Marc's Musings Reality from Marc's point of view!

For those that don’t know, I hail originally from Canada. There is a lot about America that attracts me and “Government staying out of my affairs” is a biggie. It is with no surprise then that I was very much in favor of shucking off a socialized medical system and its shortcomings for a more pay as you go system.

When I arrived here I was healthy and did not have kids so my contact with the medical system was minimal. Pretty much limited to a general physical now and then.

As I live here longer, I’m starting to grow more and more fearful of the financial repercussions of even a modest illness and find myself hesitant to take advantage of what is arguably one of the best medical systems in the world.

I’ve had a couple of procedures done over the past half decade or so and found myself annoyed that it is very difficult to get a cost for a procedure. They seem easily able to give you a bill before you go into the operating theater but try to get that bill amount when you are setting the appointment and people seem confused. On top of the, rather substantial, bill that you pay up front. The little bills that keep floating in weeks or months later are unexpected and annoying. When you call about them you will find that they are “usual and customary” but that is only for folks in the billing departments of hospitals or in insurance departments.

If I went to a mechanic and had my transmission replaced you can be sure that I am going to get an estimate from him. That estimate better be what I’m charged at the end unless something unusual comes up and, if it’s substantial, I expect a further call to ensure that I want the extra work done (maybe they notice a broken support for the engine while they’ve got the car up on the lift). You can be damn sure I’m not going to be receiving a bill from the “Oil Support Technician” or “Hydraulic Lift Specialist” two months after the fact because they consider it “Usual and Customary”.

In medicine it seems perfectly OK to have essential folks’ services completely omitted from any estimates. I had a hernia operation about 6 years ago and the anesthetist’s (or anesthesiologist’s – can never keep those two straight)  services, something that I consider quite essential when I’m to be rendered unconscious for surgery, were charged for separately at least a month after the fact. I had to call to see if this was legit or some kind of scam because I was so amazed at this boldness.

I need to have an MRI to sort out some issues left over from my bicycle accident a few months back. On Friday my doctor tells me he’ll begin a precertification for this. Today I receive a call from the MRI place to schedule an appointment. I went ahead and set up a date and decided to persue this to see if it’s possible to determine one’s liability and maybe plan for this kind of thing.

The girl on the phone for scheduling, of course, can do nothing for me to help nail down the cost of this thing. So I contact my insurance company. After 15 minutes waiting on the phone I find out that my insurance company contracts out radiology type stuff to a 3rd party precertification company. I’m told I need to call back if I want to find out more about costs because their department also doesn’t handle that.

So I call the insurance company back. We’ll leave the sorry-ass IVR system out of this conversation suffice it to say that it aided me not at all in getting to a customer service rep. All the rep is able to tell me is that I’ll have a $500 deductible and then I’m responsible for 20% of the cost beyond that. OK, that’s in my benefits plan. How much does this kind of procedure cost?  All he is able to tell me is that it will be a negotiated amount and that my liability will be as he’s already said.

So I contact the third party pre-cert group and find that my doctor’s office hasn’t yet initiated the precertification process with them and that my plan is the kind where only a doctor or the MRI folks can initiate the process. But that this process typically takes one business day, so my appointment (scheduled for next week) is not yet in jeopardy.

So I contact my doctors office to see what needs to be done, they acknowledge that they need to initiate this and that they’ll call me back.They call back within the hour and it turns out that this is the normal way that things are done since the pre-cert company likes to know where and when the procedure will occur. So I’ve jumped the gun on this part but they tell me that everything is now in place.

Finally I call the billing department of the MRI folks. It took them 10 minutes to figure out how much this was going to cost me. When I asked if this was an all inclusive price, explicitly mentioning that there’ll be someone administering an IV they did agree that I can expect another, separate bill from them that should only be in the range of “a hundred or so dollars”.

So, an MRI of my head, both with contrast and without will cost me no less than $868. With a little math that puts the “negotiated cost” at $2,340. Then I can expect at least another $100 bill to come floating in sometime after that for the IV person and I have no idea how many other folks it is “usual and customary” to have wander into the room while the procedure is under way and then send me a bill.

The care we have available might be some of the best in the world, but the cost for that care is terrifying – for its magnitude certainly but more so for its quixotic cost. For all its pitfalls, under a socialized medical scheme for all but the most catastrophic of issues my liability is capped so I do not have to put my self or my family at financial risk – heck it’s not even a risk because you cannot even begin to forecast the costs before you begin it’s really more of a game of chance than anything that can be calculated.

So color me leaning back in favor of the socialized medicine side of the debate.  If we can get to a system where I can get off the phone with an appointment and a guaranteed estimate (representing the cost both with and without insurance) and none of those “gotchas” that make this such a risk I will rethink this. Hell I can do it for my car, my cat and my washing machine. Surely we’ve got enough knowledge and experience to estimate simple procedures accurately by now.

Posted under Opinions, Retail Experiences

Several years ago I had a terrible experience with Dell’s customer service and a video card on my still-under-warranty system. The experience involved me being hung up on and eventually sourcing my own parts from my local Microcenter.

After ignoring them for my subsequent computer purchase I’ve since ordered other Dell products, mostly because they offer IMHO the best combination of customizability and pricing that I’ve been able to find. My Inspiron 530 worked pretty well except for the “missing RAM” problem that a lot of people both with and without Dell products got stung by. It was that missing RAM experience combined with my earlier customer service issue that had driven me to try a boutique online computer shop instead of Dell originally.

Once that was all sorted out I decided to go with an Alienware machine in spite of my concerns. The costs and ability to get pretty much exactly what I wanted won out in the end.

About 3 weeks after I received the new system, the fan on the Video card (ATI Radeon HD 5870) started making noises that told me that it was giving up the ghost. It was especially disappointing given that all the other fans on that computer stay very quiet depending on the load. This one fan was louder than my nearby fridge when it’s in full swing.

So I called Alienware support (still separate from Dell’s support ultimately even though the front end is the same) and all the horror stories I had heard about Dell ruining the Alienware branding proved… unfounded.

The tech was knowledgeable, we quickly came to an agreement as to the issue. They shipped out a new card which arrived a few days later and whose box I used to return the failing card with no hassle or cost.

The new card is working great and I’ve had no other issues. The Alienware machine is pricier than piecing together a machine for yourself, but that also depends on how much you value your time. I much prefer *using* my computer to tweaking it, generally speaking.

I wanted to put this kudo out there for Alienware’s support and say that my experience, at least, was just fine.

Posted under Opinions, Retail Experiences

About 3 years ago I had all 3 toilets in my house replaced by with new ones powered by Flushmate’s pressure assist systems (the actual toilets are made by Gerber).

A few days ago one of them stopped working so I started pulling it apart to figure out what the problem was. I ended up on Flushmate’s website and found a wealth of information, most useful were a series of videos showing how to test and replace various components of their system. I was originally a little hesitant to go for the new technology since I *knew* that I could always get parts for conventional toilets at my local hardware store but was not sure what would happen should I have issues with these new units.

After watching the videos I could tell right away what was not obvious from reading the install manual, the actuator shaft of the flush cartridge was sheared through, but the break was smooth enough I did not initially recognize that it was not *supposed* to be in two pieces. I called their 1-800 number and, as it was a Saturday, I ended up leaving them a voicemail with the particulars of my situation.

Come Monday morning, Dawn from flushmate called me back and we determined that the flush cartridge was indeed broken and covered under their 10 year warranty. Even though the toilet had not originally be registered with them they honored the warranty and immediately shipped out a replacement cartridge.

Thursday the part arrived by regular mail and half an hour later the toilet was right as rain.

So I wanted to toss up my story of an easy to work with company that honors its stated commitment to its product without a lot of fuss and bother.

And these are still the best toilets we have ever owned. Three years and I’m sure they can flush anything Consumer Reports can throw at them. Exactly what our sewage system needs!

Posted under Opinions, Retail Experiences

** Update June 27, 2010 **

Amusingly, the day after I posted this, the Amazon price for the physical book jumped up to $10.19 and has remained there ever since.

Not saying it’s related to *my* post, but amusing nonetheless. Just saying to anybody at Amazon who happens across this, the thrust of my post was that the Kindle price should come *down*, not the other way around…

** End Update June 27, 2010 **
I was hankering for a new book to read yesterday so I went to pick up Peter F. Hamilton’s “Fallen Dragon” from Amazon.com.  I see that the current price for the Kindle download is $9.99. But I can purchase a brand new physical copy of the book from Amazon for only $8.24. In fact fully 7 of the 22 retailers offering the book are doing so for less than the $9.99 kindle price.

Most of those are also charging shipping fees which will put them over the Kindle price. I use Amazon so much that I’m experimenting with their “Prime” service which means that I’ve already paid a flat fee for my shipping for the year so there is no additional cost to me when I purchase anything that is sold BY Amazon. It will arrive two days later for exactly the purchase price that I see listed.

With the iPad coming on the scene I’m a little surprised to see that Amazon has chosen to go this path. The price difference is trivial, only $1.75, but it certainly rankles to pay *more* for something that requires far less overhead to print, store, handle and ship than its physical counterpart. I’m sure that the price is being driven by some odd publisher-determined model.

Companies have always been in business to make money. But am I mistaken in that, in this era, they are so much more brazenly about squeezing every last penny out of you and being completely blatant about it?

Heck, I understand that both AT&T and Verizon Wireless, instead of continuing to offer a somewhat reasonable value with their unlimited plans, are looking to move BACK to forcing you to purchase buckets of minutes / data and then gleefully charging you overage fees again.

I’m personally looking for companies that I can partner with – someone that I can pay a fair price to and expect fair service from them. They make a reasonable profit and I get value for my investment. It seems many businesses today are intent only on adversarial relationships with their customers and spend a tremendous effort on extracting every last cent from you for their services. It’s no wonder that brand loyalty and customer satisfaction are so low these days. If you are squeezing your customers so hard, it does not take much to push them over the edge to find another provider or to become upset with your services. People are a lot more tolerant of companies that work with them rather than against them.

Posted under Books, Opinions, Retail Experiences

I’ve been to RosaMia 3 times now and each time have been very pleasantly impressed.

A little on the large side, their lasagna is spectacular. Gastronomic athletes may be willing to finish it but I find it much more satisfying to share it or take some home with me. Equally good has been their pizza and their Panini sandwiches (with a salad) which are exactly the right size and surprisingly tasty.

The service has always been pleasant, timely and efficient and the price is exactly in line with what I am willing to pay for a lunch trek to a restaurant.

Definitely a keeper, I have yet to be disappointed here.

Posted under Gastronomy, Opinions, Retail Experiences

I’ve been to Cabernet Restaurant for lunch a few times in my 5 plus years working in Alpharetta and it’s usually been just OK. That atmosphere  and pricing has always been a little higher-end than I tend to favor. But it seemed like it should be worthwhile as a treat.

Today I suggested to the group I was with that we should try Cabernet to see how it’s doing these days.

I have to say I was somewhat disappointed.

The service was just slow. From arriving at the front and waiting for someone to show up to seat us to every interaction with the waiter it just all took too long.  I think the situation was, even though the dining room was not even half full, there were simply not enough wait staff to host even that small a lunch crowd.

I was going to order their Filet mignon but waiting for the waiter to show up to take our order made me rethink trusting them to cook a steak. I figure that a restaurant that cannot manage its dining room probably isn’t doing so well managing the kitchen either.

I ended up ordering a Turkey Wrap which was the best thing on my plate but still pretty bland. It came with “hand cut potato chips” that were among the most tasteless I’ve ever come across. If I had been able to find a server I’d have asked for ketchup to at least give them some semblance of vitality. Also included was coleslaw – I’m more a fan of vinegar rather than creamy coleslaw – this had the distinction of being neither one nor the other and still retaining its ability to be unappetizing.

For the occasions when my drink glass was not empty it was half the time filled with the wrong drink.

One of my party did comment that the waiter knew how to deliver the menu recitation and, when he had made his way to our table I must admit he was effective at making choice items on the menu sound appealing. But that, alas, had to be the only really good thing I can say.

I will not be returning.

Posted under Gastronomy, Opinions, Retail Experiences

It took a while but I just wanted to wrap this up.

Yesterday (April 7, 2010) my credit card finally showed the refund! The amount was, as expected, the price I paid minus the shipping costs.

Here is the the final exchange we had in email leading up to the refund.

My follow up on April 2, 2010:

Hi,

Another week has passed. I’m not sure how you personally regard $2,500. But I regard this as a large sum of money.

It has now been 3 weeks (15 of your business days) since you have received the PC that I returned.

I elected to do business with Cyberpower on the strength of a friend’s recommendation in spite of your B+ rating with the Better Business Bureau ( http://www.la.bbb.org/Business-Report/Cyberpower-Inc-13080817 ).

Please respond to this email with your confirmation that the refund in full has been issued.

Marc

With the response being (April 5):

Dear Marc,

According record for RMA under 181144, refund was credited back to your account on 3/31/2010, bank or credit card company will take 2-3 business days to process, if you have any question please email or contact us.

Thank you.

RMA Status

Cyberpower Inc.(888) 900-5180 Ext. 151

I’m pleased that things have finally worked out. It was somewhat disconcerting to have to go around like this to elicit the refund. At the back of my mind I was still holding on to the option to dispute the credit card charge but – looking at the credit card fine print – this option is supposedly one that’s limited to businesses within my physical locale (within about 500 miles). But I imagine in this day of internet purchases, that that anachronism is one that is largely discounted and trotted out by the credit card folks only when they no longer wish to retain a particular customer.

Posted under Retail Experiences, Tech Stuff