Healthcare in The USA

13 May 2017

With all the strum und drang about healthcare, I thought it might be a good idea to take a fairly average health problem and look at it historically.  No screaming and shouting, no sloganeering, no breast-beating, no turd-throwing.  Just the facts.  Mine.  

I’ve got cancer and my case is typical of cancer patients.  As my doctor said, “once you’ve got cancer, you’ve always got cancer”, so this is an ongoing tale — just as cancer is for 85% of those afflicted with Emperor of All Maladies.  Oh, and as I haven’t died yet, there will be more to the story.  

When my dad died of cancer in 1959, his treatment consisted of one operation then a bottle of painkillers and it took from July 1958 to March 1959 for him to die.  Let’s compare dad’s case to mine.

  • In 2000, I had the tumor shoveled out.  Cost: $32,000.  
  • PSA tests for the next five years.  Total cost: $10,000.
  • Surgery for a complication.  Total cost: $17,000.
  • Surgery for a recurrence.  Total cost:  $12,000.
  • Oncological visits for another recurrence.  Costs so far: $550.
  • Experimental diagnostic test.  Total cost: $7,500.
  • Visits with oncologist and radiologist.  Costs so far: $900.
  • Irradiation with a proton beam.  Projected cost: $55,000.
  • Immunotherapeutic vaccines.  Projected costs: $100,000.
  • More visits to the oncologist.  Projected costs: $2,000.
  • Hospice care.  Projected costs: $5,000+.
  • Painkillers and such.  Projected costs: ?
  • Final expenses – cremation.  Projected costs: $600.

That, folks, comes up to $178,500.

So I have a question for the “I’m all right, Jack” crowd as well as the smug and callous folks who say “I don’t want my hard-earned money . . .”, and the question is: Can you take a hit like this?  

Maybe you can, or maybe will you have to:

  • Sell the house and move into a shit-hole.
  • Trade-down from the nice, reliable car to a clapped-out unreliable beater.
  • Liquidate your portfolio (you have one, don’t you?).
  • Drain the kids’ college funds.
  • Bleed usurious interest for payday loans when the bills come due.
  • Beg.  On the internet, at work, from the friends, from the family . . .
  • And, finally, file a Chapter 7.

Of course, through all of this, there will be the strain of impending debilitation, pain and death.  Those things will be watching over your shoulder 24/7/52.  Don’t forget about them, for they will compound the worry over paying for it.  Not to mention standing helplessly by as you, or someone you love Gets. All.  Fucked. Up.

Sometimes the treatments will work and the poor afflicted soul will get some good years before the cancer resurfaces in some other place.  Or, Providence be thanked, an actual cure might be achieved.  Or sadly, in our retrogressing society, it could be like it was for my dad in 1959 — or like it was in 1917 where the patient was dumped in a bed, screaming, with wrists tied to the bed rails so as to not pull out the tubes.

But cancer isn’t the only grody disease out there.  There are thousands and they can be just as taxing, just as harrowing and just as costly.

Now I’m 75 so lots of good rock-ribbed Americans will say, “Enough!  You’ve had you life.  Don’t be a drag on the public purse.  Begone!”  But what if the person we’re talking about isn’t an old goat like me but a baby?  Or a high-school cheerleader, perhaps a young parent, maybe a 40-something who’s just hit his/her stride?  Or you?  It isn’t just old dudes who get sick, you know.

Well, dear reader, there’s only one cure for America’s terrible health care problem and we all know what it is:

Medicare For All

-Merlin-


Roger

23 April 2017

We’d moved to Richfield between my 5th and 6th grades and during that summer, I made a few acquaintances, among them, Roger. Roger was quite short for being in the sixth grade, like maybe a 4th grade stature, and while short is bad enough for a young lad, there was worse. Roger was slight of build, had an undershot jaw, had a pug nose that was more like an up-turned snout than anything, was covered in freckles and was topped by a thatch of ugly red hair.  Now red hair can be beautiful, as in the case of Leslie, of whom I wrote earlier, but Roger’s appeared to result from a miscegenation of  a carrot and a pomegranate.

Roger also had an unpleasant way of looking about.  While most people with switch their gaze in rapid movements then lock on until they’ve seen enough, Roger would sloooowly peer in one direction then another without really stopping to take it all in.  He did this while wearing an expression like someone coming out from under anesthesia.

Roger was, well, homely and in a mildly disconcerting way.  You really didn’t want to be around him.  Or be seen with him.

We really didn’t like Roger.


Anyway, the school year ran on and one day, my buddy Dave and I were talking about classmates and the name Roger came up.  We enumerated his shortcomings but agreed that, in Roger’s case, still waters could indeed be running deep, so we decided to befriend Roger and give him a chance.  Roger turned out to be just what everybody thought he’d be: Dull, unimaginative, uninteresting and unlikable. But we persevered.  We agreed that, while we’d try to avoid Roger, should he come trotting over, we’d hang out with him until dinnertime then go our separate ways.  This worked for the rest of the school year.

During that summer, Dave and I continued to have contact with Roger.  Through mid-summer, our contacts were always outside, away from home as we didn’t want him to come over and bother us.  We were afraid we’d never get rid of him.  One rainy afternoon, Roger invited Dave and me over to his place.  Well what the hell, sure, why not.

Inside, Roger’s home was austere.  Everything looked two-dimensional and unsullied by human contact.  Kind of sorrowful, in a way.  And neat as a pin.  The motif was dull earth tones.  On the wall hung a large Christian cross with dried reeds; it was the room’s centerpiece.  The whole effect was not pleasant.

His parents appeared. The only thing I remember about them is his father’s left hand got shot ff in the war and the stump was now graced by a steel pincer shaped like a hook. They were quiet and cordial and seemed surprised their boy could actually bring home friends. They struck me as though Roger, their only child, was their heartbreak and despair.  They hoped for the best and prayed Dave and I were it.

We didn’t stay long.  On our way home Dave and I began to put it all together and came to the conclusion Roger was a case of arrested development.  Roger would never be more then a child with some adult attributes.  It was a sad realization. Over the next weeks, our relationship with Roger petered out.

We didn’t see Roger for all of 7th grade, but beginning with the first day of 8th, we did.  We assumed he’d moved away but on the third day of school, as we waited for the bus, who should we see coming trotting down Park Avenue but Roger.  The homunculus was just as we’d last seen him over a year ago, nothing had changed.

During that time, a new fellow moved into the neighborhood.  Brad Turnquist, by name.  Brad was a year ahead of Dave and me but this bus stop served all of the grades, so here he was, watching Roger come town the street in his little boy gait.  “What the fuck is that!” Brad said with a mean-spirited curiosity.

“That’s Roger,” said Dave with a smile.  I said nothing.

There were maybe a half-dozen of us at the bus stop. A few were making chit-chat, a few had books open, some other were looking at the sky but no one paid any attention to Roger.  We kind of regarded Roger as one of those lawn elves you see stuck in the snow at Christmas time — noticed, but ignored.  Brad, however, kept looking at Roger in a predatory sort of way, then in a few moments, turned his gaze elsewhere.

A week or two later, we discovered something we’d never noticed about Roger; he loved food.  One morning, Gail Bostrom had a doughnut and on this treat, Roger came alive. “Oh, hey. Gimme some.  Come on, gimme some” and he all but reached for Gail’s doughnut the way a puppy would when it saw a morsel.  Gail tried to avoid him but Roger would not be denied.  “Come on.  Gimmee some”, he whined.  Brad Turnquist decided to save the damsel in distress.  Tapping Roger on the head, Brad said “Hey, nerd.  She ain’t gonna give you Jack Squat.  Now fuck off.”  And so Roger did.  He moved to the periphery of the little group and looked down the street toward his house.

A little later, Roger approached Brad and called him a dirty name.  “What the fuck you call me, you little shit?” asked an astonished Brad.  That Roger could have such effrontery was, well, beyond imagining.  “I called you an ishy-poo”, said Roger through his little squenched-up pink mouth, then he took a swing at Turnquist. Of course Roger missed by the proverbial country mile but never say die, Roger advanced on Turnquist while he flailed his arms in windmill-like arcs, never getting even close to Turnquist’s nose. Turnquist began to laugh as he backed away from the wildly swinging Roger.  The rest of us joined in the merriment.  But Roger wouldn’t stop, so Turnquist reached forward, put out his hand, grabbed Roger by the head and held him at bay as Roger kept on swinging.  The group howled with laughter.


Fast forward to the tenth grade.

I’d not seen much of Roger the last few years and was glad of it.  One afternoon, Dave Olson, a large bumptious fellow and I, were talking as we pulled books from our lockers.  “That goddamned Knutson,” he said.  “Little fucker won’t leave me alone.”

“What’s the problem?” I asked.

“You know how I always have a Hershey bar close by, Right? Well Knutson, whenever he sees me with one, comes up whining ‘Gemme some, gemme some’.  Well, I finally figured out how to get rid of him.  I got an Ex-Lax bar — looks just like a Hershey bar, don’t it? “. Olson held it up as if were a great prize, and in a way, it was.  “I’m gonna re-wrap it in my Hershey bar wrapper and when the little fuck hits me up again, I’m gonna give him some.”

“Oh, Christ, Olson,” I said with a laugh, “Just don’t give him the whole bar.  Fuckin thing might kill him.”

A few days later, I was taking with Dave and he told me that Olson finally gave Roger the faux Hershey bar.  It was a big dose too, about half a bar, Dave thought.  Olson gave Roger the Ex-Lax just before the first period bell rang.  The next morning, it was the talk of the school: During an English class held in the in the last period of the day, in which Roger was a pupil, Roger began to squirm around in his seat then without asking permission, bolted for the door while holding the backside of his trousers as something within them made a soft burbling sound.  The Ex-Lax had done its magic and Roger had shit in his pants.

After shoveling out his pants and cleaning his bum as best he could, Roger went to see the school nurse who sent him home in a Taxi.

Roger’s mortification was complete.

We didn’t see much of Roger for a while and that was OK because nobody missed him.  In fact, I don’t recall seeing him at all.  He’s not entered in the year book so I’m not sure he even graduated.  However, the class website has a Dearly Departed page and, sure enough, there’s Roger’s name.  His was one of the first entries.

RIP Roger.

-Merlin-

 


There Are Two Kinds of People

12 March 2017

Years and years ago, I read a column in Car and Driver by an author whose name I’ve forgotten. In his article, he explained there are two basic types of people: The Mammonoid and the Tediophobe.

The Mammonoid is focused on the pecuniary rewards of stultifying labor. Sometimes, if Lady Luck intervenes, they will become billionaires. In any case, Mammonoids will almost always do well money-wise. However, they will be as mind-numbing and dull as a shot of Novocaine.

The Tediophobe, on the other hand, won’t mind being rich beyond the dreams of wild avarice, but hates stultifying labor more. To the Tediophobe, being like Warren Buffet and going to the same office and doing the same thing for decades on end is too horrible to contemplate, money or no.

Of course neither exists in the pure essence, there will be a mingling of the traits. Unhappily, if the traits exist in equal measure, the poor devil will be constantly torn between these two characteristics and never find satisfaction in either.

-Merlin-


27 February 2017

I have nothing to say today.  I thought I might, but sitting her at the keyboard, I realize my life is so devoid of change and variety that there is nothing to say that wouldn’t be a rehash of stuff I posted before.  Sorry.

Maybe next week.

-Merlin-


How About Maybe This?

5 February 2017

American politics is coarsened beyond anything I would have thought possible at the turn of the century.  To be sure, politics is politics and one side always finds fault with the other, but this?  Today we see families and friendships blown asunder because one’s a Democrat, the other a Republican.  One is the Scum of the Earth, the other is the Issue of the Devil.  Over time, each side has only listened to itself, causing a self-reinforcing spiral down into extremism and nonsense.

A recent example is the Supreme Court nomination of a man who is, by all accounts, is a decent fellow.  Decency notwithstanding, one side sees him as the Savior of Family Values, the other sees him as the Wrecker of Personal Liberty.  One side sees him as the apostle of financial prudence, the other sees him as stingy, insensitive and cruel.   Up until Scalia croaked, you could look at any case brought before the court and, based on its political spin, predict exactly how it would be decided.

An aside: A fellow I know said that Democrats want to tell you what to do in the board room, the Republicans want to tell you what to do in the bed room.

Scalia (unarguably recalcitrant and partisan) said this, “… politicians who pick and confirm new federal judges will naturally want only those who agree with them politically”.   Of course, in large measure, Scalia was right: A president, selecting as nominees, only those who pass through the filter of partisan correctness, contributes to the problem we have with the Supreme Court.  Contributes mightily.

Of course it’s too late to do anything about it now.  Trump has picked his man based on the man’s politics and religion. And that means some people would like to crown him with a laurel wreath and ride him through the streets in a royal triumph.  Other’s would like to string him up by his heels in a gas station and use him as a pinata.

There will be other Supreme Court nominations coming along soon, so before the vacancies occur, let me suggest a way to pick nominees that will help quiet our worst impulses.

Whenever a vacancy comes up, the sitting president will ask the bar associations of all fifty states to submit the names of three members they deem best qualified to sit on the court.  These names will come from a popular vote of each bar’s membership.  The names will be put in a fish bowl and the president will reach in and draw out, at random, three names.  These names will be publicized for all to see and after examining the three, the president will pick one.  A process like this would pretty much assure that nominees to the Supreme Court will no longer be hacks, cranks and toadies.  And who but hacks, cranks and toadies — the very people we are trying to weed out — could find fault with this concept?  Sure, people will still be miffed their guy wasn’t nominated, but they’ll be comforted by knowing the guy who did make it wasn’t the stuff of nightmares.

Imagine a Supreme Court that would say — by eight-to-one votes — a woman has a right to get an abortion at any time and, in the next breath, rule  she can walk about the streets, unhindered, with a .45 strapped to her hip?  The Golden Mean will have been achieved and that, dear reader, will cool the passions and prevent our republic from going down the toilet.

— And now that I think on it, this process might be a good way to weed out the unqualified for all elective offices.

-Merlin-


A Possible Solution

22 January 2017

To hear Paul Ryan go on about it, America is chock-a-block with parasitic welfare recipients and moochers. Well, it’s not as bad as the Speaker would have us believe, but it is a problem.  But the problem lies in human propensities not money.

Years ago, I was a Guardian ad Litem (a.k.a. Court Appointed Special Advocate) out here in Washington. We are apostles for children who are victims of abuse and neglect.  I won’t get into a full description here, but if you want to know more, go to http://snohomishcountywa.gov/881/VGAL-program and read all about it.

All of us in programs like the Guardians ad Litem see that:

  1. The vast preponderance of children who are abused and neglected come from impoverished parents.
  2. The parents are unschooled and ignorant and are satisfied with the situation. This, of course, explains the poverty.
  3. Many parents are of low IQ.  Like one of my colleagues said, “They’re as dumb as dirt”.
  4. Over 50% of the parents are felons and junkies who are incapable of looking after their own selves, let alone their children. Of the remaining 50%, most are simply felons and junkies who haven’t yet been caught.  This includes booze and tobacco.
  5. A few have, or keep, jobs.  Most don’t work.
  6. These children’s lives are truly horrifying. They live with beatings, starvation, rapes and an utter and complete lack of love and concern.
  7. Almost all of these children were unplanned and are unwanted.

By the time we see these kids, most are so bent out of shape by their home lives that they carry the baggage with them into adulthood and, in turn, foist it on their own children.  As the old saying has it, “As the twig is bent, so grows the tree” so the phenomenon of multi-generational poverty continues in an unending concatenation.

Surely the Speaker’s ire does not extend to the poor devil who came down with a grody, incapacitating disease a week before his employer unexpectedly folded up. If this poor wretch and his family are not to be put out on the street to sleep under a bridge until death takes him, he’ll need general assistance, food stamps, Medicaid and perhaps more. If simple pity doesn’t move us to provide these things out of our taxes, surely the prospect that this person will soon be back to work as a”contributing member of society” should settle the issue.

Now Speaker Ryan, being a good conservative, measures everything by loss or gain. Money rules.  Parsimony is his watchword, with cruelty coming in a close second.  Well, I have a plan that will satisfy the Speaker’s thirst for thrift while at the same time, putting an end to the woeful cycle of poverty.  It’s quite simple, really.  Here it is: Give each poor person, man or woman, whither or not they’ve been dragged into the child welfare system, $20,000, cash money, to be surgically sterilized. Tubal legation for her, vasectomy for him, all expenses paid.  After the operations, each gets to spend the night in a special low-intensity ward of a hospital where they’ll also get a nutritious dinner and breakfast.  In the morning, as soon as the doctor says they are ready to go, each is handed an envelope containing the promised 20-grand. If the man and woman are a pair, with or without benefit of clergy, they get to take home $40,000 to squander as they please.  Not bad.

An Aside: As this cohort of parents are mostly drunks and junkies, $20,000 will buy all the booze and dope they could ever want.  Consequently, there will be many overindulgences which will result in death, further reducing the numbers of people on welfare.

Gad.  Just think of the savings.  According to the Huffington Post (http://www.huffingtonpost.com/2014/08/18/cost-of-raising-a-child_n_5688179.html), the cost of raising an American child to age eighteen is $304,480 (adjusted for inflation) so that $20,000 or $40,000 looks pretty cheap, No?  And let’s not forget all the government services the issue of their loins will require: Special Ed. nutrition programs, psychologists and, for some, cells in the juvenile detention center. We save on those too.

Of course, this $20,000 will not prevent the conception and birth of just one child, it will prevent the conception and birth of many as these kinds of people breed like flies.  From my experience in the Guardian ad Litem program, such “families” usually produce three children so the savings to the taxpayer will be almost a million dollars.  Think on that for a moment.  Almost a million bucks!  And no more underclass!!

Of course this proposal will outrage the politically correct.  They will see it as an affront to humanity.  But these days, political correctness is out the window so this proposal should have no trouble being put into law.  Speaker Ryan will be pleased.

Now let’s turn for a brief moment to theology for many of the churched will object to this plan.  They maintain the Grand Realm is packed to overflowing with little souls chomping at the bit to have a life here on Earth.  I think if we could be flies on the wall, we might hear something like this:

Little Soul: Angel, dearest. When do I get to go down to Earth?

Angel: Well, I don’t have any gestating fetuses right now.  I was thinking Bill and Betty Tosspot might by ready to get a bun in the oven, but they each took the twenty-thousand simoleons and got fixed, so . . .

Little Soul: But Angel, why would they do that?  Don’t they know I want to be born on Earth?

Angel: Perhaps, but I think you should consider yourself lucky.  Bill Tosspot takes his belt to his two other kids at least once a week. A while back, he put out a cigarette on one kid’s cheek.  As for Betty, she gets falling-down drunk at least once a week and the kids have to call 9-1-1- before she comes to grief.  Besides, she turns her tricks on the living room couch, and you don’t want to see that.

Little Soul: Oh.  Well.  OK . . .  Maybe I’ll just run along and play for a while?  If you ever find a vacant fetus that’ll be born to people in a nice gated community, will you let me know?

Angel: Sure thing, kid.  Have fun.

-Merlin-

 

 

 


Social Security – Keep It or Kill It.

15 January 2017

Who wrote this? A Demopublican or Republicrat?

Back in 1959 when my dad died, almost everyone had a pension waiting for them when they hit sixty-five.  You’d get a fancy watch, a goodbye party, a pat on the back by the boss, handshakes from your colleagues and out the door you went.  A month later you got your first pension check.  If you were a union member, you usually got a pension from the brotherhood as well.

A pension.  This was part of the promise the company made to you for your decades of toil on its behalf.  These pensions were mostly the result of unions.  Pension were part of the negotiated compensation packages and while not generous, pensions took care of you.  Companies could afford these pensions because most people died in the harness before they were eligible for retirement.  In my dad’s case, cancer took his life when he was fifty-nine, six years before reaching the magic number of 65.  No pension there.

Back when Social Security was developed, most people earned their bread by back-braking toil that left them spent and used up with broken health long before age sixty-five, then they died.  If they lived beyond sixty-five, they didn’t live long.  Social Security was there to prevent these ruined old men and women from living in dire poverty.  Oh, sure, the scolds on the TV money shows put their noses in the air and sniff that it was the old farts’ own fault because they didn’t save.  Well I’ve got news for the scolds: People didn’t make enough to save.  In any case, along came FDR and Social Security which was — and still is — a compulsory savings plan.

Now it’s 2017 and pensions are things of the past, as are the unions that got them.  Now, people have to rely on the pathetic 401k plans and outright investments (mutual funds, real estate investment trusts, etc).  The trouble is these things are not reliable, as recent history has amply demonstrated.  You can get seriously burned.  Witness Enron whose collapse left many people stony-assed broke.  Of course the miscreants who skinned the investors were jailed, but that’s small comfort to the thousands whose dreams of a comfortable retirement went down the drain.  The only thing they had left was — you guessed it — Social Security.  With the death of traditional corporate pension plans, Social Security has become America’s pension plan.  For most of us today, there is nothing else.

Of course, some say Social Security is nothing but a con.  A Ponzi-like scheme that takes from the young to give to the (always deemed improvident and undeserving) old.  Yes, it does — just like the insurance policy you buy from Prudential or The Hartford or whomever.  It’s the good old free market.  Nothing wrong with that, is there?

Now, as to how much you “contribute” (their word, not mine) to your Social Security account: If you are an employee, you see the FICA deduction on every pay stub.  But that’s only half; the employer kicks in an equal amount.  Your FICA is $50, your boss kick-in another $50 for a grand total of $100. This is why Social Security is solvent.

Another seldom-recognized fact: Social Security is not part of the Federal budget.  It stands alone.  It’s independent.  To say that because the Federal budget is a mess, Social Security is a mess too, is disingenuous.

If Social Security is not as funded as well as could be, and should be, it’s because Congress keeps plundering the Social Security fund to pay for such things as pet projects and wars.  Yes, wars.  Why haven’t your taxes gone up to pay for a set of wars whose price tag, buy some accounts, is over $1,000,000,000,000?  Because Congress plundered the Social Security fund to pay for them, that’s why.  If we had prevented Congress from touching the fund, or interfering with its management, we’d all be retiring at age 50.

So, then; we should keep Social; Security, but with some provisos.

  1. Social Security remains outside the Federal budget.
  2. Congress keeps its mitts off.
  3. To reduce the temptation of raiding the fund, there will be a hefty War Tax levied on all taxpayers whenever Congress sends troops overseas to fight.
  4. FICA will apply to every dollar earned: Salary, commissions, investments, hedge funds — whatever.
  5. As with FICA, there will be no cap on incomes.
  6. Estates providing $5,000,000 or less to each heir will be tax-free.  Over that, the estate will be treated as a Social Security contribution.  It will be liquidated and the proceeds will go directly into the Social Security trust fund.  NOTE: This proviso should be especially appealing to those who heatedly admonish others to stand on their own two feet and pull themselves up by their bootstraps.

We keep Social Security.

-Merlin-