Tuesday, February 25, 2014


U.S. should quit
Role as world cop

An entry in The Israel Project's Daily Tip reports that:

    State Department officials found themselves on the defensive Monday, after an expose published by Reuters revealed that Iraq has signed a $195 million arms deal with Iran for the delivery of weapons to Iraq. Baghdad sources told the outlet that Prime Minister Nouri al-Maliki had been moved to seek arms from the Islamic Republic - in violation of a broad range of international measures up to and including an explicit United Nations ban on arms sales by Iran - after he became 'fed up with delays in U.S. arms deliveries.' State Department spokesperson Jen Psaki defended the administration, insisting both that Washington was keeping Iraq adequately armed and that it "would raise serious concerns" if the Reuters report turned out to be correct. The Reuters report cited multiple officials and included an account of documents seen by the outlet's journalists describing the deal. If confirmed the development is likely to deepen criticism, heard both domestically and from Washington's Gulf allies, that the Obama administration is withdrawing from the Middle East and allowing Iran to fill in. A recent Politico article, headlined "Who Lost Iraq?" and authored by former Council of Foreign Relations (CFR) fellow Ned Parker, opened with an Iraqi official blaming the U.S. for creating a security vacuum in the country. A New York Times article published around the same time by Michael Doran and Max Boot - respectively a Brookings Institute fellow and a CFR fellow - blasted the administration for not sufficiently "countering Iranian machinations" in among other countries Iraq.

Meanwhile, Sen. Marco Rubio, R-FL, is calling for the U.S. to punish Venezuela by withholding funds from the oil-rich country. The U.S> gives Venezuela about $400 million annually. (Oil rich and US monetary gift - how does THAT compute?)

And, of course, we have John Kerry burning jet fuel for what probably will be fruitless trips between Washington and Jerusalem and between Washington and Ramallah, with an occasional trip to Amman.

Of the three, only Venezuela is in America's "sphere of influence" (and I'm not sure that's accurate anymore; does the U.S. have any influence in Latin America?).

Here at home, SecDef (Secretary of Defense) "Chuck" Hegel is talking about reductions in ground troops and navy vessels as the world moves into a "different kind of war."

Iran and Iraq. Why should the U.S. care about Iran and Iraq? Granted, Iran is threatening the world that once it has n-weapons and a delivery method it will destroy both the Great and the Little satans (U.S. and Israel, in case your name is Rip Van Winkle). Since Iran is a sovereign nation, does the U.S. have a right to act against it? If it does, then would a pre-emptive strike be appropriate?

What about Iran's neighbors. Saudia invites non-Muslims to fight and die for it, but otherwise non-Muslims stay out. Saudia claims to fear Iran, but it does nothing to stop Iran's progress to nuclear warfare capability. Likewise the other Islamic states,

Meanwhile, Mr. Kim and Company in North Korea apparently has both "the bomb" and the means to deliver it - if not to a U.S. target, certainly to South Korea, Japan, and Taiwan/Formosa. The U.S. does nothing about that except, as in the cases of Iran, talk, talk, talk. But then neither does Japan.

The decline of U.S. "influence" did not start with Obungler, but the current occupant of 1600 Pennsylvania has hastened the slide.

ON THE OTHER HAND, does the U.S. need to be the world's policeman? Why should we care is Iran has "the bomb"? True, Israel is our ally - but almost everyone knows how American treats its allies - we promise them anything and don't even give them cheap perfume*.

I'm not suggesting that the U.S. should become isolationist, but I AM suggesting that the U.S. should "butt out" of the role of policeman to the world. The U.S. also should "butt out" of trying to force every country to be a pseudo-democracy in the U.S. mold. (The U.S. is, strictly speaking, a republican form of government, not a "democracy." The government type has nothing to do with the party in power.)

The days when Theo. Roosevelt could send The Great White Fleet around the world to show off America's prowess - and intimidate others - is over. The day when nations dealt with other nations largely is over - now we must confront hoodlems hiding behind old women and babies.

The U.S. is, in some respects, on the right path when it targets its enemies wherever they are hiding; national borders not withstanding. If Nation A offers sanctuary to a person or organization threatening America, then that nation sacrifices its sovereignty and protection from U.S. attacks on those threatening the U.S. and its citizens, wherever they might be; pre-emptive or retaliatory strike is immaterial. "Collateral damage" - death or injury to "civilian shields" and facilities - will be on the head of those in control of the country hosting the terrorists.

That "right of self-defense" must also apply to other nations as well, as example Israel. Whether or not the U.S. should come to Israel's aid - if asked as it was by England in WW1 and WW2 - needs to be considered before the need. (This obviously applies to other nations as well.) Still, I would not encourage any country to depend on a timely U.S. response - remember the '50s.

* "Promise her anything, but give her Arpege," 1927-coined commercial for a Lavin's fragrance. The polar opposite is more in line with what the U.S. did for (to) Hungary and Czechoslovakia in the 50s: "Promise Them the Mine – But Give Them the Shaft."

Wednesday, February 12, 2014

I won't recommend
Humana Advantage
Because . . .

Exercise in customer DISservice.

This is my first, and very likely my last, year as a Humana Advantage client.

A little background.

For the last several years I was covered by an AvMed Advantage program.

While there were a few bumps in the road, I generally was satisfied with AvMed and had planned a long-term relationship with the provider. Good for AvMed, good for me.

However, AvMed "delisted" my long-time Primary Care Physician (PCP), leaving me with the option of

  1. Finding a new PCP
  2. Changing Advantage providers
  3. 1 and 2, above
AvMed didn't provide a reason to delist my PCP's practice - maybe it was because as good as the medical staff is, the administrative side is … suffice it to write that it "leaves a lot to be desired."

Patients need an on-going relationship with their doctors; I had that with mine. I credit him with saving my life by correctly and promptly diagnosing an abdominal aortic aneurysm; both of my parents died of aneurysms.

I wrote above that the AvMed road was not always smooth. But AvMed did have customer service; moreover, clients could email, snail mail, or phone AvMed executives - their contact information was provided on each AvMed newsletter.

I took advantage of that information on several occasions; AvMed always responded promptly.

For all that, I was miffed that AvMed cancelled my PCP.

So I went with the second option: I looked for a new Advantage plan that listed my PCP.

I checked several plans, none of this compared favorably to AvMed.

Now I was at Option 3 - find a new Advantage plan and new PCP.

Again, I checked multiple plans.

Humana was cost effective - in some areas better than AvMed (lower specialist co-pays, break on mail order prescriptions). Not an appreciable difference - perhaps $200 over the course of a calendar year.

Humana also listed both my specialists.

So I signed up with Humana.

And then I got a surprise.

Just because a practitioner is on Humana's provider list does - surprise - NOT mean any Humana PCP can refer a patient to that specialist.

My soon-to-be former Humana PCP informed me that my specialist, although on Human's practitioner list was not on his Humana-approved list; he could not get me an authorization to visit my long-time ophthalmologist.

As with a PCP, patients need to develop a relationship with their doctors - Humana, while on one hand promising me my doctors had contracts with Humana denied me a referral to that doctor.


My about-to-be-former PCP told me I have two options:

  1. Go to a specialist on his Humana "approved" list
  2. Find a new PCP.
No brainer - find a new PCP.

But, there's a catch. I was told, by the PCP and later by Humana, that the client (me) had to contact each prospective PCP and ask the PCP('s office) if the PCP could refer to all my specialists.


I asked Humana to tell me which of four prospective PCPs I listed could refer me to my two specialists.

No response.

I asked again.

For the second time (I previously asked an unrelated question three times before I got a response) I got a message telling me "Sorry, we've been busy."

If Customer Service is so busy, why doesn't Humana increase staffing? Is image of no importance? Has Humana so many clients it can afford to antagonize them with such cavalier treatment? Apparently.

The secure email from Humana in response to my second try re PCP vs. Specialists apparently was created by a person who flunked First Grade reading. Not only was my query unanswered, but the correspondent sent me a list of possible PCPs, none of which was named in my missive to Humana.

AvMed has its problems, but AvMed - unlike Humana - takes Customer Service seriously. When dealing with health issues, I want issues dealt with the first time. Humana fails miserably when it comes to Customer Service.

If I was trying to buy something and asked the seller's CS folks a question and failed to get an answer, I'd simply find another product.

Unfortunately, with Medicare, I'm "locked in" to Humana for the duration of 2014.

I feel lied to by Humana.

    Yes, we list your specialists.

    No, you can't see your specialists because you selected a PCP who cannot refer to them.

    Oh, we didn't tell you about the restrictions? Sorry, we were busy.

Tuesday, February 11, 2014


Vendor with access to data
May be unanticipated risk

According to the Philadelphia Business Journal and other internet sources, hackers apparently accessed Target's data base via a subcontractor's data credentials.

The Wall Street Journal reports that a Pittsburgh PA refrigeration contractor began working with Target in 2006 installing and maintaining refrigerator systems in stores as the discounter expanded its fresh food offerings. Through that relationship, the contractor was linked remotely to Target's computer systems for "electronic billing, contract submission and project management.

Target's liability comes from its IT security advisors' failure to ask the important "What if" questions.

"What if" someone hacked into a vendor's system that has access to our (in this case, Target's) system?

Given that "What if," the vendor's client - Target - had several options, two of which were:

  1. Isolate its customer database from the equipment to which the vendor's system had access
  2. Have its own IT security personnel, or a qualified IT security organization, review the vendor's security measures - both data and physical access. If the security was found lacking, Target could have

    • Prevented the vendor from access to Target's system
    • Helped the vendor secure its system to Target requirements
    • Found another vendor

How difficult would it have been for Target to determine if the vendor's systems were secure?

It could have required the vendor to submit a risk management/business continuity plan, even if the plan was sanitized.

It could have insisted that the vendor have a high level of data and physical security.

It should have prevented vendor access to its customer database or if access was required for the vendor, then it should have put multiple layers of security on its own system.

I'm sure there are many more things Target could have, should have, done, but I am not an IT maven. Had I been part of Target's risk management operation, I would have consulted with my IT and security Subject Matter Experts (SMEs).

Failing to ask the "What if" questions has taken a toll on both Target's financial bottom line and on its reputation.

It could have been avoided if only someone had asked "What if?"

Friday, February 7, 2014

Humana Advantage plan

Customer DISservice

Why is it that more and more often, "customer service" is more akin to "customer disservice."

I'm a "geezer" - it beats the alternative - and I have Medicare via a Medicare Advantage plan. Financially, it's a really good deal so from a cost perspective I have no complaints.

I had AvMed for for several years and was less or more satisfied with it.

For the 2014 calendar year, AvMed

  (a) cancelled my Primary Care Physician (PCP) and
  (b) raised some of its copays albeit not egregiously.

Why AvMed cancelled my PCP's practice is between AvMed and the practice - although the practice's administration services might be the reason; the medical side was better than good - not so the admin side.

My choice then was

  (a) stay with AvMed and find a new PCP,
  (b) sign up with a different Medicare Advantage provider that had a contract with my PCP's practice, or
  (c) get a new provider and a new PCP.

There was a fourth possibility: sign up with a Medicare Supplement program; that would allow me to go to any practitioner who accepted Medicare, but that was an expensive option.

Bottom line: I checked a number of Advantage plans in my area and, after talking with several providers and checking on-line plan summaries of even more providers, I settled on Humana.

According to Humana's Web site, except for my PCP, it had all my doctors, in practitioners and facilities:

  General surgeon (Dr. Brett Cohen),

  Ophthalmologist (Dr. David Goldberger),

  Vascular surgeon (Dr. Jeffrey Hertz), and

  Hollywood Regional (nee Memorial) Hospital

Even better, the copays were less than AvMed.

So I became a Humana Medicare Advantage - perhaps DISadvantage is more accurate - client.

And then the fun began.

Both AvMed and Humana required referrals; Humana calls them "pre-authorizations." Not a problem.

I went to my new Humana PCP, who shall remain anonymous, and asked for a referral to my vascular surgeon for a one-year anniversary follow-up after an open AAA. It took Humana about a week to permit the referral. Not like the faster turn-around with AvMed, but this is Humana.

My PCP told me that he would not request a referral to my ophthalmologist until I had my eyes checked by an optometrist. That would be reasonable except my ophthalmologist is listed by Humana as a practitioner who does refractions. As a matter of fact, Eye Surgeons & Consultants, Dr. Goldberger's practice, is listed first on the page of people/organizations qualified by Humana to do refractions.

Humana recommends a couple of optical service providers. I took the one nearest me (still much father away than Eye Surgeons & Consultants). The OD who examined (and impressed me) said I needed to see an ophthalmologist about my developing cataracts - one of the reasons I wanted the appointment with Eye Surgeons & Consultants in the first place.

The OD sent his report to the PCP. I stopped by the PCP's office and gave the office staff two pages photocopied from Humana's provider book - unlike AvMed, Humana neither numbers its pages nor provides provider ID with the practitioner's name and address, making it hard to tell someone to "See Page nn" or "The practitioner ID is nnnnn" to aid in identification.

That evening the new PCP called - credit where it is due - and told me Humana gives him a list of practitioners to whom he can refer patients. Dr. Goldberger was not on this PCP's list; sorry, but I cannot be referred to my long-time ophthalmologist.

My options, the PCP told, me were two:

  1. Go to a ophthalmologist on the PCP's list

  2. Find a new PCP

The PCP explained that if I insisted on specific providers, I should either

  a. Contact the specialist and ask which Humana PCPs referred to the practice or

  b. Contact each potential PCP and ask them if they were able to refer to the selected specialists.

In 3 words: NOT MY JOB.

I accessed my Humana account and found "Contact Customer Service." It was a message form. Pretty standard.

I sent Humana my request on Sunday:

"Please tell me which PCPs can refer to the following specialists and facilities."

I know that Humana's customer service probably is closed on the weekend.

Today is Friday, a full week of "business days" and I have yet to hear from Humana's customer service. On Day 4 (Thursday) I snail-mailed a letter to Humana's customer service. Maybe that will generate a response.

Meanwhile, as Humana's approved OD pointed out, my cataracts are getting ripe and, unless an ophthalmologist decides it's time to operate, I need a new Rx for lenses. I can't do anything until Humana responds to my question.

My complaint is not only that Humana has so far failed to provide the information I need, it is more that Humana listed my specialists in its providers list and that greatly influenced my decision to buy the Humana plan. I don't understand why ANY PCP is restricted from referring to ANY practitioner listed in the providers list.

AvMed used to have someone monitoring the WWW for mention of the word "AvMed"; when a complaint or kudos hit the Web, AvMed knew it and acted on it. Hopefully Humana will do likewise.

It's customer service truly is customer DISservice and I am not a happy camper.

Humana, are you listening?

Monday, February 3, 2014


Good, bad news
About terrorism

London-based Aon Risk Solutions, the global risk management business of Aon plc (NYSE: AON), just released its annual Terrorism and Political Violence Map. to help organizations assess terrorism and political violence risk levels across the globe. The map is produced in collaboration with global risk management consultancy, the Risk Advisory Group plc,.

The good news:

  • 80 countries with terrorism perils indicated in 2014, 12% fewer than 2013
  • Europe sees notable improvement with 11 countries having civil commotion perils removed

NOTE: Canada, Mexico, and the United States were not mentioned in the report, and the map

The bad news:

For organizations with international interests (vendors, customer, etc.) , the bad news is that:

  • Thirty-three percent of all terrorism attacks affect the retail sector - 18 percent impact the transportation sector
  • Brazil facing an increased risk of unrest
  • In 2013, 52% of all terrorist attacks recorded took place in the Middle East - North Africa (MENA) region, up from 41% in 2012

While no MENA countries were specifically identified, the report noted that "A new strain of Salafi Jihadism has emerged in the Middle East and North Africa (MENA) region as evidenced by increased levels of terrorism. This is a cause and effect of the limited political recovery of post Arab Spring countries, and has contributed to widespread high-to-severe risk ratings across the region."
It is interesting to note that Israel, Jordan, and Saudi Arabia are rated in the middle of Aon's risk scale.

The Aon report claimed that "Brazil was the only Latin American country to see its risk rating increase from medium to severe due to widespread and large-scale violent anti-government protests throughout 2013. The analysis indicates this unrest will likely continue in 2014, particularly ahead of the FIFA World Cup and the October general elections."

Africa, the report continues, "remains a continent of high political violence and terrorism risk, with 22 countries having high to severe risk ratings."

Report by sector

When looking at attacks on businesses by sector, the retail and transportation sectors were significantly affected in 2013, with 33 percent of terrorism attacks affecting the retail sector, and 18 percent of attacks taking place on the transportation sector. The retail sector includes venues such as public markets, which remain vulnerable to attack as seen last year in Kenya. Terrorism remains a variable threat in the Eurasia region, with Russia and Turkey the most affected by the threat through 2013. Additionally, the Winter Olympics in Russia, which will involve significant mass transportation moves, is seen as a potential terrorist target.

Moreover, Japan, Mozambique and Bangladesh have also seen increased scores with Bangladesh witnessing civil unrest over 70 days of strikes and accompanying protests, particularly against low wages and poor working conditions in the garments industry, adding to the issues impacting the retail sector.

The full report is available at

The map is shown at