Musical Interlude

I will return to society's collapse and fighting it soon, but sometimes one needs to lighten up.

For daily songs I had been doing ten songs per year for the '80s, running from 1980 through 1989, and paused from May 1st through July 11th, as discussed in two other posts.

https://sporkful.blogspot.com/2022/06/messy-and-mattering-mays-daily-songs.html

https://sporkful.blogspot.com/2022/07/black-music-month-pride-month.html

I just posted the last song from 1989 yesterday, but one thing I found with the songs from that year is I could really see the different trends that would be around in the 90s. There is more hip hop and dance, but also things that were heading toward alternative, and probably some things you could call neo-soul. I decided to do 1990 too. 

Often when I go over a daily song project I will list the songs by date at the end. In this case, that would be 120 songs, because 1984 was so notable for songs from soundtracks that I did ten songs from movies, and then ten not from movies.

I have listed more songs than that before, but I want to do something else instead.

Going over this, and getting some questions about our postponed 30 year class reunion, I started to think about a playlist that would encapsulate the class of 1990's time at Aloha High School. It was a three year school then, so going in the day after Labor Day, 1987, and coming out the second Sunday in June 1990, what were all of the number one songs for that time period?

I made that list. And then I didn't like it that much.

I mean, that's not surprising. I love a lot of songs that didn't really chart, and detest a few that did.

Amazingly, there is at least one song I have never heard, "Dirty Diana" by Michael Jackson. (There is a lot of Michael Jackson.) I have heard of the song, but having no memory of it I assumed it came earlier or later in time. No, it was right in the thick of things.

And Steve Winwood's "Roll With It" spent 4 weeks at number 1? Why?

I think it was a good musical time in general, though maybe not as good as 1984-1986, but yeah, not my favorites at number one.

I realize that questions of taste can become heated. If your musical taste is bad, it would be wrong of me to hold it against you.

So, for your own perusal, here are the Billboard Number One songs from September 7th, 1987 through June 10th, 1990

(I might make a playlist of the daily songs I chose from 1980 through 1990. Those were good.)

1987
“La Bamba” by Los Lobos
“I Just Can't Stop Loving You” by Michael Jackson
“Didn't We Almost Have It All” by Whitney Houston
“Here I Go Again” by Whitesnake
“Lost In Emotion” by Lisa Lisa & Cult Jam
“Bad” by Michael Jackson
“I Think We're Alone Now” by Tiffany
“Mony Mony (live)” by Billy Idol
“(I've Had)} The Time of My Life” by Bill Medley and Jennifer Warnes
“Heaven Is A Place On Earth” by Belinda Carlisle
“Faith” by George Michael

1988

(“Faith” by George Michael lasted into the new year)
”So Emotional” by Whitney Houston
“Got My Mind Set On You” by George Harrison
“The Way You Make Me Feel” by Michael Jackson
“Need You Tonight” by INXS
“Could've Been” by Tiffany
“Seasons Change” by Exposé
“Father Figure” by George Michael
“Never Gonna Give You Up” by Rick Astley
“Man in the Mirror” by Michael Jackson
“Get Outta My Dreams, Get Into My Car” by Billy Ocean
“Where Do Broken Hearts Go” by Whitney Houston
“Wishing Well” by Terence Trent D'Arby
“Anything For You” by Gloria Estefan and Miami Sound Machine
“One More Try” by George Michael
“Together Forever” by Rick Astley
“Foolish Beat” by Debbie Gibson
“Dirty Diana” by Michael Jackson
“The Flame” by Cheap Trick
“Hold On To the Nights” by Richard Marx
“Roll With It” by Steve Winwood
“Monkey” by George Michael
“Sweet Child O' Mine” by Guns N' Roses
“Don't Worry, Be Happy” by Bobby McFerrin
“Love Bites” by Def Leppard
“Red Red Wine” by UB40
“A Groovy Kind of Love” by Phil Collins
“Kokomo” by The Beach Boys
“Wild, Wild West” by The Escape Club
“Bad Medicine” by Bon Jovi
“Baby, I Love Your Way/Freebird Medley” by Will To Power
“Look Away” by Chicago
“Every Rose Has Its Thorn” by Poison

1989

(“Every Rose Has Its Thorn” by Poison lasted into the new year)
“My Prerogative” by Bobby Brown
“Two Hearts” by Phil Collins
“When I'm With You” by Sheriff
“Straight Up” by Paula Abdul
“Lost In Your Eyes” by Debbie Gibson
“The Living Years” by Mike + the Mechanics
“Eternal Flame” by The Bangles
“The Look” by Roxette
“She Drives Me Crazy” by Fine Young Cannibals
“Like A Prayer” by Madonna
“I'll Be There For You” by Bon Jovi
“Forever Your Girl” by Paula Abdul
“Rock On” by Michael Damian
“Wind Beneath My Wings” by Bette Midler
“I'll Be Loving You (Forever)” by New Kids on the Block
“Satisfied” by Richard Marx
“Baby Don't Forget My Number” by Milli Vanilli
“Good Thing” by Fine Young Cannibals
“If You Don't Know Me By Now” by Simply Red
“Toy Soldiers” by Martika
“Batdance” by Prince
“Right Here Waiting” by Richard Marx
“Cold Hearted” by Paula Abdul
“Hangin' Tough” by New Kids on the Block
“Don't Wanna Lose You” by Gloria Estefan
“Girl I'm Gonna Miss You” by Milli Vanilli
“Miss You Much” by Janet Jackson
“Listen To Your Heart” by Roxette
“When I See You Smile” by Band English
“Blame It On The Rain” by Milli Vanilli
“We Didn't Start the Fire” by Billy Joel
“Another Day in Paradise” by Phil Collins

1990 (through June 10th)

(“Another Day in Paradise” by Phil Collins lasted into the new year)
“How Am I Supposed To Live Without You” by Michael Bolton
“Opposites Attract” by Paula Abdul with The Wild Pair
“Escapade” by Janet Jackson
“Black Velvet” by Alannah Myles
“Love Will Lead You Back” by Taylor Dayne
“I'll Be Your Everything” by Tommy Page
“Nothing Compares 2 U” by Sinéad O'Connor
“Vogue” by Madonna
“Hold On” by Wilson Phillips

("It Must Have Been Love” by Roxette was the next number one for us new high school graduates.)

Falling apart: Global

There is one more factor driving call volume. 

It is not the one that gives us the most extra calls, but it has such a pronounced impact in other ways that addressing it is important.

Of course I am referring to global warming.

Medicaid programs frequently have a program attached for flexible funding. It can be used when there is something that would be helpful for health but is not a medical procedure. Perhaps the medical procedure you need is only done at a few locations, none of them close. Flexible funding could provide for travel. Perhaps eating healthy meals would be more possible with a small investment in cookware.

Usually those applications are filled out by doctors, who are familiar with the individual medical needs so can speak to the risks and benefits. However, offices are backed up, and for a seasonal need there is a good chance that the patient would not be able to get in on time.

That is why we are submitting the requests for assistance with air conditioning.

That is not ideal. We can't give a real medical reason. Sometimes they may mention a condition where heat would have an impact, but really, if they see that they can get assistance with air conditioning or purifying, of course that sounds good. They will call, and we will put the request in.

The obvious driver there is that we live in an area where the climate was once milder. Housing is not set up for the new reality, especially older housing. It does get hotter now, and less predictably. That affects comfort, ability to do other things, and yes, health.

It is perhaps less obvious that if we go back to the original staffing shortages caused by COVID, that climate change may play a role in the spread of new diseases.

It's not the only factor. Certainly as habitat loss causes humans and non-humans to come closer together, that increases the risk of zoonotic diseases spreading, and air pollution can have a profound effect on lung health even without a rise in overall temperature. The point is that environmental health and individual health are connected.

If the medical industry got short-staffed with COVID, what will happen when you add monkeypox and polio to the mix?

Last week when I was asking the wrapping up questions, like "is your sense of well-being wrapped up in other people not having their needs met in demonstration of the fact that you are worth more?"... that felt like I might be going a little too hard too early. It still seemed necessary.

This series sort of started with how unbearable my job is right now. I am just one person, but the factors that make my life difficult affect many others, and they are tied in with other factors that affect more people, with an influence that will continue to grow.

That sounds dire, but it doesn't have to be. We can make things better, if we decide to.

Please. Not just for me.

Staffing again: The Next Level

One factor driving call volume is that doctors' offices are overworked as well.

Members call because they need to change their primary care provider when the assigned one can't get them in until November. Maybe they got a referral to a specialist, but the specialist can't get them in.

I can't say that the only issue is a doctor shortage. When COVID first hit, many non-emergency surgeries were postponed, partly for safety and partly because hospitals were full. There could be some residual backlog from that. Once a backlog starts it is hard to get out.

However, we have also lost doctors and nurses to COVID. Some have died, some may now be disabled, and some are just burnt out.

I believe I made it pretty clear in the last post that I support universal health care. That doesn't need to be Medicare for all (there are ways in which Medicaid for all might be better), but there should be something.

However, we could probably change that structure far faster than we can change the amount of health care providers out there, and we will need more. 

I referred in an earlier post to the two months required for training for my job, but also then the time and experience required before you become adept. That affects the ability to make change.

What if the training takes eight years? (Depending on how you count it.)

What if that training is becoming more and more financially inaccessible?

Astronomical debt may increase stress in a way that contributes to burnout, but that's assuming someone still takes it on. How many people who would make great doctors are just deciding that it's out of reach?

The current system has its flaws; there can be some really good arguments for a training process that requires less sleep deprivation and substance abuse and the complete takeover of one's life. Changes that make the process better for the learners won't necessarily get them through faster.

Even Navy corpsman training takes fourteen weeks.

There are things we can do. 

College used to be a lot more affordable, and we should get back to that. It still takes time.

You have probably seen nurse practitioners and physician assistants doing more. That can be helpful.

We might be able to do a crash course, where lots of people take something similar to the corpsman training, and then work in association with medical doctors. Locating candidates, setting up training, and arranging places for them to practice also requires work.

Infrastructure isn't just roads and power lines. 

There is a lot that goes into a functioning society, but the giant first step is deciding priorities.

Do we want people to be well? When you're sick, do you want to be able to get care? When your mother falls, do you want her to have wait a few hours to be treated? 

For people you don't know, can you believe that they should also be able to receive medical care?

If not, is your sense of well-being wrapped up in other people not having their needs met in demonstration of the fact that you are worth more?

And just in case I have not spelled out enough complications, there is one more thing driving calls.

Falling apart: Systemic

One of the bad moments with this current job was when I realized that it is sucking the life out of me at a level similar to taking care of my mother did toward the end. The levels of mental beating down, the wearing on executive function, and the overall tiredness are similar.

This job definitely pays better, but the compensation with the care giving is that I knew what I was doing was important and necessary, at least based on the resources we had.

That is less clear in this case.

I provide phone support for a few different health plans. Two of them are Medicaid programs; the rest are Medicare supplements. That means that our members are on these plans due to disability, poverty, or old age, often with a certain vulnerability.

I understand the necessity of my job in that navigating health care can be confusing and require assistance. I can't help but know how much of that is because we make it hard to get health care. The  obstacles are put there to save money, prioritizing money over health.

That is not necessary.

When we are talking the worker shortage, understand that it requires thousands of people to administer insurance. We have built an entire industry around limiting health care, and then helping people navigate those limits.

Those are the people working for the insurance companies, definitely, but also the government employees trying to work out the alternatives need when medical care is tied to employment. It requires a whole field of people who are capable of translating medical reports into correctly coded claims that have a chance of being paid, then another field of people checking those claims for errors that can potentially result in non-payment.

I do not only talk to our members; I also talk to people checking the status of claims, or complaining about rejected claims or trying to understand them and get them corrected.

A large portion of these callers are based in call centers in India. While they are often very friendly and professional, the language barriers and the general complication of medical claims and insufficient training results in lengthy calls, where I may answer the exact same string of questions for every claim for the same member, then do it all over again for a different member.

This is not efficient! 

I mean, if they are paid cheaply enough it might be cost-efficient (though probably exploitative), but that is a big part of my volume increase, and it's hard to feel like it is benefiting anyone.

Placing obstacles to health care means some won't get it. It's not even always something where the plan says "NO', but there is an error in the navigation. 

More than once, I have had someone tell me that I saved their life. That was usually just sending an e-mail, but they needed someone to do it, and it hadn't been done yet.

The lie of capitalism is that through competition eventually there will be better results for everyone. 

That might have been more true when unions and protective legislation were strong, but we are past that now. I am not even proposing capitalism or socialism as the answer, at least not in the Marxist sense, for various reasons, but the preeminence of capitalism needs to be challenged.

I know that people are more important than profits. That makes an already difficult job -- and certainly not the highest in profits because of my specific area -- more difficult.

But I stay, because I need income.

"Essentially we all live in the same country, called capitalism." -- Bong Joon Ho

There are two specific things driving call volume that leads to even worse issues, so count on at least one more post.

Falling apart: Inter-organizational

I may be the only one really struggling with the call volume (I suspect I am not), but there is no question that the call volume is higher. 

Rather, I should specify that there is a combination of more calls coming in and fewer people to answer those calls. The increase is in both total call volume and the quantity of calls fielded by individual agents as our number decreases.

I was in a situation once (not a call center), where there was a lot of attrition, but due to automation and other factors, it did not increase the work load for anyone. That is not happening here.

I was on the team that helped determine the requirements for the automation process. As the volume kept declining and I got laid off, I could "joke" that I efficiently put myself out of a job. 

I would love to have some ideas for how to do that now.

There are a few factors driving the increase in total calls, but focusing first on the diminished work force, I think we have to look at COVID.

The obvious beginning is looking at deaths during the pandemic, and how that reduced the workforce. There are people who will tell you that it was only the elderly, and that they weren't working. Not only is that not true, but it also overlooks how some of those elderly may have been childcare providers, either for family members or in other settings. 

Child care is a serious factor in the ability of parents to work.

It may be less obvious but still in mind to consider those who have long COVID symptoms. Some of the people entering and exiting the work force may be exiting because they find that they cannot keep up. 

I have thought of that, but a recent thread that I read got me thinking more about people working through those symptoms. I am angry at myself for not bookmarking this thread, because I can't find it now. However, it pointed out that on any given day, there will probably be some people out sick, but also some people working through brain fog.

A lot of the volume that I deal with comes from human error. 

It's not always on our side; I may be talking to someone who has incomplete notes from a coworker, or they took down incorrect information.

Sometimes, though, someone is calling back, and as I check the details from previous calls I will notice something that was not previously noticed that is pertinent and wholly changes what needs to be done.

That is not necessarily due to brain fog either. We have a lot of newer people. I am unusually good in general about sussing out details and spotting inconsistencies, but I am better at it after a few months of looking at things. Medical claims are complex. If I spot something that someone much newer on the phones missed, that is not surprising. Even knowing where to look to see what you might miss takes time.

It's harder if they are dealing with brain fog, and if the reason they are newer is because we lost someone else to brain fog (or death), it becomes more of a web than a cycle. 

Webs are sticky.

That is not even taking into account the one relatively good result of the pandemic, in that employee shortages have increased wages. If someone finds that they can't do this job, the odds of them finding something else they can live on have increased.

(Bank of America and former Treasury Secretary Lawrence Summers have some thoughts about this, as do I, but not right now.)

As it is, I am receiving more calls lately from people just checking to make sure certain faxes have been received. For this particular process, the total review is two weeks, so they know that won't have happened yet, but they don't trust it to have gotten in at all. There is a lack of confidence, whether it is on their side, ours, or the reliability of faxing.

We can keep hiring people away from other jobs, and we can keep losing people to still other jobs, but is this effective? Is it productive? Is it good?

And is it all related to another problem entirely?

Related links:

https://www.latimes.com/business/story/2022-06-23/column-do-we-need-to-raise-unemployment-no-we-need-to-protect-jobs

https://theintercept.com/2022/07/29/bank-of-america-worker-conditions-worse/