A friend has been trying to reinstate her mother’s Postal Service Health Benefits drug plan coverage for the past six months. The plan is administered by Kaiser.
The reinstatement, which everyone involved agrees is proper, has been stalled because my friend’s mother hasn’t signed a form Kaiser claims to have mailed her in March.
The form cannot be filled out online, or emailed, or picked up in person. A physical copy must be sent by US Mail.
In multiple phone conversations, an assortment of Kaiser employees has promised to re-mail the form. It will arrive, they promise, within three to five business days of the most recent conversation.
It is now July. The form has still not arrived.
Many of us in the Parkinson’s community will recognize this experience as we try to get an appointment with a neurologist, or question a medical bill, or appeal an insurance coverage denial. Outside the medical world, it happens when we attempt to obtain warranty repairs, or airline refunds, or even just navigate an automated phone tree.
Lost forms. Endless hold times and disconnected calls. Repeating our stories to a new stranger every time.
In a recent Atlantic article*, journalist Chris Colin calls this stuff “sludge:” deliberate corporate obstacles like paperwork, long wait times, and procedural hoops. The goal: wear you down until you give up.
With enough time, persistence, and organizational skills, it’s possible to fight through the sludge and get that appointment, or refund, or insurance coverage.
But the system delivers huge cost savings to corporations by putting boulders in our path and waiting us out.
Researchers have shown how sludge leads people to forgo essential benefits and quietly accept outcomes they never would have otherwise chosen….
…When I started talking with people about their sludge stories, I noticed that almost all ended the same way—with a weary, bedraggled Fuck it. Beholding the sheer unaccountability of the system, they’d pay that erroneous medical bill or give up on contesting that ticket. And this isn’t happening just here and there. Instead, I came to see this as a permanent condition. We are living in the state of Fuck it.
Colin describes how Cigna saved millions of dollars in 2023 by automatically rejecting claims, correctly guessing that most patients wouldn’t bother to appeal. How Toyota’s financing division was caught “thwarting refunds and deliberately setting up a dead-end hotline for canceling products and services.” And how Ford tortured him for months before finally agreeing to buy back a defective Ford Escape.
For folks with Parkinson’s, who are often dealing with a lack of energy, cognitive issues, apathy or depression, sludge can be a diabolically effective tactic. Stress is particularly hard on those with a chronic illness — and sludge creates stress.
What can we do about it? Colin came up with an intriguing gathering event he calls “Admin Night.”
“Admin Night” isn’t a party. It isn’t laborious taking-care-of-business. It’s both! At the appointed hour, friends come over with beer and a folder of disputed charges, expiring miles, summer-camp paperwork. Five minutes of chitchat, half an hour of quiet admin, rinse, repeat. At the end of each gathering, everyone names a minor bureaucratic victory and the group lets out a supportive cheer.
Admin Night rules. In an era of fraying social ties, it claws back a sliver of hang time. Part of the appeal is simply being able to socialize while plowing through the to-do list—a 21st-century efficiency fetish if ever there was one. But just as satisfying is having this species of modern enervation brought into the light.
Can the small wins of Admin Night overcome the sinister forces of corporate sludge? It’s not a cure, it’s a Band Aid.
But the experts tell us that social opportunities are crucial for slowing Parkinson’s progression. As Colin points out, Admin Night checks that box.
And a small win is a win.
*h/t to my friend Paul Danzer for bringing this article to my attention.
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Bonus for Those Who Read to the Bottom
Don Henley’s “Boys of Summer,” faster and louder.
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Karen O of the Yeah Yeah Yeahs. And Willie.
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Cranberries’ lead singer overpowers Fleetwood Mac.
Shakin' Street -- A Parkinson's Blog 
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