“That’s Covered By Our Insurance?” “Correct.”


Here’s an excerpt of a recorded telephone conversation between David Cienfuegos’s wife and a rep from Anthem Blue Cross (“Howard”) prior to a surgery that Cienfuegos underwent:

Wife: So how can I find out if the doctor we’re working with is contracting with Anthem?

Howard: If you know the doctor’s name, I can look them up for you.

Wife: The doctor who is doing the procedure … is Dr. Werthman, W-e-r-t-h-m-a-n.

Howard: Philip?… Yes, that doctor is in-network.

Wife: Oh, OK. So when I submit my claim form, that goes towards the in-network deductible?

Howard: Correct…. That is correct.

Wife: I just wanted to then confirm that the procedure, veri — I’m sorry, what was it called again? I know I gave you the name.

Howard: Uh, varicocele. I am not quite sure how you pronounce it.

Wife: Varicocele. That’s covered by our insurance?

Howard: Correct.

You’ve probably guessed the punchline already: After the surgery, Anthem denied Cienfuegos’s claim, saying his doctor was out of network and the procedure wasn’t covered. This is the kind of innovation and cost-cutting efficiency that makes it so important to keep private insurers at the core of our health care system.

DOES IT FEEL LIKE POLITICS IS AT A BREAKING POINT?

Headshot of Editor in Chief of Mother Jones, Clara Jeffery

It sure feels that way to me, and here at Mother Jones, we’ve been thinking a lot about what journalism needs to do differently, and how we can have the biggest impact.

We kept coming back to one word: corruption. Democracy and the rule of law being undermined by those with wealth and power for their own gain. So we're launching an ambitious Mother Jones Corruption Project to do deep, time-intensive reporting on systemic corruption, and asking the MoJo community to help crowdfund it.

We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We want to dig into the forces and decisions that have allowed massive conflicts of interest, influence peddling, and win-at-all-costs politics to flourish.

It's unlike anything we've done, and we have seed funding to get started, but we're looking to raise $500,000 from readers by July when we'll be making key budgeting decisions—and the more resources we have by then, the deeper we can dig. If our plan sounds good to you, please help kickstart it with a tax-deductible donation today.

Thanks for reading—whether or not you can pitch in today, or ever, I'm glad you're with us.

Signed by Clara Jeffery

Clara Jeffery, Editor-in-Chief

We Recommend

Latest

Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate

Share your feedback: We’re planning to launch a new version of the comments section. Help us test it.