Insurers Reap Hidden Fees by Slashing Payments.The answer is a little-known data analytics firm called MultiPlan. It works with UnitedHealthcare, Cigna, Aetna and other big insurers to decide how much so-called out-of-network medical providers should be paid. It promises to help contain medical costs using fair and independent analysis.You May Get the Bill.
A little-known data firm helps health insurers make more when less of an out-of-network claim gets paid. Patients can be on the hook for the difference.
But a New York Times investigation, based on interviews and confidential documents, shows that MultiPlan and the insurance companies have a large and mostly hidden financial incentive to cut those reimbursements as much as possible, even if it means saddling patients with large bills. The formula for MultiPlan and the insurance companies is simple: The smaller the reimbursement, the larger their fee.But when employees see a provider outside the network, as Ms. Lawson did, many insurance companies consult with MultiPlan, which typically recommends that the employer pay less than the provider billed. The difference between the bill and the sum actually paid amounts to a savings for the employer. But, The Times found, it means big money for MultiPlan and the insurer, since both companies often charge the employer a percentage of the savings as a processing fee.
Pragmatic politics focused on the public interest for those uncomfortable with America's two-party system and its way of doing politics. Considering the interface of politics with psychology, cognitive science, social behavior, morality and history.
Etiquette
Sunday, April 7, 2024
Brass knuckles capitalism at work in America's overpriced heath care system
Saturday, April 6, 2024
Another Middle East war front opens?; The hopelessness of the Republican Party
Another source commented: Is Israel's plan to draw the US into a war with Iran? -- Iranian leaders will feel heavy pressure to respond forcefully. The extent of that pressure can be appreciated by imagining if the roles were reversed. If Iran had bombed an embassy of Israel or the United States, a violent and lethal response would be not just expected but demanded by politicians and publics alike. .... Speaking a day after the attack, Iranian Supreme Leader Ali Khamenei vowed revenge and said “Israel will be punished.” The Iranian representative at the United Nations Security Council asserted Iran’s right to a “decisive response to such reprehensible acts.”Israel has grown increasingly impatient with the daily exchanges of fire with Hezbollah, which have escalated in recent days, and warned of the possibility of a full-fledged war. Iranian-backed Houthi rebels in Yemen have also been launching long-range missiles toward Israel, including on Monday.
While Iran’s consular building was leveled in the attack, according to Syria’s state news agency, its main embassy building remained intact. Still, the Iranian ambassador’s residence was inside the consular building.
Iran’s ambassador, Hossein Akbari, vowed revenge for the strike “at the same magnitude and harshness.”
Hamas and Islamic Jihad — another Palestinian militant group backed by Iran — accused Israel of seeking to widen the conflict in Gaza.
Experts said there was no doubt that Iran would retaliate. The strike in Syria was a “major escalation,” Charles Lister, a Syria expert at the Middle East Institute in Washington, said on the social media platform X.
It is still 90 seconds to midnight -- 2024 Doomsday Clock Statement
The war in Ukraine and the widespread and growing reliance on nuclear weapons increase the risk of nuclear escalation. China, Russia, and the United States are all spending huge sums to expand or modernize their nuclear arsenals, adding to the ever-present danger of nuclear war through mistake or miscalculation. .... And the war in Gaza between Israel and Hamas has the potential to escalate into a wider Middle Eastern conflict that could pose unpredictable threats, regionally and globally.
When a top Republican says Russian propaganda has infected the GOP
House Foreign Affairs Committee Chairman Michael McCaul is the latest to point out such a problem in his party[In 2019] former Trump national security aide Fiona Hill made an extraordinary plea. Seated in front of congressional Republicans, she implored them not to spread Russian propaganda.
“In the course of this investigation, I would ask that you please not promote politically driven falsehoods that so clearly advance Russian interests,” she told them. She was referring to comments they had made during her earlier deposition breathing life into a baseless, Trump-backed suggestion that Ukraine, rather than Russia, interfered in the 2016 U.S. election.
“These fictions are harmful even if they’re deployed for purely domestic political purposes,” she added.Republicans on the [first Trump impeachment inquiry] committee blanched at the suggestion that they had served as conduits for Russian misinformation, but Hill refused to back down.
Five years later, Republicans are starting to grapple more publicly with the idea that this kind of thing is happening in their ranks.The most striking example came this week. In an interview with Puck News’s Julia Ioffe, Rep. Michael McCaul (R-Tex.) — none other than the GOP chairman of the House Foreign Affairs Committee — flat-out said that Russian propaganda had “infected a good chunk of my party’s base.”
McCaul suggested conservative media was to blame.
“There are some more nighttime entertainment shows that seem to spin, like, I see the Russian propaganda in some of it — and it’s almost identical [to what they’re saying on Russian state television] — on our airwaves,” McCaul said.
He also cited “these people that read various conspiracy-theory outlets that are just not accurate, and they actually model Russian propaganda.”
Former congresswoman Liz Cheney (R-Wyo.) said there is now “a Putin wing of the Republican Party.”
In 2022, Sen. Mitt Romney (R-Utah) called the pro-Putin sentiments in some corners of his party “almost treasonous,” while allowing that perhaps his fellow Republicans were just attention-seekers.
What may be the most famous example: when House GOP leaders in 2016 privately joked about Trump being compromised by Russia, as later reported by The Washington Post.
The day after The Post broke the news that the Russians had hacked the Democratic National Committee, then-House Majority Leader Kevin McCarthy (R-Calif.) quipped that perhaps Russia had gotten Democrats’ opposition research about Trump.
“There’s two people, I think, Putin pays,” McCarthy added, “[Rep. Dana] Rohrabacher and Trump.” (Rohrabacher was an openly pro-Russian Republican from California.)
Then-House Speaker Paul D. Ryan (R-Wis.) quickly tried to steer the conversation in another direction and urged people to be discreet. [Yeah, God forbid House Republicans are honest with the American people, fools and dupes that they are -- Hey Speaker Ryan! Thank you for your service /s]
“. . . . the typical citizen drops down to a lower level of mental performance as soon as he enters the political field. He argues and analyzes in a way which he would readily recognize as infantile within the sphere of his real interests. . . . cherished ideas and judgments we bring to politics are stereotypes and simplifications with little room for adjustment as the facts change. . . . . the real environment is altogether too big, too complex, and too fleeting for direct acquaintance. We are not equipped to deal with so much subtlety, so much variety, so many permutations and combinations. Although we have to act in that environment, we have to reconstruct it on a simpler model before we can manage it.”
Nancy Pelosi & 39 House Dems urge Biden to stop arming Israel until conditions are met
The NYT writes:
Forty House Democrats including Representative Nancy Pelosi, the former speaker, sent a letter on Friday to Mr. Biden and Secretary of State Antony J. Blinken expressing displeasure with their approach to Israel. The group called on the Biden administration to deny Israel weapons pending an independent investigation into how Israel's airstrikes killing 7 humanitarian aid workers last week happened, and tie any new aid to conditions “to ensure it is used in compliance with U.S. and international law.”
The letter reads, in part:
"Given the horrifying facts on the ground, we are also greatly concerned by your recent decision to authorize an arms transfer to Israel, which reportedly includes 1,800 MK-84 2,000-pound bombs, 500 MK-82 500-pound bombs, and 25 F-35A fighter jets.6 The MK-84 2000-pound bombs have been linked to multiple mass casualty events in Gaza and are capable of killing or wounding people more than 1,000 feet away. We are also concerned by recent reports that the administration is considering authorizing another $18 billion arms transfer to include dozens of F-15 aircraft.7
In light of the recent strike against aid workers and the ever-worsening humanitarian crisis, we believe it is unjustifiable to approve these weapons transfers. We again strongly urge you to withhold any offensive weapons transfers until the investigation into the airstrike is concluded and, if it is found this strike violated U.S. or international law, those responsible are held accountable. And we again urge you to ensure that any future military assistance to Israel, including already authorized transfers, is subject to conditions to ensure it is used in compliance with U.S. and international law."
It is important that the letter specifies that suspending and conditioning military assistance must include "already authorized transfers." As discussed below, and in a long NYT article published today, the funding of this war has been anything but transparent. Much of the military assistance has not been approved by the current Congress, but rather has been sent under a $38 billion aid agreement from the Obama-era. The reps in the letter are referring to that and other "pre-approved" spending, such as that discussed in this WaPo article on Biden's "quiet transfers" of money and weapons to Israel approved long ago in 2008. He "quietly transferred" those weapons and money 2 weeks ago without notifying lawmakers in Congress, even as tensions about funding the war were already beginning to mount.
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The humanitarian workers killed by Israel were Australian, British, Palestinian, Polish and a dual citizen of the United States and Canada. The leaders and citizens of those countries have expressed outrage, causing what appears to be a reappraisal of Biden's policy of unconditional aid in the US.
Several top Senators-- including staunch Biden ally and friend, Chris Coons, are no calling on Biden to condition aid to Israel. Sarah Sidner on CNN asked Coons if it was time to stop relying only on "carrots" and start using "sticks" to leverage any further aid to Israel. Coons replied:
"I think we're at that point...If Prime Minister Benjamin Netanyahu were to were to order the IDF into Rafa at scale, if they were to drop thousand pound bombs and send in a battalion to go after Hamas make no provision for civilians and humanitarian aid, then I would vote to condition aid to Israel. I've never been here before. I've been a strong supporter of Israel the whole time I've served in congress...[B]ut the tactics by which the current PM is making decisions don't reflect the best interests of Israel or the United States." (CNN News Central with Sarah Sidner, April 4, 2024)
Biden called Netanyahu on Thursday. He stopped short of conditioning military aid. However, he issued a stark warning to Israeli Prime Minister Benjamin Netanyahu that future U.S. support for Israel's Gaza war depends on the swift implementation of new steps to protect civilians and aid workers. Though this is still only talk and not a policy change, Netanyahu-- after the call-- announced that Israel would open Gaza aid routes, including the Erez crossing. Israel depends on the US desperately right now, not vice versa. If tougher talk from Biden led to a promise like that, imagine what real diplomacy (using leverage as we do with other countries) might achieve. We've seen the carrots AND sticks approach work to achieve US ends in Israel under Reagan (the bombing of Lebanon in 1982 was stopped) and Bush I (who was able to pressure Israel using leverage in 90s). At the time, a younger Biden raised his voice objecting vehemently to Bush's approach at an AIPAC dinner. But Bush 1 laid the groundwork for what would become Oslo Accords, while Biden's approach of "never disagreeing with Israel publicly" has only led to the current impasse. He should revise his playbook if he wants the results he now says he wants, namely, an end to what he calls the "over the top" and "indiscriminate" killing of civilians, and immediate help for thousands and thousands of starving Gazans.
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Meanwhile, as the tone of many Democrats in office has changed after Israel killed American and European aid workers, so has that of mainstream media here. So, I'll end this update by linking to a NY Times piece which describes in some detail just how non-transparent the funding of this war has been to date. The NYT explains processes by which President Biden sends arms to Israel under an Obama-era $38 billion aid
agreement that runs until 2026. Israel’s purchases include the types of
bombs dropped in Gaza. The following is an excerpt.
The NYT writes:
"The process of arms delivery to Israel is opaque, and the pipeline for weapons to the country is long. The United States has sent tens of thousands of weapons to the country since the Oct. 7 killings by Hamas attackers, but many were approved by Congress and the State Department long ago and funded with money mandated by the Obama-era agreement, known as a memorandum of understanding.
“At any given time, delivery on these sales is constantly taking place,” said Dana Stroul, who recently departed as the Pentagon’s top official for Middle East affairs.
"Mr. Biden has
the power to limit any foreign arms deliveries, even ones previously
approved by Congress. Far from cutting off Israel, however, he is
pushing a request he made shortly after the Oct. 7 attacks for $14
billion in additional arms aid to the country and U.S. military
operations in the Middle East. The money has been stalled in Congress
amid disputes over Ukraine aid and U.S. border security and faces growing Democratic concern. "
Friday, April 5, 2024
News bits: Self-interest politics; Corrupted, partisan Republican judges; Lying to judges
Former President Trump’s growing criticism of Israel’s war against Hamas in Gaza signals a glaring break from GOP talking points backing Israel’s right to self-defense. Trump allies played down the importance of his interview with Israeli reporters last week, saying his staunch support of Israel would continue in a potential second term.
John Bolton, who served for 17 months as Trump’s White House national security adviser, told The Hill the former president’s stance on Israel will largely depend on the environment he inherits and on what would best serve his own interests.
“At bottom, Trump doesn’t have a national security policy,” Bolton said, calling the former president’s approach “ad hoc.” “He sees things primarily through the prism of, ‘Does this benefit Donald Trump?’”
Texas Supreme Court justice implies Democrats will cheat in 2024 electionTexas Supreme Court Justice John Devine is facing new questions about his impartiality after a clip went viral this week in which he implied that Democrats plan to cheat against presumptive Republican presidential nominee Donald Trump in the 2024 election.
“Do you really think the Democrats are going to roll over and let Trump be president again?” Devine asked in a keynote speech at the Texas Tea Party Republican Women’s 2023 Christmas event. “You think they’re just going to go away, all of a sudden find Jesus and [there will] be an honest election? I don’t think so.”
But election disputes weren’t the only hot-button issues on which Devine opined that night. Throughout his 40-minute speech, he blasted legal challenges to Texas’ abortion laws as a “mockery of God,” and invoked apocalyptic language when discussing Democrats — saying his judgeship gave him a “front-row seat to the end of the world.”
“Our culture is dying before our very eyes,” he said. “The church seems to be weakened and not know what to do. We have a corrupted government. On a federal level, we’re run by a criminal enterprise. … None of you are going to escape this. And so I would implore you to get closer to the Lord. I would implore you to prepare. I would implore you to bring other people on board.”
Trump’s Lawyers Told the Court That No One Would Give Him a Bond. Then He Got a Lifeline, but They Didn’t Tell the Judges.
An appeals court reduced Trump’s bond by more than 60% after his attorneys claimed it was a “practical impossibility” to pay the full amount. Their failure to disclose a proposal from a billionaire financier may have violated ethics rules.
But before the judges ruled, the impossible became possible: A billionaire lender approached Trump about providing a bond for the full amount.
The lawyers never filed paperwork alerting the appeals court. That failure may have violated ethics rules, legal experts say.
About plastics
What began with cellophane in the 1930s picked up speed with the rise of plastic clamshells in the 1980s and bagged salads in the 1990s. Online grocery shopping turbocharged it. But now the race is on for what people who grow and sell fruits and vegetables are calling a moon shot: breaking plastic’s stranglehold on produce.
In a March survey among produce professionals on LinkedIn, the shift to biodegradable material was voted the top trend. “It’s big,” said Soren Bjorn, chief executive officer of Driscoll’s, the world’s biggest grower of berries, which has switched to paper containers in many European markets.Spain has a plastic tax. France has severely limited plastic-wrapped produce and the European Union is about to add its own restrictions. Canada is trying to hammer out a plan that could eliminate plastic packaging of produce by 95 percent by 2028. In the United States, 11 states have already restricted plastic packaging. As part of a sweeping anti-waste plan, the Biden administration is calling for new ways to package food that uses climate-friendly, antimicrobial material designed to reduce reliance on plastic.Yet plastic has so far been the most effective tool to fight another environmental threat: food waste.Selling produce is like holding a melting ice cube and asking how much someone will pay for it. Time is of the essence, and plastic works well to slow the decay of vegetables and fruit. That means less produce is tossed into the garbage, where it creates almost 60 percent of landfill methane emissions, according to a 2023 report by the Environmental Protection Agency.
Consumers increasingly report that using less plastic and packaging matters to them, but their shopping habits tell a different story. American shoppers bought $4.3 billion worth of bagged salad last year, according to the International Fresh Produce Association. Marketing experiments and independent research both show that price, quality and convenience drive food choices more than environmental concerns.
Battle lines seem to be drawn between the never-plastic crowd and shoppers who prefer the ease of fresh salad greens delivered to their door. (emphasis added)
By 2025, Nestle promises not to use any plastic in its products that isn’t recyclable. By that same year, L’Oreal says all of its packaging will be “refillable, reusable, recyclable or compostable.”
And by 2030, Procter & Gamble pledges that it will halve its use of virgin plastic resin made from petroleum.
To get there, these companies and others are promoting a new generation of recycling plants, called “advanced” or “chemical” recycling, that promise to recycle many more products than can be recycled today.
So far, advanced recycling is struggling to deliver on its promise. Nevertheless, the new technology is being hailed by the plastics industry as a solution to an exploding global waste problem.PureCycle Technologies, a company that features prominently in Nestlé, L’Oréal, and Procter & Gamble’s plastics commitments, runs one such facility, a $500 million plant in Ironton, Ohio. The plant was originally to start operating in 2020, with the capacity to process as much as 182 tons of discarded polypropylene, a hard-to-recycle plastic used widely in single-use cups [some of which are 0% recycled], yogurt tubs, coffee pods [so far 0% recycled] and clothing fibers [so far >90% not recycled], every day.
But PureCycle’s recent months have instead been filled with setbacks: technical issues at the plant, shareholder lawsuits, questions over the technology and a startling report from contrarian investors who make money when a stock price falls. They said that they had flown a drone over the facility that showed that the plant was far from being able to make much new plastic.
PureCycle, based in Orlando, Fla., said it remained on track. “We’re ramping up production,” its chief executive, Dustin Olson, said during a recent tour of the plant, a constellation of pipes, storage tanks and cooling towers in Ironton, near the Ohio River. “We believe in this technology. We’ve seen it work,” he said. “We’re making leaps and bounds.”
PureCycle’s woes are emblematic of broad trouble faced by a new generation of recycling plants that have struggled to keep up with the growing tide of global plastic production, which scientists say could almost quadruple by midcentury.
A chemical-recycling facility in Tigard, Ore., a joint venture between Agilyx and Americas Styrenics, is in the process of shutting down after millions of dollars in losses. A plant in Ashley, Ind., that had aimed to recycle 100,000 tons of plastic a year by 2021 had processed only 2,000 tons in total as of late 2023, after fires, oil spills and worker safety complaints.
Thursday, April 4, 2024
How radical right authoritarians corrupt the law, persecute voters and hate on elections
A Reversal Cannot Undo the DamageCaused by This Voting Fraud CaseWhile the prosecution of Ms. Mason may have failed, it still could have broader consequences in chilling people’s willingness to exercise their right to vote. Few would want to vote if it means going through what Ms. Mason did. As such, the reversal in her case cannot undo much of the damage that irresponsible Texas prosecutors wrought.
As the federal circuit court of appeals that oversees Texas recognized decades ago, “short of physical violence,” nothing has “a more chilling effect” on voting than “baseless arrests and prosecutions.” Unfortunately, that may be the point of bringing cases like Ms. Mason’s, as they suggest apparent racial disparities at work in voting-fraud prosecutions.
When Ms. Mason voted, she was on federal supervised release, which is like a term of probation that federal criminal defendants serve after leaving prison. Those on release must obey certain court-ordered conditions but are otherwise free to live their life as they see fit. Under Texas law, such individuals are ineligible to vote, which Ms. Mason did not know. Prosecutors charged her anyway, convicting her on a theory that they did not have to prove that she knew she was ineligible; they just had to prove that she was ineligible.
An appellate court agreed with prosecutors’ theory and upheld her conviction, while noting: “The evidence does not show that she voted for any fraudulent purpose.”
Texas’ highest criminal court ruled that the state’s voter fraud statute requires proof that a defendant knew she was ineligible and sent the case back to the lower appellate court, where Ms. Mason’s conviction was overturned.