It’s Complicated

My own moral code is somewhat complicated. As all of you know, I am not a believer in any sort of deity. I guess that’s odd, being that I grew up in a Catholic household and was sent to a Christian private school for three years. My parents were hoping that the experience would help. It didn’t. All my experiences with organized religion did was make me believe that the people in the churches were mostly lying hypocrites. There is a joke I once heard that goes like this:

When I was a kid, I wanted to pray for a bike, but I know God doesn’t work like that. So I stole a bike and then prayed for forgiveness.

My experiences really turned me away from religion, but I also knew that I needed to develop my own moral and ethical code. That was when I discovered Robert A Heinlein. In more than a couple of his stories, his characters remarked on the importance of developing one for yourself, and that is exactly what I did.

I am free, no matter what rules surround me. If I find them tolerable, I tolerate them; if I find them too obnoxious, I break them. I am free because I know that I alone am morally responsible for everything I do.- RAH

In doing this, I looked at many different philosophies. For example, there are some cultures that don’t believe in owning property. To outsiders, they don’t believe that taking something that you want is stealing, since no one actually owns property. Still other cultures believe that objects belong to the maker. I discarded those and kept looking.

I think that it’s fair to say that most of my personal ethics and morals are a close parallel to Christian beliefs. So even though I don’t claim to believe in the spiritual and mythological parts of Christianity, I do align quite closely with its tenets on most things. I guess you can say that I am Christian adjacent. I guess, growing up on Heinlein novels, a lot of my outlook is close to his. Why did L. Ron Hubbard become the prophet for a religion, but RAH was not the founder of a political party? Puzzling.

Force and Violence

My first and most important one is that it is always morally wrong to initiate violence or force against another. That doesn’t mean that you have to wait for the other guy to throw the first punch- quite the contrary. Force to me doesn’t just mean that you are physically striking someone. I can use force against you in various ways- shouting in your ear with a megaphone, shining a laser in your eyes, or even sitting at the end of your driveway so that you cannot leave your house without running me over are all uses of force. Taking something of yours while daring you to do something about it is still force. I think this part of my philosophy came from that time when I was a child and my dad told me that I wasn’t allowed to start a fight. So I just forced the other kid to throw the first punch by being a royal asshole. Now that I am an adult, I know that there are more ways to start a fight than merely hitting someone, and I recognize it to be wrong.

Still, anyone who attempts to use force against me will have a fight on their hands. That fight might be a physical one, a legal one, or some other pushback.

Stealing and Fraud

We all trade our time in order to secure property. Whether we make the object, or trade our labor for money in order to buy the object, everything we own represents a slice of our limited lifetime. Stealing an object is no different than stealing time from another’s life or making them your slave. On the contrary, gift giving is indirectly giving someone some of your life, whether the gift is an object or your time, it still represents something.

It’s also wrong to use deception to take things from others. Lying to someone and telling them that this car has never had mechanical problems when you know damned well that it needs a new transmission is still stealing, it’s just stealing by fraud. It’s wrong.

I have no problem with charging all that the traffic will bear- an eager seller and a willing buyer is fine with me- as long as both are honest about what is being traded. I won’t sell you a broken car, you don’t pay me with a counterfeit bill.

Taxes and Charity

Taxes for the public good aren’t stealing as long as everyone gets the same benefit. So a tax that pays for police, courts, streets, or fire service can be a good thing, while a tax that takes money to hand out to people simply because they are poor is nothing more than theft.

“There is no worse tyranny than to force a man to pay for what he does not want merely because you think it would be good for him.”- RAH

Taxes are not levied for the benefit of the taxed.- Also RAH

Defending the Helpless

I also believe that we have a duty here in this life to defend those who are unable to defend themselves. I will always fight for what I think is right- even at great personal cost. In fact, the times in my life that got me in the most trouble were the times that I stood my ground and defended my principles.

There are plenty of things that I believe, and I suspect that many who claim to be Christians would find that our beliefs are actually quite closely aligned.

Limited Government:

I believe in a government that primarily focuses on internal police, courts, and external defense. Other matters should be handled by individuals and private organizations.

That we were slaves I had known all my life—and nothing could be done about it. True, we weren’t bought and sold—but as long as Authority held monopoly over what we had to have and what we could sell to buy it, we were slaves.- RAH

Individual Liberty:

I stand behind individual freedom, including freedom of speech, thought, and expression. Censorship and any attempt to control people’s knowledge or beliefs is wrong. That’s why I run this blog.

Distrust of Authority:

I have a great deal of skepticism towards authority, particularly government authority, but also authority of organized religion. How the pope can tell us we need to donate to the poor while he is taking a crap on a solid gold toilet just smacks of hypocrisy. It is far too easy for power to be abused. That is where the founders were so very wise in keeping government of limited power. That was destroyed from the Civil war on.

It is a truism that almost any sect, cult, or religion will legislate its creed into law if it acquires the political power to do so, and will follow it by suppressing opposition, subverting all education to seize early the minds of the young, and by killing, locking up, or driving underground all heretics.- RAH

Still, we need government. Why? Because true anarchy can’t exist, because someone with a yearning for power will always take it, by force if necessary. That’s why police morally exist- to protect the rights of those who are accused of crimes to receive a fair trial. The problem is that people don’t monitor their government to ensure that the powers aren’t being abused. Too much effort? No, it’s that people are good at wanting to use government power to force others to follow their own beliefs.

There must be a yearning deep in the human heart to stop other people from doing as they please.- RAH

Importance of Education and Critical Thinking:

Education and critical thinking are tools for individuals to resist tyranny and make informed decisions. However, education institutions can twist education to be a tool for ignorance, tyranny, and actually increase ignorance. That’s what we are seeing now. See my post tomorrow about Harvard.

I just do my absolute best to be worthy of being treated the way that I treat others. How would I feel if someone treated me or my loved ones the way that I am treating you? That doesn’t mean that I will be a doormat, and it doesn’t make me a Saint- after all, I sometimes fall short of my goal. I am far from perfect, even in meeting my own standards. We are all a work in progress.

I have committed transgressions against others, because I am not perfect. Some of the things that I did and said in my youth truly shame me when I think about them. I hope that those I hurt or offended through my faults have forgiven me. I am not that person any longer.

Does that make me Christian adjacent? I don’t know, but that’s my code. Parts of it, anyhow. It is what enables me to look myself in the eye in that mirror in the morning. I think that RAH and myself would have gotten along quite well.

Nope. Not Messing with That

My last day at work, I was the response nurse. In that position, you are the nurse that isn’t assigned to any patients, and instead spending your day helping the other nurses in the ED with anything that happens requiring a spare set of skilled hands. You spend your day getting difficult IVs, helping with complicated drug administration, and assisting with difficult patients. As it turns out, it was one of those days where a lot of weird stuff happens.

  • We had three cardiac arrests. One of them was REALLY ill when he came in. He was completely out of his head, and would only yell his sister’s name (he lived with her) and that we were trying to kill him. He had a Lactic Acid of 15, a Hemoglobin of 5.2, Troponin of 500, and a rectal temperature of 91.5f. Two hours later, he was dead. When I notified his sister, she was hysterical, telling me that he was all she had left in the world. She was heart broken that he had been calling for her and she wasn’t there. Heart wrenching.
  • Then there were the two heart attacks that went directly to the cath lab. One of them died on the operating table.
  • The woman who was being arrested for her 19th felony and started complaining of chest pain. A clear case of incarceritis.. She was agitated and combative. I wanted to give her Ativan, but there is a nationwide shortage. Ten milligrams of Valium later, she took a nap. When she woke up, she went to jail.
  • A woman who has been coming in for weeks complaining that she keeps falling, but we can never find anything. Right after she got in the ED, her blood pressure dropped to 72/42. Problem found.
  • A list of other alerts: Sepsis, Respiratory, Seizures, and a couple of falls with associated broken hips.

The oddest one was a Baker Act that came in. It was a young woman who would talk completely normally for a while. Then she began speaking Latin in a very low pitched, gravelly voice. Then she would switch back to her normal voice, and claim to not remember a thing about what just happened. The family told me that this was odd, because she doesn’t know Latin. The girl’s family asked me what she was saying. It took a bit, because my Latin is not very good. We eventually figured it out. What she was saying was that “The girl is gone. I am Satan.” While she was acting like that, she would look at you with the creepiest expression on her face. Bone chilling.

That is some freaky shit. Her head CT showed a rather large tumor in her brain. Still, I am not playing with that shit, even though I am not religious in the least. That was some next level, spooky stuff.

She got sent to a mental health facility. It was an emotionally draining day, and I am sleeping in. I am typing this and going to back to bed. I didn’t sleep well after that horrible trainwreck of a shift.

Unscrewed

Earlier this month, my employer royally screwed me when they told me that I could no longer see my doctor and instead had to see a company doctor. This was a bid to force me on to a cheaper medication regimen.

So I grabbed a large tube of KY and unscrewed myself. The first thing that I did was contact my wife’s employer and asked how we could add me to her insurance even though we were outside of the annual open enrollment period. The answer was we needed to show that I had lost my current coverage through no fault of my own, so I got a letter from my doctor’s office that said “Due to changes in my insurance plan, my doctor was no longer covered by that plan.”

Once I was added to the wife’s plan, I waited for the new insurance card to come in the mail, took it to the doctor’s office, got added back to the practice, and made an appointment. He wrote me a new prescription, and now we are waiting for the medications to be approved by the new insurance company.

I am also looking for a new job. I interviewed for one yesterday and they were excited to see me. It looked like a good place to work. However, the job offer was not at a good pay scale. I was willing to take a cut in pay, but the offer they made was a full 25% less than I make now. That was just too low, and was an even lower offer than one I turned down last month.

The search continues.

Identity Theft

I have been the victim of identity theft a couple of times. A year ago, someone opened an online bank account using my information. I am sure that information had been obtained through one of the many data breaches that have happened in recent years. This episode was easy to clear up. Just call the bank in question, tell them that it was fraudulent, and it’s a done deal. Identity theft is so common nowadays, it’s become routine.

That wasn’t always the case. About 25 years ago, I was the victim of identity theft. I had just divorced my first wife and I needed a car, seeing as how she had gotten most everything in the divorce. I went to a small used car dealer, and it turns out that they were a bit, shall we say, shady. The finance manager had a scam going- he would file finance paperwork for several cars using the information of customers and by cutting and pasting their signatures onto multiple sales contracts. He would then take the checks for the car sales that had never actually happened. Since the dealer hadn’t sold those cars, they never missed the checks. He was also making money on the side by selling people’s financial information.

You can complain to the credit reporting agencies, but their investigations are a joke. In the end, it took me about two years to clear my name.

I solved it by becoming a pro se litigant. I sued several collection agencies and one fairly largish bank- SunTrust. I wasn’t greedy about it. Each entity I sued, I settled out of court for a few hundred dollars and for removing the credit line from my record. The Suntrust people were vindictive. They reported the “forgiven” loan to the IRS as income, and I wound up having to pay the IRS about 8 thousand dollars in taxes on the income when they subsequently audited me. I tried telling the IRS that my identity had been stolen, but back then it was such a new crime that they didn’t believe me.

Years later, SunTrust and their lawyers turned out to be just as shady and I wound up suing them half a dozen times with the mortgage scandal that caused my bankruptcy. It’s why I won’t do business with Truist to this day, that being the bank that SunTrust morphed into.

Working On It

I continue to work on my issue. I have until the end of April, which is when the medications run out. I have received no fewer than 50 emails on the subject, and they are therefore too numerous to answer individually because of my work schedule. I thank each and every one of you who have emailed, messaged, and posted comments.

There has been a major breakthrough, and it appears as though I have solved the problem by getting rid of the insurance company that caused the problem in the first place. I will know more in the next few days. More to follow.

Not Defeatist

I’m not defeated, and my last posts weren’t intended to convey that impression. Just because you are getting screwed doesn’t mean that you have to keep allowing it. I’m going to lose access to at least one doctor. My PCP has fired me from the practice, so I will have to get a new one. I am not sure yet about my endocrinologist.

I have been talking to some doctor friends, ones who work for my employer, and ones who do not. The doctors who DO work for my employer aren’t going to be able to write me a prescription for the more expensive drugs, and the insurance company says that I *have* to use the company’s pharmacy.

Usually, a provider or pharmacy that is not on the preferred list can still be used, albeit at a higher rate. They aren’t doing that here, and it’s being done that way to force patients onto the cheapest plan possible.

There are several loopholes in the system, and I plan on exploiting those. I will know within a month if I can make that work or not. All I know is that I am NOT going on insulin.

In my case, I need to get a doctor that will work with me, PLUS I need to get at least one refill on my medication under the current insurance, so that I have enough to last me until the open enrollment period for my wife’s insurance in July. I know plenty of doctors, but it’s the double hit of doctor PLUS pharmacy that is making it tough.

The rules and laws here are complex, but in complexity, there are loopholes. The more rules there are, the more holes there are to drive through. I have time to explore those, and even though I am screwed, I won’t be screwed forever. I don’t plan on staying that way.

Insurance companies hate diabetics even more than they hate smokers. The reason for this is that diabetics are famous for not complying with doctor instructions, and the disease is a progressive one. You don’t ever become cured of diabetes, the best you can do is manage or delay it. What manages it today will likely not manage it a year or two from now. It requires constant vigilance on the part of the patient and the providers. It’s a lot of work, and most of those who have it do not manage it well and wind up with complications like kidney, eye, heart, and brain problems. They wind up with nervous system problems, bone problems, and GI problems like gastroparesis. Treating all of this is expensive. The faster the patient dies, the cheaper all of that is from an insurance standpoint.

It isn’t that the insurance company is TRYING to kill you. No, they look at costs, and say “Gee, when we give drug X, diabetics cost us $y over their lifetime. When we give drug Z, they cost us $2y over their lifetime. Let’s only allow drug x.” They just don’t bother looking at anything else, it’s a pure monetary decision.

For those reasons, insurance companies WANT you to keep eating like shit and taking insulin, knowing that this will save them money over the long run. That’s why insurance companies want you to eat a regular diet and take cheap medicines like metformin. It’s up to each diabetic to carefully monitor their A1C, find trustworthy doctors who care about their patients, and keep on your insurance company’s ass. No one cares as much about you as you do.

Normal blogging to resume soon.

Update

Shady stuff with my health insurance. The way that health insurance works with large employers is that the employer pays the bills, and the actual insurance company administers the entire thing. It’s cheaper for the employer that way.

I tried to get added to my wife’s insurance. It is outside of her open enrollment period, so I need a letter saying that I am no longer able to see my chosen doctor under my current insurance. No one will put it in writing- not the insurance company, nor my employer’s benefits team.

The insurance company says that the decision to force me to use certain doctors came from my employer’s benefits team. The benefits team says that it came from the insurance company. They both suggested that I go to the insurance benefits webpage and look up my doctor to see that he isn’t on the list. That isn’t good enough- to get coverage, I have to prove that my coverage changed. No one will give me that.

Even worse, even if I wanted to change doctors, it’s snowbird season. Few of the doctors in the area are accepting new patients. Of the ones who are, the next appointment is in June. I pointed out that I only have medications until mid April. I was told “well, you can always go to the emergency room. They can refill your medicine.” I can’t believe that it’s illegal to pay cash for a doctor visit if you have insurance and your insurance won’t pay for it, so your only choice is to start patronizing the emergency room.

No. The emergency room will only give insulin. That’s the point of this. I don’t want to be an insulin dependent diabetic. That is a death sentence, it’s only a matter of time at that point. I have done this for more than 30 years, and I know where that road ends.

I will have to deal with this on my next weekday off. It’s daunting.

Screwed

I am a diabetic, and have been for two decades. I always knew that I would be, mostly because of my family medical history. My Father, his mother, and his father all had diabetes. It killed every one of them before they were 64 years old. I often joke that I lost the genetic lottery. My grandfather died when he was 47 years old. My grandmother, when she was 63- after having to live without legs for two years. My father died at 62. When I was diagnosed with diabetes, I lived in fear that I too would be dead before I could collect Social Security.

About 4 years ago, the diabetic medicines that I was on stopped being effective, and my A1C climbed to 10.0. This is a part of the disease- diabetes is a progressive disease. My doctor wanted to put me on Insulin, but knowing just how fragile diabetics become when they go on Insulin, I wanted other options. I see the story every day- insulin dependent diabetics inevitably go down the same road, ending in amputations, kidney failure, and death. Having to be on Insulin is a death sentence. I wasn’t going to do it.

That’s when the new class of diabetic medicines came along, and they were a miracle drug. Once I began taking Mounjaro, my A1C dropped to the mid 6’s, and my blood sugar is now well controlled. For the first time, I began thinking that I might actually make it to my 70’s. My last A1C was 6.2.

Since I could prove that I had been on Metformin and Actos for more than a decade, my insurance was willing to cover the $3,000 per month charge for the medicine. Insurance companies hate these new drugs- that’s why they got the Biden administration to go on a rampage to lower the cost of Insulin- they needed a cheaper alternative to the new medications.

Then two years ago, I got a new job. A new job means new insurance. The hospital that I work for, who is also my insurance company, requires you to get all of your medicine from the company’s pharmacy. That pharmacy has done everything that they can to force me to switch from the more expensive drug and take insulin. They delay filling my prescriptions, and say that they don’t have any, but if I would only switch to insulin, they have plenty of that available. I refused, and kept forcing them to pay for the drugs. As long as my doctor says that this drug is medically necessary, the insurance has to pay for it.

So this month, two months after the open enrollment period ended, my insurance company informed me that they will no longer pay for me to see any doctor who isn’t employed by the company that owns the hospital, and not coincidentally, the pharmacy. Not only that, but they are prohibiting me from paying out of pocket to see my current doctor. That was confirmed by my doctor this morning. They were threatened with legal action if they continued to see me for cash while I have active insurance. All of my future doctor’s appointments were cancelled. I offered to pay cash, and my doctor’s office told me that they can’t let me do that as long as I have active insurance. Now I am forced to see a company doctor, who will immediately place me on insulin.

I have a three month supply of medication left, and will be out of it by April 28. I can be added to my wife’s insurance during her open enrollment period, but that isn’t until July 1. It looks like they are going to force me to become Insulin dependent. I am sitting here thinking that my employer would rather kill me than pay for my medicine.

The only way to be added to my wife’s insurance earlier is to get a new job, and it has to be involuntary. I have to find a new job, then find a way to get fired, and I have to do it within the next three months. Maybe I can ask my boss to do me a favor and fire me.

My only other option is to try to convince a compounding pharmacy to sell me some generic, but you have to be obese for that to be legal, and I am not fat enough for that.

I am screwed.

Milking It

Being a female dominated profession, nursing has quite a few new mothers. A couple of them are abusing the law to their advantage. The PUMP Act states that women must be permitted breaks so that they can be milked like a cow, and boy are some of them milking it.

While at work, I was instructed to cover one of these women’s patients while she went to go pump. She was gone for 2 hours. When she returned, she was only back for half an hour before she took a lunch break. After returning from that, she went to go pump again for another hour and a half. In all, she was off the floor for over 5 hours out of her 12 hour shift. When we told her that we thought she was taking too long, with even another woman telling her that it doesn’t take that long to pump, she replied that she can go as often and for as long as she deems necessary.

So we went to supervision to complain. They explained to us that there is nothing that they can do. Apparently, they had spoken to her about it, only to get a phone call from her lawyer the next day. So hands off. It’s so bad, that they are now afraid of her:

Last week, while I was covering her patients, I walked into the room of one of them to find a woman covered in blood, with large blood clots on the bed. She had a pulse of 120 and was complaining of belly pain. She had been lying there for over 2 hours like that. I intervened and went to the doctor. Turns out it was coming from her bladder, and I measured more than a liter of blood loss.

I got the patient straightened out before the nurse returned. About an hour later, I noticed on the telemetry board that the patient had a blood pressure of 80/50 and a heart rate of 120. I spoke to her and she told me that the patient would be fine. I went over her head to the charge nurse. Yeah, I dropped a dime on her.

The woman was taken to emergency surgery. The nurse? Nothing happened to her.

The very next day, same nurse had placed a patient on 2 liters of oxygen. The patient was in obvious distress with an O2 saturation of 78%. Another nurse saw this, took over care, called respiratory, and had the patient placed on BiPAP. Again, no repercussions for nurse slacker’s complete lack of anything competent.

I have told the charge nurse that I will not be placing my name anywhere on that nurse’s chart and refuse to watch over her patients while she is off the floor. I am not risking my medical license for that incompetent, lazy slacker of a nurse. You can’t make me assume care for someone else’s patients, especially when I already have 3 or 4 patients of my own.

It’s My Money

No post yesterday because I was arguing with a bank. We decided to eliminate some debts. One of them was a loan with a small regional bank, let’s call them creditor bank, who we had requested a payoff quote from. The quote was for $41,800. We signed an authorization for them to perform an ACH from our checking account for that amount. That transfer cleared on Friday.

This morning, I get a notice from my bank that my checking account is overdrawn by more than $30,000. Of course, I call immediately to see what the problem is. It turns out that the creditor bank performed a second transfer in the amount of $41,300. The transfer was pending, so it hadn’t officially cleared yet. I paid $35 to put an immediate stop payment on that transfer.

Multiple calls to Creditor bank eventually wound up in an account representative, myself, and the manager on a three way call. The story they gave me was too crazy to make up. According to them, the amount of the payoff that I was quoted was incorrect. The payoff was actually $41,300, which was $500 less than what they had originally quoted me. Instead of simply mailing me a check for the overpayment, the bank thought that it would be a good idea to go ahead and take the correct amount out of my bank as a second ACH transfer, then the plan was that they would refund the original ACH payment back to me in 10 business days.

My response was: “And you think that is a good idea?” They thought that it was.

Ok, dummies. Wouldn’t it be easier to simply refund the $500 overpayment, rather than perform an ACH transfer that you weren’t authorized to withdraw, and then have to go back and refund more than $40,000? You do know that what you did was called stealing? Did you think that I wouldn’t miss the money?

No, they responded, because we were not intending to keep the money, we intended to refund the incorrect amount all along.

My answer to that was, “Well, I had to sign an authorization for you to perform the original transfer. Where is the signed authorization for the second transfer?” Crickets.

How can a bank, people whose job it is to handle money be so monumentally obtuse? I am not intimately familiar with banking regulations, but I am betting that what they did was not legal, and if it is, then one has to wonder why.

It took me most of the day playing phone tag to get it straightened out.