An Appalling Appeal: 11 Months and Counting

Today I was finally able to submit handed in the appeal I waited over three years to submit. And it is just an APPEAL! Not even a decision. Not a win, but also not a loss.

The APPEAL has given me the strength to keep going. In part because it shows that I haven't lost and in part because it means that somebody actually listening.

So listen carefully, my friends. It was not too long ago that I had almost everything a young person needs to succeed in this world.

Or maybe not.

As for my most current insurance dispute... I feel that I have done everything humanly possible to be sympathetic towards health care provider who is NOT providing care. I cannot sacrifice my own well being for every bright eyed bushy tailed wanna be who is too stupid to see that I am far from.

I had such a battle this week. It culminated in the end like every other battle I have taken on. I only won because ultimately but we are all losing.

For every underqualifed, health care provider who has NOT provided the adequate, there are many more like me. Alienated just enough to give up on fashion, etiquette and social norms, but not enough to walk from it all.

We are keeping watch. We are taking names, and I for one do not give a rat's ass about "keeping the peace."

Having been on both sides if the proverbial couch, I have the perspective is both enlightening and scary at the same time.
I look back and want to say shout "told you so" from the nearest roof top.

Crazy is crazy does... out loud. I may be enjoying this just a little too much.

Sometimes I try to look at this fight, (I meant to say this life) objectively.

I can see my own future, and I can see where it is taking me. I know how it will end it I don't keep up the pace.

It is amazing at how far we will go to have nothing at all.

I have come this far, and on some level I almost enjoy the dance. No. On some level, I actually love the dance.

No. I won't give up now. Because without this turmoil, this means to an end, this demonstration project of futility and determination, and without it, I am nothing at all. I can't lose what I never had. I won’t be another sell-out-- mostly because I don't know how.

I am then the voice of perseverance. I am one voice of perseverance. I am one of 47 million Americans. And today I am I am still fighting the good fight.

This battle; this challenge; this half won war this fight has come to define me. And without that, I am not really much of anything at all...

As someone once told me, if you don’t stand for something, you will fall for anything. I've already fallen, but I sure as shit stand for something.

"... so for now, I write. Maybe later listen. And if there is any justice left in this world, maybe someday, I'll actually live. "

Good night, folks. It is time for that break.

Elyssa Durant
Nashville, Tennessee

An Open Letter to the TNDP

June 24, 2009


Dear Mr Forrester:

I have a HUGE problem with the "Chip in for Chip Campaign" I feel this is a grievous misrepresentation of the TNDP and the incestuous affiliation it appears to have with the NCO.

What an awful way to start you tenure and try to gain support from local, vocal advocates and activists like myself. http://www.actblue.com/page/chipin

Unfortunately, duty calls, and I don't have the time to fully express just how disturbed I was by how betrayed I feel by the TNDP that caused me to question the ethics of my own party. a breach of ethics within the Democratic party.

But rest assured I will return to this topic with further details, and a copy of a letter I received from one of of your staff members the day after we discussed the possibility of summoning volunteers from the health care lobby to get your new office up and running.

Although you did invite me both verbally and through e-mail, I was told by one of your staffers that I was not welcome since I "Chip doesn't even know you, AND because I did not even volunteer at the Obama Headquarters."

Sorry-- I was hitting the streets with Health Care for America Now [HCAN] and manning the phones for Cover the Uninsured.

This campaign was misrepresented to me as a non-profit supporting the community through and by local activists and advocates right here in Nashville.

The website revisions validate that transformation from as the NCO slowly morphed into the TNDP.

This kind of and followed up with one of the most disgusting displays of all the things ugly we hate about politics.

NCO is NOT act blue. As a former lobbyist, I am deeply offended by the ethics and misrepresentation of the TNDP. Especially after being told I am not a welcome volunteer at YOUR office.

Bad business, Chip.

It is unfortunate that you have surrounded yourself with people who are working against you to further their own political agenda hoping they may someday replace you.

It was interesting to watch how quickly the dispersed when the "Chips were down."

As a life-long democrat who missed only one election since I turned 18, I truly hope your staff (especially the "NCO" can recognize how seriously they are jeopardizing and alienating members of the Democratic party.

Unfortunately, I can't donate money, but I would have more than happy to volunteer time. Therefore, I am formally requesting a refund of the $5.44 I donated online.

I shared the letter with a friend in the Republican Party because it was so offensive and shocking. I think you deserve a copy as well. I will try to get that o you in the near future.

Please note, it is not personal against you, but In the meantime, I would like to formally request a refund of $5.44. You can make it payable to charity of MY choice, however since I am unemployed and on disability, I wouldn't object if you made the check out to "cash."

Sincerely yours,

Elyssa Durant, Ed.M.
Nashville, Tennessee

Reviewing Reform: This Reform is a Farce!

I did not need another reason to demonstrate the need for immediate action concerning healthcare reform, however for those who feel Obama's current plan for reform is right on target, let me try to convince you otherwise. We need IMMEDIATE intervention.

However for anyone who needs to be reminded that we need to move forward, please read the excerpt below from KnoxViews:

"Blue Cross CEOs gorge on profits from premiums."

"The chief executive officer of Blue Cross of Tennessee got a big salary boost to over $2 million this year. Searches for "salary president ceo blue cross [statename]" will get you the figures for the rest of the states. To keep it simple, though, let's just assume that the 50 CEOs of each Blue Cross operation in each of the 50 states makes roughly what the top guy in Tennessee gets, Tennessee not being exactly one of the wealthiest states. That means we're looking at well over $100 million of our health insurance premiums poured into the homes, yachts, and kids' private schools of a tiny elite instead of going into the provision of health care for Americans."

-Vigil Proudfoot, KnoxViews available: http://knoxviews.mobi/node/11418

To learn that the CEO of Blue Cross Tennessee received a $2 million bonus is really not news at all. It is merely more of the same, and exactly what we can expect if the Healthcare Industry is expected to "curb" their spending. It just ain't gonna happen.

To learn that the CEO of Blue Cross Tennessee received a $2 million bonus is really not news at all. It is merely more of the same, and exactly what we can expect if the Healthcare Industry is expected to "curb" their spending. It just ain't gonna happen.

This just goes to show that we MUST have immediate intervention, regulation, oversight, and accountability over the Healthcare Marketplace. Not just the private companies such as Aetna or US HealthCare; make no mistake about it CMS Medicaid and Medicare have plenty of problems that must be addressed those programs are to intended to be the model for the rest of the country.



Obama's plan to come to the table with the Healthcare Industry is being passed off as Healthcare "reform" is a farce. The concept of self-regulation as the newest chapter in healthcare reform effort is a joke and my concerns continue to grow with each passing day. Since that compromise was made, have any of us seen any movement towards reform? Is there any evidence that we are moving toward covering the uninsured, lowering the cost of American healthcare or making it more accessible?


Asking or expecting the health industry to reduce costs through self-regulation without accountability is simply ridiculous. Especially when we see reports such as these that show a CEO salary of several million dollars.

Health care is already completely self-regulated and controlled. A person does not have free choice when choosing a provider. Due to an unholy alliance of provider networks, insurance underwriters, pharmaceutical conglomerates and private for profit hospital corporations such as HCA.

By negotiating with providers and developing one-size-fits-all prescription formularies and treatment protocols, we remove the ability for the consumer to make independent informed decisions about the value of various treatment options.

We rely upon one the ratings of physicians who have self-interest in controlling access and information to accurate information through their reliance upon Certification and Licensing Boards. By limiting access into the profession, health care costs are inflated and it is near impossible for the consumer to determine the fair value of a health care service.

Second, the consumer is far removed from the negotiating process, so we do not have a good sense of the fair, free market value of one particular service in comparison to another. All you need to do is look at any EOB (explanation of benefits) report for your last trip to the hospital.

Billing codes are used and assigned through various service departments and the insurance carrier then decides which services are covered and at what rate. They use the terms like “Reasonable and Customary Rates” and then choose to pay 80% of that amount. Therefore, by definition, that 20% must be built in to the billing rates to adjust for the actual (and expected) rate of reimbursement.

Such complicated billing procedures and methods are so complicated and technical that the end recipient of services (the consumer) really has no idea if an X-ray costs $90 or $73. Add into that a separate fee for the radiologist, and sometimes a charge just to use the facility, and even smart people find it difficult to understand.

The bills are then processed by an insurance adjuster who must determine primary and secondary (supplemental) plans and determine who is responsible for what, the end cost and intricate design is truly “priceless.”

Good luck to those people who actually purchased supplemental plans they saw advertised on TV, you have been duped. Giving people (especially the infirm and the elderly) a false sense of security is unfair and unjust.

Without regulation, intervention and enforcement, many people will continue to believe they are prepared and protected from that ultimate for “just in case” scenario that results in major, catastrophic medical loss.

The administrative cost alone on the part of the “Responsible Party” is probably more costly than the initial service they received at whatever hospital for whatever condition.

You cannot apply basic economic theory and free market principles to health care. Health care is fundamentally different and should be considered a public good.

We cannot believe or expect health insurance conglomerates will control their own spending and free from government intervention. We need to do something NOW!


"You may not care how much I know, but you don't know how much I care!"



Available online: http://my.barackobama.com/page/community/post/elyssadurant/gGGGBH

SCREW THE BLUES: Reform the Reform

To learn that the CEO of Blue Cross Tennessee received a $2 million bonus is really not news at all. It is merely more of the same, and exactly what we can expect if the Healthcare Industry is expected to "curb" their spending. It just ain't gonna happen.

This is just goes to demonstrate that we MUST have immediate intervention, regulation, oversight and accountability over the Healthcare Marketplace.

I did not need another reason to demonstrate the need for immediate intervention, however for those who do, please read the excerpt below from KnoxViews:

"Blue Cross CEOs gorge on profits from premiums."

"The chief executive officer of Blue Cross of Tennessee got a big salary boost to over $2 million this year. Searches for "salary president ceo blue cross [statename]" will get you the figures for the rest of the states. To keep it simple, though, let's just assume that the 50 CEOs of each Blue Cross operation in each of the 50 states makes roughly what the top guy in Tennessee gets, Tennessee not being exactly one of the wealthiest states. That means we're looking at well over $100 million of our health insurance premiums poured into the homes, yachts, and kids' private schools of a tiny elite instead of going into the provision of health care for Americans." -Vigil Proudfoot, KnoxViews available: http://knoxviews.mobi/node/11418


Obama's plan to come to the table with the Healthcare Industry is being passed off as Healthcare "reform" is a farce. The concept of self-regulation as the newest chapter in healthcare reform effort is a joke, and my concerns continue to grow with each passing day. Since that compromise was made, have any of us seen any movement towards reform or seen our healthcare dollars get more bang for the buck?

Asking or expecting the health industry to reduce costs through self-regulation without accountability is simply ridiculous. Especially when we see reports such as these that show a CEO salary of several million dollars.

Health care is already completely self-regulated and controlled. A person does not have free choice when choosing a provider. Due to an unholy alliance of provider networks, insurance underwriters, pharmaceutical conglomerates and private for profit hospital corporations such as HCA.

By negotiating with providers and developing one-size-fits-all prescription formularies and treatment protocols, we remove the ability for the consumer to make independent informed decisions about the value of various treatment options.

We rely upon one the ratings of physicians who have self-interest in controlling access and information to accurate information through their reliance upon Certification and Licensing Boards. By limiting access into the profession, health care costs are inflated and it is near impossible for the consumer to determine the fair value of a health care service.

Second, the consumer is far removed from the negotiating process, so we do not have a good sense of the fair, free market value of one particular service in comparison to another. All you need to do is look at any EOB (explanation of benefits) report for your last trip to the hospital.

Billing codes are used and assigned through various service departments and the insurance carrier then decides which services are covered and at what rate. They use the terms like “Reasonable and Customary Rates” and then choose to pay 80% of that amount. Therefore, by definition, that 20% must be built in to the billing rates to adjust for the actual (and expected) rate of reimbursement.

Such complicated billing procedures and methods are so complicated and technical that the end recipient of services (the consumer) really has no idea if an X-ray costs $90 or $73. Add into that a separate fee for the radiologist, and sometimes a charge just to use the facility, and even smart people find it difficult to understand.

The bills are then processed by an insurance adjuster who must determine primary and secondary (supplemental) plans and determine who is responsible for what, the end cost and intricate design is truly “priceless.”

Good luck to those people who actually purchased supplemental plans they saw advertised on TV, you have been duped. Giving people (especially the infirm and the elderly) a false sense of security is unfair and unjust.

Without regulation, intervention and enforcement, many people will continue to believe they are prepared and protected from that ultimate for “just in case” scenario that results in major, catastrophic medical loss.

The administrative cost alone on the part of the “Responsible Party” is probably more costly than the initial service they received at whatever hospital for whatever condition.

You cannot apply basic economic theory and free market principles to health care. Health care is fundamentally different and should be considered a public good.


We cannot believe or expect health insurance conglomerates will control their own spending and free from government intervention. We need to do something NOW!


Elyssa Durant, Ed.M.
Nashville, Tennessee

"You may not care how much I know, but you don't know how much I care!"


Available online: http://knoxviews.mobi/node/11418

"Twanks" A Special Gift from Across the Pond

rmolden's TweetMic recording

Posted using ShareThis

Thank you for putting your personal touch and flair into a special tribute to those who have touched your life. We should all be so generous.

Always remember that it is far more productive to give tell someone they have done something right, rather than be critical when they happen to do wrong. We should all be so generous with our words, I have decided to share this very special message with all of you.

You can hear more Twitter Chatter and the voice of Richard Molden at: http://twitter.com/rmolden

CENSORSHIP & SILENCING

China blocks Twitter, Flickr, YouTube, and more ahead of Tiananmen Anniversary

http://current.com/items/90144225_china-blocks-twitter-flickr-youtube-and-more-ahead-of-tiananmen-anniversary.htm



Posted by ElyssaD on current.com:

We even have a silencing issue here in Nashville, Tennessee where the schools decided to block certain websites.

Silencing of any type can be harmful and cruel in many ways. Imposing formal censorship threatens our individual freedoms and democracy everywhere.

Let the children speak, let them learn, and let them be heard.

http://www.oasisjournals.com/2009/06/tennessee-schools-end-unconstitutional-censorship-of-gay-educational-web-sites-after-aclu-la

How The Unemployed Pass The Time

At 22 I was diagnosed with a degenerative spinal condition. Yes, there are times when the pain is so terrible, I cannot lifet myself out pf ed or tie my shoes. But far worse is having the knowledge that the level of damage to my spinal cord could have been stopped had I received adequate health care.

Yes, I had insurance. But who was there to make them pay???

14 years later, I finally received surgical intervention, and can feel my hands again-- and as a writer, that has been a miraculous gift.

Through the toughest times in my life, no one told me I was wasting my time and money on an education I would never be able to use.

After all I just wanted a diversion.

Even more disturbing than the damage to my spinal cord, is the realization that I missed mosre than 14 years of my life. So not only did I waste my time and money on an education I will never be able to use, I wasted a window of opportunity. A moment in time when I almost had a world the world at my fingertips.

Without any real place to go after college, I felt I had no other choice than to become a professional student of sorts—you know, the ones who stay in school forever to take advantage of cheap housing, health insurance, and student loans.

Unfortunately, I wandered aimlessly through the system acquiring useless knowledge and letters after my name that do not mean jack in the real world. But it distracted mye from the fact that my spinal cord continued to worsen my physical and emotional health.

So with no prosepects on the horizon-- and so thrilled thto feel my hands today, that the one thing I can do is write. So for now, I write, maybe tomorrow I'll read, but if there is any justice left in this world, maybe someday I will actually live.

http://thepowersthatbeat.blogspot.com/

http://my.barackobama.com/page/community/post/elyssadurant/gGxh4R/commentary