Medicare Part D or how to impoverish the elderly

The trumpeting cry behind the Medicare Part D program was that it would finally provide prescription drug coverage for the elderly and disabled. AARP, the powerful advocacy organization, rallied behind it, giving cover to that bastard.

But as it turned out, Bush created Medicare Part D as an insured pay flow for private vendors, middlemen between drug companies and hapless recipients. It is widely known that the government will not negotiate for lower drug prices for its vast constituency, unlike the Veterans Administration.

When I examine one case, that of a close relative who receives prescription drug benefits through a Medicare-preferred private insurer, it is obvious that the concern is not for the person who needs medicine but for the bottom line of the insurer.

She pays premiums of $100 per month (an increase of 80% from a year ago) for the opportunity to have $2400 worth of drug costs covered. The calculation of that $2400 includes the entire cost of the drug, not merely the co-pay. So if you buy a drug with a co-pay of $40 but the total cost of the drug is $350 (not uncommon), the $350 counts towards the $2400 initial coverage. Once you hit that $2400 mark, you fall into what is known as the "doughnut hole". (Meaningful name) Then confusion and dismay follow in short order.

In the "doughnut hole" you have to pay 100% out of pocket for your prescription drug costs until you have spent $3600. The calculation of that $3600 out-of-pocket figure includes your co-pays over the year. It's very confusing for her, and she can read without moving her lips.

The way it breaks down is: She pays about $100 monthly premiums, about $1200 per year, plus $3600 out of pocket for $2,400 worth of benefits. Unless somehow she gets through that $3600 doughnut hole intact in order to qualify for catastrophic coverage, wherein she only has to pay 5% of total drug costs.

So she pays $4800 for $2400 worth of benefits. But she has to keep paying the premiums in case she god forbid is diagnosed with something unexpected that may entail runaway drug costs (i.e. cancer, diabetes, et al). This is not insurance for her. This is insurance for them.

When I contacted this magnanimous "preferred" vendor, I didn't get the impression that the customer service reps were prepped and ready to serve. My vision was that of a desk, a chair and a telephone under a bare light bulb in an anonymous rent-by-the-month room-for-an-office. I have nothing against a bare bones operation. I just wonder where the profits are going. Maybe the CEO can send my aunt a postcard during his vacation in Tuscany, or the blueprints of his new McMansion. Then she'll feel better about skipping her insulin.

Oops! Russia Just took over BP

What a jolly theoretical world. British Petroleum (or BP, or Beyond Petroleum, as its tagline goes) is having a little trouble with its Russian partners in a venture known as TNK-BP Ltd. In fact, the head of the BP venture, Robert Dudley, has just fled Moscow, officially because the Russians wouldn't renew his work visa. Unofficially, he's been barraged by threats and intimidation from the Russian consortium, AAR, which owns 50% of the venture.

The Russian government denies that it backs the effort to force out BP in order to nationalize the company. It won't get involved, it says. It's merely a matter between Dudley and the consortium's dissatisfied board and shareholders. But Dudley says he's been subject to investigations, intimidation and inquiries. The three Is.

Update: Sammmy's Time Machine

Although it's hard to believe anything that The Post's Page Six publishes (their writers do have a habit of blackmailing people), the story has a ring of true wishful thinking. An anonymous trader who worked with Samuel Israel the Third in the mid-90s tipped off one of Richard Johnson's henchmen that the fugitive (now Armed and Dangerous) boasted to him that he built a time machine, and even brought acquaintances to see the contraption:

"This guy Sam was crazy and told people he was actually working on a time machine for the government," said our source. "He brought two of my friends from Wall Street into his basement and showed them some contraption. Now that's a nutcase."--NY Post, Page Six, 6/18/08, "Fled to the Past"

As I recall in the movie, Rod Taylor went back to the past and far into the future with his machine courtesy of the mind of H.G. Wells. In the future man was mute, enslaved by slavering overlords who fattened them up for food. Think progress.

Maybe he brought it with him in the RV. I'm sure his investors would love to step into it and set it backwards to the '90s. In fact, if it were possible according to the law of physics, all Wall Street financial institutions would leap into it and dial it back to the 1990s.

What Makes Sammy Run?

According to today's NY Times, the girlfriend of Samuel Israel III, Debra Ryan, was just indicted for aiding and abetting Sam's flight from justice on June 9.

Sam pleaded guilty in 2005 to defrauding investors of more than $400 million through his Bayou hedge fund. He was supposed to report to prison for a 20-year sentence on June 9. Instead, authorities found his abandoned GMC Enterprise SUV on the shoulder of the Bear Mountain Bridge overhanging the Hudson River with the phrase, "Suicide is Painless" scrawled in dust on its hood. No trace of Sammy. Although the bridge has had its share of suicide dives, the bodies were usually recovered within hours.

The investors in Bayou were furious. Not only was he sentenced to prison, he also agreed to pay back millions of pilfered dollars. They were not amused nor fooled by his middle finger homage to a cheeky anti-war movie. They knew who it was directed at.

As to the details coughed up by Ms. Ryan: Two days before his date with the slammer, the two of them packed up his white 2007 Coach Freelander Recreational Vehicle, NY license number EEN-5973. They attached a blue 2005 Yamaha motor scooter to it. Early in the morning of June 9 she drove her car alongside him driving the RV to a rest stop near Interstate 684, where he left the RV. Then she drove him back to their home in Armonk, NY, where presumably he got into his GMC Enterprise SUV and drove to the Bear Mountain Bridge to stage his poorly executed suicide attempt.

I'll be glad to work on the Sammy case for a 10% finders fee. It shouldn't be too difficult. I'll just keep my eye out for a portly, baldish white collar criminal with a bad back on a motor scooter or the same driving a barge-like RV with a nationally broadcast license number.

Keith & Richard (cont'd)

Someone in the audience asked how we could survive the Bataan Death March (also known as the Democratic primary battle). Richard, who, after all, is a comedian, said he was ill-equipped to answer that question. But he directed the audience to Bruce Springsteen's website and said quietly (for Richard) that if you support Obama and don't speak out, there is a special place in hell reserved for you.

After the talk, Jeff and I were milling about with members of the audience who were patiently waiting in queues at the signing table. As we were walking out of the Y, I suddenly grabbed him by the arm and took him back to that area. There were innovative graphic novel-like strips on the wall obviously done by young people, some in the manner of Japanese anime. Very imaginative. I vaguely remember that the plot of one concerned a female student/spy scheming with ominous characters about high school milk money. Lots of slanted lines, shadow and light.

We never got close to the wall. Keith Olbermann in the flesh was walking towards us. He was very tall. And big. (Speaking as someone who knows one, he has a big head too.) I was very excited and pushed Jeffrey up to him. Keith was surrounded by a tight group of affluent, older, well-dressed women. Jeff was very happy. He approached Keith like a close talker and said, "You've been one of my true heroes. Thanks for all you've done." He answered in a clear, deep, broadcaster's voice, "Thanks very much. Jeff: "I'm a sports fan." And: "I wish Channel 2, 4 and 7 could report news like you do." He leaned forward and loudly whispered, "Don't hold your breath."

Keith Olbermann & Richard Lewis @ 92Y

Last evening Jeff and I went to see a "talk" between 2 old friends at the 92nd St. Y auditorium. It always seems awkward to the two acquaintances involved (particularly when they are not professional interviewers or persons used to be questioned, as it was with Paul Krugman and Leonard Lopate). So I waited for Keith and Richard to warm up to the situation. And they did.

Richard rambled willingly, often out of focus. It was fun for a while but I couldn't follow him towards the end. Maybe I got distracted by the difference between a stream-of-consciousness stand-up and a tightly disciplined news anchor. But Richard was disciplined in his own right. He started by riffing on his dysfunctional family, where he didn't get any attention or any positive attention, anyway. His mother used to show him her Caesarean scar. "I couldn't get an erection for a week." He alternated between standup banter and serious matters, like addiction, almost dying and throwing his life away. Losing everything he worked for. And he admitted freely, if he didn't think it would all happen again, he might plunge back into drinking.

He dispelled the myth of drugs giving artists "creativity." As he said, (I paraphrase: I didn't tape it unlike him), he admired Jimi Hendrix very much. Some of the riffs Jimi created in the studio were just out of this world like a UFO. But to be honest and he spoke to a lot of guys who were there in the 60s, his shows were sloppy and he'd hit the wrong notes as often as the right ones, or more often. He, Richard, felt more clear-headed, controlled and that he was doing the best work of his life now that he was sober (for 14 years). He talked about Jonathan Winters, the comic he admired the most, who was still active at the age of 82. Who was sober for 30+ years, and who had survived 2 nervous breakdowns during the time when it wasn't fashionable to go in and out of rehab.

He told a funny joke about Oscar Levant, to whom he compared his own twitching, "When Jack Paar asked Oscar what he did for exercise, Oscar replied, 'I trip, stumble and fall into a coma.'"

Richard was overwhelmed by the Commander-in-Chief, who he called "someone who should be crayoning." He talked about the lack of rebellion in the country, and reminisced about the 60s (which, of course, is an aspect of the boomers that annoys people the most). But he remembers storming the barricades, taking over the administration's office (hey, I remember that too and for me it wasn't in the 60s--I was in college in 1972) and how there was a rebellious spirit in the land. He wondered about the lack of passion now. Keith replied that it was because at that time the young were subject to the military draft. And there was no draft now. Then he corrected himself. "Pardon, there is a back-door draft," where men and women who enlisted for regular duty kept being shipped back to Iraq for two, three, four deployments without any time in between to catch their breaths.

Yes! It worked in La Biblioteca! Onward...

and upward!

Just a few notes...Jeff told me that Italy outlawed extreme skinniness...there are food shortage riots erupting globally...American farmers (or industrial agribusiness) are growing corn for biofuel (ethanol), although I have not seen one fueling station pumping ethanol or any ethanol-powered vehicles...in fact, many farmers are growing corn instead of soybeans which means there is also a cooking oil shortage globally...

Let's get down to brass tacks. It seems like the economy is declining rapidly. In fact, you might say that if the economy were a person, the entire body is in septic shock. I just read that retailers, especially stolid, popular ones (like Linens 'n Things, which I never heard of but read about yesterday also, which had been a major acquisition of some fuckhead private equity person who bought it by accessing debt then piling it onto the retail store which was second in revenue only to Bed Bath & Beyond. Now this fuckhead can't pay the debt costs so it's teetering on the edge of bankruptcy.) Too many parentheses. Whatever.

The problem with problems in retail for instance is that they're like the center of an umbrella with many spokes attached to them for dear life. Vendors, like fabric suppliers and manufacturers of chairs, blenders, aluminum siding (no, wait, that's not right), 600-thread Egyptian cotton sheets and many others are very worried they won't get paid so they stop shipping product. Bankers and other financiers see the piled up debt on top of Linens 'N Things straining like a flimsy rooftop covered with snow and they pull out their support. The decline escalates until the store careens into bankruptcy.

In the meantime, inflation pressures are piling up. Consumers are pulling back on their spending because unemployment is growing. That is just common sense. I don't need to see the jimmied figures because I see the headlines: Bear Stearns goes under, blah blah files for bankruptcy. Of course the bodies lie on the sidewalk. Everyone at Bear is sitting around waiting for the axe to fall. They might as well pack up and leave. The first thing that usually occurs when there are declining revenues is that people are laid off. Labor is the highest cost of a business (for the most part) so to fire people is the fastest way to stem the bleeding.

Of course what has captured the headlines for the past few months is the deflation in the housing sector, or (to be as euphemism-free as possible), falling housing prices. Economic news is more dire daily and what passed for optimism is also declining (like saying, it's sure that we'll be peering at a bottom any time now).

So now you can try to stack up the problems according to which is more appalling or cataclysmic (I love using thesaurus.reference.com): Declining wealth due to falling housing prices; negative equity (loans worth more than the collateral they're built on); no savings (part of our economy, a big part, was generated by rampant consumer spending); lots of debt everywhere, individual and corporate; rising unemployment; hideously high food prices globally leading to unrest and the toppling of a government (Haiti); the gated communities of hedge funds and auction-rate securities (gated in the sense that no investor can get their money out); horrifying price increases in prescription drugs, $5-a-gallon gasoline, $10-a-gallon milk; $4 a dozen eggs...how is it that everything collapsed at the same time?