Good morning/afternoon all.
I woke up with a bit of a headache, various pains in my joints (spine seems to be the worse today, but only slightly worse than my left hip) and a stuffy nose. Like every other day, my abdomenal region was distended and I experience a vague sense of discomfort. The palms of hands have broken out with odd little bumps which itch interminably, and only give me relief while I sleep. I will not eat any solid food until this evening because once I do I’ll feel nauseated, my abdomen will swell even larger, and I’ll be forced to retire to bed. I take a gaggle of medications, all of which are palliative in that they treat only my underlying symptoms, and not my underlying condition, for which no medical doctors have been able to provide me with a conclusive diagnosis.
I’ve been to specialists in gastroenterology, immunology, functional disorders, rheumatology and even rare genetic diseases. I’ve been seen by doctors at the Mayo Clinic and participated in protocols at the NIH (National Institutes of Health). I’ve had my gall bladder removed and so many colonoscopies and endoscopies, Cat scans, MRI’s and other even stranger procedures involving irradiated substances, dyes, DNA tests, etc. that I’ve lost count. No one understands my condition or its cause. All who have seen me agree, however, that my condition made it impossible for me to continue to work as an attorney.
Yet, back in 2000, a doctor employed by my disability insurance carrier, after looking over the already numerous medical reports from the various doctors I had seen (this was pre-Mayo Clinic and NIH, but I’d already seen over a dozen different specialists), concluded, without once having examined me, that whatever my condition was, he did not consider it disabling, and so the insurance carrier, from which my law firm purchased its group disability policy, was able to deny my claim for disability benefits.
You see, that doctor, was paid on a contract basis by the disability carrier. He must have known that his compensation and continued employment depended upon him finding that X number of claimants were not disabled. So, in my case, he latched on to a comment in one report from one specialist I had seen, which he felt supported his position that I was not disabled. My law firm and I took the insurance company to court, where the judge agreed with us that under normal standards of proof I had a case, but since this was a special employee benefit plan created under ERISA in which the insurance carrier acted as the trustee for my disability plan. As trustee, all they had to do to show that they had wrongly denied my claim was prove that they had not acted arbitrarily and capriciously, a standard of proof so low, that short of a smoking gun memo to the insurance company’s doctor directing him to deny my claim no matter what my condition, I was bound to lose. As I did.
The judge in my case ruled that his hands were tied. Since the insurance carrier had my case reviewed by a medical professional, and he had concluded that I was not disabled, the company had not acted arbitrarily and capriciously. My lawsuit was dismissed.
The insurance company doctor didn’t have to understand my condition, nor did he even make the attempt to do so. Nor did the insurance company even try to understand my situation. That wasn’t their objective. Their objective was to maximize profits, and to do that they had to minimize payouts to disability claimants, like myself. It was a rigged game, one in which Congress had colluded with the Insurance industry when it established the ERISA framework for employee benefit plans. Too bad for me. My result was, in one sense pre-determined. Absent a condition that no one in their right mind could deny created a disability (say, becoming a paraplegic, for example, or a severe stroke, etc.) I was screwed.
So why am I discussing what is old history for me now? Why am I dredging up this unpleasant memory from my past? Well, it’s not to complain about insurance companies and the way they have emasculated patient’s rights (though I’m sure that would make an interesting and valuable blog post in and of itself). No, my purpose today is to use my story as a metaphor.
Follow me below the fold and I’ll do my best to explain what I mean.
You see, the key to my story is literally the word I chose for the title of this little essay: understanding.
Understanding something, whether it’s someone’s medical condition, or a national security issue such as the threat posed to our country by terrorism, is hard work. It requires approaching the situation with an open mind, with no predetermined biases or prejudices about what you might discover once you dive in. It means that you have to look at all the information provided to you, and then analyze that information carefully, checking and re-checking each source for that bit of data for credibility and reliability. It requires listening to opposing viewpoints about the value of the information available to you. It means taking the time to assess the situation, and not jumping to early or easy conclusions. It especially requires you to listen most attentively to those who know more about the problems or issues involved than you do.
Bush went to war in Iraq because of a fundamental failure to understand what we would be getting ourselves into after we deposed Saddam Hussein. Indeed, the neoconservatives at the Pentagon and in Vice president Cheney’s office, who controlled the policy’s formulation and implementation, were woefully lacking in their efforts to understand the region, the people, the true threat posed by Iraq and even the goals they hoped to accomplish. It’s not like they didn’t have lots of information available to them.
They were told by the CIA, other foreign intelligence agencies, and even Colin Powell, that Saddam was contained and not a threat to the United states or its neighbors.
They were advised by intelligence reports that any connection between Osama bin Laden’s Al Qaeda network and the Iraqi government were tenuous at best, and that Saddam’s government had not been involved in the 9/11 attacks.
They were warned by General Shinseki, then head of the Joints Chiefs of Staff, that any invasion and occupation of Iraq would require many hundreds of thousands of troops more that they were planning to deploy in order to adequately secure the country post-invasion.
The State Department’s own working groups on Iraq prepared an extensive plan for the occupation phase of the Operation Iraqi Freedom called the “Future of Iraq Project”, which, in over 1200 pages, spelled out in great detail many of the problems which could be (and in fact were) encountered after deposing Saddam’s regime and occupying the country.
Yet despite this great mass of information that was available to the Bush administration we recently discovered that our President, the man who made the decision to invade Iraq, didn’t even know there were two sects of Islam, Sunni and Shi’a, antagonistic to one another, and that large populations of both co-existed uneasily in Iraq. He didn’t know this, rather fundamental and essential fact, because understanding, in general, was not a prerequisite to making the decision that led to war.
Understanding the situation on the ground in Iraq regarding the various animosities between Arab and Kurd, Sunni and Shi’ite, tribe vs., tribe, was not considered important. Understanding the history of Britain’s past occupation of the region following World War I, which resulted in a bloody and prolonged insurgency was not considered relevant.
Understanding the consequences on the region of destroying Saddam’s regime, and how this might empower and embolden a more militant Iran, was never on the neocons radar screen.
You see, Bush and the Neocons upon which he relies have never seen understanding as a key goal. Indeed, they have deliberately ignored the warnings and predictions of experts and critics. Understanding was seen by them as something for wimps. Real men know what they want and they go out and get it. The process of understanding the problem or issue which confronts them only gets in their way.
So, you see, this was why the intelligence was fixed around the policy. Much like my insurance company, they knew what their goal was, and they didn’t want or need to understand the situation before making their decision. What they needed were justifications for going ahead and doing what they wanted to all along. And that’s exactly what they got.
Now in the case of my disability insurance carrier, the only persons who were affected by the company’s refusal to understand my situation and honestly evaluate my disability claim were the members of my family and I.
But the people who were affected by President Bush’s failure, and the failure of his advisors and policy makers, to understand the situation in Iraq before going in with guns, bombs and missiles blazing are thousands of dead and wounded, Iraqis and Americans alike, the millions made homeless or suffering from the prolonged stress of a bloody and ever more violent conflict, and the future safety and security of the entire Western world, Europe and America, both, from the increased rage and hatred directed toward all of us by ordinary Muslims, whether in the Middle East or in our own societies.
And it seems likely that Bush is about to repeat the very same mistakes he made regarding Iraq with respect to Iran. Once again he is preparing to go to war with another Middle Eastern, oil rich country without understanding their culture, their politics, or the likely consequences that will flow from any such attack.
That is what happens when you refuse to understand the world in which you live. You keep repeating the same mistakes you’ve made before. And, in Bush’s case, his continued refusal to understand the world in which he “decides” what America should do next is increasingly dangerous to us all.
Denial of Disability Claims under ERISA
Bush administration’s Foreign Policy