Monthly Archives: March 2012

Why Health Care CANNOT Be Fixed

Pessimist, me?  No more than I am pessimistic about the chances of the Mississippi starting to run north from the delta to Minnesota.  Just aware of the realities.

Fact is, that there are three things which combine to head our current American health care system over the cliff, soon to be replaced by some other system.

First, everyone agrees that health care is horribly expensive and getting more so.  It now consumes one-sixth of the American economy.  The one thing everyone seems to agree on is that this trend cannot continue.  But costs cannot be lowered to any great extent because the consumers of health care do not know what health care costs and they don’t care.    When is the last time you shopped for a doctor based on price?  Who is the last person who told you he changed from Dr Bob to Dr Tom because Dr Tom charges $15 less for an office visit?  And why not?  Because someone else pays the actual bill.  We care about our deductible and our co-pay, neither of which has anything to do with actual costs of care.  When there is no consumer pressure on prices, prices go up.  That’s Economics 101.  There is no theoretical ceiling to this phenomenon.   We do complain about our insurance premiums going up, but that is a symptom, not the cause.

Twenty-plus years ago, my young daughter fell while playing and cracked a bone in her elbow. Her doctor gave us the following scenario: “Well, current wisdom is to hospitalize her, do surgery to install a screw in the bone to secure it, cast it, and bring her in for x-rays every couple of weeks for a couple of months.  Then, we put her in physical therapy to recover the function lost in treatment.  But a few years ago, we would just splint it, wait two weeks to see how it’s healing, do one x-ray, let her get a little physical therapy, then let her finish the process by using that elbow for a little longer every day outside the splint.”

Since we had no insurance and actually paid the bill ourselves, this was a helpful revelation.  We took the “old way” and that little girl healed just fine. At about one-tenth the cost.  When’s the last time you had this kind of discussion with your pediatrician?

Second, we have recently developed a very entitled view about our health.  Grandad’s generation accepted aches and pains as part of life, and more so as a part of old age.  Not us, boy.  If it hurts, or even annoys us, we beat it to the physician for treatment and whip out our insurance card.  Acne gets prescription meds and dermatologists are among the best paid of all physicians.  Male pattern baldness is now considered a treatable disease, not just a fact of life, and billions-with-a-B have been spent on prescription Rogaine.   If Granny’s 80 year old knee gets stiff and painful, she gets not pain meds but a new titanium/nylon knee replacement for a mere $25,000 from taxpayers.  When wanting a longer-lasting erection entitles any man to medical intervention, we have passed the point of no return and reason has left the building.

Third, we have decided that end-of-life is also a treatable disorder.  The majority of medical care expenditures are incurred by the elderly, and much of this is life-sustaining care.

I don’t mean to sound hard-hearted.  Nobody wants his loved one to suffer, but when the choice used to be bankrupting the next generation or suffering personal pain, most of our recent ancestors would have found the choice easy.

Note that none of these problems have to do with government policy.  It’s not the problem, so it can’t be the solution.

 

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Quote of the Day

From N.T. Wright’s book, Simply Jesus

[Christianity] isn’t about “religion” in the sense the Western world has imagined for over two hundred years. This is about everything: life, art, the universe, justice, death, money. It’s about politics, philosophy, culture, and being human.”

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Text-drunk driving

I really really wonder about people texting and driving.  Not that they are doing it, but that they are still doing it.  America finally learned that drinking and driving was nothing to be taken lightly, and now we have a phenomenon which is far more dangerous, simply because the number of participants has increased by an order of magnitude.  In the 1970’s, it took enough kids getting killed on our highways for Mothers Against Drunk Driving to become a force to be reckoned with and to raise the public consciousness.  Who’s going to step up this time?

It won’t be another “Mothers” group… they’re the second largest perpetrators of the current traffic menace, trailing only their teenagers.  But teens are not expected to see the long view, thus, the clever invention of older humans inserted into their lives to help provide that view and protect them from the more dangerous forms of adolescent myopia.  It is Mom, who is playing Words-With-Friends on her I-phone at the stoplight, whose assigned task it is to warn Junior and Juniorette,  “Hey, that’s dangerous!”  But she can’t put the phone down long enough to do so, as she has to answer, now– and I do mean RIGHT THIS VERY SECOND—  Cousin Janet’s text about how old Aunt Doris really is.  I am now hearing from teens and tweens who are reaching out to take the phone out of Mom’s hand on the way to school, in an act of self-preservation. When the so-called responsible members of society start acting irresponsibly, who protects us from them?

There is a current ad campaign on TV which demonstrates quite dramatically the risks of texting and driving.  Well produced, matter-of-fact, accurate.  Much better than the old “this is your brain on drugs” bromides.  Kids are starting to get the message.  Now if we can get moms on board.  I can keep dodging them in traffic, but I don’t know for how long.

At the risk of sounding sexist, this is so far primarily a female adult phenomenon.  Women do things together, they share, they communicate. (Guys grunt, which cannot be texted.) Now women get to become virtually inseparable via text, tweet and Facebook, all while at the wheel.  Moms who would not feed little Billy store-brand milk strap his little Oshkoshed behind into a car-seat and go charging through traffic while updating their status and “liking” things.  But guys, don’t feel left out, real time access to NFL highlights and scrolling headlines and ballscores are there to put us right smack in the same drunkenly weaving boat.  Anything foolish they can do, we can do better.

Now, as a man who can remember the advent of the Code-A-Phone, I admit I do not fathom our recent evolution from AT&T’s old “reach out and touch someone” to the more current “reach out and touch everybody you know, right this very second, and never ever ever ever let them go, even for a moment” style of communication.  But there is a point at which this current obsession with texting at the wheel moves beyond fodder for a curmudgeonly rant and escalates to a place where someone in the American Household is going to have to start raising his voice and saying, “Dammit, that’s dangerous!”

Gentlemen, time to step up.  Or we can just wait for the bodies to pile up like we did the last time we had a problem like this. Just remember whose bodies they are going to be.  Last time somebody saw the bodies and did something, it was the Moms.  Maybe this time it’s Dad’s turn.

Maybe we could get an earlier start this time.

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Try a puppy

Yes, I work adoptions, finding homes for children who have been brought into the foster care system and whose parents are no longer on the scene.  I take great joy in some folks who are trying to adopt.  Some of these parents impress me with the power of their love and commitment and their willingness to put these kiddos’ often immense needs before their own.   Other parents, not so much.

To those of you who are looking for someone to fit your family fantasies and to make your imagined life complete, please, I beg of you, just get a dog.  There are all breeds, so you can handpick the size and shape and color and temperament that will fit your lifestyle.  It’s the perfect custom companion.  A child is just not like that.

I receive home studies from folks honestly seeking to adopt; who want a white girl between 4 and 8 (old enough to be housebroken but still young enough to be cute), a child without inconvenient connections to birth family, who will be bright enough to be academically successful so as to fit in with her highly-educated parents.  Aarghh!  These are not custom cabinets, folks, these are little people.  Little people who have been through the pain and trauma of losing an entire family, because of mom and dad’s abuse and neglect.  These kids have been saddled with problems by parents who put themselves first, and they need someone to love them, to commit to them, not pick through them like the last extra-large shirts on the clearance rack.  The last thing these children need is you turning up your nose because they’re not the right color or size or because they get in trouble at school or because they don’t immediately jump up and lick your face when you introduce yourselves.

So, if you want a child to meet your wants instead of one for whose needs you can sacrifice your wants, please try a dog.  Get what you want.  Puppies will love you, they won’t have ADHD, they’ll be fine at the kennel once in a while and they’ll enhance your lifestyle instead of turning it upside down.  Because any parent can tell you, that’s exactly what children do.

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What should a church look like?

What should the church be like?

A members-only club with a stringent application process and effective vetting?

A free theater which lets the public watch our public performances?

A family religion business which makes sure the founder can make a good living?

A lodge where the main reason for membership is that your dad is a lifetime member?

OR…

A community which has firm and definite ideas about how things should be, but where anyone can get in on the discussion and where there is always an open chair at the dinner table.

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The exact right word

Rush Limbaugh has committed the cardinal sin of broadcasting– causing his sponsors to flee– not because of his opinion, but of the oafish and clumsy way he expressed it.  A Georgetown law student appears before a congressional committee and tells them that she needs someone else to pay for her birth control, because birth control for a law student could cost as much as $3000 for her three years in school.  Here’s what El Rushbo should have said:

“I did the math, and that’s about 1300 condoms a year from Walgreens.  Any student who needs that much protection is working her way through college… or is at least attempting a double major.”

See?  The same listeners would have been steamed, but when you stay this side of the Howard Stern line, your advertisers don’t have to run for the hills.  You can do more with a rapier wit than with a curmudgeon’s bludgeon.

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Hello world!

New blog!   This one is to allow me a wider range of topics. Still playing with the format, so be patient!

 

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