Martin C. Winer | This is what happens when Martin gets tired of sending mass emails.

TAG | insurance

Walmart
I never thought that I’d see Walmart as the victim of anything — indeed I see them as the root of most things retail and evil — but this story gave me a moment of pause:
http://well.blogs.nytimes.com/2008/04/04/injured-woman-wins-wal-mart-saga/
Deborah Shank, a Walmart employee was tragically injured in a car accident. Her medical expenses were covered by the Walmart health plan.

The woman’s family arrived at a settlement with the trucking company (the defendant) to the tune of $417,000. Her medical expenses were some $470,000.

Walmart exercised its ‘equitable subrogation’ clause of her policy to collect the funds they had paid out for her health care. This clause is a common feature of most group benefit plans and the practice of collecting on the insured’s settlements is likewise common. The family refused to reimburse the Walmart plan. Walmart sued them and won. They appealed and lost. They took Walmart to the supreme court and were refused an hearing.

Finally Keith Olbermann took up her cause and broadcast her case every night on TV. After what amounted to a crusade against the evil empire, Walmart backed down and agrees to review its subrogation clause. I have plenty of justifications for calling Walmart and evil empire, however, I’m having trouble finding justification for calling them such in this particular case.

This is clearly a tragic case but group policies have the right, moreover the obligation, to protect the contributions and viability of the group plan. If this case sets a (social) precedent and it’s likely that it will, then insurance plans will be forced to pass the cost of this precedent on to all group plan subscribers in the form of higher premiums.

There is a great temptation to look at the coffers of corporations or insurance companies as a deep bottomless pits. This following exchange from ‘Seinfeld’ is emblematic of the general attitude towards large public companies or entities. In this case, Kramer tells Jerry how it is ‘ok’ to defraud the post office:
Jerry : So we’re going to make the Post Office pay for my new stereo ?
Kramer : It’s just a write off for them.
Jerry : How is it a write off ?
Kramer : They just write it off .
Jerry : Write it off what ?
Kramer : Jerry all these big companies they write off everything
Jerry : You don’t even know what a write off is.
Kramer : Do you ?
Jerry : No . I don’t .
Kramer : But they do and they are the ones writing it off .
Jerry : I wish I just had the last twenty seconds of my life back .

Money however, is a finite resource and doesn’t come out of thin air. The only entity capable of manufacturing money out of thin air is the Federal Reserve, but that is the topic of another conversation. In the final estimation, Sachs was paid for her medical expenses twice and that cost will be passed on by the insurance companies to the rest of us in the form of higher premiums.

Being sure to be clear here, we’re not discussing denying Sachs any care. If the settlement was for ongoing health care, then the insurance company should collect her $417,000 but continue to pay her as necessary for ongoing care. If the settlement was for previous health care and she has no further need, while her case is tragic, Walmart is owed the money.

It’s ironic that no one discusses the ‘evil’ of the lawyers who collected their legal fees. The lawyers, instead, are correctly perceived as having performed their duties and have been duly compensated. While I detest the general avarice of Walmart, in this case they’ve met their obligation of caring for, and if necessary providing ongoing care for, their injured employee and were simply trying to avoid paying twice.

Perhaps the true tragedy of this case, beyond the obvious tragedy of Sachs’ story, is that the media is capable of misdirecting the court of public opinion to overrule the Supreme Court.

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The State of The Union – As Seen on TV
Martin C. Winer

But first a word about how this article was written:  This article was the result of a ‘cluster’ or a free-word association.  This is an exercise which is meant to use the ‘right brain’ to spur creativity and generate writing topics.  You can create your own clusters or bubbles here: http://www.bubbl.us/ but it’s best to do them with pen and paper since one tends to self edit when typing.  Each word you see italicized below is from the cluster.  Usually, the idea is to take one theme from the cluster and write about it.  I thought it would be a challenge to include ALL the words and still have the article tell a cohesive story.   Read the article, taking note of the italicized words.  Then see the cluster below.

I have been worried about the state of the world as of late.  Being recently unemployed with no meaningful job on the horizon, I was wondering when I’d be returning to the 9-5 lifestyle.  It’s not that I ravish 9-5, as Dolly Parton’s famous song correctly puts it, 9-5 is all “takin and no giving” but it beats aimlessly strolling on sidewalks waiting for a direction to unfold.  Up until recently I was a member of the over 30 and unmarried class.  Fortune changes quickly and I now find myself suddenly being married with children.  The responsibilities are understandably far different.  Curious as to what direction my life would take over the next months and years, I turned on the familiar glowing oracle fitted in every living room, the television.

dolly-parton-insurance

While I waited for my big screen TV, a vestige of my former employed self, to come to life, I recalled that a comic had mentioned that Dolly Parton had insured her breasts.  I wondered if the comic was putting us on, as he was apt to do.  Would an insurance company take premiums for such a ridiculous item?  What was the counterparty risk?  Were her breasts in good hands with Allstate (TM)?  The TV came to life with the evening news reporting of another hemorrhage on Wall Street of 213 ethereal points, with AIG requesting more bailout money.  Evidently, indeed, insurance companies would take premiums on just about anything and the only boobs in the interaction were the policy holders who actually thought the policy was worth something.  Bored with the evening news I changed the channel.

Dick Cheney was on “State of the Union” with John King on CNN.  Cheney, a bastion of the old guard was set to be ‘grilled’ by King as to the sins of his administration.  I flipped right past the interview because I knew it could not yield the satisfaction I was seeking.  Waterboarding and assassination squads would be second nature to a man like Cheney who shot his hunting partner in the face.  Waterboarding I imagined was just his technique for cleaning his felled game, human or otherwise.  I wasn’t interested in the past, I was curious to know what my future held.

http://cn1.kaboodle.com/hi/img/2/0/0/33/8/AAAAAq9XGwgAAAAAADOFMw.jpg

There was an infomercial on with 90 year old Jack Lalanne sporting his leisure suit and his juicer.  I am a late night TV watcher and infomercials plague the airwaves from dusk ‘til dawnJack Lalanne was born in 1914 and looked to be in better health than myself all thanks to his 1/2 horsepower juicer.  In went an orange, apple, and every other healthy fruit your mother tried to get you to eat as a child.  Out poured a fountain of youth which had purportedly kept Lalanne in such great shape over these many years, yet somehow, it hadn’t managed to save his fashion sense.  The leisure suit was last popular when the juice on everyone’s lips was Juice Newton, “Grease” was the new movie and disco was still in style.  I was intrigued with the notion of extended life and wondered if indeed Lalanne’s juicer could provide it.  Even if it could, what would my life be like, aged 90+ years drinking fruit and vegetables all day?  Would my life be fulfilling?  I changed the channel seeking an answer from the glowing oracle of TV.

The next infomercial was for Extenz tablets; an all natural ‘Male Enhancement’.  Well this held some promise now didn’t it?  At least my latter years could be herbally augmented with extra length and girth.  But just what were these pills I thought to myself?  “An all natural male enhancement?” I wondered to myself.  Didn’t we already have such a thing in Dolly Parton?  What were these herbs and how were they discovered?  Did someone eat a salad with wild herbs one night with shocking results in the bedroom?  How did they then suspect the salad and not anything else?  My mind was awash with questions and I wasn’t much in the thinking mood.  I wanted answers, not questions.  Come on oracle of television, what would my life be like?  The only effort I was willing to exert was in flipping channels.

Yet as I flipped there were a plethora of Viagra and its new copy Cialis ads.  Was the television intimating that my future would need these?  A Viagra ad promised that at age 50 I could trade in my sedan for a Harley Davidson and with one pill have the vigor of a 20 year old.  A Cialis ad promised 36 hour or daily dosing options to make sure I would be able to respond when the mood was right.  If I was as old as Jack Lalanne, would my wife still be ready for me?  I’d be worried about breaking bones at that age.  Another flip would quell that fear.

Once a month Boniva would rebuild my wife’s bones without the need to remember a weekly pill.  There would be no need to take those chalky calcium pills once a day.  Of course memory at that age will be compromised so the once a month dosing is ideal.  Side effects could include liver and kidney disease but at least you would only have to endure them once a month.  God bless Big Pharma.  I could have a once a day boner and my wife could have healthy bones all month.  I was comforted that the future would be bright.  My comfort was not long lasting, at least not as long lasting as 36 hour Cialis promised to be, when it occurred to me that Big Pharma was suffering from a horrible case of misplaced priorities.  With all of their attention focused on bones and boners, they had dropped the two big balls of cancer and heart disease.  I curiously imagined a big Pharma strategizing kick off meeting with people brainstorming on new drug targets and somehow bones and boners getting to the top of the list over cancer and heart disease.  I only hoped that Jack Lalanne’s fountain of youth Juice could get my wife and I past those two roadblocks.

I calmed myself thinking that my 90th year was well off, I being only 35 now.  Big Pharma had time to readjust their priorities.  I continued my flipping to discover yet another Big Pharma commercial for Requip, a medication for Restless Leg Syndrome (RLS).  My legs were perfectly atrophied into their TV watching position.  I didn’t believe that such a condition could occur.  “My doctor said ‘Requip’” said the announcer as a television doctor mouthed “Requip”.  I imagined that the doctor mouthed “bullsh*t” in response to the patients complaint.  [0u92R90U R ‘ jixz-]0039;ffaS980059-09ATRE MT3.  Oops, I’m ever so sorry about that previous mess, you see my arms tend to spontaneously move uncontrollably every so often…  Oh my, could it be I have Restless Arms Syndrome (RAS)?  Well at least I know that Big Pharma is on the case.  Perhaps if I ingest Requip while standing on my head, the medication will settle in the appropriate appendages?  Parenthetically I wonder if all Requip contains is a bottle of gel caps filled with Brandy?  All it seemed Big Pharma could do for me in my latter years was give calm legs and arms and a rock hard erection.  The Viagra commercial warned that any erection lasting over 4 hours constituted a medical risk and thus I knew my fulfillment from Big Pharma would leave me with 20 remaining hours in the day to fill with what?  What would I do?  I looked to the financial stations to see if I had any prospect of finding a job.

CNBC was heralding the success of the latest Apple Computer quarterly results.  The IPhone and the IPod were unrelenting successes.  The host discussed the failing health of Steve Jobs as a concern for the future of the company and since we now know all that Big Pharma is good for, the concern is justified.  I myself am not a gadget freak.  I often mockingly eye people walking down the street sweaty palmed typing at lunatic speeds on their Palm, Blackberry or blueberry or whatever the latest berry is.  I have no need to be so totally connected, but evidently there is a huge market for these devices.  Just the same I was delighted to see the success of Apple whose Macintosh computer was, in my mind, the superior computer in 1985.  Bill Gates was the smarter CEO, not the better innovator.  Steve Jobs didn’t allow clones of Macintosh’s while Gates allowed clones of the PC.  As a result Apple’s market share fell like Newton’s apple under newly discovered gravity.  With all the discussion of executive compensation these days, I think Steve Jobs deserves the lion’s share of the reward when it comes to innovation.  The IPod is simple to use media device which takes advantage of the recent wave of music piracy and MP3’s that puts the tale of the Maersk Alabama to shame.  Now don’t get me wrong, copyright infringement was not created by Jobs, he only capitalized on it.  The IPhone is the next logical extension of a handheld computing device incorporating maps, navigation and a whole host of other useful features we come to expect from Apple.  The Macintosh, the IMac as it’s now called, is gaining market share in leaps and bounds.  I guessed that I had attained some inspiration from the glowing oracle;  perseverance, like that of Steve Jobs in the face of constant opposition and I too could one day go on to innovate a pile of handheld devices – or something like that.  Of course this special was being aired on CNBC the so called financial news network that managed to complete miss any predictions of the financial collapse which had claimed my job.  I wasn’t about to take any advice from them.  No, the Corruption National Broadcasting System as I had renamed them would have to find another mark. I dismissed them with a flip of the channel.

The Cheney Interview was over on CNN and now Anderson Cooper on A.C. 360 was sporting a pie chart showing the distributions of the American reinvestment Plan.  There were huge allotments for infrastructure building projects.  A clip revealed workers building bridges all over the country.  Wasn’t it another Democratic president who wanted to build a bridge to the 21st century?  Now are we building bridges out of Chapter 11?  There was discussion of incentives to homeowners to renovate and rejuvenate their properties.  I thought of stopping in at Home Depot but immediately balked because the 27 minute hand waving discussion with 17 year old ‘Skippy’ who works there never seems to get me the results I want.  For all the talk of hope and economic plans CNN was pushing out, I knew that the recession was receding faster than Dick Cheney’s hairline.

Rembrant - Raising of Lazarus

Then they aired a clip of the master of hope: President Obama.  “America has been great and shall rise to be great again” he prophesized.  I thought this had a familiar tone.  I quickly switched to the Catholic Television Service and the pastor proudly boomed “and the phoenix shall rise out of the ashes just as Jesus raised Lazarus from the dead.”  The pastor went on to solicit donations for a new building project.  This also had familiar overtones and I flipped back quickly to CNN.  “It will take considerable investment from us all but we shall rebuild and come back stronger” proudly acclaimed Obama.  It then occurred to me that Obama was more than just a President, he was our primary minister.  He then intimated at his plan to remove toxic assets from the books of the banks without providing the necessary details I was looking for; undoubtedly he would turn water into wine.  The rhetoric of hope was overflowing my ears and I needed a counter position to ground myself again.  Luckily there was the FOX network who was lambasting Obama as the bane of humanity whose short stint in office had already thrown the economy into apocalypse from which only a miracle could now save us.

Putin and other former Soviet interviewees were quoted as saying that the end of capitalism has finally come.  A commentator remarked: “the American dream of picket fences has been replaced by picket lines” as the video showed protesting auto workers.  Am auto worker protested: “The companies are trying to divide and conquer us, taking advantage of this downturn to cut our benefits and pay.  I say enough taxing the middle class!”  Cheers and hurrahs followed.  My brain was like a pair of Levi’s jeans iconically being pulled by these two polarized stations in opposite directions, at the risk of ripping.  There had to be some truth on the glowing oracle of television.  PBS I thought to myself quickly.  That will save me.

Jim Lehrer

Jim Lehrer

(Ed. Note: Actually it’s IOWA that is ok with Gay Rights, not Oklahoma.  In my cluster, I confused the two, but I went with it because the challenge was to write an article using all the clustered words.  I was only off by a 10 hour drive anyways.  :)   )

Public Broadcasting, publicly funded and publicly ignored in favour of watching MTV to hear if Britney Spears of Lindsay Lohan were wearing underwear today.  Today Jim Lehrer was discussing the state of Gay Rights.  Evidently in Ahnold’s (sic) California the rights of gays have been ‘terminated’.   Ironically, Oklahoma seems “Ok” with gay marriage.  Is that what the song “Oklahoma, OK” is about from the musical Oklahoma?  The world seemed upside down.  Had I inverted myself such that Requip went to my arms and forgot about it?  Oklahoma was a place where I expected politicians to spout the bible about ‘being Fruitful and multiplying’ and how homosexuality was unnatural.  In liberal California, I expect them to say anything goes, from Gay Rights to cloning dolly the sheep.  After all doesn’t Hotel California by the Eagles promise “Plenty of room at the Hotel California / Any time of year, you can find it here”?  I couldn’t make sense of my world.  I was about as comfortable as a man swimming in itchy wool trunks.  I needed to flip the channel quickly.

Kim Kardashian

Kim Kardashian

Chicks Who Love Guns

Up next was a documentary “American Justice” revisiting the O.J. Simpson trial.  It brought back names like Mezza Luna, Nicole Brown, Robert Kardashian, Kim Kardashian… whoops my mind wandered.  Robert Kardashian had helped set a murderer free but brought us Kim Kardashian.  Now they say justice should be blind, but have you seen Kim Kardashian?  He was off the hook in my books but the rest of the characters who let O.J. go were open to attack in my imagination.  I recast the events of that fateful night as a Quentin Tarantino movie.  I’d have my justice, if only in my imagination.  Nicole Brown would now be Jackie Brown.  She would seductively seduce O.J. by dancing for him like Salma Hayek in Tarantino’s “From Dusk ‘Til Dawn”.  She’d then immediately turn into a vampire and eat him alive.  Next, Travolta and Samuel Jackson from Pulp Fiction would show up and after quoting Ezekiel 25:17 would lace into the O.J. lawyers.  Finally the women from “Chicks who love Guns” as seen in Jackie Brown, armed with the AK-47 and they would deal with every “mother [t]ucker” in the jury room.  Returning from my daydream I realized that 10 years had passed and there was no justice to be spoken of.  The only thing I had learned from the episode was that justice is a function of wealth and that O.J. stood for Orenthall James, not Orange Juice.  I’m not admitting I was that stupid however, I’m about to write another article: “If I was that stupid, here’s how I’d admit it.”

I knew how the O.J. saga ended so I flipped again to see what else was on the glowing oracle.  John Sebastian crooned “Welcome Back, to the same old place where you started from…”  It was a rerun of Welcome Back Kotter.  Truly, I was basically back where I had started from, only an hour of flipping elapsed.  I knew nothing more of the future than when I started.  Sure I knew that my bones and boners would be safe, boobs could be insured, and that if I worked very hard, I might find a job.  But I was looking for important answers to important questions like, what would justice be like in the future?  What would the economy be like?  I was sure that Kotter’s Vinni Barbarino wasn’t going to be able to answer my questions.  With that, I turned off the glowing oracle for the night.

‘Apple’ cluster which generated the article.

This is the free word association (or cluster, or bubble) which generated the article.  Again, each italicized above came from the cluster below.

appleCluster


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On this anniversary of Sept 11, I am privy to a pre-release of a recent report from the 9/11 committee.  The report details the wholesale destruction of the US economy by Al Qaeda operatives operating within the United States in a coordinated strategy to bring the US economy to its knees. 

Evidently the terrorist attacks on Sept 11, 2001 were really just a smokescreen for the more prolonged strategy to destroy our economy.  It started with Fedr Al Grin, a high ranking operative deeply embedded in the US banking system, decided to lower interest rates under the guise of stabilizing the economy. 

Below is a transcript of the interrogation of the recently captured Al Qaeda operative Hanny P’Alsin:

This [Fedr Al Grin's actions] led to freely available money which the “infidels gulped up like candy.”  Fedr Al Grin smiled happily watching the infidels load up on overpriced housing and cars they couldn’t afford until 2005 when he started to tighten the noose he had placed around the necks of the infidels.

In 2005 Fedr Al Grin started to raise the interest rates, again under the guise of protecting the economy, and the foolish infidels fell for it.  Suddenly they all began to realize that they were living beyond their means as the money supply evaporated.  Fedr Al Grin played the clarinet as the mortgage market burned.  The Department of Homeland defense became wise to Fedr Al Grin and had him removed from office.  Under water boarding at Abu Ghraib, Fedr Al Grin admitted to many of his sins and wrote an expose detailing the turbulent times he had overseen. 

However, while Fedr Al Grin was on one hand admitting to the evils of the system he had overseen, he had already placed a backup, his protoge Bin Bernik in place.  Bin Bernik watched as banks suffered and fell.  In their weakest moment, he offered help with a secret system to bail them out with infidel taxpayer dollars.  Bin Bernik was well trained by Fedr Al Grin to use a financial terrorist tactic to counterfeit US treasury notes.  By printing too many of them and using this counterfeit money to bail out and own financial institutions, Ben Bernik was and is covertly taxing the entire infidel population into bankruptcy.

One by one the mighty infidels fell.  Bear Sterns, survivor of the great depression sacrificed itself at the feet of Ben Bernik and his plan.  Freddie and Fannie, sacrificed themselves to Bin Bernik saddling the infidels of America with $5 trillion dollars in debt in a single weekend.  Even to this very day, the great intelligence of this plan is still giving fruit.  Lehman Brothers of New York is faltering, soon to fall. 

The US infidel automakers are also rallying to the cry of Bin Bernik.  They too want this free money which secretly bankrupts the US economy.  Airlines, insurance companies, all too big to fail, will sing the song of Bin Bernik to their destruction.  Bin Bernik will happily supply all these companies with counterfeit currency and thus dilute the savings of all the infidels until their lavish economy implodes.

On this anniversary of 9/11 we as Americans have come to realize that all our problems exist overseas.  Clearly this latest report serves only to amplify our need for our continued efforts in the Middle East occupying more sovereign nations to ensure our freedom.  I call on all Americans to pick one of the non-invaded ’stans (Pakistan, Turkmenistan, Uzbekistan, Tajikistan) for immediate attack.  It doesn’t matter which one, clearly any country ending in ’stan will harbor some sort of terrorist.  Only in so doing will we secure freedom for our children and security at home.

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