1. I have worked in medical billing for over a decade now on the provider side. I regularly say my job should not exist. And certainly not at my pay grade. I would love to talk to you about this at some point because if people understood just how fucked our system is, they wouldn’t accept it.
2. Your essay on the rot in media gave me my grand unified theory of misery. Private equity and finance is a virus that destroys everything it comes in contact with and makes everyone but the few people it enriches miserable. It’s destroyed housing, higher education, entertainment, and I don’t know how the status quo is renewable as a result.
And it is ONLY private insurance. My job currently is running a team that handles the billing for skilled nursing facilities. Anything that requires higher level follow up is on me. Medicare and Medi-Cal (California Medicaid) pay like clockwork.
What makes my blood boil is when I get a Medicare or Medi-Cal plan “administered” by private insurance that has a call center off shore. It’s insanity.
Damn, that was a whole other phenomenon I could've gotten into here. Our "solution" to service is now just that you get to "rate the service" offered by the dude working out of a call center in Bangladesh. As if the problem is whether or not the offshored employee is courteous, and not that you have to navigate a labyrinthine phone tree in order to fix any small problem that a company that actually cared wouldn't have had in the first place. And that's when they're not replacing the phone banks with an AI chat bot.
But yes, as I just explained to the provider services liaison of an insurance company that recently off-shored its call centers when his response to my complaint was “we’ll definitely definitely take this as an opportunity for coaching”: “this is not a training issue. This is an issue of a company choosing to have customer service provided by individuals who have no experience with the service in a non-native language. If you asked me to provide customer service for Filipino healthcare in Tagalog I’d be bad at it too!”
as someone who gives financial advice for a living, "never choose a Medicare Advantage plan" is one of the clearest things I try to beat into people's skulls when they're in their 60's
"(When I brought up the monthly doctor fee on twitter, a bunch of people responded “how much for no ads?” which is very good joke)."
It IS a good joke!
Also, thinking about not having another chunk of money taken from your paycheck. If "they" took a chunk but stopped taking some of the current chunks, I think we'd all appreciate it.
I'm less than six months from having my student loans forgiven (two degrees that I don't use!), because I've worked for the federal government for about ten years. I'm glad I got into this boring, but livable job - stability! excellent benefits! ample PTO! working from home full-time! - but also, shouldn't those things be a given for everyone?
FIRST WORLD GRIPE: the fee that makes me want to kill everyone in the world is "choose your own seat on the airplane." Like, if I was upgrading from coach to first, that's one thing. But I literally just want an aisle seat, in the class I'm already sitting in, on this $125, 75-minute flight from Kansas City to Chicago that I take at least twice a year. Why do I need to pay $25 more for that?
You could sweep all 50 states if you ran for President on "dissolve Ticketmaster" and "immediate death penalty for anyone operating a robocall company"
I almost went with Ticketmaster here, but I figured that went without saying. I love that they charge a service fee if you want to sell your tickets, and then charge ANOTHER service fee to sell them to someone else - three rounds of fees on a single ticket!
If you really want to ride the misery train (standing room only) check out the book "Our Lives in Their Portfolios" and you'll see why the next time you pay for parking in a place like Chicago the money will be going to Morgan Stanley Infrastructure Partners.
Asset managers are snapping up vital infrastructure (water treatment, electricity, etc.), stripping down quality in pursuit of lower costs, then selling within 5 years of acquiring the asset.
Privatization is a major part of the problem. Reminds me of your Robocop retrospective from a few years ago.
Unfortunately, this may have the unintended consequence of hurting restaurants which have tried to ban tipping in favor of a service fee which is considered more fair. I don't love being nickel and dimed (especially the SF restaurants which add "health care surcharges") but I feel bad for the restaurateurs who have made a sincere effort to come up with a different method of compensating employees rather than relying on customers' arbitrary tips. (One local restaurant in my town recently posted a receipt to Facebook—a customer had crossed out the tip line and added a note, "I don't believe in tipping.") Running a restaurant in the high-cost Bay Area is difficult and this might make it more so.
Limp Bizkit was right! "Everything is fucked, everybody sucks."
Our broet laureate
This rocked, and channeled all of the incandescent rage I feel several times per week
Vince, I had many thoughts reading this:
1. I have worked in medical billing for over a decade now on the provider side. I regularly say my job should not exist. And certainly not at my pay grade. I would love to talk to you about this at some point because if people understood just how fucked our system is, they wouldn’t accept it.
2. Your essay on the rot in media gave me my grand unified theory of misery. Private equity and finance is a virus that destroys everything it comes in contact with and makes everyone but the few people it enriches miserable. It’s destroyed housing, higher education, entertainment, and I don’t know how the status quo is renewable as a result.
Absolutely. We have an insane number of administrative jobs dedicated solely to badgering insurance companies into paying money they owe.
And it is ONLY private insurance. My job currently is running a team that handles the billing for skilled nursing facilities. Anything that requires higher level follow up is on me. Medicare and Medi-Cal (California Medicaid) pay like clockwork.
What makes my blood boil is when I get a Medicare or Medi-Cal plan “administered” by private insurance that has a call center off shore. It’s insanity.
Damn, that was a whole other phenomenon I could've gotten into here. Our "solution" to service is now just that you get to "rate the service" offered by the dude working out of a call center in Bangladesh. As if the problem is whether or not the offshored employee is courteous, and not that you have to navigate a labyrinthine phone tree in order to fix any small problem that a company that actually cared wouldn't have had in the first place. And that's when they're not replacing the phone banks with an AI chat bot.
Pro-tip: always hit zero, it gets you to a human.
But yes, as I just explained to the provider services liaison of an insurance company that recently off-shored its call centers when his response to my complaint was “we’ll definitely definitely take this as an opportunity for coaching”: “this is not a training issue. This is an issue of a company choosing to have customer service provided by individuals who have no experience with the service in a non-native language. If you asked me to provide customer service for Filipino healthcare in Tagalog I’d be bad at it too!”
as someone who gives financial advice for a living, "never choose a Medicare Advantage plan" is one of the clearest things I try to beat into people's skulls when they're in their 60's
"(When I brought up the monthly doctor fee on twitter, a bunch of people responded “how much for no ads?” which is very good joke)."
It IS a good joke!
Also, thinking about not having another chunk of money taken from your paycheck. If "they" took a chunk but stopped taking some of the current chunks, I think we'd all appreciate it.
I'm less than six months from having my student loans forgiven (two degrees that I don't use!), because I've worked for the federal government for about ten years. I'm glad I got into this boring, but livable job - stability! excellent benefits! ample PTO! working from home full-time! - but also, shouldn't those things be a given for everyone?
FIRST WORLD GRIPE: the fee that makes me want to kill everyone in the world is "choose your own seat on the airplane." Like, if I was upgrading from coach to first, that's one thing. But I literally just want an aisle seat, in the class I'm already sitting in, on this $125, 75-minute flight from Kansas City to Chicago that I take at least twice a year. Why do I need to pay $25 more for that?
I'll raise you everything done by Ticketmaster. If I ran the world the public execution of those motherfuckers would be a "first 100 days" thing.
You could sweep all 50 states if you ran for President on "dissolve Ticketmaster" and "immediate death penalty for anyone operating a robocall company"
I almost went with Ticketmaster here, but I figured that went without saying. I love that they charge a service fee if you want to sell your tickets, and then charge ANOTHER service fee to sell them to someone else - three rounds of fees on a single ticket!
Wait, you guys get to see doctors?
-a Canadian
Great article!
If you really want to ride the misery train (standing room only) check out the book "Our Lives in Their Portfolios" and you'll see why the next time you pay for parking in a place like Chicago the money will be going to Morgan Stanley Infrastructure Partners.
Asset managers are snapping up vital infrastructure (water treatment, electricity, etc.), stripping down quality in pursuit of lower costs, then selling within 5 years of acquiring the asset.
Privatization is a major part of the problem. Reminds me of your Robocop retrospective from a few years ago.
I request a link to this RoboCop retroperspective. I offer this RoboCop "Bitches leave" story link in exchange.
https://youtu.be/31rrZeTH9HI?si=MDKyMb_tjQQ1LSgF
https://uproxx.com/filmdrunk/robocop-retrospective-30/
In a well-intended move to get rid of junk fees (like ridiculous Ticketmaster charges), California is about to ban all service fees: https://sf.eater.com/2024/5/3/24148146/california-junk-fee-ban-restaurants-bars
Unfortunately, this may have the unintended consequence of hurting restaurants which have tried to ban tipping in favor of a service fee which is considered more fair. I don't love being nickel and dimed (especially the SF restaurants which add "health care surcharges") but I feel bad for the restaurateurs who have made a sincere effort to come up with a different method of compensating employees rather than relying on customers' arbitrary tips. (One local restaurant in my town recently posted a receipt to Facebook—a customer had crossed out the tip line and added a note, "I don't believe in tipping.") Running a restaurant in the high-cost Bay Area is difficult and this might make it more so.