Australian for "customer service"

Web site says for specific information, please download this brochure. Brochure says for specific information, please consult the web site.

Toll-free number says "we are currently closed. If you need assistance, please see our web site." Web site says "If you need assistance, please call our toll-free number."

In the United States, you will be asked to navigate an answering machine tree, and possibly be put on hold each step of the way before being told to contact another department, explain your problem again, and be put on hold again. In Australia, you will likely reach a customer service agent in another country who will have virtually no sense of how to solve your problem, and once they consult their computer prompts or supervisor, you will be told that you'll need to call back during business hours.

Business front

You've walked by a restaurant a few times and you've never seen anyone in it. But the menu looks good, the place is clean, and it looks like they've spent a fair amount of money making the place look nice. You wonder how long they could stay in business without customers. So you take a chance.

Your food comes, and it seems decent enough, but your order is wrong. The woman who seated you is counting receipts, but it seems odd there could be so many receipts when there have been no customers. Her appearance is such that you imagine she might have been in the world's oldest profession before getting into the restaurant business. A second woman says she will correct your order, and explains that there's a new cook. Does this mean they have had more than one cook and yet you've never seen a customer there? Things start seeming a bit more odd, and the second woman also seems that she has potentially worked in the world's oldest profession.

Your order is corrected, the food is ok, but as you are getting ready to pay, at the counter one woman is berating another for having not cleaned the toilets. The woman being berated has limited English, and is trying to clarify the multitude of tasks she's been ordered to perform. They are not kind to her. You begin to suspect that maybe the primary business of this restaurant is not serving food, but perhaps a front for human trafficking or money laundering. Yeah - I have a vivid imagination. And there are a lot of odd store fronts in the Sydney suburbs - businesses that never seem to have any customers, but somehow keep the lights on.

Sydney hostage situation news coverage

The news coverage of the hostage situation in Sydney was similar to what coverage would occur in the US with a few exceptions:

• An event of this scope would create frequent television program interruptions as the story developed, but not non-stop coverage as ABC (Australian Broadcasting Corp) did - except perhaps on a local level (within the city in which it occurred).
• There were a few news bulletins about coverage of the event in other parts of the world, and expressions of concern from other world leaders. In the US, how a domestic event is portrayed in other countries is virtually never shown in US media, and there is rarely any publicity about expressions voiced by other world leaders (unless related to international relations). Of course, the United States is known for being insular and oblivious to the sentiments of other nations. But from the perspective of an American in Australia, the portrayal of the news and concern of other national leaders seemed aimed towards a sentiment of "you're not alone down there; the world knows you exist." That same sentiment, if it were expressed towards the US would seem odd. Of course, after 9/11, a much larger event, it was expressed that the US had global sympathy - but that sympathy was soon squandered. I do not recall any international commentary publicized after the Boston Marathon bombing, other than that the Russians had warned the US regarding the perpetrators.

Thanksgiving - again.

Two years in, I'm going to repeat myself. Halloween sort of works in Sydney, even if it's out of context. Thanksgiving? Forget it. Australia should never even consider adopting another continent's holiday that falls at the wrong time of the year for celebrating harvest.

And while we're winding up for the Christmas season (unlike the US government, Australia's has more historical ties to the Anglican Church) - I've got nothing against Australians celebrating their religious holiday in the middle of the summer. What disturbs me though, is adopting winter solstice trappings for what is locally a summer solstice event (and they poke fun at POMs?!).

Australia seems only to have recently come to its senses in terms of locally appropriate celebrations surrounding winter solstice (you know - when it's cold and the days are short). Sydney's Festival of Lights is a fine beginning for what should be a season of holidays in the Southern Hemisphere, to brighten spirits on those dark days. Oh sure, I'm a newcomer here - Australia is going to do whatever the hell it wants. But my contribution to this cultural stew is to urge more locally appropriate holidays - holidays or celebrations that fit with local harvests and the solstices as they are locally experienced; not based on the opposite side of the planet. Stand up, Australia!

Sharks and bears

Yesterday, I was swimming at Bronte - two coves over. The water was wonderful. What's most amusing about the article below is Australians seem to have the same attitude towards sharks as hikers of the Appalachian trail have towards bears. They launched jetskis to shoo the shark away, and everyone was back in the water 35 minutes later. At Bronte, there were a fair number of bluebottles on the beach (aka Portugese Man of War), but I didn't see any in the water. They were also having a lifesaving club event, with about 30 participants swimming a fair distance out from the beach, with plenty of chaperones on boards. Third Shark sighting at Bondi

Guns, butter, freedom

The U.S. citizens who proudly wave around firearms as "their right!" are the same citizens who are proud that their country produces some of the finest jet fighters in the world. Their rhetoric is that they need these firearms to protect themselves against tyrannical government - as if the Queen of England might on a whim rummage through some old stockpiles and find redcoats with muskets to send to their door. They know in their hearts that their pea-shooters are irrelevant against a government with jet fighters and cruise missiles.

What they really won't say out loud is their fear is really of their neighbor, or the people in the neighborhood up the street, or across town; or of mob rule. Some of these people have never lived without the fear that the people in the other neighborhood will some day rise up and knock on their door, or fear that the country is filled with criminals just waiting for the right moment to take them out. So they can't possibly understand that "freedom" means more than needing to carry a firearm - that there might actually be freedom from the constant fear of whatever might be lurking outside ones doorstep.

These people will proclaim that they have the best democracy on earth, and their freedom to wave around a firearm is proof of it. Never mind that every evening their televisions bring them video examples of the worst governments on earth; scenes of people waving around firearms triumphantly because they have vanquished their neighbors. How alien is the notion that if democracy were truly successful, people wouldn't need firearms to protect themselves from their neighbors or the government; that the whole notion is that a compromise would have been reached towards democratic rules everyone could live with? And the government - which they elected is the one which they greatly fear? Again, it's the government their neighbors elected they fear - not the one they've happily bestowed with paramilitary equipment.

They might rationalize that the constitution doesn't guarantee happiness, it only allows for the pursuit of happiness. Yet could it not be possible for a democracy to create rules where, at the very least, firearms are not required to maintain the social fabric? There are a fair number of people who highly romanticize the frontier town; the old gunslinger who saves the town from the bully. They don't see themselves as the bully with the gun; they wait for the day they get to play hero. And they have no notion that perhaps by waving around their firearm, it just might be that they are the ones being the bully.

Proper Crow

The mewling of the Australian crows was amusing at first. But now there are a couple that hang out near our window occasionally. I've decided when they're around, I need to open the window and let them know what a proud crow sounds like. Link to American crow sounds.

Food Budget

When we were in San Francisco, Fay was a bit frustrated and befuddled by my restaurant habits. I tended to rotate between a fairly small number, spread across town. "You need to try new things!" She didn't understand that those restaurants were the result of at least two years of search - there was a price point, and there was a quality factor. The research involved food poisoning more than once with the goal to find the cheapest food that was still ok quality. If you eat out very often, the cost adds up quickly. Now, here in Sydney, two years in, I've really only settled on two places - sadly both chains. Sometimes I walk for hours past dozens of restaurants and nothing looks like it's in the range. It's largely a price thing - but if there's one thing worse than bad food, it's paying too much for bad food.

Last night's California roll? No wonder it was so cheap. There was no avocado in it.

Moved

Three guys and an undersized truck helped us move yesterday. The lead guy was from Australia, the others from France and Estonia here on working holiday visas. The working holiday visa system seems to be huge here, though I don't really have a good sense of the overall politics. I know from personal experience that the universities are making a lot of money from foreign students (both in Australia and in the US). I know there are a lot of companies downtown Sydney that cater to young people working and travelling (backpackers). I have no idea what percentage of these people end up becoming permanent residents or marrying a local; or whether, like in the US, almost all vegetable and fruit cultivation is handled by immigrant workers (in the US, a fair percentage of them being undocumented workers).

UK - just as many hoops?

Surprise conversation of the day... the guy giving us an estimate on a heating system emigrated from the UK four years ago. He did heating and plumbing in the UK, and he does that in Sydney. It turns out he had just as many hassles in terms of obtaining proper work qualifications. He was led to believe that he could easily get his license based on his UK license and education. Not so. Had to go back to school, now for three years to get the same qualifications. He also talked about the market size and mark-up of products. Certainly the market is smaller here, but it could be larger - more old homes in Sydney might have heat - if there weren't such a mark up and those protecting their share of the pie here. Of course, everyone wants those who are licensed to be competent - but he says the education here was not as extensive for gas systems - safer?

Moving right along - language

We're going to be moving soon - as an American would say it. As an Australian would say it, we'll be moving house. Oddly, these are expressions that neither the Americans nor the Australians have quite right. Of course we're moving - as if there would come a day when we lie entirely motionless? And neither my wife nor I are strong enough to move a house. Its contents, perhaps - so in that regard the Australians are a bit closer to being correct. In the U.S., we'd potentially call a mover, or if we're going upscale, perhaps a relocation specialist. Australians would call a removalist. A removalist? An American might think that an odd expression for a hit man. A removalist might potentially just remove; if you want to get rid of your belongings. But a removalist might also place. That is, they might place your items in your new residence. There are no placists.

More specifically, we would be relocating our residence. Well, not the actual residence - we'll be changing the address at which we live. So in Australian, we might be moving residence, or moving address, but I don't think Australians say that; at least that I've heard (don't quote me on that one).

Let's say we'll be changing neighborhoods. I've heard Australians sneer at that spelling of neighbourhood, but let me tell you something. The Americans are going to win on the word neighborhood. Why? Because eventually a generation of Australians, perhaps texting without spell-check, will get tired of that extra "u". Then again, maybe the Americans won't win - horses neigh, but parliamentarians nay. And some day neigh could get the nay.

1789? 1776?

From Ethics and Law for Australian Nurses by Kim Atkins, Bonnie Britton, and Sheryl de Lacy:

The ideas of the Enlightenment - individual liberty and the moral equality of all persons - inspired the French Revolution in 1789, which replaced the hereditary monarchy of France with a democratic government. This became the model for political reform across Europe, Great Britain and the colonies in the Americas and Australia. This is why the French Revolution is considered to be so historically significant.

Leaving out a few words, are the authors actually saying that "The French Revolution in 1789...became the model for political reform...(in) the colonies in the Americas"? I believe there's a group of about 300 million people on a different continent who were taught at a very young age that in 1776, a document was adopted that says, "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."

The framers of the American constitution not only had the ideas of the Enlightenment as a basis, but also the constitution of The Iroquois Confederacy of Nations as a model.

Eurocentrism?

Redwoods in New Zealand

Visiting the north island of New Zealand.  I had spotted a redwood forest at the edge of Rotorua.  Here's the story from the brochure: In 1899 trees from all over the world were planted here to determine which of 171 species would grow well. Of the trees planted,  the radiata pine became an important commercial species. The  redwoods also thrived and a grove of 15 acres remains.

First semester nursing school

I managed to pass my first semester of nursing school. The biggest shock was that every class required an essay that was around 40% of the overall grade. Oddly, my favorite (favourite) class was the one that I just barely passed. That class was about Australia's (theoretical) approach to health care, which is different from (to) the US approach. I completely grasped the concepts, but the final exam required writing three essays, and I hadn't memorized nine specific points requested by one of the questions about community capacity building. I never imagined essay writing, community capacity building, and Freudian theories would be such critical components of nursing education.

Winter swim :-)

We took a stroll today along the eastern shore from Bronte Beach to Gordon's Bay and back. As the day warmed, we decided it really might be warm enough for a dip, so we took the plunge. Once acclimated,the water temperature on the skin seemed ever so slightly warmer than the air temperature, which is to say very nice for the middle of winter!

How Australia works

I am slowly figuring out how the Australian mind works. Oh sure, some things are obvious. Other things, not so much.

Construction nearby

Since they're building an apartment complex up the street, I'm getting a view of how the construction progresses, as well as what the soil subsurface looks like in the neighborhood. I had never thought much about ground stabilization where it's critical. In the photo, you can see the concrete ledge they've created. First they dug down to that level. Then they drilled holes all around the edge. They poured concrete into the holes and to create the ledge, but apparently had forms to make the columns hollow - as you can see wires protruding from each "pillar" which was underground when it was poured. Once that concrete hardened, they dug below the surface concrete, which now appears as the ledge. The columns (which were holes with forms inside) are now visible, and they ran what looks like electrical conduit through them to supply the parking garage lighting system. I recall hearing about a project in Indianapolis (USA) that didn't use adequate stabilization, and a nearby building settled and cracked as a result.

As you can see, the soil is pretty solid clay. We're basically on a large hill, so when it rains the water drains off pretty quickly. Our back yard has dirt that seems much more fertile, but from the construction site I can see our soil is probably just a thin layer that may have been brought in. We've had a couple of heavy rains since they started digging, and the clay accumulated surprisingly little water. I think they have some deeper holes on site that catch the water or may connect into subterranean drainage.

Exam "reading time" ?

Yet another confusing thing about the educational institution I'm attending. I have three final exams, two multiple choice, one essay. All of the exams have a 10 minute "reading time", two hour duration (plus that 10 minutes), and you're not allowed to leave your seat for the first 90 minutes. I guess the "no leaving" policy is to prevent people from somehow copying the test and transmitting answers to someone else. I get that. I have a policy - once I've concentrated on and answered questions, I don't go back and second-guess. Technically, I could have gone through every question again and made sure I marked the answer I wanted to mark, but that to me only seems like prolonging the pain. I'm not one to quibble over every single grade point.

The part I really don't get is the "reading time". You're supposed to read the exam; you're not allowed to use your pencil or mark anything. I can see how this could be helpful on the essay exam - you need to think through how you're going to compose your answers to an allotted word count, and you can start that in your head during the "reading time". But for a multiple-choice exam of 100 questions, it seems a bit silly to read through the exam and not be able to make any marks. Sure, maybe your brain can start ruminating over the questions you read and don't immediately know the answer? But if you're ruminating, you may be concentrating less on each of the other questions as you get to them. I suppose there's some scientifically derived strategy for using this reading time for a multiple choice exam of 100 questions? Personally, I'd just as soon get on with marking the answers.

Americans in... Paris?

Act one of this podcast is amusing. David Sedaris says,"He's drinking wine, he's smoking a cigarette, and he's picking his nose. Those are three good reasons to live in France."

Act three, though, is phenomenal for its encapsulation of race in the United States, and also the core of what it is to be "American." In Paris, African-Americans are accepted; African-French rejected? Or is it just a class thing? Race... class... Here in Australia, for some time there was actually a "White Australia" policy, and it might be said that racism is worse than in the United States. In Sydney, brown skin is common; very dark skin less so, and I had been here 18 months before I realized aboriginals have the same spectrum of skin color as do African-Americans. There are separatists and assimilationists, but in general, it's the same "us" and "them" mentality as in the United States. But the story told of an African-American woman in Paris speaks to another factor. When I see people with very dark skin in Australia, my mind sorts through the features and clothing; Aboriginal. Melanesian. African. Every now and then, what I'm looking at adds up to "American." I want to run up and ask them if they're American, with the sense that I have more in common with them than 99% of the people on this continent. But I think it would be rude, and I refrain. Still I think - ...former military? ...athlete? ...tourist? Being white, I am the invisible immigrant. That is, until I open my mouth and say something. This American Life: Americans in Paris

Prison work

Was talking with a classmate. He is a Muslim, moved from India to Australia as a teenager, and has a job working as a nursing assistant in a prison. He said the thing that shocked and surprised him the most working in the prison was condom distribution. Apparently they are very proactive in distributing condoms among the prison population in New South Wales.

Slave labor & British traditions

Apparently even after World War II, Australia continued its founding tradition that boats filled with immigrants (in this case children) were useful as cheap labor. The lost children

What *is* a professional nurse?

ok, I've just confirmed with a physical therapist from Italy (nursing school classmate) what is annoying us both. There doesn't seem to be much emphasis on actual medical knowledge, yet there's lip service to it. As in... there are poorly edited medical passages in the text book that are clearly just lifted from somewhere else, without an effort to adjust everything to the same level of complexity and understanding level. Then the lecture teachers clearly don't understand what they're talking about; they're just glossing over, and can't answer questions to the same depth as presented in the text. They have advanced degrees in *nursing* but have substantial gaps in their *medical* knowledge. (in lab, an instructor gave the wrong name for a major bone, and at least 5 of 20 students trained in other countries knew she was wrong).

University life - post cloud

I am now in my second week of going back to school to get a Bachelor of Nursing degree from University of Technology Sydney. There are about 800 students in my class, and it seems more are international students than students born in Australia. Unfortunately, I am paying 3x normal tuition because I am an international student, having not yet become a permanent resident. I've been out of work too long and am too old to waste any more time waiting, since getting employment has been more challenging than expected.

In our first week of class, we are given a huge volume of reading; lab policies, state policies regarding nursing, national standards, information about vaccines and police checks, and last but not least, volumes of homework reading. All of this reading comes in a variety of formats. Some publishers are still not on board with digital, so there are two huge, heavy text books, and a couple of smaller ones, there are pdfs, there are web sites with reading, there are journal articles that must be accessed through the library web portal, and there is a paper handout or two. Instructors are assigning reading snippets here and there in the textbooks, rather than following the published order.

Since international students contribute so much tuition cash, there is a lot of money put into advertising to attract them, and quite a flashy welcome. There are a lot of resources committed to getting students up to speed with writing quality. There is counseling for those who are homesick. Though all of the students understand English as a condition of admission, a fair number have apparently not conversed extensively in English.

One of the big challenges for everyone - it seems staff and the university included - is getting everything organized in the era of "THE CLOUD". The university is using a program called Blackboard. It's a good, comprehensive database connected to a typical, designed-by-accretion (which means messy and visually distracting) interface. To find anything for a class requires digging through multiple folders, and lots of links appear that are actually empty, not having yet been filled. I've found that the Android and iTunes Apps are actually much cleaner than the browser interface. However, then there's the matter of organizing your reading and downloads; keeping track of what you've read, and having it in a form convenient to refer to later. This is complicated by the fact that some files have different types of Digital Rights Management (DRM), so my efforts to download everything and keep it in one place is not an option. My anxiety at being behind in reading was compounded when in one class, the teacher held up printouts of required reading - which was not the same reading I thought I needed. I still haven't located in Blackboard the reading she held up.

One student said she's using iCloud - downloading everything into folders, then changing the color of the files as she completes the reading. Though organizing files in Android's "My Library" is pretty straightforward, moving files around in Android folders themselves is pretty clunky. Initially I used Evernote to keep some files; I haven't tried Google Drive (which might organize more effectively IF I can get various formats downloaded into it). The school doesn't expect everyone to have computers and tablets, and has invested heavily in rows and rows of computers for students to use. Admin has set up every student with an online desktop. You don't see this when you log in from home (you see the messy Blackboard interface, or one of dozens of other facility home pages), It's clear when you log into a school computer that perhaps it might be possible to organize things better from the desktop they've set up. That would be a great irony if THE CLOUD, in the process of liberating our data and making it multi-platform, is actually requiring us all to sit at the computer banks at school rather than accessing it from anywhere. Hmmm... I suppose there's a way to access that desktop from home - but I don't have time to mess with it. I need to focus on extracting required reading through Blackboard, since assignments are coming due!

Summary: the material isn't a challenge; the volume is a bit of a challenge; but the greatest challenge is accessing and organizing all of it. THE CLOUD is currently giving me a headache!

Australia: Wasting Human Capital?

In my first nursing class, I met a young man who has been in Australia for five years, but was originally from India. "I was thinking about studying mechanical engineering. Then I looked at the jobs available online. There were only about two jobs for engineers, and about 50 jobs for nurses. So I'm studying nursing."

My story is similar, though it's not engineering. I have over 20 years experience in medical laboratories. In the San Francisco Bay area, biotech is as hot as other information technologies. I was given a $3000 sign-on bonus the last time I was hired, and there are hundreds of biotech companies, a number of which can use the lab skills of someone trained and licensed in a medical laboratory. Here in Australia, there is a thin sliver of biotech. There are a handful of larger companies. There are lots of tiny three-person companies - they are PhDs or innovators who get their concept to working stage, then sell it off to a large company in the US or Germany. Unlike the San Francisco Bay Area, where there are hundreds of companies working their products up to full-level production, here in Sydney, the inventions get sold off before getting scaled to production. This makes a few PhDs wealthy, but rather than employing a range of aspiring PhDs in laboratories, aspiring PhDs are employed by academic labs (with constantly threatened government support), where the focus is more basic research than streamlining product to market.

It's been said that there just isn't the investment capital in Australia for biotech, and investors don't understand it. There *is* investment capital, but yes, biotech is not well understood, because the sliver of people with a science background is so thin. And because there are few jobs for people with those degrees, there's not much inspiration to study for advanced degrees in those fields. I was shocked, after taking a tour of Australia's one nuclear reactor, at a discussion of some schoolgirls who had also just taken the tour. "What do you want to do when you grow up?"

"Food service."

"Yaay!! Cool!! Waitress!" They were totally serious; totally excited about the notion of food service - and this was after getting the full public relations presentation of a very impressive nuclear facility. On the one hand, I've found it refreshing that the sense of egalitarianism here makes being a "tradie" as honorable as any other profession. It reminds me of growing up in Indiana - a state that also exports intellectual capital. Indiana only wishes it could have the tourism business that thrives in Australia - Indy 500 notwithstanding. On the other hand, I've been a bit appalled that in some respects Australia seems trapped in a colonial mentality, where a handful of administrators are getting wealthy selling off resources to other countries rather than using it to build local infrastructure. I had a discussion with a Chinese student who *is* studying engineering in Australia. He had to work as a cook for several years before Australia would grant him residency, at which point he could afford to go to school - because strangely enough, Australia thinks it has a shortage of cooks, while its engineers go begging for jobs. Or maybe it's a back-door to letting people in, because the cooks have less political clout than the handful of engineers protecting their turf? The Chinese student and I agreed that the main way to a larger economy is having a larger population, but the immigration philosophy is that people have to be kept out to preserve the quality of life for those already here. At any rate, it's a confusing economy that envies the U.S. but works really hard to preserve its status quo.

Do you speak English?

Interesting note regarding accents at orientation for international students at University of Technology Sydney (UTS) .  The presenter remarked in passing "some of you may have learned English from watching American television programs".   The presenter herself did not have a strong accent; what I would describe as a fairly "clean"  form of English.  However,  an Australian might describe what I say is "clean"  as being an "American"  accent.  In general,  Australians don't know a lot about American regional accents.  They probably don't know what they'd describe as an "American"  accent is actually the typical announcer voice in the United States which is fairly devoid of regional accents. So the classic "American accent"  is actually a form that may even have been practiced to intentionally strip traces of any regional accents. 

Similarly,  I was once listening to the radio and Fay explained to me that the announcers didn't normally speak the way they were speaking,  they were sort of poking fun of regional Australian accents.  I didn't even realize their "joke"  -  it all sounded like Australians speaking to me.  It struck me during the orientation at UTS that one person had a much more distinct Australian accent. He was the head of the security department.  The presentation consisted of the head of the international student department,  and a panel of about 10 people representing different departments or services.  The strongest accent overall was a guy who was probably from India,  representing IT services. I would not say that all of the others had "American"  accents,  but their English was,  again,  what I'd describe as "clean".  There is some sense that Australian's may be losing their accents for what is considered "American English",  but I would argue that the English of American announcers isn't so much "American"  but a form that's been stripped of American regional accents. So don't fear being overtaken by "American English" -  it's simply a form that different regions can understand as being stripped of accent.  Of course,  Southerners (in the US and Australians)  might refer to it as a "Yankee accent" -  which in the southern US means "northern".  But there isn't a specific place in the "north"  that is the origin of that "accent" ; if anything,  the source might be California,  a frontier of the melting pot which emerged as the source of much American media.

Summer Holiday

I don't think it completely sunk in last year... The "Christmas break" here is actually the launch of "summer vacation" for kids. School is actually year-round, but there are some substantial breaks here and there, including this extended one. School starts back up towards the end of February / early March.

Healthcare debate, Australian style

Universal health care is a given in Australia. But the government is always looking for ways to cut expenses - especially those elected to office on the promise of cutting unnecessary costs. The latest storm is brewing on two fronts. The current government is proposing a $6 fee to visit a primary care physician. Private insurance companies are wanting permission from the government to cover primary care costs over the reimbursement rate.

On the $6 proposal, of course advocates are saying poor people will put off visiting the doctor if they have to pay anything. The private insurance proposal is more complicated, as is how private insurers operate in Australia, and what they're allowed to cover. Currently, primary care doctors can charge above the Medicare reimbursement rate, and patients have to pay the difference out of their own pocket. Some doctors only charge the reimbursement rate, and this gives them a steady flow of patients who don't want any out-of-pocket expenses. As more patients have private insurance, insurance is not allowed to cover the higher fees because that could potentially exert upward pressure on physician fees, if they were covered and private insurance patients felt no pain from their own wallet. Eventually there could arise two standards of care - one for patients without insurance, and one for patients with insurance. Insurance companies are arguing that people avoid seeing a doctor because of the out-of-pocket fees. In reality, these would only be patients who are seeing doctors who charge above the reimbursement rate.

It's all rather complicated, but I think I've got the basics right.