Opuscula It Simply Cannot be Any worse

I HAVE CONTRACTED WITH FOUR (4) Medicare Advantage companies since applying for Medicare years ago.

I currently am with Anthem/Simply Healthcare’s Simply HMO plan.

I long for December 31, 2018 when the plan and I will part company.

(I suspect Simply also similarly is waiting for year’s end.)

Getting information from Simply about contracted dentist is like – well, pulling teeth.

Simply has a lengthy list of dental providers on its web site
http://providers.simplyhealthcareplans.com/SimplyProviders/Masterpage/contentPages/ProviderSearch.aspx

The site can be accessed sans sign on; it’s an “open” page.

The problem is that the providers on the list apparently are NOT for Simply members.

If these providers are not available to members, WHY LIST THEM?

I asked Simply Member Services if I could see an orthodontist.

No. I have to see a general dentist first. The general dentist might refer me to an orthodontist and if the dental services subcontractor is in a good mood, I might be allowed to see the orthodontist.

Same story with my eyes. I was told by Simply Member Services I would need to see an optometrist who could refer me to an ophthalmologist. Turns out Member Services was wrong (again) and I have to go back to my PCP for a referral.

Member Services gave me the name of several general dentists distant from my residence.

Rather than ASK where I lived, the Member Services person assumed one of the dentists she listed would be close at hand. We all know what “assume” means.

I checked Simply’s dental providers site and failed to find ANY of the names on the list Member Services sent.

Two weeks – and several emails later – someone at Simply Member Services sent an email with a link to DentaQuest, the dental services subcontractor Anthem/Simply employs.

Finally.

Again, I have to wonder if Anthem/Simply won’t allow Medicare Advantage members to use the dentists lists on the Simply web site, WHY LIST THEM? It would be better, at least to my Edward Bear mind, to provide the link to DentaQuest.¹

DentaQuest is not without its own faux pas.

The first local dentist I called told me the dentist specializes in treating children! The dentist was listed as: “Dentist -General Practice , Dentist -Orthodontics And Dentofacial Orthopedics”. The Sweet Young Thing who answered the call quickly (and politely) disabused me of the idea that this was the practitioner for me.

The second call I made got me an appointment with a “Dentist – General Practice.”

Awesome Ella, the Sweet Young Thing at the second dentist’s office – everything was “awesome,” ergo “Awesome Ella” – managed to get me a next day appointment. Despite Ms. Ella’s upbeat charm, my anxiousness about sitting myself down in a dentist’s chair remains at a high level.

Hopefully I won’t have to go through this “Find a dentist” effort again, certainly not with Simply.

The amazing – and sad – thing about my several weeks search for a dentist could have been avoided had someone at Anthem or Simply used their head.

My opinion of Simply is based largely on Member Services’ performance. I give it an F minus.

The individuals may be competent but restricted by a PHB² in what they can tell a subscriber or they may simply be incompetent. Either way. December 31 can’t get here soon enough.

Next year – if I survive this one – I’ll go back to a plan that actually has specialists in my area (I now have to go to Dangerous Dade [County] for an ENT specialist) and a hospital I trust. Fortunately, my PCP is a man of many plans.

A FEW MORE WORDS ABOUT DENTAQUEST

I was just at the DentaQuest site looking for an email contact to inform it of the faux pas on the list of dentists where it lists one dentist as everything but what she is: a dentist specializing in children.

I searched for DentaQuest contact information and Google returned a page that included a link to customer reviews. DentaQuest had an overall 1.5 star rating at http://tinyurl.com/y7l8v84k .

Most of the complaints were about the company, albeit a few were about the practitioners.

At least Simply has an email contact for Member Services; that’s more than DentaQuest seems to offer. DentaQuests’ customer service was not popular with the company’s clients.

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Sources

1. http://tinyurl.com/ydenvxms

2. PHB: Pointy-Haired Boss (see Dilbert comics)

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on Simply awful

Opuscula “In” is in, “Into” is out

WHEN I WAS A YOUNG LAD, Back when Hector was a pup¹, the difference between “in” and “into” was explained thusly:

Three boys were swimming in the creek.
A fourth boy jumped into the creek to swim with them.

I cannot recall the last time I read – or heard – “into” correctly used.

Famous authors infamously misuse the word “in” when the word they should have used is “into.”

Perhaps their English is different than mine.

Perhaps misuse of “in” is an acceptable Fowler-ism².

Or, perhaps, it simply is a matter of being too lazy to teach – and learn – “proper” English.

American English – more correctly U.S. English since Canada is very much “American” being on the North American continent – is a long-time victim of Madison Avenue (i.e., advertising) and now of smart phones and limited character text messages that encourage (force?) use of abbreviations and emoticons/emojis. (Yes, Virginia, there ARE differences between U.S. and Canadian English.)

Admittedly some abbreviations are better than keying or saying the words they represent. SNAFU and WTF are two that immediately come to mind.

OVER THE LINGUISTIC RAINBOW

Everything is “over” or “under” when it should be “more than” or “less than.”

Tv had made the ignorant masses so accustomed to the misuse of over and under that the only time anyone hears or reads “greater than” (>) or “less than” (<) is when the subject relates to computers.

I am driven “bonkers” every time I hear “Under than $200” – or any amount – when the “under” is 1¢: $199.99.

Although I admit it is picayunish, the U.S. does NOT have “pennies.” The Brits have pennies and the Germans have pennies. The U.S. has cents (despite, or in spite of, the long ago “penny post card”.)

One red cent. There is no obvious link between “cents” – which due to their value are on life support – and “sense” (common or otherwise) which our politicians on both side of the aisle seem to shun like a plague. FYI: President Lincoln’s profile does NOT appear on all one cent coins.

According to the tv talking heads (and their never-identified writers), something might be terribly unique.” The only thing “terrible” about “terribly unique” is the “terrible” part. Unique, as are a few other words, is not modifiable. Something is unique or it is not. Period. Full stop.

My Spouse, who has English as her fourth language is so accustomed to my screams of outrage when I hear a modified unique (e.g., most unique, very unique) she often beats me to the punch.

A BAD SPEL^cq

Back in the day, grammar/primary/elementary school scholars – weren’t we all? – were taught to “spell a word as it sounds. Today, spelling seems to have reverted to Shakespearean times. Rather than moving on from phonetic spelling to correct or “standard” spelling our ritin has bekom fonetik again, largely thanks to the shorthand of electronic media.

Thanks to “electronic media,” fewer and fewer people read. Granted, there are those who borrow or buy e-books, but reading paper books is almost passe’. (I’m a geezer and a frequenter of my Local Lending Library.)

The consequences of NOT reading are (at least) two-fold.

1. Small vocabularies and
2. Lousy speleng^cq

(If truth be known, I’m dependent on the word processor’s spell check.)

Spelling became a “lost art” years ago. As a reporter in a small town, I was allowed to read some collegians’ appeals to the local court to forgive certain misdemeanors. The appeals were laughable, at least to the judge and to this scrivener. The errors might have been expected from a third grade student, but from a college sophomore? Inexcusable.

I don’t expect everyone to be a Hubert Horatio Humphrey Jr. or Wm. F. Buckley Jr., political opposites but sharing a love – and knowledge of – the English language.

An aside. I have never met anyone named “Senior.” There may be a person whose given or family name is “Senior,” but we have yet to meet. Juniors I’ve know aplenty, and a few with numbers after their surname. Traditionally, when the senior person dies, the “junior” is dropped from the son’s name.

Merriam-Webster offers a daily email with a “Word of the Day.” Subscriptions are free. It’s not as good as reading a book and learning a new word by looking it up in an Unabridged or even on-line, but it’s a start to vocabulary building.

I once worked with a fellow I nicknamed “Third Definition Gregory.” Mr. Gregory was fond of using a common word’s third definition (assuming here was one). I was forced on more than one occasion to resort to the Unabridged. Unfortunately for the world, “Third Definition” became a PR flack in the City-East (NYC) and his words were lost in a puff of fluff.

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Sources

1. http://www.worldwidewords.org/qa/qa-sin1.htm

2. https://www.youtube.com/watch?v=xwFVOU3zkRc

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on In vs. Into

Opuscula Leftists have eyes That cannot see, Ears that cannot hear

DO THE MATH

There are, according to Wikipedia¹, at least 45 nations where Muslims are more than 50% of the population; this does NOT include the non-nation “Palestinian Authority.”

From how many countries does President Trump want to place a temporary ban on immigration and visitors?

SEVEN

Contrary to the leftists, the president banned ALL residents of these seven countries from instant visas.² According to Wikipedia, Muslims – while the majority religion in the seven countries – are not the ONLY people in those countries. Non-Muslims from those countries also are covered by the ban.

WHY BAN ANYONE FROM THE SEVEN countries?

The seven countries whose citizens were banned:³

• Iran (added in 1984), Sudan (1993) and Syria (1979) are the only countries on the U.S. State Department’s list of "state sponsors of terrorism." They were determined by the secretary of state to have "repeatedly provided support for acts of international terrorism."
• Iraq, Libya, Somalia and Yemen are on the State Department’s list of "terrorist safe havens" -- where terrorists operate "in relative security." But nine other countries or regions are on the safe havens list, too.

Had the president been “anti-Muslim” (rather than anti-terrorist), the ban would have banned Muslims from each of the 45 countries (and the PA) that have majority Muslim populations.

Or, he could have banned Muslims entry while allowing non-Muslims to enter the U.S. THAT would opened him to a charge of “racism.”

Was Trump the first to ban travelers from these countries?

According to Politifact³,

The Obama-signed law contains provisions that restrict travel to the United States for people who lived in or visited Iran, Iraq, Sudan, or Syria since March 2011. They must have a visa to enter the United States; they can’t use what is known as the Visa Waiver Program, which allows 90-day U.S. visits to other foreign visitors.

The law was soon expanded by Obama’s Department of Homeland Security to cover Libya, Somalia, and Yemen. They were identified in the agency’s announcement as "countries of concern," a phrase used in the law.

President Trump’s Executive Order can be read on the Federal Register at
https://www.federalregister.gov/documents/2017/02/01/2017-02281/protecting-the-nation-from-foreign-terrorist-entry-into-the-united-states

The travel ban issue now is before the U.S. Supreme Court.

Obama-appointee Justice Elena Kagan, who is Jewish, challenged the Trump administration’s lawyer over whether a similar ban on Israelis by an anti-Semitic president would be constitutional.⁴

The U.S. already discriminates against Israelis – Jews, Muslims, and Christians. Less blatant than when Trump’s predecessor was in the White House, but Israelis still require a visa to enter the U.S. unlike many “friendly” countries.

According to Wikipedia⁵,

Citizens of 38 countries and territories are eligible for visa-free entry into the United States under the Visa Waiver Program (VWP). All of the countries selected by the US government to be in the program are high-income economies with a very high Human Development Index that are generally regarded as developed countries.

How Israel missed the cut is known only in the halls of the notoriously anti-Semitic State Department.

Brunei, with a Muslim population of more than 67%⁶ is on the VWP list.

It is interesting to note that Morocco is not on either Obama’s or Trump’s list despite the fact that Moroccan Muslims were at the controls of the planes on 9-11-2001 and allegedly have terrorized European communities. Lebanese, despite loss of nationhood to the terrorist group, Hezbollah, and Egyptians, with terrorists at large, are not banned from entry into the U.S.

Obviously, Muslims are not banned from entering the U.S. so claims that the president is an anti-Muslim racist are only in the minds of the leftists. (Where were their cries of racism or Islamophobia when Trump’s predecessor was in the White House doing the same thing? Pots and kettles.)

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Sources

1. https://en.wikipedia.org/wiki/Islam_by_country

2. http://www.bbc.com/news/world-us-canada-38781302

3. http://tinyurl.com/hf4y6xc

4. http://tinyurl.com/yanow45y

5. https://en.wikipedia.org/wiki/Visa_Waiver_Program

6. https://en.wikipedia.org/wiki/Brunei#Religion

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on Eyes that cannot see

Opuscula What changed?

WHEN I WAS A TEEN in junior high school and high school in south Florida we rarely had a fist fight on campus, and only a few off campus.

But even Miami wasn’t New York, Chicago, LA, or their environs. Blackboard Jungle and West Side Story may have been “real life” up north, and while there were gangs in south Florida (e.g., the Little River Rats), .aside from hearing about their presence, I never saw evidence of the gangs.

We knew about zip guns and stilettos and switchblades, but very little of that knowledge was used in “combat.” My friends and I went everywhere in Dade (Miami) and Broward (Fort Lauderdale) counties with no concern about gangs.

THE BIGGEST “DUST UP” was after the Miami High vs. Edison High Thanksgiving football game. Post game sock hops were notorious for ending up in brawls, but most injuries were minor and caused by fists, not knives and certainly not guns.

Today it seems that grabbing a firearm is a first response to a real or imagined insult.

What changed?

One thing that HAS changed is population density.

It once was suggested to me that when a certain density is reached, the population becomes ungovernable.

Metropolitan New York density: 56,012 per square mile
Los Angeles density: 23,887
Miami density: 20,267.
Figures are from 2010 census.¹

The most recent mass shooting (Marjory Stoneman Douglas High School in Parkland, Florida) can be blamed on an inattentive or lazy government.

The shooter, if media reports are true, .never should have been allowed to own a firearm. Florida law prohibits certain people – felons, those who deemed mentally unstable, those dishonorably discharged from the military as examples –from legally acquiring and keeping firearms.

A number of agencies have admitted they failed to prevent the shooter from possessing firearms.

You also have to wonder how the alleged shooter managed to conceal a rifle as he entered the school. AR-15s and AK-47s are hardly “pocket guns.”

When I was a pre-teen and teenager, we had more horse operas than cop shows. Despite someone being “killed” on almost every episode of Gunsmoke, the “grab a gun to settle things” culture was well into the future. “Paladin” (Richard Boone in Have Gun Will Travel²) at least was an erudite gun slinger who often went a full half-hour without shooting anyone. (I confess I’m still a fan of Have Gun, not so much of Gunsmoke.) Even the cop shows I watched – Dragnet, Badge 714, and Adam-12 – rarely had shootouts.

Times have changed.

It seems that almost every day someone is murdered in Dade County, most frequently by an illegally obtained gun. There are too many “accidental” shootings with guns that should have been locked in a gun safe. Child on child shootings are the real tragedy.

When I was about six years old I learned about gun safety. I am not an NRA member, but I do have a concealed carry license. I mention the NRA because, despite liberals’ condemnation of the organization, I understand no NRA member has ever been charged with a mass shooting.

Back in the day we wasted our change on pin ball – and then Pacman came on the scene. Violent video games were only in the minds of the creators.

Today, if it’s not violent games and tv shows (who can afford movies?), its violence on the news. The bloodier the better for the tv “journalists.” To be fair, that seems to be what “sells.”

Because so many people have guns – most often illegally obtained guns – cops are now more inclined to shoot suspects who either reach for something or have something in their hand, even if that “something” later turns out to be a cell phone. (Truth in blogging: My first born is a cop.) The best, perhaps only way, to avoid being shot by a cop is to comply with the cop’s orders – sort it out later in court. Cops are not always right, but they always are cops.

I am not a sociologist and – although I have my “suspicions” – I wonder what has changed from the 1950s and even 1960s to turn us into a nation whose youngsters immediately turn to deadly weapons to settle disputes once settled – worst case – by fists.

Until law enforcement and social agencies can keep up with people know to have mental issues, the murder rates will continue to climb -- one by one or one by 58³.

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Sources

1. http://tinyurl.com/y8ygznfz

2. http://purehistory.org/have-gun-will-travel/

3. https://en.wikipedia.org/wiki/2017_Las_Vegas_shooting

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on What changed?

Enterprise Risk Management (ERM) Real risk management Vs. Disaster recovery & Business Continuity

ONE OF THE PROBLEMS WITH THE TERM “RISK MANAGEMENT” is that it means different things to different people.

For many. “risk management” means something related to insurance.

To others, “risk management” means patient safety.

To this scrivener, “risk management” should be prefaced with the word “enterprise” and it should include everything and anything that might impact “business as usual.”

ENTERPRISE RISK MANAGEMENT is more than “just” insurance, although it includes insurance as a way to mitigate loss due to a risk.

It also is more than “just” patient safety,” although in a medical environment patient safety should be a primary concern.

Enterprise risk management is the maturing of a process that started with Disaster Recovery (DR), a function associated solely with Information Technology (IT) or Management Information Systems (MIS). I got my start with DR on a data company’s national network.

DR morphed into Business Continuity, (BC). Business Continuity focused on an organization’s profit center(s) and what it took to keep the profit centers profitable. BC was primarily “within the confines of the organization’s building(s).” (Business Continuity in “government speak” is Continuation Of OPerations, COOP.)

The trouble with business continuity is that it failed to consider “I/O” – input and output.

Even organizations lacking product production – e.g., widgets, doo-hickies, and thingies of all types and shapes – still have I/O. Production facilities are more obvious candidates for enterprise risk management, but all organizations – even non-profits – need a viable (read “proven”) enterprise risk management plan.

Even charities need a plan. What happens if contributions dry up; how will commitments to clients be sustained?

Then there is image. The organization’s image can make or break it. In this day and age of “social” media, an organization is well advised to monitor what is being said about it.

Never forget regulators. EVERYTHING is regulated by some government or association somewhere. (OK, almost everything except the media, social and otherwise.)

Enterprise risk management is not nuclear science; it is “thinking outside the box” to identify ALL threats to “business as usual.” After the identification comes triage – which threats are most likely to occur. Then comes decisions to avoid (expensive) or mitigate the threats. Even if a threat is considered highly unlikely, the plan should include how to respond to it “in the event of.” Insurance may be part of the mitigation plan, but the policy must be c-a-r-e-f-u-l-l-y read and vetted by both an insurance adjuster (not associated with the insurer) and a lawyer who specializes in insurance.

What type insurance to consider? Here are five broad categories: Business interruption, Directors and Officers, Liability, Physical hazards (fire, flood, etc.), Workers’ compensation. The list is NOT “all inclusive.”

One thing an enterprise risk management practitioner cannot be is an expert in all industries or even all organizations in one of the North American Industry Classification System (NAICS) classifications. (NAICS superseded the Standard Industrial Classification (SIC) system. It was developed jointly by the U.S. Economic Classification Policy Committee (ECPC), Statistics Canada , and Mexico's Instituto Nacional de Estadistica y Geografia , to allow for a high level of comparability in business statistics among the North American countries. ¹)

The practitioner must

Have highly visible support from senior management

Work closely with Subject Matter Experts – the people who actually do the work

John Donne was spot on when he penned “No man is an island.”². This is especially true with enterprise risk management.

Finally, management must commit to both exercising the plan and maintaining the plan. Lack of either and the plan won’t be worth the paper on which it is printed. (Yes, Virginia, there should be a paper copy, “just in case.”)

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Sources

1. http://tinyurl.com/yaoym7y2

2. Complete poem at: http://tinyurl.com/yajdumzj

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on Real risk management

Opuscula Disaster if U.S. quits Nuke deal with Iran? Question: What deal?

SUSAN RICE, NATIONAL SECURITY ADVISER to ex-president Barack Obama, argues that an American abandonment of the Iran nuclear deal could be disastrous.¹

Ms. Rice conveniently ignores the fact that Iran, like its Russian sponsor, signs agreements only to ignore the agreements’ conditions.

Just like the “Palestinian Authority” and the Oslo agreement.

AMONG OTHER THINGS, the Iran agreement called for unobstructed inspections of all Iranian nuclear sites.

That never happened.

Either the Iranians prevented inspectors from entering a site or they delayed access to the site until any evidence of Iran’s violations of the agreement were hidden.

Just like Russia.

When UN inspectors wanted to investigate the latest chemical attacks in Syria, Russia blocked the effort. It later said there could be an international investigative team, but as the team was being assembled, Russia reneged and blocked the investigators.

That, of course, begs the questions:

1. When did Russia become Syria’s government to allow or deny entry into the country?
2. Why should Russia CARE? The world already knows parts for the chemical containers came from Germany and that the containers were manufactured in Iran. Perhaps the chemicals in the containers could be traced back to Russia?

Iran at once boasts it can mate together enough nuclear bombs and ICBM delivery systems to destroy Israel and U.S. assets in the area while at the same time telling U.S. and European liberals that it isn’t working on such weaponry.

A Janis with a Persian face.²

Despite the reality on the ground, the Obama adviser still contends that "The nuclear agreement works. It distanced Iran from nuclear weapons and gives us the ability to verify and monitor Iran's obligations. If we destroy the agreement, and that is the meaning of American abandonment, it will first of all create a crisis of trust between us and our European partners," Rice said at the J Street decade conference.

Consider her audience: J Street.^{3, 4}

Rice added that "Abandoning the nuclear agreement on the eve of the expected meeting between President Trump and North Korean ruler Kim Jong-il, in preparation for an agreement on the North Korean nuclear program, will send a message that the United States cannot be relied upon, which signs an agreement but also can withdraw from it."

The U.S. has a very long history of abrogating promises, formal and otherwise.

• The Hungarian Revolution exposed the contradictions in United States (U.S.) policy that had existed since the formation of the Psychological Warfare Campaign during the Truman Administration and grown during the Eisenhower Administration. Because of leadership failures and organizational problems within the Eisenhower Administration, this psychological warfare effort encouraged the Hungarian people to rise up in rebellion, even though the Administration was unprepared to support such an uprising and the Department of State had opposed such agitation. ⁵
• The Broken Policy Promises of W. Bush, Clinton, and Obama report from Foreign Policy magazine.⁶

Never mind Washington’s lengthy litany of broken agreements to the American Indians.

Breaking agreements seems to be Standard Operating Procedure (SOP) for most governments. North Korea is no exception so any agreement between the U.S. and North Korea will be worth less than the papers on which it is printed. That is NOT to state that, unlike the Iranian agreement, it won’t be violated before the ink is dry; hopefully it will be honored by both parties for a long time.

Theo. Roosevelt repeatedly said Treaties are not worth the paper they are printed on.⁷

Ms. Rice is entitled to her opinion and she is entitled to spin her opinions to satisfy her audience, but opinion not withstanding, the facts fail to support her argument.

Sources

1. http://tinyurl.com/yaehqx4s

2. http://tinyurl.com/yd2av7dn

3, http://tinyurl.com/h9osb7j

4. http://tinyurl.com/ya6xots2

5. www.dtic.mil/dtic/tr/fulltext/u2/a589819.pdf

6. http://tinyurl.com/y77kbfsb

7. http://tinyurl.com/ya89akaw

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on Rice & Iran

Opuscula First mistresses And other ladies In the White House

IT’S A FUNNY THING, president after president has had extra-marital “interests” and the press usually was silent.

According to Beowulf Boritt¹ who designed the sets for Clinton the Musical not all presidential lovers were women.

• Franklin Delano Roosevelt had a mistress, Lucy Mercer. Eleanor knew about her; Mercer was engaged as Eleanor’s social secretary. Meanwhile, Eleanor managed by giving her attention to Lorena Hickok.
  

• Dwight D. Eisenhower had a mistress; his chauffeur during WW 2 . Mamie knew about her.
  

• John Fitzgerald Kennedy was infamously known as a womanizer. Jackie turned a blind eye. JFK outdid all his presidential peers, having affairs with Marilyn Monroe, Blaze Starr, Judith Exner, Jayne Mansfield, Pam Turnure, and Jill Cowan.
  

• Wm. Jefferson Clinton was caught with his pants down – literally – even though he “never had sex with that woman." It briefly made the news. Clinton also was sexually linked to Jennifer Flowers. Hillary had to aware of his “peccadilloes.”
  

• Thom. Jefferson famously had an affair with Sally Hemmings, but by then he was a widower.
  

• Geo. H.W. Bush had Jennifer Firtzgerald.
  

• James A. Garfield had a fling with Lucia Gilbert Calhoun, a reporter, yet apparently the affair never made the pages of her paper.

Not all presidential lovers were women, at least according to Boritt.

Boritt contends that James Buchanan and William Rufus King were an item.

It may be easier to list presidents to whom no extra-marital liaisons are attached.

Harry S Truman, Richard Milhouse Nixon, and Lyndon Baines Johnson come to mind. Truman’s wife, Bess, stayed home, leaving Mr. Truman at the mercy of the Washington ladies.

TRUMP’S AFFAIR(S)

Today’s “media” delights in headlining President Trump’s liaisons with the ladies.

Why he would want a relationship – of any type – with a porn star (Stephanie Clifford a/k/a “Stormy” Daniels) is beyond my ken. Perhaps, as he allegedly suggested, “because he could.”

Newsweek headlined How Many Times Has Trump Cheated on His Wives? Here's What We Know² and listed Marla Maples (when he was married to Ivana). The Wall Street Journal!, according to Newsweek, claimed Mr. Trump had a fling with Karen McDougal, the 1998 Playmate of the Year. Trump denies this.

Meanwhile, 19 women are alleging “sexual misconduct.”³. Many of the claims date back decades causing one to wonder (a) why these claims were not made in a timely manner and (b) if some of the claims simply are “me, too,” jump on the bandwagon claims.

While this scrivener does not condone sexual impropriety, it seems that Trump's extra-marital affairs are a subject for discussion between Trump and his spouse, not between Trump and the media.

Looking back on the silence of the media when previous presidents had, in some cases, fairly blatant affairs, it seems hypocritical to headline Trump’s alleged “sexual misconduct.”

Perhaps Americans are “prudish” when it comes to their presidents – certainly not to their representatives in the Senate and House (Edward Ted Kennedy comes to mind) – but if we are, we are among a minority. Even “staid ol’ England” has its scandals. France is famous for sexual peccadilloes among its politicians.

Mr. Trump suggests that the leftist media is on a “witch hunt,” looking for any tidbit that might embarrass him. That might be “OK” if the media could not see out of one eye and was blind in the other about other politicians – namely Hillary and friends – who also should be held to the same standard.

Benghazi? Email server? History covered by the cobwebs of “journalists” who slant or spin the news to their favorites’ advantage.

Mr. Trump may be a “sexist pig,” but we’ve been electing “sexist pigs” to office for more than a century if reports are to be believed. Same goes for scoundrels in the White House.

Unlike several of his predecessors, Mr. Trump is not diplomatically polite. He’s rude and crude, but for the first time in decades, other nations leaders listen when he speaks. No one will accuse Mr. Trump of being a pantywaist.

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Sources

1. http://tinyurl.com/y75v3h8s

2. http://tinyurl.com/yakw2pge

3. http://tinyurl.com/yb6kbdse

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on First mistresses

Opuscula Where oh where Is Medicare hiding?

TODAY’S MAIL BROUGHT my quarterly statement from AvMed, a Medicare Advantage insurer.

According to AvMed, it paid out $221.20 for provider services.

My share was $0.

So why am I complaining?

I’M UPSET BECAUSE someone is scamming Medicare.

I’m also complaining because the only ways I can get Medicare’s attention to alert it to the scam is to telephone, fax, or use its web mail.

• I loathe the telephone and being on hold for “forever”
• My excellent phone service lacks fax support
• The web mail insisted I keyed an unacceptable character; it didn’t let me know WHAT that character might be, but simply refused to forward my message.

Medicare raised the basic rate from $104/month to $134/month and, I’m given to understand, it will go up again next year to $154/month.

Imagine a person trying to survive on minimal Social Security now having to pay an onerous portion to Medicare. This increase was in the works before Trump took office, so don’t blame him.

We – Medicare recipients – are frequently encouraged to report what we perceive to be scams taking advantage of Medicare’s “largess.”

Apparently AvMed doesn’t care that someone is billing it for services never rendered to a former subscriber.

I have not been an AvMed subscriber since 12/31/2016.

The more an insurance company pays out, the more Medicare pays the company. There is no impetuous for an insurer to report what, to this scrivener at least, is a blatant attempt to scam Medicare.

AvMed is a pretty good company. Because it has providers I want, I’ll go back to it in October, even though there are other companies with better benefits. It’s a balancing act.

I don’t want to think that AvMed is a willing partner in the scam, but since it’s been two years since I was with AvMed and it still claims to be paying providers for services not rendered . . .

I sent a snail mail letter to AvMed Member Services in Miami detailing my complaint.

I was going to send a copy to CMS (Medicare), but CMS lacks a mailing address. Seems impossible, but such is life with government agencies. It’s easy to contact the IRS, why not CMS?

I did manage to send a web mail note to CMS telling it someone is scamming it and asking for someone to call me for details. It is NOT likely a Medicare rep will call and even if I am called, what are the odds (slim to none) that anything will be done?

I could write to my congresswoman, but she is less than useless. (When she was asked for help in the past, she simply ignored the request.) Maybe I should contact presidential want-to-be Marco Rubio.

I don’t have the resources (read “connections”) to investigate why AvMed claims it paid some provider for some services never rendered and I am beginning to suspect that, despite encouraging reporting of Medicare abuse, no one really cares. After all, it’s easy to increase the monthly rates.

I am a little “upset” since I paid into Medicare since its inception and now I’m having to pay again.

Our government at work. (Maybe we’re better off when it goes on strike.)

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PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on Medicare scam

Opuscula Silent Dems bow As GOP’s Trump Speaks and acts

ALL GENERALITIES ARE LIES.
However, there is a grain of truth in all generalities; smoke and fire if you will.

THERE ARE MANY WHO condemn President Trump for everything he says and does – and a few who condemn him for things he does NOT say or do.

But unlike some of his Democratic predecessors in the White House, Trump DOES what he says he will do (if the Congress and the Courts don’t overrule him).

AMERICA AS “RODNEY DANGERFIELD”

American lost the world’s respect starting with one-termer Jimmy Carter who gave in to the Iranians and allowed them to capture and humiliate U.S. diplomats when the embassy was seized.

What did Mr. Carter do?

Nothing.

Mr. Clinton was no better.

When the Iranians – same folks that should have caused Mr. Carter a red face – successfully attacked the USS Cole, what did Mr. Clinton do?

Same as Mr. Carter: Nothing.

There are equally silent Republicans.

Ex-president Geo. W. Bush, a/k/a Bush 2, not only was silent after Muslim terrorists brought down the Twin Towers (9-11-2001), along with more than 3,000 innocents (including those who died in the disaster and the aftermath), but was a propagandist for the Muslims.

Geo. W also famously told the world that the invasion of Iraq was “successfully completed.” As the world knows, it wasn’t completed.

On the flip side, former president Lyndon Baines Johnson usually did what he promised; sometimes to the nation’s benefit (e.g., Head Start) and sometimes not (e.g., Vietnam). Granted, Vietnam was not LBJ’s war.

BOWING OBAMA

Two-term leftist president Barack Obama kowtowed to his Muslim friends and declared an “Arab spring,” but then did nothing when he and his secretary of state allowed Muslims to murder Americans during a planned “spontaneous” uprising in Benghazi. It was the secretary’s “do nothing” attitude before the “spontaneous” attack that directly led to the American deaths. (Imagine if she became president!)

Bowing, showing submission to someone or something¹ is Mr. Obama’s trademark.

According to The Atlantic², the ex-president has bowed to

1. 2009: Obama bows to the Saudi King
2. 2009: Obama bows to the Queen of England
3. 2009: Obama bows to the Japanese Emperor
4. 2010: Obama bows to a Republican
5. 2010: Obama bows to the mayor of Tampa
6. 2010: Obama bows to the Chinese
7. 2012: Obama bows to Felipe Calderon
8. 2013: Obama bows to a Communist

TRADITION

It’s a grand Democrat tradition to do nothing – at least until the polls and soothsayers approve an action. This goes back at least to Franklin Delano Roosevelt (FDR) who preferred to violate U.S. citizens basic rights (by putting them into concentration camps) while sending a boatload of Jews back to Germany and death. FDR also forbade American bomber crews from dropping bombs on railroad tracks beneath them on their way to and from bomb runs on "approved" nazi targets.

Once the polls and soothsayers said it was OK – and with a little help from the Imperial Japanese Navy’s attack on Pearl Harbor (allegedly known to the White House BEFORE the attack) – FDR finally allowed Americans to save Europe (once again).

WHERE THE BUCK STOPS

President Harry S (no period) Truman proved that some Democrats are doers.

FDR had plans in motion to create and use an atomic bomb. Would he or wouldn’t he?

He failed to share his thoughts with his vice-president.

Mr. Truman who, having served in WW 1 knew the horrors of war first hand, decided “the bomb” could end the war in the Pacific and save American and allied lives. He ordered the bombing of two Japanese cities. That led to the surrender.

Mr. Truman, protecting the sovereignty of the president’s role as Commander-in-Chief, cashiered a popular general for disobeying orders. The president was roundly criticized for his action, an act that preserved presidential (civilian) control of the military and one that may have cost him election to a full four-year term. (He lost to a general.)

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Sources

1. http://kencarlson.org/bible/worship/we-bow-down-2/

2. http://tinyurl.com/y9qodvk8

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on Do vs. Don’t do

Opuscula Who’s really guilty For chem attacks In Syrian conflict

WHILE PRESIDENT TRUMP & FRIENDS try to determine if Al-Assad is responsible for the chemical missile attack on men, women, and children, the question that needs to be asked is: ”Who supplied the missiles and the chemicals?”

According to the Foundation for the Defense of Democracies¹,

After a Syrian photographer found parts made by German company, the Krempel Group, in the remains of Iranian-produced chemical rockets that gassed Syrian civilians in January and February, the firm rejected on Wednesday new US warnings about the dangers of conducting business with the Islamic Republic.

Syria is not known for a defensive – or in this case, offensive – war materials industry. Hezbollah probably has as much capability to make missiles as Syria, but it saves its effort to attack Israel.

Germany, despite reparations to victims of the nazis, will sell anything to anyone. The government sells simple submarines (e.g., not nuclear) to Israel while German companies sell missile components to all comers.

American criticisms fall on deaf ears when the Deutchmark is concerned.

The bottom line: the Germans need to admit they were instrumental in the chemical attacks on Syrian non-combatants – not one, not twice, but it seems, thrice.

Iran, with designs on a re-established Muslim caliphate – not “Arab” caliphate since the Iranians are Persians who quickly will tell you that are not Arabs (whose language and culture are “beneath” those of the Persians) – wants to make political inroads into those Arab states they disparage.

To that end, Iran provides war material and expandable soldiers to Syria and Lebanon – the country that used to be a country of consequence but now is ruled by Hezbollah that, in turn is beholden to the ayatollahs in Iran.

What Iran cannot buy from Germany and Russia, it barters from North Korea.

For the Middle East, it’s politics as usual.

But Al-Assad is not solely to blame for the chemical attacks – if indeed he ordered them. Germany and Iran are equally as guilty.

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Sources

1. http://tinyurl.com/y8ysb9aw

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

BCPLANNER:

Opuscula Good advice, Free advice, Too little advice

THE STATE OF FLORIDA, as do most states, has an Emergency Preparedness Guide.¹ The state even will help individuals make personal, location-specific plans.².

As an enterprise risk management practitioner, I’d give Florida’s planning tools a B+.

Why not an A?

Because there is no mitigation effort in the plan.

The plan is not even a 100% complete disaster recovery plan.

For all that, review the plan as a general check list. No one ever thinks of everything.

A RISK MANAGEMENT PLAN ALWAYS includes RISK AVOIDANCE AND MITIGATION

Before we moved into our current house, I confirmed the structure was not in a flood zone. It’s easy enough to find out. Start with the Federal Emergency Management Agency’s (FEMA) Is Your Property In A Flood Zone? Find Out In 2 Minutes Or Less! site.³ The site includes a video for the reading impaired.

The site also links to the FEMA Flood Map Service Center. Plug in the building’s address, a place, or longitude/latitude coordinates and – almost magically, the information will appear.

However, just because a structure is not in a FEMA identified flood zone, heavy rains can cause street flooding, and street flooding can creep up to the doors, so laying a supply of sand bags or other barriers is wise. Some cities offer residents free sand bags; just come early.

Insurance companies give discounts for wind mitigation in hurricane-prone areas. Wind mitigation includes making sure the roof won’t blow off (as many did when Hurricane Andrew hit south Florida) and that glass windows and doors are protected from flying debris.

WISE land owners will make certain all trees are trimmed and all loose objects are secured, thereby reducing the risk of flying debris.

Florida’s Emergency Preparedness Guide briefly mentions cell (mobile) phones. It recommends having extra charged batteries. Most folks do not have spare cell phone batteries and some “smart” phones make battery exchange difficult. Better: get a car charger. (While out and about, get a two to five-gallon jerry can (spare can for fuel), top off the vehicle’s gas tank and fill the jerrycan. Do NOT wait until the last minute to buy a fuel container – like bottled water, the closer the event, the scarcer the containers.)

PHOTOGRAPH EVERYTHING inside and outside the structure. Insurance companies want to know that the damaged property was owned and OK before the event. Store the images where they are safe from the event – preferably in at least TWO different locations. (Send yourself emails with the photos as attachments.)

WHAT’S MISSING

There is no mention of post-event recovery. You can’t have “disaster recovery” without “recovery” options.

I failed to see any suggestions re

• What to do to mitigate additional damage (e.g., cover broken windows with something to prevent rain water entering the building)
• Contact restoration organizations
• What to check to assure the restoration organization is legitimate
• Who to contact if you believe you have been scammed

It is a good idea to have a list of qualified, licensed and insured, contractors’ contact information at hand. While “money talks” and helps set contractor response priorities, the first to call for help often is the first to receive help.

BOTTOM LINE

The “bottom line” for Florida’s Emergency Preparedness Guide is that it’s a good starting point but a guide that needed an enterprise risk management practitioner’s involvement. It’s “better than nothing,” but it could have been a lot more beneficial had it had input from people who think avoidance and mitigation in addition to disaster recovery.

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Sources

1. http://tinyurl.com/y7ffcvmt

2. http://tinyurl.com/ybsreg5u

3. https://retipster.com/floodzone/

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on Emergency plan

Opuscula Only in Israel: Treasonous pol Rails against country

A NUMBER OF ISRAELI NEWS sites have reported that Arab Members of Knesset (Mks) are calling for Israeli Arabs to join with Muslims in Gaza to invade Israel.

The leader of the anti-Israel group in the country’s Knesset (=parliament) is Israeli-educated Hanin Zoabi. ¹

ACCORDING TO ONE Israeli media account², Zoabi

1. Called for Palestinian Authority residents in Judea and Samaria to join the protests on the Gaza border
2. Called Israel a “fascist” country and called for an investigation into the deaths of Arab protesters during a news conference at the United Nations headquarters in New York
3. Said “We need millions of Palestinians to march on Jerusalem. That is the aspiration.”

To her call for “millions of Palestinians to march on Jerusalem” she adds that this won’t happen because “the Israelis would kill them.”

ZOABI AND REALITY

Zoabi, faced with the reality of Israel and Arab women’s rights, chooses to ignore the truth.

The MK was aboard the Turkish provocation vessel Mavi Marmara when Israeli commandos boarded the ship (after it refused to stop for inspection). The vessel was found to be carrying not just “peaceful passengers,” but war materials to be used against Israel. (A later ship, the Turkish ship Lady Leyla , carrying more than 10,000 tons of humanitarian aid for the Gaza Strip has reached the Israeli port of Ashdod from which the aid was trans-shipped overland to Gaza.³ Had the Mavi Marmara been carrying aid to Gaza and not contraband, it too could have berthed at Ashdod; it’s purpose, however, was to provoke Israel to board it at sea, to create an international incident – with Zoabi right in the middle.)

Zoabi castigates Israel as being a “fascist” state (ibid.) Despite two degrees from Israeli universities – one of which was in “journalism” – she apparently does not know the definition of the word “fascism” (and by extension, “fascist”). Merriam-Webster explains that fascism stands for a centralized autocratic government headed by a dictatorial leader, severe economic and social regimentation, and forcible suppression of opposition.⁴ Israel could never be considered a “fascist state” under MW’s definition. (Anyone who believes Zoabi never has been to Israel and seen Israelis of all religions treated with respect and general equality.)

Poll after poll suggests that – if a poll can be believed – most Muslims living in Israel prefer to live in Israel than in the PA areas or any neighboring Muslim state (e.g., Egypt, Iran and Iraq, Jordan, Lebanon, Saudi Arabia, Syria,) I specify Israeli MUSLIMS since there are non-Muslim Arab residents of Israel.

Israel’s army has an Arab (Druze) general. He is an army general – not a general for Druze or Muslims. Israel’s Knesset (obviously) has Muslim Mks. Israel’s highest court had a Muslim justice.

Imagine an Israeli – of any faith – as a general in a Muslim army. or a member of the ruling body, or a member of the country’s highest court.

Yet, according to Zoabi – from her seat in Israel’s parliament – Israel is a “fascist” country.

When I lived in Israel (circa 1976) I could, and did, take either an “Arab” bus or an Egged bus to Nazareth (for school business). Muslims had, and exercised, the same options.

Having lived in Israel, the only discrimination I see is that practiced against women – Arab women, Jewish women, both can suffer equally – albeit not legally – abuse by their male relatives.

If Zoabi finds life in Israel so distasteful, so racist, so unsatisfactory that she has to align herself with the radicals who would wipe out all the Jews and throw “Palestine” back into the middle ages (along with Saudi Arabia, Syria, and Iran), let her relocate to the PA areas. Would she be welcomed as a member of the PA’s parliament? How about the despots ruling Gaza?

Zoabi bites the hand that feeds her and her rants should been seen as those of a spoiled child, one out to spite the people who give her the soapbox.

Every country has people like Zoabi, but most countries don’t tolerate traitors in government. Her statements to whomever will listen are without doubt treasonous and she should – at a minimum – be stripped of her Knesset seat.

But that won’t happen in”fascist” Israel where she is protected by the courts.

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Sources

1. http://tinyurl.com/ycpnpmyn

2. http://tinyurl.com/ydh74qr5

3. http://tinyurl.com/zup8hop

4. https://www.merriam-webster.com/dictionary/fascism

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

BCPLANNER: Comments on Zoabi

Opuscula How do we know Who launched Chemical attack?

I’M ALWAYS A LITTLE CONCERNED when we have a knee-jerk reaction to something.

Example: Syrian dictator Bashar al-Assad is blamed for a chemical attack on some of his foes.

He may, indeed, have ordered the attack. It would not surprise this scrivener if someone had evidence that Al-Assad DID order the attack.

Maybe Russia’s Vladimir Vladimirovich Putin ordered the attack. How about Iran’s Supreme Leader, Ali Khamenei.

I am absolutely certain there are many American leftists who blame President Trump or “the Israelis”.

As a former newspaper reporter and editor, I have to ask: WHERE IS THE EVIDENCE.

Al-Assad claims the images displayed by the media are manipulated; not current. It’s hard to believe the media would lie to us, right? (If you believe that, I have a bridge in New York to sell you.)

But why are the world’s capitals silent about evidence.

Has anyone examined the chemicals used in the attack? Has anyone tried to trace the chemicals’ origins?

I am not against “punishing” whomever ordered the attack. If Al-Assad ordered the attack, he should be eliminated; he’s not fit to rule in his own home, let alone an entire country.

How were the chemicals disbursed?

Israel seems to believe that Al-Assad’s air force delivered the chemicals from their aircraft.

That probably is the thinking in Washington as well.

Both Israel and the U.S. are suspected of bombing Syrian air force bases. On the other hand, the U.S. and Israel are blamed for almost everything that discomforts the petty tyrants that control the Middle East.

Syria was, for many years, relatively quiet politically.

Then came Barack Obama’s “Arab Spring” that unleashed pretenders to thrones across the Middle East, from Libya to Syria. Obama’s intent might have been honorable – free the poor from their oppressive leaders – but what Obama failed to understand is that most of the Arabs had loyalties to their tribes, not their countries. In the case of Iraq, Syria, and Lebanon, the states were artificially created by the “Great Powers” (England and France) after the Ottoman Empire was in ashes following WW 1. (The colonial powers, including Germany, The Netherlands, England, and France, and to a lesser extent, Italy, carved up the world willy-nilly, drawing borders where if was convenient for the colonizers while ignoring tribal land distribution. We still pay for their arrogance with “mini-wars” between tribes.)

Still, the question remains:

WHERE’S THE EVIDENCE?

Assuming that Al-Assad is wrong with his claim that the images are media manipulation, than someone ordered the recent chemical attack.

We know that Muslim leaders will murder their subjects without remorse – consider Hamas sending children to shied their “brave fighters” from Israeli soldiers. How about the Muslims who sent children from Iran into the Iraqi mine fields so that they, rather than Iran’s “brave solders,” would be blown to smithereens. (It’s “OK,” Iraq did the same thing.)

Too bad PITA is concerned only with animals and not children.

Would Putin be concerned about a few Muslims being assaulted with chemicals in far-away Syria? Given his background, probably not.

Maybe the anti-Al-Assad forces attacked themselves to garner media attention and to get more outsiders (e.g., U.S., Israel) to enter the fray on the rebel’s side. (Israel would be unwise to take sides in this civil war. It is enough that it treats injured Syrians, sans questions re political alliances, in an effort to show the Syrians that Israel is NOT the enemy.)

President Trump pontificates from the White House that he will “do” something in revenge for the inhuman attacks. But in order to “do” anything, he MUST know, beyond a reasonable doubt who is behind the attacks.

The U.S. State Department can’t provide reliable information; most “diplomats” in the Middle East don’t speak, read, or write the local variation on Arabic; likewise, the CIA is often no better. All information that President Trump will have before him will be second or third hand – or worse.

I have no problem with punishing whomever ordered the chemical attack, but I DO have a problem with attacking someone sans evidence, sans some proof - a “smoking gun” that points at this or that person or organization.

If President Trump decides that Putin and Company are behind the attacks and he orders attacks on Russian troops in the area, there might be war between the U.S. and Russia. If President Trump orders an attack on Russian forces and the Russians are NOT behind the chemical attacks, the likelihood of war between the U.S. and Russia is almost 100 percent.

Until there is reliable evidence, President Trump is between a rock and a hard spot (or between the hammer and the anvil): on the one hand, he is being urged to avenge the victims of a chemical attack while on the other hand, he doesn’t have – or at least does not share-- strong evidence of the perpetrator. No matter what he does, he will be castigated and disparaged.

As an old Wendy’s commercial went: ”Where’s the beef?”

For Americans, at least for this scrivener, the question is: “Where’s the evidence?”

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PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Comments on Evidence

Opuscula Anthem’s Simply Simply has awful Member ‘support’

I’M A GEEZER (it beats the alternative). I currently am insured by Anthem’s Simply healthcare Medicare Advantage plan.

For me, it simply is a mistake.

PUTTING IT SIMPLY, Simply's main problem is it’s Member Services that, since January 1, seems to be staffed by people who are unable to comprehend simple English.

Because Simply has a unique way of handling referrals – something not covered in the Evidence of Coverage (EOC) – I am forced to deal with Member Services.

For example, in order to see an ophthalmologist, I am forced to see an optometrist; my Primary Care Physician (PCP) – who I see quarterly – cannot make a referral to an ophthalmologist, despite the fact that I am a Type 2 diabetic. A visit to an ophthalmologist for a diabetic is required in the EOC.

Now, the optometrist was a good guy and – although he, too, thought having a referral through his office was something my PCP could/should do – and he made the referral. (I still have been unable to contact the ophthalmologist’s office; another problem.)

Referrals to an orthodontist has to be approved not by Simply but by its contract agency based on a general dentist’s recommendation.

ANYWAY, I sent an email to Simply's Member Services and asked what I needed to do to see a dental specialist.

Funny enough, Simply lists pedodontists! it ins list of dental providers. A pedodontist, according to the Kool Smiles web site¹ is a dentist who specialize in pediatric dentistry – dentistry for your children. Mind, my Simply is a Medicare Advantage plan for people 65 years old and older (please, not “65 or over). I seriously doubt a person on Medicare age needs a pedodontist.

In my initial email I provided my Member ID and my email for the reply.

Several days later I noted the message light on the phone blinking.

Someone in their Member Services mentality called. Based on the caller’s comments, it was blatantly obvious that the caller had no concept of my query.

I sent another email, again specifying what I needed and explicitly telling Member Services to reply by email – NOT by phone.

Proving Member Services simply can’t comprehend English^*, a Sweet Young Thing (SYT) called the house. Remember? I specifically wrote to respond by email. I want to avoid “he said, she said” debates. The SYT launched into her spiel, but I managed to stop her in mid-sentence – that would have been rude, but she failed to follow instructions --- and finally convinced her to put the information into an email.

* Over the years I have successfully labored as a newspaper reporter and editor, a PR flack, and a technical writer in the U.S. and elsewhere.

The email arrived … it failed to accurately respond to my query and it included what, I’m sure, the SYT thought helpful – three dentists in my ZIP code – but distant from my residence.

At this point I simply gave up on Simply Member Services..

Had the SYT simply responded to my query:

Can I see any provider on the list? Yes/No
No
If NO, what is the classification of the providers I can see?
Probably “General Dentistry”; I could gave found a practitioner close to my residence

One other simple complaint about Simply: The company has too few providers in my area. If I want to travel to Miami – I don’t – than Simply might be acceptable.

Simply can be compared to a store that advertises a product at an unheard of low price, but only has one or two of the sale items – maybe in the future it will come closer to meeting its members’ needs.

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SINCE I JOINED MEDICARE, I have had four plan providers, one twice (and on January 1, 2019, thrice): AvMed, Humana, United Healthcare’s Preferred Care Partners, and now Anthem/Simply.. None have been wholly satisfactory.

Humana introduced me to “capitated” Primary Care Physicians (PCPs). Basically that means that while Humana has a long list of providers, each PCP had a much shorter list of providers to whom the patient could be referred.

Lesson learned: I now check to assure that my PCP can refer me to any provider on the plan’s roster.

United Healthcare/Preferred Care offered a $45/month Over The Counter (OTC) allowance the first year I was with the plan. Then, the allowance was reduced to $25 per quarter.

United Healthcare didn’t give me the providers I wanted; another strike against the company. On the other hand, all my prescriptions were no cost (either Tier 1 of Tier 2); more on that later.

Simply was not as generous with its OTC allowance as United Healthcare HAD been – it’s allowance is $25/month, and, like United Healthcare, all my medications were free to me but my providers were not the ones I wanted (specifically Hollywood Memorial and my vascular surgeon).

The local Publix supermarket pharmacy gets all my business. Publix absorbs the cost for several of my medications; the insurer never sees a charge for the medications Publix gives free to all who need the drug.

All of the one-time plans had my current PCP so at least I knew my doctor.

Which brings me to AvMed.

AvMed was my first Advantage plan provider. When I was shopping, I talked to several plan representatives. What the AvMed rep told me – which proved to be true – is that while AvMed only offered five “free days” in a hospital, most hospital stays were five days or less. Three operations (at Memorial) later, I’m satisfied the AvMed rep was right. (The three operations were (1) an open Abdominal Aortic Aneurysm repair (a/k/a Triple A), (2) a FemPop bypass, and (3) a hernia repair.)

Because of my vascular history, when I was with Preferred Care I got a referral to a vascular surgeon at a prestigious clinic/hospital. The surgeon ordered – for the same day – an ultra-sound scan and an MRI. With my AAA, first there was the ultrasound, to determine if there WAS an aneurysm and where it was hiding. The dye and MRI came later so the surgeon knew exactly what was needed.

Had the ultra-sound (ordered by my then PCP) failed to show the aneurysm, a referral to the vascular surgeon and the dye and tube would have been unnecessary.

I am what is known as a Claustrophobic with a capital “C.”

Why order all the tests simultaneously rather than serially? Money, Money for the clinic/hospital. Money for the vascular surgeon. Would United Healthcare care? No and no again. The taxpayer would have paid the bill. (Medicare plans get more than my token monthly payment; the more the plan spends, the more the Federal government pays to the plan.)

AvMed and I parted company once when either AvMed canceled my then PCP’s practice or my then PCP’s practice canceled AvMed.

I left AvMed again because it was charging me what I deemed too much for one of my prescriptions.

The drug had a co-pay for a 90-day supply of $75 – more than the local pharmacy changed retail.

Both United Healthcare and Anthem’s Simply list the medication as Tier 2: $0 co-pay. AvMed lists the medication at Tier 3.

Suffer the loss of my preferred hospital and vascular surgeon or spend $300/year for co-pays (that I might claim as a tax deduction). But, based on past experience, get Member Services personnel who know how to comprehend simple English.

Tough choice.

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Sources

**1. http://tinyurl.com/y9qvcwlx

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

BCPLANNER: Comments on Simply insurance