment. Tarjeta de salud—free medical care. Departamento de la Familia—money and food. You’ve pretty much got your life taken care of, right there.
But to get all this, the agencies require documents verifying that you do have a kid, and that she or he is in school. So the teachers spend time filling out these documents.
Hunh?
Let me put this car in reverse and tell you that I’m not at my best today. Yes, I did the trot, but it was more instinct / habit than Marc out there. I spent most of yesterday on the only throne I’ll ever own, and when I wasn’t there, I was in bed. I am, to speak frankly, metaphorically and literally flushing out the holidays.
Which may be why this situation, even on an island with a zest for absurdity, seems crazy.
OK—let’s do a list:
  1. Teachers teach. They don’t fill out documents, or teach values, or police the school grounds. They just teach, for which they should be paid as much as the governor, easily.
  2. Parents parent. Part of which is to say to the kid that the teacher is to be respected, and part of which is to make sure that the teacher is…respectable (OK, but you know what I mean.) Another part of which is to make sure that their kids know—school is work, your education is the most important thing in your life right now, and will be for the rest of your life.
  3. Governments govern. Which means that I can drink the water (no), drive the roads without breaking an axle (no), go out on the street at night (what, are you crazy?), or send my kid to a public school (unthinkable).
Right, so now we have all the roles defined. Let’s talk about those public schools.
“Lock your kid in the marquesina!” I was once busily saying—actually repeating—to a student. She had just told me that she had announced to the director of the private school her kids were in, “the only reason I’m paying you ten grand a year is that gate over there!”
(A break for anyone who doesn’t know what a marquesina is. It’s a garage, but much more. It’s also a place where you sit, where you entertain neighbors, where you drink beer and watch fights. Importantly, it’s enclosed and has a gate that can be locked. So it’s safe.)
In the public schools, there are no substitute teachers. So what happens when missis (common nickname for a teacher—a little hangover from the Americans) is missing? The school dumps the kids on the street.
OK—so maybe your child has a cell phone and you’re at home, eating bonbons and reading French novels. You hop in the car and get your kid.
Oh, sorry—forgot. That was the fifties.
If you really would prefer that your child not become a street urchin, then you pay for a private school. The education—with some exceptions, of course—is just as dreadful. But they’ve got a gate and a lock and you know where you kid is gonna be when you drop him or her off at seven in the morning. Now all you gotta do is deal with the boss.
Well, my solution was to lock the kid up in the marquesina every day—with, of course, the 500$ of textbooks you shelled out for him. No, it’s not abuse. You’ll give him food and drink, safety, bathroom, etc. You could, of course, put a closed-circuit monitoring system in the marquesina, and follow him periodically throughout the day. Tremendous idea, if I do say so myself: thinking outside the caja as usual!
Well, I thought it was a good idea.
Predictably, it was shot down.
What I am telling you at obscene length is that the public schools are terrible, for the most part.
It now must be said.
You don’t have a right to have a kid. Not if you’re so damned stupid and lazy and uncaring that you can’t hustle your fat Departamento-de-la-Familia-fed ASS down to the school to pick up a report card. I can’t prevent you from having a kid, but I sure as hell won’t support you, you lazy fat cow who stands in front of me in the supermarket while your kids play tag between my knees, and you’re eating chips and drinking Coca-Cola—too damn busy to fish out your tarjeta de la familia card to pay for all the junk you’re slopping into your kids!
Whew….
Now then, back to bed….