Archive for the Healthcare Category

A Giant Tangent, Chapter 2: The Balancing Point

Posted in Boyhood, Healthcare, Life After 50 on January 19, 2011 by Thomas N. Schenden

I checked my watch. It had only been thirty minutes since we jumped on board this northbound freight, but I could feel several hours’ travel in my bones already. The romance of hitching rides on trains was already fading, and in its place was a growing longing for a real chair.

“If you have any change in your pockets, you don’t want to sit there.”

“I’ll be fine, Jack,” I said, annoyed, as I bumped and rattled and literally flew up off the floor of the train car.

“Any false teeth?”

What’s your problem? What’s it matter if I have change or false teeth or what?

“Brother, you’re sittin’ right over the wheels, and box car wheels don’t like company — they’ll shake ya down so hard your change will be in your shoes and your teeth will be in your pockets. You’d best move over here where the ride’s smoother. And have a drink of this, it’ll settle your stomach down quick-like.”

Jack was right about the wheels, and he was right about his wine, too. We sat side by side over what had to be some kind of balancing point on the freight car floor and hardly felt a bump. As we passed his pint of port back and forth, watching the sun come up over the Tehachapis, my thoughts turned back to the week before.

It had been a bad year, and it was only February. In fact, it had been a bad couple of years, and that was about as honest as I was going to allow myself to be at the moment. I felt like I was caught in some kind of sequence that was running its course and not yet complete. There had been a divorce, a car crash, a bout with cancer, and the death of my dear old pops. When my department was informed last week that the company had been sold to an equity management firm, it wasn’t hard to imagine what was next.

Still, there was some comfort available in the news. Even if the new ownership, aptly named “Blackstake” decided to turn us all out onto the streets, I’d already experienced far worse. In fact, at 52, middle age was bearing down on me, and I felt like I was bearing up under it pretty well.

And all the while, Jack was observing me closely, another one of his endearing and annoying habits. Really, Jack was an observer of people in general, and was very skilled at summing up situations before others even noticed anything worthy of analysis.

“Brother, you’re not sober enough to be this quiet. What’s eatin’ at ya?”

Jack, you’ve probably got a better idea than I do. I don’t do analysis well, but I know when something isn’t right, and I’m feeling that now.

The loud, jostling clack of the car as it bumped over the tracks punctuated my thoughts and brought them forward at an increasing speed.

“I mean, it’s been a fucked up couple of years, hasn’t it? And all of it comes after years that I just seemed to sleep through. Really, what happened in my forties? While you were out seeing the world, I was driving a mouse in a cubicle. My big accomplishment? I’m an expert at Microsoft Word, Excel and Powerpoint. And now, these people are poised to dump us all and do I care? I don’t know! But something about it is sickening.”

Jack pulled his Luckys out of his pocket, gave the pack a shake and held it out to me.

“Thanks Jack, but you know I don’t –

“Brother, just take the goddamn cigarette. I know your problem and it’s not new to me or you or anyone else who’s had a lungful of responsibility. But remember who you are now, you’re a giant, and pardon the pun but that’s no small thing. In three steps we’ll be halfway up this state and there’s no looking back for you. Now take a look at that.”

Jack motioned at the scenery out the large door on the right side of the car. I’d simply describe it as stunning, but Jack never let a strong impression go without a full blown soliloquy.

“That sun has been doing that same thing for millions of years, coming up over those mountains just like that, shining through those pines just like that, blazing through that morning haze just like that, and where have you been? You’ve been worrying about schedules and budgets and memos; you’ve been using up your precious life on someone else’s cares.

He had a point, at least at that particular moment, and by changing the subject he was doing it again, gently bumping me in another direction, maybe not the right direction but the direction he knew best. And I don’t even think he thought it was best for me, but it worked for him and he was loaning it to me. There was comfort in that, anyway.

“Brother, you know what I see?”

The train had been slowing for several minutes and as the rhythm slackened, the car grew quieter. We bumped along, and I took my time before answering.

“What’s that Jack?”

“I see a scroll, an untold tale that’s just unfolding across the sky like a kind of road or a path, and our names are written on it and there’s all kinds of untold adventure written on it, written ages ago. This train is destiny, man, it’s pure steel power chargin’ down the track and it knows – we don’t but it does – it knows where it’s goin’ and when it’s arrivin’. I’m real sorry about this state you’re in brother, it’s real mixed up but it’s not in front of us, it’s not on this train, and it’s not on the scroll.”


The American Healthcare Debate

Posted in Healthcare on November 12, 2009 by Thomas N. Schenden

In high school, Pete was an athletic, gregarious and outgoing student. In college he sustained a major back injury that was never treated properly and caused him continuous pain. But Pete managed, and went about his life with his wife, children and career. As his pain became a larger and larger obstacle, his use of pain medication turned into abuse. Thus began Pete’s slow decline, first with marital separation, then job loss, then divorce, then more job loss and then the loss of his health insurance. When Pete’s struggle with pain meds became too great to bear, he visited the emergency clinic at his local hospital.

But on his most recent visit to the clinic Pete appeared to be OK. After some testing there were indications that Pete might need help, but it was also discovered that he had no health insurance. Instead of admitting him for additional testing, Pete was sent home. Two hours later his sister found him dead in his apartment.

There is a great debate underway in Congress to solve this serious problem. But when discussing the subject of health care in America, it is as if our political landscape is defined by caricatures. Democrats will have you believe that Republicans are selfish individualists, interested only in riding around inside the well-lined pockets of pharmaceutical companies and insurance providers. Republicans, on the other hand, see Democrats as wild-eyed socialists, intent on using their President to marshal through an anti-capitalist healthcare system that will ruin Medicare and bring down the entire economy, or what is left of it.

The result is a stagnant debate that objectifies the most vulnerable Americans into broad categories of either the useful or the costly.

One common protest is that our government is incapable of designing and operating such a complex system as national healthcare. But there are many examples of efficient, well-run systems without which our public life would come to a screeching halt.

The Dwight D. Eisenhower National System of Interstate and Defense Highways, commonly called the Interstate Highway System, was developed in the mid-1950s. This system of roadways is both the largest integrated highway system in the world and the largest public works project in history. Besides its unquestioned usefulness as a transportation system, our interstates have become a unifying factor in our national life, making neighbors of distant strangers.

Similarly, our public school system ensures that a consistently high level of education is available to all Americans. This government requirement makes education affordable for the needy and even provides a kind of egalitarian mask that makes most students look like each other, regardless of their economic background.

These are not impersonal systems designed by a bureaucracy. Our schools, our highways and many other national initiatives were painstakingly built by Americans who wanted a better future for themselves and their families. These systems draw our nation together and unite us in ways that are often invisible.

Those who see only politics in the healthcare debate do so at their own peril. While we like to believe that we are masters of our own destinies, calamities can get the best of anyone, requiring more from the individual than he or she has left to give. At what point will we realize that our humanity – this living, American organism – requires vigilance? When will it become clear to us that our national health depends on the health of all of our citizens?

No, Let’s Not Change Anything. . .

Posted in Healthcare on July 19, 2009 by Thomas N. Schenden

Guest Contribution from a Concerned Citizen

My wife, who comes from Japan, was involved in a serious head-on collision with a truck while riding her scooter. She woke up in the hospital with a busted-up face, missing teeth, shattered shoulder, cracked ribs. She had to go through numerous surgeries, months and months of rehab. She got good medical in Tokyo, the bill was affordable, and she lives today.

If this happened in America, we would have to get attorneys, fight it out in court, wait years for a decision, they would log-roll and stall. If it was me, we’d lose the house.

Screw anybody that says decent medical is anything other than a good thing. To hell with anybody who barks from his suburban driveway he never even stepped out of. Why does America, which is supposed to be number one, have one of the highest infant mortality rates of any first world country? We’re behind so many supposedly backward nations. I have friends in Canada, and the care they get just as a matter of course is astounding. When I got some kinda Pink-Eye shit last year, it cost me a month down and $400. Ridiculous. My Canadian friend staying with me said it would have been a $30 clinic fee.

It’s disgusting how this idiotic, ignorant underclass has bought such a line of horseshit. These people would rather stick with their own party line and vote against their own fellow citizens rather than support initiatives that would improve the health of our nation. Pathetic.

Don’t Call it Obamacare

Posted in Healthcare on July 18, 2009 by Thomas N. Schenden

Guest Contribution from a Concerned Citizen

Health care reform? Nationalized health care? Whatever you call it, it’s the next thing in the chain of evolution of our nation and society, another part of the fabric that holds us together and keeps us strong. Other countries have figured out that collective solidarity has better results. Look at our nation like a factory, so it doesn’t come out sounding Socialist and therefore scary. You got a factory (the nation) and it’s productive. Do you invest in new technology, for the future (schools, hospitals) or do you run it into the ground, divest as much profit out of it as possible and gut it…? Should the shareholders get all the profits, for short-term gain? Or do you want to keep it a going concern for generations? We’ve seen the results of Enron-Think and AIG tactics lately, so you can see that the free market mentality of the last twenty years is totally bankrupt. It doesn’t work anymore, it never did, it was just a matter of time before all the effects came to bear such bitter fruit…

Treating the populace like interchangeable, disposable parts is a really stupid, short-term strategy, but using the insurance model in conjunction with the profit motive to monitor people’s health is criminal. My father was in the aerospace industry for decades and had great insurance. When he retired, they were on a HMO plan. My Mom got some kind of problem, she was shuttled around from doctor to doctor, and was even told by certain MDs that they were hampered by the system… Anyway, long story short, she got insufficient care and treatment, which led to dire, catastrophic events and an early, wrongful death. They were paid-in, in good stead, but the profit margins of the HMO would only allow a certain degree of care and oversight. So she’s dead now, another statistic. The lawyers packed up the paperwork and that was that. So, I say to anybody that thinks that health care is and always should be in private, profit-oriented business leaders’ hands… get a life.

This is why a high court in San Diego struck down the right of private companies to build and maintain traffic cameras at intersections: If the company that was doing the surveillance, and issuing citations to citizens, was the same company calibrating those cameras, then the profit motive would be biased towards the company, and the drivers ticketed would just be part of an unchecked revenue stream, without proper oversight.

If we didn’t have the Fed ramming down food-safety down the industry’s throat, we’d still be eating the tainted meat and rotted produce that the Food Safety Act has helped to get rid of. If we didn’t have the Fed issuing guidelines and funds for Interstate Highways building and maintaining, we’d still be driving on dirt roads going through the Southwest. If you want to actually look at it with a clear, objective eye, all our roads and fuels are Federally subsidized. They’re socialized. We all pay extra taxes to build and maintain the roads we drive on. In other countries, the actual cost of driving is much, much higher. Gas costs more, the tolls are exorbitant, parking is outlandish. People have to actually pay more for the privilege of driving. It’s not seen as a “right” like over here. We demand the “right” to buy any kind of car we want, drive it wherever we want, and bitch about having to smog it and pay so much for gas. It doesn’t work that way in most of the rest of the world. The more organized societies get, the more complicated they have to be. It works with all natural organisms, it’s a constant of the universe, a supreme law. So; are we to buck the trend, and defy supreme laws? Or do we look at things rationally and do what we have to do?

America has to start looking at what we do, how we do it, and why, a lot more carefully. The days of felling vast tracts of timberland and getting easy coal and oil out of the ground to burn at will are over. We have finite resources, be they clean water, clean air, natural forests, etc. The idea of digging shit out of the ground, sending it in mile-long container ships to China, to be manufactured into useless consumer goods with a two-year shelf life, only to be brought back to American and ultimately dumped into landfills is ridiculously stupid. The idea that there is always more, just grab it, every man for himself, and too bad for those that fall behind — these are all signs of a weak society. A short-term mindset will not build, or keep an empire. Only long-term management will keep growth steady, and steady growth is what we need, not crack-head instant gratification, free-wheeling banking based on bullshit, an economy based on faked numbers and rampant speculation.

Health care is right there. It shouldn’t be posited as a “right,” it should be seen as a inevitable factor in maintaining the health and wealth of the nation. Long-term gains, for everybody. Better productivity out of the workplace, less absenteeism, less impact on emergency clinics where the costs jump in geometric proportions.

Again, I say good riddance to all those idiots who want to rant about it. They’re on the short road of evolution, let them pass away into the night…