In the Chemo Room: 17 minutes to appeal $176,365 bill

I go back to the chemo room later today, but this morning I sat in on a medical panel that heard my appeal of Anthem Blue Cross Blue Shield's denial of $176,365 of radiation "benefits" I received last summer.

To make that clear: Anthem has initially refused to pay my doctors and my hospital $176,000 for treatments I received through May and June 2010 based on the company's medical protocols that don't consider the type of radiation therapy I received a standard treatment for metastasized colorectal cancer. 

Both my doctors, Thomas Kenney, oncologist, and Seth Reiner, radiation, were on the 17-minute teleconferenced call as the appeal hearing was conducted, and both explained why they prescribed the treatments I was given. The panel seemed to agree, but a majority vote is to decide the issue and I am to be informed in 24 hours how the vote went down.

It was all very professional, and my doctors both said they have participated in such review/appeals in the past. It is part of the "system" of health care we've got going for us here in America, and the new "affordable" health care act passed by Democrats last year probably won't change this part of the system.

The law preserved the role of private-sector health-insurance companies in the health-care industry, so health insurers, in order to preserve profit margins, will challenge doctors on protocols in order to keep from paying as much as possible on insurance policies that are racking up huge costs for care. If the company is successful, the bills fall to the patient, no matter their ability to pay, and the insurance company dodges, in my case, this one $176,000 bullet.

Anthem Blue Cross has already paid much more for my care during my near four-year battle against the disease, so I don't blame them for this attempt to save themselves some money. It's good business.

And its good business on my part and my doctors' parts to appeal initial decisions and make the insurance company pay. That's all part of the initial transaction I made with the insurer, and why I keep paying my ever-increasing premiums. The appeal process adds costs to the "system," but that's a policy the wise heads of industry and government have adopted. 

Of course, a public option to private health insurance might suggest a cure to this national chronic economic illness. But that's another story.

Romero promises economic development across state agencies

Dwayne Romero, the state's new economic development director, officially resigns from his seat as an Aspen city councilman today and has promised a cross-agency approach to economic development problems like mountain congestion on Interstate 70.

"I think that's an integrated approach, a cross-sectional, cross-agency state of mind, and a philosophical approach to how this particular administration chooses to pursue its work," Romero said in an interview last week.

I asked him whether he considers taking part in the decade-long discussion over how to fix I-70 congestion, largely the purview of the Colorado Department of Transportation, was a legitimate role for the director of the Colorado Office of Economic Development and International Trade.

"I do," said Romero. "You know traffic and congestion around I-70 isn't going to go away overnight," he said. "These are difficult, meaty, hairy issues." And I-70 traffic cannot be considered a narrow concern for just transportation experts.

"It clearly feeds jobs in the tourism economy," he said. "Every time a new business looks to the state, they measure things like the strength of our infrastructure, and how well it's adapted to, and it services our constituents," he said. "And choke points along I-70 do not help that story."

I asked him the question because I have long considered the economic development director to be in a unique position to influence practically any state government undertaking, since any new government undertaking is going to involve private businesses as contractors.

From straightening out the human-services department's computer problems, to building a transmission line across the state, to fixing the state's roads and bridges, government agencies don't do the work itself, but hire and pay private contractors to do it.

But hiring private contractors in Colorado has long been a convoluted and time-wasting (therefore money-wasting) process that often discourages local small businesses and even medium-sized firms from taking part. Romero would do well to involve his department in reforming that area of state government as well. Or at least inject itself into reforms on the side of small businesses and all Colorado companies.

Romero said during the interview that OEDIT, his department, will also be greatly concerned with carrying out Gov. John Hickenlooper's primary dictate to all state agencies, which, in Romero's words, is: "Getting our budget balanced and at the same time focus on how we improve the performance of government."

"We understand that at the state level we need to make sure that our government is run like a very effective business, and we're responsible for our revenues, and we're responsible for the delivery of our services," he said. He wants small business and all business across the state to respect the administration's business-like efficiency, and gain enough confidence in Colorado's economy to add jobs and grow.

That will require his department and other state agencies to craft "efficiencies and economies that help, if you will, deliver more effectively on the services that we provide, perhaps at a slightly less dollar value," suggesting a tightening of the state workforce in order to meet budget demands.

"That's where I would rely on my private-sector, small-business and business management experience," he said when I asked whether new duties would not stretch his current department's staffing requirements.

"No," he said. "That concept of dropping or diluting to zero other initiatives or other focuses is just foreign to me. You know, when you make priorities, you focus your resources and energies. Really strong leadership would suggest you still are able to perform your other missions and your other capacities. Having a priority of effort is what small business has to do every day." 

Courting business becoming a political trend

Gov. John Hickenlooper

President Barack Obama is not the only chief-executive-of-state courting the business community big time. Our own Gov. John Hickenlooper met with ten CEOs of the state's largest employers last Friday in a meeting that so far has gone relatively unreported except by him.

The president met with the U.S. Chamber of Commerce on Monday and asked its business membership to "get in the game" of hiring to reduce the nation's unemployment. 

Hickenlooper hasn't said he asked the Colorado CEOs to open their doors and hire more unemployed Colorado workers, but he did say Monday on Mike Rosen's radio show that the CEOs "had all kinds of specific suggestions in terms of changing the taxes we ... have on business, not to lower them, but just to make them more fair."

He also said that raising corporate taxes in the state now "would put up a neon sign saying we don't want any [new] businesses" coming to the state -- exactly the opposite of the "aggressively pro-business" message Hickenlooper, like Obama, wants to send right now.

Both chief executives want Corporate America to pitch in and contribute to economic recovery. We don't know whether Hickenlooper specifically asked the Colorado employers to do that because his two-and-a- half-hour session with the execs in his Capitol office was deemed a "private meeting," according to spokesman Eric Brown.

Brown also said the governor "regularly meets with business leaders and will continue to do so."

That's a good thing for both the governor and the state because Hickenlooper needs business on his side if he expects to accomplish anything during his term. That's a reality that escaped his predecessor Bill Ritter, whose governance was in marked contrast to Obama's and Hickenlooper's because it followed a national Democratic agenda rather than one crafted by him for Colorado.

Obama, a former community organizer, and Hickenlooper, an entrepreneur with a Democratic bent, have realized from the start of their political careers that government has to work with business for the common good of all citizens.

They realize, too, that neither liberals who like to shut out business interests from government, nor free-market conservatives who want government to stay out of business altogether, hold the proper respect for the joint venture that our society demands from both its public and private sectors.

Hickenlooper told reporters and economic development specialists after his Friday morning meeting with the CEOs that Ken Tuchman of Teletech Holdings Inc., one of those businessmen who attended, suggested to the group that the tightening economy over the past three years has made all their companies "better and stronger," in Hickenlooper's words.

Operating lean and mean will do that for a company, but as Obama suggested to the U.S. Chamber, the time for Colorado's big businesses to get off the sidelines and hire people is now. Let's hope our new governor pressed the same point with his C-level executive friends.

Eco-devo tour might get it right this time

Gov. Hick takes to the road today to do a little more of what his transition team started regarding Colorado's economic-development strategy.

So far, Hick has not named a director of the Office of Economic Development and International Trade, and to my mind that's a good thing. The last two governors did a poor job crafting a strategy for the office that actually accomplished something.

Which meant the state and its small businesses suffered for 12 years from a high-level lack of concern for the prosperity of Colorado's small-business owners. Small business, after all, generates the most jobs in our economy, and the state's interest in business owners who are job generators only makes sense.

That was not the strategy of the last two governors. Both Bill Owens, who thought a free market should allow small business to fend for itself, and Bill Ritter, who had a Democrat's instinct for stepping away from anything that smelled of the monied interests in Colorado, allowed the economic-development office to flounder.

I think both governors hoped the Denver Metro Chamber of Commerce and its own economic-development arm would cover their asses on the eco-devo front during their terms.

But the Denver chamber had its own problems of perception rooted in its sometimes blind following of big-business interests. It paid lip service to small business, but I think its leaders felt more comfortable, more powerful and more influential dealing with the bigs. They simply paid less attention to the smalls.

The Hickenlooper team's encore tour of statewide economic-development interests promises a broader approach our new governor calls "bottom-up."

Outstate eco-devo folks have learned from the past that the phrase might mean they are just in for another spanking. Here's hoping for more from the state's newest chief executive. 

Self-interest, a Republican earmark

Dick Wadhams, Colorado's cutthroat Republican chairman, says Tom Tancredo's third-party bid for governor is based in his own self-interest.

So what's new about that?

All Republican Party politics in Colorado is driven by the self-interests of its rich, establishmentarian membership. Conservative or not, Republicans in the state consistently argue for the least amount of government in order to preserve their privileged existence. Most of Colorado's executive business community also subscribes to that party line.

Check out the rising percentage of poor children in Colorado: 15 percent of all children in Colorado lived in poverty in 2008 compared with 10 percent in 2000. In 2008, they numbered about 179, 000 kids, said Lisa Piscopo of the Colorado Children's Campaign.

Guess who was in power for most of that time: a Republican governor who did nothing for Colorado's poor through 2006, and diminishing Republican majorities in the legislature, although a quartet of Democratic millionaires started to chip away at that power base late in 2004.

Limited government, which Republicans in Colorado hold up as one of their highest values, naturally limits the ability of the state to care for its poorest citizens, and naturally leads to lower and lower taxes that eventually starve the government of any sustenance at all.

That's the philosophy Republican Party leaders are trying to take to Colorado voters in November, and only the financially struggling Republican middle class are politically blind enough not to see that's what their party stands for.

Tancredo's run for governor will not only split the Republican vote in Colorado, it will cut down statewide voter turnout. Self-interested people don't go to the polls when they know there will be no victor to throw them their rightful share of the spoils.

End 30 years of anti-tax rhetoric

In Wednesday's newspaper, a Doonesbury character, Havoc, tries to convince an Afghan warlord to stop making money from the Taliban through the drug trade, and suggests the warlord tax his people instead.

"Taxes!" Havoc says. "That's it -- taxes!"

But the warlord responds glumly: "I don't believe in them. Reagan changed my life."

I laughed because the comic strip so fit my frame of mind chasing down an interview with Carol Hedges, right, senior fiscal analyst for the Colorado Fiscal Policy Institute, an organization that recently raised a minor ruckus on the ColoradoBiz website where the institute posted a piece it titled: "Maybe Colorado's taxes aren't so taxing after all."

In a comment stream, one of the magazine's conservative readers questioned the politics of the institute as hardly non-partisan, as it described itself, and questioned the magazine for not "calling out" the group as a "liberal think tank."

I asked Hedges whether her group was liberal or not, and she said she had taught her children that labeling people was intellectually lazy. "Do they mean that the organization ... [believes] that we have to have a strong public sector in order to support the private-sector activities of the market? Well, if that's what they mean by liberal call me a liberal, rock on, that's who we are," she said.

"But what I find so interesting is that I was at a presentation recently and somebody said that in Colorado we have a broad political spectrum: We have the far right that doesn't believe in government, and we have the far left who believe that government is the solution for everything.

"And I stopped that person," Hedges said. She asked, "Who would that be? Who is that far left that thinks government is the solution to everything? ... I don't think there is an organization in Colorado that that would be descriptive of, and I know it isn't a label that would be descriptive of our organization."

The Colorado Fiscal Policy Institute is a unit of the Colorado Center on Law and Policy, which describes itself as nonprofit and nonpartisan. The institute started about ten years ago, in Hedges' words, "to find justice and economic security for all Coloradans."

"We originally got started as a volunteer organization that was helping folks understand sort of the unique budget and fiscal constraints in Colorado, to help them do their advocacy work on behalf of families and economic justice, etc.," she said.

I was interested in the group after reading the ColoradoBiz piece because it seemed to be stating what is obvious to me but which never seems acceptable to conservative business interests in Colorado. Government services cost money, and people and businesses that pay taxes fund those operations, much like sales fund a business operation.

Taxes are the government's revenue stream; without them there would be no government. That's why the warlord's comment in the Doonesbury strip struck me as funny. Reagan was the American leader who turned the nation against being taxed for services government provides. Here's more from Hedges:

"We've had basically thirty years of anti-tax, anti-government rhetoric, which has been the predominant narrative in this country around how we support one another....

"We think that the public sector is important. We think it is the most efficient and accountable way to provide certain foundational services upon which people and businesses rely: education, transportation, higher education, to some extent health care. But we want a system, a public system, that is accountable, is effecient, is effective. We believe that the market economy can't work if we don't have a strong public partner to match up with the private sector."

"In Colorado," Hedges said, "our public officials are actually not the decision makers on this stuff. That's one of the most interesting things about Colorado, from my perspective. The decision makers on taxes are voters. And I think that the pendulum has swung so far on the anti-tax message, particularly as it relates to really large corporations, that voters are beginning to say: 'I do want higher ed, K-12, roads, clean air, clean water, access to the mountains when I want to get there. Is there somebody that's not paying their fair share?'"

"We're a think tank," Hedges said. "We do research, we do analysis.... As I said, it's been thirty years of anti-government rhetoric that we're combatting, and I think one of our big efforts ... is to help voters and to help citizens to connect up the benefits they get from private-sector and different public-sector investments.

"What did government do for you today? ... People don't think about things like: Well, they made sure my water was drinkable, and they inspected the restaurant where I grabbed my lunch to make sure everybody was concerned about my health. ... People generally don't think about government and education ... but it's what comes from your taxes."

That's the message Hedges' institute is going to be touting for the next year or so as Colorado voters try to dig themselves out of the fiscal hole the state has dug itself with tax-limiting state constitutional amendments like TABOR and three new proposed amendments that will go to voters in November. Hedges said her institute is not against TABOR, and would just as soon keep voters in charge of deciding how much they want to be taxed for government services.

"The real issue is," she said, "Are citizens willing to invest more in the public sector?"

Good roads, good schools and a good infrastructure for doing business in Colorado are the choices Colorado voters must address even beyond November elections. The state needs its voters and businesses to invest in themselves, to invest in Colorado. Its future is at stake.

Business needs a Broncos win

Colorado's business community needs a Broncos' win against the San Diego Chargers on Sunday.

I have learned since arriving in the state in 1988, the morale of Colorado business takes a cue from the success of the Denver Broncos, and I have come to believe that the success of all the state's professional sports teams seems to set a tone for the success of the entire state.

I know that sounds crazy, but give me a listen.

When I was the night city editor of the Denver Post, I would drive to work on Sundays at a time when those lucky enough to attend Broncos games had already found their parking spots at Mile High Stadium, and the rest of the city was already positioned in front of its TV sets.

Central Denver was hushed and quiet in the middle of the day, waiting the kickoff.

After a loss, on Monday's in the middle of the day, the city was almost as quiet and palpably depressed.

Then the Avalanche came to town and promptly won the city's first national professional sports title. The Broncos followed with two consecutive Super Bowl championships (it should have been three, but the Broncs were beaten by Jacksonville in the first year they also should have won the championship, which, with the next two wins, would have made history).

The Rockies made the playoffs early on and two years ago went to the World Series. The Nuggets made the playoffs several times since I have been in Colorado, but never with as strong a team as they have now, one with a realistic opportunity to take an NBA championship.

Yet it's the Broncos that still set the tone, and you could feel that already this year when they surprisingly won six games in a row as Colorado was feeling the first little urges of a national business recovery. Once again, the state was leading the nation and gathering praise for its growing alternative energy industry, school reform and even health-care delivery on the Western Slope.

Then the Broncos lost to Baltimore. Winter had come early. National unemployment hit 10 percent. Stimulus dollars were being reported to have hired way too many people than seemed realistic.

And the Broncos dropped two more, while the Chargers kept winning.

For some reason, the Broncos and other winning sports franchises in Colorado seem to inspire business and political leadership in the state. There's no objective proof for that, but the winning lifts a burden that winter's snow and cold often impose.

Colorado needs the Broncos to beat the Chargers at home to show the state's business and political communities that the team's improvement over the off-season wasn't just a mirage. And that the inklings of economic improvement in Colorado weren't just false positives.

When the state's professional sports teams are winning, Coloradans, their business leaders and their political leaders are energized. And right now, Colorado cannot afford to let its energy and leadership slip.

Business needs a Broncos win on Sunday.