Back in June 2014, I submitted a claim to Aetna for services from health care providers. The providers in question are among the increasing number who bill their patients for services, then have their patients submit receipts to their health insurance provider.(This is in the USA, by the way. You can tell that it doesn’t involve a single-payer system.)

The expectation is that the insurers reimburse the insured. At least, that was my expectation. I think that it is also Aetna’s expectation and intention. But, seven months and many phone calls and electronic messages later, I have yet to receive the bulk of the reimbursement. I did receive one check, but that was for less than 10% of the amount due.

I think that this is due to incompetence on the part of Aetna. The many employees I talked with on the phone seemed sincere in their wish to help me. They also seemed to be having difficulty getting the relevant information from their information systems. That’s why I suspect that it is organizational, rather than individual, incompetence.

Could it be an attempt by Aetna to avoid paying? I don’t think so. Aetna has not argued that it is not liable to pay for the particular services for which I sent the receipts. I think that Hanlon’s razor is applicable here: “Never attribute to malice that which is adequately explained by stupidity.”

Aetna claim that a check was sent to a previous address, even though a new and accurate address was on file. I believe that. I requested a stop of that check, and the issue and sending of a new check. Aetna said yes.

We now seem to be in a cycle.

  • I ask Aetna where the check is, since I should have received it by now.
  • Aetna tells me that the previous check wasn’t stopped, and that a new check wasn’t cut.
  • Aetna tells me that the previous check will be stopped, and that a new check will be cut.
  • Time passes.
  • Back to start of cycle.

I decided to try to find a senior Aetna executive whose part of the organization deals with paying claims. I think that person is Meg McCarthy, Exec VP, Operations & Technology. I tried to find her email address. I did not succeed, although I did find out about many awards and media appearances, and that her annual compensation exceeds $4M (that’s four million US dollars).

Any ideas on how to get Aetna to actually cut and send the check? I’m getting so desperate, I may resort to writing a letter on paper and sending it to Ms McCarthy, in the hope that she or someone who can actually get something done in Aetna sees it. Thank you for reading, anyway.

A poem inspired by the tabletop game Harbour.

Gullsbottom is a harbor town.
I’ll tell you of it, mate:
The leading occupations there
Are crime and real estate.

Why do you ask? You’re moving there?
Crime’s not for you, you think?
You’d like to talk of property?
You’re paying for the drinks?

Don’t flash your cash in Gullsbottom—
Unless you want to float
In harbour deep, with money gone,
And slash across your throat.

How do you buy your buildings
Using neither coins nor notes?
You sell goods from your warehouse,
Which are loaded onto boats.

The money gained by selling goods
Buys buildings the same moment;
So you don’t have to carry cash
To be violently stolen.

When goods are sold, the prices change:
The goods just sold go down.
And that may inconvenience
Your rivals in the town.

You’ll start with just a few goods.
You will visit various buildings.
With swift and shrewd and simple moves
Your warehouse you’ll be filling.

So it’s all about the buildings:
You will use them to get goods;
Which you ship to buy the buildings,
To be big boss of the ‘hood…

Which you’ll be when your collection
Of bought buildings is the best;
And I’m certain that your actions
Will be smarter than the rest.

You say it’s time you must set off
Toward your new abode?
Gullsbottom bound you are now?
Let’s have one more for the road!

The Kickstarter Ecosystem

January 22, 2015

Kickstarter is a crowdfunding platform: an internet service that enables the funding of projects by bringing together the creators of those projects with backers, who provide the money to fund the projects. The typical successful project has many backers (hence the term crowdfunding), each of whom receives a reward. (This note on the Kickstarter Ecosystem is also available as a single-sheet PDF, which includes three figures and one table.)

One particularly successful project, the COOLEST cooler, attracted over 60,000 backers and over $13M (yes, that’s thirteen million dollars, US). Over $50,000 of those backers chose as their reward one cooler delivered within the USA, at a cost of $200 ($185, plus $15 shipping). Shipping made the cost higher for the over 7,000 backers who had a cooler delivered to a country other than the USA. Other backers chose more modest rewards, such as a COOLEST party cup and blended drink book for $25. The most expensive reward cost $2,000, and included a visit from the project creator.

The COOLEST example illustrates two essential and specific flows between creators and backers. First, payment flows from backers to creators. Currently, Kickstarter directs backers to an Amazon online payment service. It will soon migrate to the Stripe service.

The second process, fulfillment, includes the packing, transport, and delivery of rewards to backers. Kickstarter leaves the fulfillment decision to project creators.

KickstarterEcoSysKickstarter, then, is not only a web site: it is also an ecosystem, including online services, logistics providers, and other creatures. The figure illustrates this ecosystem. (In the PDF, it is Figure 3, and the relationship between Kickstarter and specific social media is illustrated in Table 1.)

One of the advantages of crowdfunding for the project creator is that backers have incentives to recruit further backers. If a project does not achieve its funding goal, backers do not get their rewards (and neither do they make their payments). Some projects are structured so that this incentive persists even after the funding goal has been met. Creators may specify stretch goals: specific funding targets above the initial goal, with rewards improving as each stretch goal is met. This is an economic incentive for backers to recruit. There may also be a social incentive: backers may feel that their friends would like to know about the opportunity to fund the project, and to receive a reward for doing so.

Backers and creators often use social media to tell prospective backers about projects. Facebook and Twitter fit here, since they are so widely used. Other social media have a narrower focus, and are important within specific niches of the Kickstarter ecosystem.

Tabletop games provide an example of a niche, and of the categorization of Kickstarter projects. A creator may place a project in one of a number (currently fifteen) of broad categories, some of which have subcategories. For example, the Games category has two subcategories: Tabletop and Video.

Tabletop games include board games and card games. Such games are the focus of BoardGameGeek. If the purpose of a project is to fund a new board game, the project’s creator is likely to be active on BoardGameGeek, as well as on Facebook, Twitter, and Kickstarter itself.

Finally, the exhibit shows that there are other Kickstarter complements, besides those already discussed. One example is Kicktraq, which takes data from Kickstarter projects and generates charts and other material of interest to creators and to others who use or watch Kickstarter.

I welcome comments, especially suggestions for improvement on this version of this note on Kickstarter. I am thinking of expanding on other Kickstarter complements. I stopped writing here because the PDF/Word version just fits on to one (double-sided) sheet of paper, but that’s a rather arbitrary limit.

Monument Valley Fever

January 21, 2015

ScreenshotI can’t remember where I found out about Monument Valley (“adventure of impossible architecture and forgiveness”) but I do know that it has been played a lot in our house since I bought it a week or so ago. Yesterday evening I couldn’t play, or read the ebook I wanted to, because each kid had claimed one of our two iPads.

The image is a screenshot from the second “chapter” of MV. The game encourages screenshots. I presume that’s so that people will take and share them; it seems to have worked on me.

Princess Ida, in white, needs to step on to the button in the center near the top. Some of the path (the darker part) can be turned using the handle. But that part of the path seems to have risen far above Ida as a result of the last button she stepped on to. What’s a Princess to do in order to get to the next lovely set of puzzles?

The base game consists of ten (X) chapters. My favorite is The Box (XIII), which I can’t describe without spoiling. Then Forgotten Shores adds eight (viii) appendices. That’s eighteen (X + viii) levels, each with its own look and theme. While I love MV, I understand that some people prefer longer, tougher games. I don’t understand the people who trashed Forgotten Shores because it cost money ($2).

As you journey through the levels you see and inhabit different environments, find new ways of changing those environments, encounter black crows and have the princess in white interact with them in various ways. You may well feel, as I did, that the game-makers want to you overcome the challenges, without making too many of them too easy for you, and that the main reward is entering and experiencing the next environment.

Congratulations on Monument Valley to ustwogames, who recently posted some interesting numbers about the game: sales of over $5M; development costs, substantial but far lower; and so on. Michelle Starr at CNET contrasted Monument Valley’s pricing with the freemium model: I for one am glad that I never saw ads in Monument Valley.

Haiku for January 2005

January 8, 2015

Colors! New year’s dawn?
No, return of last pizza
From 2014.

The haiku describes the my first waking minutes of 2015. No, I didn’t celebrate the new year wildly I didn’t even stay up to see in 2015.

I’m pretty sure that I had a viral infection. It probably wasn’t flu: I had a flu shot a month or two ago. It probably wasn’t the pizza that made me sick: none of my partners in pizza were sick that night. However, some have been ill subsequently, in a manner compatible with the virus hypothesis.

I just ate cheese for the first time this year, having avoided it since the incident described in the haiku. Some time later this month. I’ll be ready to eat pizza again, and then to make my first batch of pizza of the year.

February will see at least one haiku from me. It will also see another new year: the year of the goat, or sheep, will start on February 19.

I hope that the new year is a happy and healthy one for you.

The Christmas on Fire

December 29, 2014

Christmas tradition in the country of my birth includes setting food on fire. The country in question is the United Kingdom, and the food is Christmas pudding. The pudding comes after the main course, which often involves turkey roasted in the oven.

Our main course yesterday was lamb. To be more specific, I used Alton Brown’s Silence of the Leg O’ Lamb recipe. I bought a six-pound leg (without the shank), already boned, rolled, and tied. I made the lovely paste of garlic, mint leaves, mustard, and so on and smeared it on the leg.I fired up the grill, emptying the drip tray first.

When the grill’s built-in thermometer read 500 F, I put in the lamb, in such a way that it was not over a flame. I flipped it a little over 20 minutes later. It looked a little more charred that I’d expected, but things seem to be going well. I went inside to the kitchen to tend to other dishes, such as mashed potatoes, and a simple but successful combination of snow peas, bacon, and white wine.

I was summoned from the kitchen with the news that the grill required my attention. There was a rather impressive fire, originating from the drip tray. No photos or videos were taken; I’m not sure whether that’s good new or bad news.

From this point on, the story becomes happier, if less exciting. I turned off the gas. The fire went out. I emptied the drip tray again. I turned the gas back on. I served the lamb a little later than intended, with the exterior rather more charred than intended. But the inside was tasty, much of it pink. The main course was not followed by Christmas pudding, or by any further fire.

I hope that you have eaten well this holiday season, and that you have been safe from fire and other hazards.

Books: To E- or not to E-?

December 14, 2014

16019808532_3c6a940a6c_oI love books, and am getting used to the idea that a book isn’t necessarily a physical object. These days, I buy more books made of electrons than books made of dead trees.

The photo shows the first three books in Lemony Snicket’s current series, All the Wrong Questions. Each is in different form.

  1. Who Could That Be at This Hour? I have in hardback. I’d been meaning to try out the series for a while. I bought this particular edition because it was only $4 at a book fair at my kids’s school. Reading it made me want more books in the series, preferably in dead tree form. Although this is not a long book, this is a pleasingly chunky volume, with apt illustrations by Seth.
  2. When Did You See Her Last? I have in paperback. I bought it from Amazon, where the paperback edition was $7, and the Kindle edition only 35c cheaper. Still I wanted more.
  3. Shouldn’t You Be in School? I have as an ebook: on Kindle, to be specific. That edition was only $2 when I bought it (it now, a couple of weeks later, $4). I did have some concerns that the illustrations wouldn’t work as well on a tablet’s screen, but the cover and other illustrations show pretty well, I think.

As you can see, price sways me toward ebooks, but a lower ebook price doesn’t always defeat dead trees. But sometimes time defeats dead trees: a download takes seconds, rather than the hours or days involved in dead tree pickup or delivery. Sometimes ebooks win because they don’t take up shelf space, or gather dust.

How do you make the decisions between the ebooks and dead tree books?