Tuesday, October 8, 2013

Furloughs and Nobels

As anyone who has been following me on facebook knows, the government shutdown is having a tremendously negative effect on science: the evidence is all around us [1,2,3,4]. Furloughs and temporary lab closures may be coming my way, too, if Congress doesn't get its act together.
At the same time, from across the Atlantic comes news of this year's Nobel Prize in Physics. One should not ignore the unfortunate fact that the "discovery" of the Higgs boson came from CERN and not from Fermilab - in other words, the US decision to shut down the Tevatron had unforeseen effects.
The Nobel announcement should be a clarion call to those whose job it is to regulate/fund/otherwise facilitate US science. If we keep playing games with our scientists, as the US is doing now, we will lose out on future discoveries. We will fall behind in technological advances. We will slowly but surely drain ourselves of expertise, as existing scientists move on to other places and the future generations of scientists are left with no training, no laboratories, and no funding.
Of course, there are more dire situations that have been caused by the government shutdown (cessation of WIC, etc), which I don't mean to minimize. But science is suffering, too.


  1. I'm also off the job. After participating in orderly shutdown activities, I spent my Oct 1st writing an appeal to my private health insurer because of a wrongful claim denial. Instead of universal health care, the "affordable" care act empowers a corrupt system. Why are the Democrats fighting so hard to maintain a system that denies care to a disabled child who had a pre-authorization for the care in question? The "affordable" care act is unforgivable, and so are the modern-day crony-capitalist democrats.

    1. My apologies that you've been furloughed, but I'm surprised at your assessment of the ACA. If you were writing to the insurance company on the 1st of October, it means that whatever treatment started the wrongful claim issue took place long before this month - which means it fell outside the purview of the ACA timeline. That places the blame squarely on the insurance company alone (and we all know how bad they can be! Remedying that is part of the reason the ACA was championed in the first place - hence beginning Jan 1 2014 you *cannot* be denied coverage for a preexisting condition, *period*). Given that the substantial changes from the ACA have only just begun (two weeks ago), I'm surprised that you feel that it's already "unforgivable".
      I think that everybody on the Hill, regardless of affiliation, needs to get their act together and deal with the issue at hand - the shutdown. It was only since roughly 1980 that the Judicial branch started interpreting funding gaps as necessitating actual closures of government entities; unlike Europe, for instance, where normal government services (health care, education, welfare programs, transportation...) continue operating, regardless of whether the government has come to an agreement over budgets (or, in fact, regardless of whether there is a government - look at Belgium). People like you could still be at your job, doing what you always do, still getting paid, while the government stands at an impasse; that sounds much better than the current system. I think we should fix that.

  2. Coverage was not denied, payment for treatment was denied to a person with coverage. Thus, the insurance company gets the juicy premium and doesn't pay the provider. The denial in question has to do with a "new" rule, that is effectively unwritten. The new rule was written by the corporate headquarters and will impact every plan by every regional outlet of one of the largest insurance companies. E.g. corporate headquarters of blue crucifix / blue screen makes a new rule that impacts all regional blue crucifix / blue screen plans, including those that will eventually be purchased through an ACA exchange.

    The new rule requires that durable medical equipment be obtained in same state where the subscriber lives. For sake of example, the subscriber lives in West Memphis, Arkansas and works in and has employer-provided coverage from blue crucifix / blue screen of Memphis, Tennessee. This is not the case, but geographically equivalent to my situation. The durable medical equipment in question is custom manufactured to molds of the patient, and requires fitting by a person with a college degree and proper certification. All providers within a reasonable distance of West Memphis, Arkansas are across state lines in Tennessee. Prior to service, both myself and the provider confirmed coverage for the exact service in question. The claim was denied. I didn't understand the EOB, so I called. The first insurance rep also did not understand the denial, and had to ask a supervisor. It was at this time that I was informed of the "new" rule. If the agent didn't know, how am I to know? The agent also indicated her displeasure with the new rule from corporate, which she said is impacting "a lot" of people.

    Lets assume that everyone that appeals wins. What percentage of people will simply not appeal within the allowed time? The bill will go to collections, and the insurance company can say "cha-ching". Let's suppose that this is illegal and/or a violation of contract. Class action? Who does that help? Victim gets $10 for their $2000 loss and the lawyers get millions. Government action? Hah! This administration and modern democrats are in bed with big business. Jeffery Immelt - was he the tax fairness czar or jobs czar? If blue crucifix / blue screen were ever worried about being targeted by the people and their government for reform, they could just do what the MPAA did and get a democrat-for-hire (Chris Dodd).

    The ACA is just a payday for a corrupt industry. It doesn't matter what is written within the thousands of pages of the ACA, they can still take the premium and deny payment for care and profit from the statistical likelihood of appeal and/or legal action.

    1. It sounds like a horrible situation to be in, and it also sounds like the insurance company is taking advantage of the fact that nobody is fully acquainted with the new rules... I still don't think I'd blame anyone but the company in this particular instance.
      That said, I do feel your pain. For a while I was employed in one state and working in another - and in my case the two states were not at all geographically linked. I was living out-of-network, which made everything far too expensive, but getting back in network meant just as much money spent in travel costs. It was a lose-lose situation, one that could have been avoided if health care in the US was actually "socialized."

  3. Certain measures can be taken in case of furloughs.


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