Our Health Care Dilemma - Part 3 - Quo Vadis?

If you are old enough to recall the 1951 film of that title, starring Robert Taylor and Deborah Kerr, you should know that the translation is, "Where are you going?"  That is what I hope to divulge in this, the third and final installment of the series.  I hope you took my advice last week and thought long and hard about where you stand on our current health care dilemma, because we will all be directly, and probably disastrously, affected by ObamaCare.

In the first two parts, I tried to develop a primary cause for the rising costs of health care. I am convinced that the biggest factor affecting cost is government intervention in the system.  I'm afraid that it will now become a huge factor in quality of care as well, and I don't anticipate improvement, but rather decline in that aspect, as has been demonstrated time and again in every single country that practices socialized medicine. Longer waiting periods and fewer doctors has proven to be the universal outcome.

Now, I'm not naive, and we all know there are cases of greed and fraud among the health care providers.  Anytime you create a system as large as Medicare/Medicaid, you invite fraud.  I'll even give you a crystal clear example.  I used to take warfarin, a generic drug, to control blood coagulation, and it was necessary to get tested once a month at a clinic.  I quit warfarin, which cost me pennies for each pill, and had my doctor prescribe another drug that costs me over $250-per-month, because every time I went to that clinic for testing a doctor billed Medicare $100. He bills that $100 for every single patient who gets tested there, and yet, I have never met him, and I suspect he has never set foot in the clinic. The new, expensive drug does not require the prothrombin time test, so I no longer go to that clinic and pay that crook.

We are now on the verge of a government-sponsored and soon-to-be single-payer health care system geared to cover literally every single person in this country, citizen or not. Now I ask you, what could possibly go wrong?

Here is what is already wrong with ObamaCare.   

• In 2010, the Federal Register, the official journal of the federal government of the United States, contained a prediction that 93 million Americans would lose their current healthcare coverage if the Affordable Care Act (ACA) was passed.  President Obama continued to tell us that "...if you like your healthcare, you can keep it ... Period." This is what he says now.
• Nancy Pelosi made a statement in favor of the ACA that, "We have to pass it to learn what's in it."  That is, according to physicians, the definition of a stool sample. I'll let you draw your own conclusions.
• President Obama promised on many occasions that premiums for the new healthcare would be reduced by $2500 per family of four.  To date, people who have been able to sign up for the ACA have found that premiums and deductibles are much higher than their prior healthcare contained.
• The government website to register for ObamaCare, which cost taxpayers over 500 million dollars, has not operated properly since it was activated, and only a handful of people have been able to sign up.  (That may be a blessing in disguise.)
• The "death panels" that Sarah Palin was mocked and castigated for mentioning, do, in fact, exist and are fully operational.  And they are exactly as Palin described them; no licensed physicians need apply. The people who get to decide whether or not you can be treated are all pencil-pushing accountants, not doctors.
• There are over 20 new taxes in the ACA and, while most are business taxes, they will all be passed through to the middle class consumers of those goods and services.
• We are only in the infant stages of ObamaCare, and there are many who predict that costs will far exceed estimates, and premiums in future years for all health insurance will again rise dramatically. 

One little detail that the ACA left out, one that may be an escape hatch for everyone, is that , while the IRS can penalize you for not having a healthcare plan, they cannot force you to pay the fine—or tax, as Chief Justice Roberts termed it.  The only way they can collect it is to deduct it from any federal tax refund you may have coming.  That is all the more reason to use the W-4 to maximize withholding so that you always owe tax with your federal return.  No refund = no penalty.

If anyone would like to accuse me of "hating" President Obama because he is black, I do not. I do dislike him, but I don't "hate" anyone because of the color of his or her skin.  There are many, many reasons detailed above as to what I dislike about the Obama  administration. For the record, I also disliked George W Bush for implementing the Medicare Part D prescription drug program.  I disliked his father for promising not to raise taxes and then breaking that promise.  I disliked LBJ for not only his Medicare and Medicaid schemes, but also for the Great Society debacle, which started all this madness.

As further proof that I don't hate President Obama because he is black, I would, in a heartbeat, vote for Herman Cain, another black man, for president.  In fact, I can think of several black, Hispanic and Asiatic Americans, men and women, whom I would gladly vote for as president.

I know this column was way too long, but it was necessary to put this much detail in to counter a bad bill that was 2600 pages long itself, and has over 22,000 pages of rules and regulations to govern it.  I trust that you appreciate my effort.

Our Health Care Dilemma - Part 2 - A Brief Medical History

This is the second in a 3-part series.  I could have put it all in one column, but it would have been too long to read in one sitting.  In this part, I'm going to go back to some of my medical records, all of which my wife has kept since we were married 51 years ago.

I'm not concerned about providing some personal and private medical facts about myself and my family.  After all, most of this stuff will soon be available online to anyone with a computer and the time to find it.

But first, the answer to some of those questions I posed in the first column.  How did we get to here from there; there being the days when health care was either provided in the home by some inventive and caring parents, or by a doctor who made "house calls" or saw you in his or her office without an appointment.  What's more, you weren't charged an arm or a leg for the treatment.  Here being... well, let's examine it.

To repeat the questions, "Why did the costs go up for treatment we sometimes wait hours, or days, or even months to receive?" Was it the greedy insurance companies?  Was it the high cost of modern technology?  Was it the greed of the health care providers?  Was it due to inflation of wages and prices in general? 

Fact: In 1965, President Lyndon Johnson signed into law a bill passed by Congress that established two national and government-sponsored health care programs, Medicare and Medicaid.  Medicare was for the elderly and Medicaid was for the poor.  What could be more fair?  Other than those people able to afford private health care, and those who were insured by their employers, seniors and the indigent were the primary segment of our society that needed help with the costs of that care.

I married in 1962 and our first child was born in 1966.  I wasn't eligible for either Medicare or Medicaid, but then, I really didn't need help with the cost of Judy's pregnancy or Brad's birth.  I still have the bill from Kenmore Mercy Hospital, dated 5/26/1966, for the 5-day stay ($180) plus the live birth ($175) with incidentals ($94), for a total bill of  $449.  Insurance paid all but $100.

While greed, technological advances, and inflation mentioned above might have had some influence on costs, none of them would, individually or in concert, account for the astronomical increase that took place from 1965 to today.  Even when my daughter was born in 1971, the cost-per-day for the hospital room was only $42.50, up from $25 in 1966.  But that increase was already fifty-eight-percent in less than 5 years. 

No, there is only one big contributing factor that would cause costs to rise so much: Government health care comes with very strict limitations on reimbursement, and those limits are not based on actual cost of treatment, but on a percentage of the cost.  So, if a specific procedure costs $500, a pencil pusher somewhere pegs the maximum payment for that procedure at 40-percent, or $200.  In order for the provider to recover the actual cost, the bill must be submitted for $1250.  That is 150-percent inflation.  And every time the cost of treatment goes up for the provider, it goes up 150-percent for the payee - in this case, the government.

When our beneficial government got involved in the providing of healthcare - something that was never authorized or condoned by the Constitution or any amendments thereto - they became the largest cause of inflated prices for that care, not only for the elderly and the poor, but for everyone.  After all, when you send a bill to one insurer, you also have to charge every other insurer that same price to dispel any hint of fraud or favoritism. 

From 1975 onward, the prices for hospital stays, tests, supplies, doctor visits, surgical procedures and just about everything else took off faster than a jet on afterburner.  To  give you an idea of how rapid it was, and how high it went, I had coronary bypass surgery in October of 1980, and the total cost for doctors, anesthesia, surgery and hospital stay was a shade over $9,700.

In a more recent case, my outpatient visit to the hospital in 2010 for implantation of a cardio pacemaker/defibrillator came to $81,340.20 and I didn't even spend a single night in the hospital.  Of course, Medicare and United Healthcare only paid a combined total of about $15,000 after discounts and adjustments, but still, you can see the effects of costs to payments.  I attribute about 90-percent of that to Medicare/Medicaid billing practices, which have leapfrogged with payment schedules in an endless upward, out of control spiral.

Now that I've established a valid reason for the high cost of medicine and healthcare today, we still have some other contributing factors.  I'll expose those in the final chapter next week, but meanwhile, think about where you stand on the current threshold of complete control of your well-being entrusted to some bureaucrat in Washington.

Our Health Care Dilemma - Part 1 - The Gory Glory Days

This is the first of a 3-part series on our current health care in America.  The views expressed in this column are my own exclusive ones, and I make no apology for them.  However, I challenge you that, if you can find any evidence to dispute what I am about to present, I would love to have you either send me a message with the facts, or post your comments at the website whenilk.blogspot.com.  I promise to publish your comments as a follow up column (anonymously, of course) if you don't want to put them on the blog.

I recall in my youth in the 1940s and 1950s that when I was sick or injured our family doctor would come to our house, or my parents would take me to the doctor's office and he would treat me that same day.  The ER - emergency room at the hospital - was used only for emergencies, those times when injury or illness was serious enough that there was no option but to treat at the hospital.

The bill for treatment, whether in the home or at the doctor's office, was always, to my knowledge, reasonable.  It was often paid by my parents, but I'm sure we had some kind of health insurance, as well, and higher cost care was paid by an insurer.  And, with all the treatment that a family of seven needed, I never heard my parents complain about the high cost of health care.

At times when no quick treatment was available, we made do with what we had in the vicinity, or in the medicine cabinet.  For those of you too young to have seen it, a medicine cabinet was that wall mounted or built-in, 3-inch deep, 3-tiered box in most bathrooms, usually with a hinged mirror door, that contained every home remedy known to humankind. There seemed to be a pill or liquid in there for every known malady, plus a few things YOU WERE NEVER TO TOUCH!  They must have been toxic.

Our house was a magnet for the neighborhood kids to play, maybe because we had a side yard with a sunken badminton court cum ice hockey rink in it.  Of course, that was an arena for accidents, as was the side street alongside it where we played baseball, football and other games on the concrete surface.  I can recall my mom fashioning a sling from a Life Magazine, an old tee shirt and a belt to splint a broken arm.  She was a whiz with homemade aids for all kinds of ailments, too.  Unless there was blood and guts, she could make a temporary fix for it, and often the blood didn't stop her either.

Little did we know that there was a major transformation taking place in health care back in those halcyon days.  It's no secret that sometime between 1965 and 1975, the house call and the unscheduled visit to the doctor became obsolete, replaced by the immediate care clinic and the hospital emergency room for those who couldn't wait. Meanwhile the cost for treatment also rose faster than the sun on a clear summer day.  You may ask, "Why?"  Was it the greedy insurance companies?  Was it the high cost of modern technology?  Was it the greed of the health care providers?  Was it due to inflation of wages and prices in general?

We're going to explore just what happened to our medical costs and treatments in the next part in the series, so stay tuned and keep this column handy to review next week.

Emergency Lighting

This is an idea that I borrowed from one of my email buddies.  There was no author shown, and research didn’t turn up any originator either, so I’ll publish it under my byline with apologies if I stepped on someone’s idea.

If you experience a power outage at your house at night, the first thing you do is get out the candles or a flashlight or some other source of light.  If a light source isn’t available then you sit in the dark hoping the lights will come back on soon. And let’s face it; we have become very dependent on lighting in our lives. Even on a dark and stormy day we sometimes depend on indoor lights, so loss of power is a big deal.

Here’s an idea! Use outdoor solar lights inside when the current is off.  You can stick them in a jars or bottles. Then place them on a table or counter to serve as your emergency lighting. When the emergency is over and the power comes back on, just put them back outside to recharge.  If the outage lasts several days, just keep recharging them outside during the day and bring them in at night. They are safer than candles to use and cheaper than batteries. 

 

If you know a storm is coming, the sky is dark and you fear loss of electricity, you can even bring your solar lights inside and charge them with your indoor lights.  That’s right, they don’t really require sunlight to charge but work equally well with incandescent or even fluorescent light as the charging source.

The light can be removed from the post used to stand it in the  ground and will fit into a small water bottle.  They also fit into most of the larger liter bottles.  You need a weight in the plastic bottle to keep it from tipping over. You can put in a few of the pretty "flat marbles" that are made for aquariums and vases.  (You can also use sand, aquarium gravel; whatever you have available.)

There are all types of solar lights available.  I noticed that Target had some on sale for $11 for a set of six that normally cost $30. So I went to Target and found that they also had individual solar mini-lights for $2.  However, after using one of the mini-lights, I determined that they aren’t bright enough to read by. They will allow you to get around without tripping over furniture, but they are more like a night light than a regular wattage light bulb. 
 

My recommendation is that you purchase a solar light about the size of a regular light bulb.  Some are even marked "Bright" on the label, so they are the best choice.  Also, don't figure on using one light per room.  Two or three would be better, and if you plan to read a book or magazine by solar light, you'll need one right up close, no more than a foot or two away.

Solar lights will keep glowing for at least 6 hours if fully charged, plenty of time to take you through an evening outage.  They are great decorative lights that will serve in a storm or other power outage. When not in use as emergency lighting the solar lights make nice sidewalk or driveway lights, so they never go to waste. They look nice and they do not attract flying bugs like the outdoor lights around the doorways.

Isn’t this a great idea!

A Gathering of Eagles

If you ever go into a stand-alone McDonalds Restaurant – any McDonalds in any town or location will do – between the hours of 6 AM and 9 AM, I can guarantee that you will find a group of old men sitting at a table chatting and having their breakfast. 

Why can I make this claim?  First, because I’ve been one of those guys from time to time. And second, I have some experience with visiting the fast food giant at various times and locations throughout America in the early morning hours. Without fail, there are always that familiar set of elders, usually all males, laughing and sharing the coffee and eats.

I look at McDonalds as the retiree’s water cooler, and I have lots of good memories of my times sitting at the one on Trans-Mountain Boulevard in Northeast El Paso with five or six of my “buddies.” 

When you look back at past times, I guess the campfire was the original meeting place for the elders, but the pot-bellied stove, the barbershop, and other warm and friendly places where men gathered for a confabulation later replaced it.  Eventually, it had to be a McDonald’s Restaurant or some other equally welcoming fast food joint. I think Mickey-Ds got the nod due to its ubiquitousness.

Harking back to that place in El Paso, I want to relate a tale about my meetings there.  I had been partaking of my early breakfast with the boys for several months before I learned an interesting fact; one of them had a famous brother.

The man I knew simply as H. D. (he said it stood for “Heavy Duty” and I never did learn what names went with the initials) started talking about his brother, Ronnie, one morning.  Everyone else at the table knew exactly who he was referring to, but I was the newcomer and, consequently, in the dark.  Eventually, the conversation got around to Ronnie’s movie roles.  My curiosity piqued, I asked about what movies his brother was in.  H. D. responded that the biggest one was Deliverance.

The light went off in my head and I looked at old H. D. again and immediately saw the resemblance to Ronnie Cox.  Well, I was flabbergasted, but I still wasn’t completely convinced that he was related.  Everyone at the table assured me that he was, and to prove it for certain, I got a picture the next morning signed by Ronnie to his brother.

H. D. Cox might have been the most connected with celebrity, but he wasn't the most interesting of the group.  That honor went to another, whose name I've misplaced.  he was the oldest of us, well into his 70s even back then.  His claim to fame was his expertise in repairing anything mechanical or electrical.  If you had an old appliance or tool - almost anything - that had given up the ghost, he could strip it down and make it work again. I think he sold his "fixer-uppers" and lived off the profits.  He was an interesting old guy.

Since I had been one of the old geezers at those morning meets out west, I always try to greet the old-timers at any McDonalds when I walk in the door.  I’ve never joined another group quite like them, and I treasure my memory of those fellows in El Paso.  I do stop in every once in a while at our McDonalds in Grovetown and visit for a few minutes. It’s always a good way to start the day.

Pretty in Pink

October is Breast Cancer Awareness Month, and just in case you haven't noticed, there is a lot of hoopla, and ribbons, and garments, and apparel to remind us.

I've watched the silliness of pink golf clubs and golf balls on PGA pros, pink shoes and towels on NFL players, pink penalty flags in the pockets of the NFL referees—well, that one only lasted a week, since it caused so much confusion on the field—complete pink outfits on PGA golfer Ricky Fowler and even pink products, like 5-Hour Energy.

I won't apologize for making light of this farce.  After all, breast cancer, while a serious problem, is not as pervasive as prostate cancer in men, and which month is it that we herald Prostate Cancer Awareness?  And come to think of it, HOW do we show our support for PCA?  Baby blue golf clubs, NFL apparel, penalty flags, and  on and on?

Why can't we men have our own cause célèbre?  Is it really more important for the ladies to "save the ta-tas" than it is for men to ... (well, let's not get too graphic here)  The fact is, though, that prostate cancer kills about the same number of men as breast cancer kills women, yet breast cancer research and awareness gets four times as much funding as prostate cancer.

Hey, I've got an idea... lets make the prostate cancer awareness symbol a pair of blue walnuts.  After all, they always describe the prostate gland as being, "...about the size of a walnut."  What could be more American male than a pair of blue nuts?

While we're on the subject, why is it that, if breast cancer awareness is so important, the scheduling of mammograms has now been scaled back?  In case you're too busy (or lazy) to click on the link, here is a summary of the changes recommended by the USPSTF, a.k.a. United States Preventive Services Task Force:

• Routine screening of average-risk women should begin at age 50, not age 40.
• Routine screening should end at age 74.
• Women should get screening mammograms every two years instead of annually.
• Breast self-exams have little value, based on findings from several large studies.

That last one is really a bummer, because when it comes to palpating the breast, we guys are always more than happy to volunteer and assist.
 

I cannot leave the subject without one more piece of sarcastic humor.  Here is my favorite cartoon on the mammogram/manogram dilemma...

Okay, all kidding aside, do whatever it takes to get screened periodically for any form of cancer, but especially for these two killers.  Early detection is critical to cure rates.

Variation on a Nursery Rhyme

I want to give credit where credit is due.  The idea you will read about is not wholly mine, but was subtly suggested by my house guests from earlier this year.  whether intentional or not, they put this thought in my head, and I believe it is a good one.

After our guests had left for home, I discovered that there were pennies on the floor in both bedrooms.  Was that merely an accident?  Did the penny drop out of a pocket when pants were being hung up for the night?  Or was it a purposeful gesture?

I guess we all know the old nursery rhyme that goes:

See a penny, pick it up

And all day you'll have good luck.

See a penny, let it lay,

Bad luck you'll have all the day.

There are variations on the poem, and some even say that the original rhyme referred to a 'pin' instead of a penny.  Also, some people say the superstition involved goes a step further and includes an admonition that:

If the penny faces north,

Then your luck will have some worth.

But if its face is heading south,

Then your luck will be in drouth.

In other words, if the penny is heads up, your luck will be good, but if it's tails up, you're in for some bad luck instead. (Look up the definition of 'drouth' in case you think that was a misprint)  In reference to the second verse, you've probably heard the old proverb, "It turns up like a bad penny."  That is also a reference to the bad luck associated with a penny found with the head facing up.

I mention the variations only to acquaint you with them, but the first printed rhyme above is the one I subscribe to, if there is any esoteric significance in picking up a penny.  I always do pick them up, and on more than one occasion I've found the proverb to be true. I don't look first to see which side is up, either.

The discovery of the pennies in each of the bedrooms gave me an inspiration.  As you all know, my wife and I are road trippers.  We travel at least four times a year, and most of that travel involves overnight stays at hotels.  Our hotel stays number about 30 per year, and we always leave a gratuity for the maids who will clean and straighten our room.

My thought is that, if the room was in satisfactory condition when we checked in, or if it was even more than we expected—yes, that happens from time to time—in addition to the tip we leave on the desk, I will purposely drop a penny on the floor somewhere in the room. I think you get the idea, don't you?  Why not give the maid a share of the 'good luck' that comes from the find?

Now, just in case the maid believes in that other part of the blessing/curse, I will always leave the penny heads up so that there is no doubt which way I want things to go.

I believe I've discovered a new way to enhance my gratuities, don't you?