Sunday, June 27, 2010
I took Goldilocks to the beach yesterday. Mainly because the rest of the family needed a break, but also because it was hot and he loves the water. We have a state park with a very nice beach only 15 minutes away. So we went and had a great time for about an hour, until Goldilocks needed to use the restroom. I, for once didn’t panic about if he would say something inappropriate to a stranger or walk into the wrong restroom. He’s been doing so well in this area, when Papa & Brother Bear are around, that I didn’t worry at all. I didn’t even get out of the water, it’s only about 50 yards to the restroom. What could happen? I watched him go to the correct door, yeah! Then he came out and came back to the water. I asked him how it went. He answered “okay, but the floor was wet, I fell & I’m bleeding to death” Goldilocks says he’s bleeding a lot when he’s not, so I thought, “oh, sure,” but I did look just in case. He did indeed have a cut on the back of his head that was bleeding. It didn’t look bad. I hustled him out of the water, grabbed a towel to apply direct pressure, held it on with one hand and gathered our things with the other hand. Walked him to the car, got him in and realized, we don’t have a first aid kit in our car (we do now). I quick called Papa Bear to see if the rangers had a first aid station and drove Goldilocks up to the main gate. The whole time applying direct pressure and not looking at the wound. When the ranger showed up she took one look at the wound and said in a loud voice “It may need stitches” Thanks lady, now I have a hysterical Autistic kid screaming the whole way home. Papa Bear looked at it. A small cut not very deep. Asked how long it bled, less than five minutes. We cleaned it up and gave the boy a Tylenol for his headache. No stitches were needed, it’s healing nicely. It really wasn’t so bad. So why do I feel like a heel for not walking him to the men’s room & waiting outside the door? Like I could have stopped this from happening, if I did something differently.
Sunday, June 20, 2010
You Can Run, but you Can't Hide
Certain hotel chains provide their guests with a complimentary newspaper, usually USA Today. So imagine my annoyance when I opened my door this morning and found The Countywide Universal Amalgamated Journal Sentinel Tribune Post Dispatch News-Free Press Sun Chronicle Daily Planet Democrat Observer!
Labels: Humor, Paper Trained
Saturday, June 19, 2010
The Countywide Universal Amalgamated Journal Sentinel Tribune Post Dispatch News-Free Press Sun Chronicle Daily Planet Democrat Observer, discontinued.
You remember that I never wanted the paper. And it turned out not to be the one MB wanted, either. It was a lousy source of news, and not that great on coupons, either. I hated to throw it in the dumpster, so I was spending over an hour each week (closer to two hours) shredding and composting it. I didn't care about getting my money back; I just wanted them to stop sending it. I almost would have paid them not to deliver the paper. But I'd had so much trouble starting a subscription, I dreaded canceling it.
Did you ever have AOL? At one time, (in the early '90s) they had the best rates in town. As more people went online, new ISPs entered the market, and competition brought the price down. AOL responded by doubling their base price and offering unlimited access. (Strange as it may sound now, Internet service used to be billed like cell phone service: you paid a monthly fee and got a limited number of minutes. Any use over that time cost you extra.) The problem was that you couldn't get through. You'd get a busy signal every time. Eventually, other providers began offering unlimited service at lower prices, and you could actually connect. Rather than improve their service, AOL tried to keep people from canceling. If you called to cancel, first they would try to talk you out of it. If that didn't work, they would try to sell you on another plan. One plan they tried to sell me was called "Bring Your Own Access". If I paid the same price they were charging for Internet, but bought my Internet service from another provider, they would allow me to access their content through my other provider. I could even keep my email address. All this for the same price I was already paying them for Internet, but they wouldn't have to provide it! If you didn't fall for that, they'd start bargaining. A common ploy was to offer one month of free service. Then you'd have to call them up and try canceling again, and listen to the same song and dance again, or they'd continue billing you. And you couldn't get the free service twice. Even if you got them to agree to cancel your service, they would "accidentally" lose the cancellation order and keep billing you. It took most customers three calls to AOL to get their service cancelled. I had to tell my credit card company to stop paying them.
I feared I'd face similar obstacles canceling the paper. And it was MB's paper, so I didn't want to cancel it without talking to her. Then one day she said, (God bless her!) "Why don't we just cancel the paper?" And she made the call. Like I said, I don't deserve her.
The next day, no paper. About a week later, we received a check in the mail, refunding the portion of the introductory subscription we hadn't used. The Countywide Universal Amalgamated Journal Sentinel Tribune Post Dispatch News-Free Press Sun Chronicle Daily Planet Democrat Observer does a lousy job of reporting the news. Their salesmen lie. They are slow to start a subscription, and seem to have a hard time delivering the paper to the right address or even the right town. But if you ever want to cancel a newspaper subscription, I recommend this one.
Did you ever have AOL? At one time, (in the early '90s) they had the best rates in town. As more people went online, new ISPs entered the market, and competition brought the price down. AOL responded by doubling their base price and offering unlimited access. (Strange as it may sound now, Internet service used to be billed like cell phone service: you paid a monthly fee and got a limited number of minutes. Any use over that time cost you extra.) The problem was that you couldn't get through. You'd get a busy signal every time. Eventually, other providers began offering unlimited service at lower prices, and you could actually connect. Rather than improve their service, AOL tried to keep people from canceling. If you called to cancel, first they would try to talk you out of it. If that didn't work, they would try to sell you on another plan. One plan they tried to sell me was called "Bring Your Own Access". If I paid the same price they were charging for Internet, but bought my Internet service from another provider, they would allow me to access their content through my other provider. I could even keep my email address. All this for the same price I was already paying them for Internet, but they wouldn't have to provide it! If you didn't fall for that, they'd start bargaining. A common ploy was to offer one month of free service. Then you'd have to call them up and try canceling again, and listen to the same song and dance again, or they'd continue billing you. And you couldn't get the free service twice. Even if you got them to agree to cancel your service, they would "accidentally" lose the cancellation order and keep billing you. It took most customers three calls to AOL to get their service cancelled. I had to tell my credit card company to stop paying them.
I feared I'd face similar obstacles canceling the paper. And it was MB's paper, so I didn't want to cancel it without talking to her. Then one day she said, (God bless her!) "Why don't we just cancel the paper?" And she made the call. Like I said, I don't deserve her.
The next day, no paper. About a week later, we received a check in the mail, refunding the portion of the introductory subscription we hadn't used. The Countywide Universal Amalgamated Journal Sentinel Tribune Post Dispatch News-Free Press Sun Chronicle Daily Planet Democrat Observer does a lousy job of reporting the news. Their salesmen lie. They are slow to start a subscription, and seem to have a hard time delivering the paper to the right address or even the right town. But if you ever want to cancel a newspaper subscription, I recommend this one.
Labels: Humor, Mama Bear, Paper Trained
Friday, June 18, 2010
And what better way to say "I love you." than with the gift of a... stapler?
Yes, I know, the correct answer is supposed to be spatula. And I sent Mama Bear a virtual spatula as a thank-you. I even gave her a spatula with the Spatula City label on our wedding day, and she carried it proudly in her bouquet.
But I've been envying Arby's stapler ever since he posted about it. So, when Mama Bear asked what I might like for Father's Day, I had to think for a moment. She suggested cash because she knows I am saving for a computer. She has an obsolete laptop that can check email, and that's about it. My computer is somewhat more powerful, but it's nine years old, and the boys are needing it more and more for school. And I really would like to have a laptop. But the more I thought about it, the clearer it became that what I really wanted was a stapler like Arby's.
So I asked for one. She had to go to three stores to find it, but oh, was it worth it! I won't try to describe it, because Arby has already described it so eloquently. But it's red. And it's metal. And it opens out flat if you want to staple something to a bulletin board. And it doesn't care if I'm stapling two sheets or twenty, it expertly joins them with a satisfying "ka-chunk." Let's do that again slowly: "kut-a-chunk".
And she didn't even make me wait for Father's Day. She said this was just an "I love you" gift. As if that weren't enough, she managed to score us a free hotel night and get Grandma to take the boys. But guess which weekend? That's right, June 19-20.
She was bummed that it meant we'd miss celebrating Father's Day as a family. So we celebrated last Sunday. She asked what I'd like for dinner, but nothing sounded quite right. Then I thought of steaks on the grill. So we swung by the grocery store after church, and she selected some, and told me not to look at the price tags. Then she volunteered to cook them. That's the thing about grilling: I'm as big a pyro as the next guy, (No, let's be honest here. I'm a bigger pyro than the average male.) but I hate to cook as much as I love to eat. So I set up the grill, and she grilled the steaks. Sirloin and mashed potatoes—does it get any better than that?
Yes, it does. Mama and the boys set up a treasure hunt that afternoon. They broke the money for my gift into fives, hid them, and gave me clues. They gave me the first clue as a freebie. In each hiding place was a fiver and the next clue. The first clue read: "You're a great Dad. You are good at many things. We have hidden your gifts to test your finding skills. Your first gift is hiding in a musical spot."
Then I heard, "Yoo-hoo! I'm hiding!" (pause, followed by a giggle and then another pause,) "Boing-boing!" (pause) "I'm over here!" (more giggles)
On top of the piano, behind some CDs, I found that goofy talking Easter Egg. When I opened it, it said, "Surprise! You found me!" (more giggles)
Inside was the first fiver and the next clue: "Look for your next gift under the object that makes the 'ka-chunk' sound."
Found that one right away. The next clue read, "All of this finding is tiring. Maybe a strong drink would help. Your next gift is hidden where you would make yourself a strong drink."
Sure enough, it was in the basket of my four dollar Goodwill espresso machine. The next clue read, "Your next gift is inside the wordiest gift you have ever given me."
I ran straight to the shelf, pulled out the dictionary, and began riffling through the pages. I first realized she was something special when she asked for a dictionary for her birthday. She later told me that she had asked for one several times before, but no one else had ever believed that was really what she wanted.
So I get to celebrate Father's Day three weeks in a row. I got a stapler that would make Tim Taylor proud, a steak dinner, twenty bucks for my computer fund, and a free hotel night with my wife.
At this point, all the men are wondering, "Papa Bear, what did you do to deserve such a wonderful wife?"
And that's just the point. I don't.
But I've been envying Arby's stapler ever since he posted about it. So, when Mama Bear asked what I might like for Father's Day, I had to think for a moment. She suggested cash because she knows I am saving for a computer. She has an obsolete laptop that can check email, and that's about it. My computer is somewhat more powerful, but it's nine years old, and the boys are needing it more and more for school. And I really would like to have a laptop. But the more I thought about it, the clearer it became that what I really wanted was a stapler like Arby's.
So I asked for one. She had to go to three stores to find it, but oh, was it worth it! I won't try to describe it, because Arby has already described it so eloquently. But it's red. And it's metal. And it opens out flat if you want to staple something to a bulletin board. And it doesn't care if I'm stapling two sheets or twenty, it expertly joins them with a satisfying "ka-chunk." Let's do that again slowly: "kut-a-chunk".
And she didn't even make me wait for Father's Day. She said this was just an "I love you" gift. As if that weren't enough, she managed to score us a free hotel night and get Grandma to take the boys. But guess which weekend? That's right, June 19-20.
She was bummed that it meant we'd miss celebrating Father's Day as a family. So we celebrated last Sunday. She asked what I'd like for dinner, but nothing sounded quite right. Then I thought of steaks on the grill. So we swung by the grocery store after church, and she selected some, and told me not to look at the price tags. Then she volunteered to cook them. That's the thing about grilling: I'm as big a pyro as the next guy, (No, let's be honest here. I'm a bigger pyro than the average male.) but I hate to cook as much as I love to eat. So I set up the grill, and she grilled the steaks. Sirloin and mashed potatoes—does it get any better than that?
Yes, it does. Mama and the boys set up a treasure hunt that afternoon. They broke the money for my gift into fives, hid them, and gave me clues. They gave me the first clue as a freebie. In each hiding place was a fiver and the next clue. The first clue read: "You're a great Dad. You are good at many things. We have hidden your gifts to test your finding skills. Your first gift is hiding in a musical spot."
Then I heard, "Yoo-hoo! I'm hiding!" (pause, followed by a giggle and then another pause,) "Boing-boing!" (pause) "I'm over here!" (more giggles)
On top of the piano, behind some CDs, I found that goofy talking Easter Egg. When I opened it, it said, "Surprise! You found me!" (more giggles)
Inside was the first fiver and the next clue: "Look for your next gift under the object that makes the 'ka-chunk' sound."
Found that one right away. The next clue read, "All of this finding is tiring. Maybe a strong drink would help. Your next gift is hidden where you would make yourself a strong drink."
Sure enough, it was in the basket of my four dollar Goodwill espresso machine. The next clue read, "Your next gift is inside the wordiest gift you have ever given me."
I ran straight to the shelf, pulled out the dictionary, and began riffling through the pages. I first realized she was something special when she asked for a dictionary for her birthday. She later told me that she had asked for one several times before, but no one else had ever believed that was really what she wanted.
So I get to celebrate Father's Day three weeks in a row. I got a stapler that would make Tim Taylor proud, a steak dinner, twenty bucks for my computer fund, and a free hotel night with my wife.
At this point, all the men are wondering, "Papa Bear, what did you do to deserve such a wonderful wife?"
And that's just the point. I don't.
Labels: Al Yankovic, cooking, Mama Bear, Something to Offend Everyone, spatulas, staplers, tools, UHF
At bedtime, I always pray with GL when I tuck him in. He always prays the same prayer:
Dear God,
I love you.
Amen
But last night was different. After I prayed my usual prayer, he prayed:
Dear God,
1-2-3
Good Night!
Dear God,
I love you.
Amen
But last night was different. After I prayed my usual prayer, he prayed:
Dear God,
1-2-3
Good Night!
Labels: autism, Humor, Prayer, Quotes, Something to Offend Everyone, weather report
Thursday, June 17, 2010
Just wait until they start pretending not to ration care
GL saw the orthopedist yesterday. He sees him every year. It's always a difficult visit for GL because he is afraid of the x-ray machines, with their cold tables, big, mysterious moving parts, and strange noises, and because he knows this is the doctor who uses the "s" word: "surgery". He also refuses to believe that there is any such thing as a doctor who doesn't give shots in his office, and is sure every doctor is secretly planning to stick needles in him.
His hip is fine, but we had actually moved this visit up because his ankles had got so much worse in the last months. He's walking on the inside of his feet again, and the medial malleoli nearly touch the floor when he stands without shoes. When we took him to have his orthotics adjusted, the orthotist said it wasn't the orthotics, it was because the insides of his shoes were worn down. So we replaced them, and he wore down the insides again. He's worn out four pairs of shoes since January. So I was hoping for new orthotics, maybe even going back to AFOs, if needed, and a new scrip for PT because he is obviously losing ground here, and his prior authorization ran out about the time his ankles took a turn for the worse.
I always get anxious preparing for a doctor visit. I feel like I have to gather all the right information, present it in exactly the right way, and present my kid and myself in exactly the right way, or my kid won't get the care he needs, and it will be all my fault. Yes, doctors are supposed to be observant, and treat everyone the same, but there are times when that just doesn't happen. And there are times when the doctor has obviously made up her mind before she even examines your kid. That doesn't keep me from second-guessing myself. "Maybe if I had said... or not said... Did she that think he's a malingerer? or a spoiled brat? Or that I'm some kind of a nut?... Is she jumping to conclusions about... and refusing to consider...? How could I have explained it differently?"
Like the first time I took him in for his ankles. They had looked fine, but as soon as he began to walk, there was obviously something wrong. The more he walked, the worse it got. At the only clinic Medicaid would pay for (I was a student at the time) a different doctor saw him every time. I booked an appointment. When the doctor walked in the room, she asked him a question. He refused to answer, so she immediately diagnosed him as nonverbal. (Like Donkey, sure, he talked, it was getting him to shut up that was the problem. Except around people he didn't like.) She insisted there was nothing wrong with his ankles, and wouldn't even let me take off his shoes to show her. The next week, I managed to get another appointment. I'd done some homework on the subject, but it wasn't necessary. Sure enough, we saw someone else. She took one look at his ankles and referred him directly to the orthopedist. And he talked to her.
We had the usual anxiety at the doctor's office yesterday, plus more than the usual yelling and screaming. But we managed to get him on the x-ray table despite his protests. When, instead of a high, whistling whine followed by a shrill beeeeep, the machine made a boodeloodeleep, he actually giggled. Then it was back to the waiting room. Every time another patient was called, he would jump up and yell, "No! No! I won't go back there! You can't make me!"
When he was called, he put on a similar performance, and added, "No shots!"
The assistant who called us back wanted me to confirm the list of meds he is on. Sounds easy, with only one med missing from the list, but the list was all brand names, and his insurance only pays for generics. We could list his meds but, not being a nurse, she had no idea which brand names they were equivalent to. We finally figured it out, but it took some detective work.
Another assistant performed the exam. She never introduced herself, neither by name nor by title. She could have been a doctor, a nurse, a receptionist, or a cafeteria worker who borrowed a white coat. We never did find out who she was. She asked a lot of questions, but we had to fill her in on the case, including surgeries that should have been in his records. When she was done, she left us waiting in the exam room for over an hour. Then the orthopedist showed up with a third assistant. This assistant performed an abbreviated exam while the orthopedist stood off to one side and announced that GL did not need surgery or new orthotics; he just needed high-tops. I showed him GL's orthotics and the wear pattern on his shoes. (In less than a month, the inside of the heels has completely worn away.) He said that he doesn't want to put him in something more restrictive. I thought more restrictive was the point of high-tops, but I asked if PT might help to strengthen his ankles. He said that no, this was not a muscle problem, it was a ligament problem, so PT wouldn't help. So if his current orthotics aren't working, strengthening the muscles won't help, and AFOs are too restrictive, what will hold this kid's ankles off the ground so he can walk on his feet and not his ankles? And a month from now, when he's chewed up a pair of high-tops that aren't working, how long will it take to get another appointment, and what will he do then? Heavy sigh.
GL has been seeing this orthopedist for the last five years. Until now, we've had a good working relationship. He's always been happy to prescribe whatever GL needs. And I might be willing to trust him if I hadn't seen the same pattern with all of GL's doctors lately. They're afraid that if they prescribe or refer more than the insurance companies want, the insurance companies or the government will limit their referrals and prescriptions. Insurance companies don't make money by providing health care. They make money by collecting premiums and then denying as much care as they possibly can. So the doctors self-limit care to what they think will satisfy the insurance companies, who then set that level of care as the new standard, and try to cut claims even further.
Obamacare is going to be worse, not better. I'm not opposed to providing care for the poor and the disabled; I've just seen what kind of care the government provides. The poor and the disabled get Medicaid. Medicaid treats providers so poorly that it's almost impossible to find a provider who accepts it. Single-payer would have put everyone on Medicaid. "But doctors would have to take it," you may argue, "if it were the only game in town." For anyone with the brains and ambition to become a doctor, medicine is never the only game in town. They keep playing because payments haven't yet been cut to what they could make doing something else, but cut payments enough, and they will begin to retire earlier, go to law school, or go to work for insurance companies and lawyers, cutting claims further, and helping sue the remaining doctors. Medicine will become the province of the dedicated and the incompetent.
Think leaving practice for a second career is too big a move for an established physician? Based on population trends alone, for the next twenty years, we will have more physicians retiring or dying than entering the profession. Cut payments enough, and enrolling in med school begins to sound like a sucker's bet.
So, if we can't cut payments to physicians without cutting the quality of care, wouldn't it be a safer bet to put the government in charge than private insurers? No. If a private insurer cuts claims enough, customers will switch companies. There is at least that check on their power. A company that refuses to listen to its customers will eventually go bankrupt. If you're on a government plan, and they won't pay, what are your options? 1) Go outside the plan, and pay out of pocket, like many Canadians do, coming to the U.S. If you can afford this route, why bother with the government plan? 2) If you can't afford to go off-plan, you can settle for second-rate care. If you've never been on Medicaid, you don't understand how bad government care can be. 3) Lobby for legislation to force the plan to provide preferential coverage for people with your condition. With Boomers reaching retirement age, there simply won't be enough money to treat everyone for everything. Every disease will become a political football. Of course, by the time you have a condition, it is unlikely you can get the law changed in time to help you. You will suffer with poor treatment treatment or none at all, and either get well or die first.
With all the above-mentioned pressures on the medical and insurance systems, isn't it best to keep private insurance, but under close government supervision? No. In that environment, there would be two possible outcomes: 1) the government guarantees the insurance companies the right to make a profit, making them even more powerful, (that's why the insurance and pharmaceutical companies were competing to cast themselves as good guys and each other as bad guys in the healthcare debate) or 2) under heavy regulation, private insurers go out of business one by one, leaving the remaining insurers more powerful and less affordable. If insurance is mandatory, but costs more and more while providing less and less, many of us will be forced to buy some sort of minimum coverage until the government comes to rescue us from the situation it created with some sort of single-payer plan. Eventually, only the very rich and powerful will be able to opt out. The rest of us will be forced, one by one, into some sort of single-payer system, just like Obama wanted in the first place.
There. I vented about several things that were bothering me. I feel a bit better. If you want to leave a comment, feel free, but remember it is my policy to reject all anonymous comments. If you leave an anonymous comment, it will be rejected, not because I disagree, but because it is anonymous. And don't be the moron leaving an anonymous comment objecting to my right to reject anonymous comments.
His hip is fine, but we had actually moved this visit up because his ankles had got so much worse in the last months. He's walking on the inside of his feet again, and the medial malleoli nearly touch the floor when he stands without shoes. When we took him to have his orthotics adjusted, the orthotist said it wasn't the orthotics, it was because the insides of his shoes were worn down. So we replaced them, and he wore down the insides again. He's worn out four pairs of shoes since January. So I was hoping for new orthotics, maybe even going back to AFOs, if needed, and a new scrip for PT because he is obviously losing ground here, and his prior authorization ran out about the time his ankles took a turn for the worse.
I always get anxious preparing for a doctor visit. I feel like I have to gather all the right information, present it in exactly the right way, and present my kid and myself in exactly the right way, or my kid won't get the care he needs, and it will be all my fault. Yes, doctors are supposed to be observant, and treat everyone the same, but there are times when that just doesn't happen. And there are times when the doctor has obviously made up her mind before she even examines your kid. That doesn't keep me from second-guessing myself. "Maybe if I had said... or not said... Did she that think he's a malingerer? or a spoiled brat? Or that I'm some kind of a nut?... Is she jumping to conclusions about... and refusing to consider...? How could I have explained it differently?"
Like the first time I took him in for his ankles. They had looked fine, but as soon as he began to walk, there was obviously something wrong. The more he walked, the worse it got. At the only clinic Medicaid would pay for (I was a student at the time) a different doctor saw him every time. I booked an appointment. When the doctor walked in the room, she asked him a question. He refused to answer, so she immediately diagnosed him as nonverbal. (Like Donkey, sure, he talked, it was getting him to shut up that was the problem. Except around people he didn't like.) She insisted there was nothing wrong with his ankles, and wouldn't even let me take off his shoes to show her. The next week, I managed to get another appointment. I'd done some homework on the subject, but it wasn't necessary. Sure enough, we saw someone else. She took one look at his ankles and referred him directly to the orthopedist. And he talked to her.
We had the usual anxiety at the doctor's office yesterday, plus more than the usual yelling and screaming. But we managed to get him on the x-ray table despite his protests. When, instead of a high, whistling whine followed by a shrill beeeeep, the machine made a boodeloodeleep, he actually giggled. Then it was back to the waiting room. Every time another patient was called, he would jump up and yell, "No! No! I won't go back there! You can't make me!"
When he was called, he put on a similar performance, and added, "No shots!"
The assistant who called us back wanted me to confirm the list of meds he is on. Sounds easy, with only one med missing from the list, but the list was all brand names, and his insurance only pays for generics. We could list his meds but, not being a nurse, she had no idea which brand names they were equivalent to. We finally figured it out, but it took some detective work.
Another assistant performed the exam. She never introduced herself, neither by name nor by title. She could have been a doctor, a nurse, a receptionist, or a cafeteria worker who borrowed a white coat. We never did find out who she was. She asked a lot of questions, but we had to fill her in on the case, including surgeries that should have been in his records. When she was done, she left us waiting in the exam room for over an hour. Then the orthopedist showed up with a third assistant. This assistant performed an abbreviated exam while the orthopedist stood off to one side and announced that GL did not need surgery or new orthotics; he just needed high-tops. I showed him GL's orthotics and the wear pattern on his shoes. (In less than a month, the inside of the heels has completely worn away.) He said that he doesn't want to put him in something more restrictive. I thought more restrictive was the point of high-tops, but I asked if PT might help to strengthen his ankles. He said that no, this was not a muscle problem, it was a ligament problem, so PT wouldn't help. So if his current orthotics aren't working, strengthening the muscles won't help, and AFOs are too restrictive, what will hold this kid's ankles off the ground so he can walk on his feet and not his ankles? And a month from now, when he's chewed up a pair of high-tops that aren't working, how long will it take to get another appointment, and what will he do then? Heavy sigh.
GL has been seeing this orthopedist for the last five years. Until now, we've had a good working relationship. He's always been happy to prescribe whatever GL needs. And I might be willing to trust him if I hadn't seen the same pattern with all of GL's doctors lately. They're afraid that if they prescribe or refer more than the insurance companies want, the insurance companies or the government will limit their referrals and prescriptions. Insurance companies don't make money by providing health care. They make money by collecting premiums and then denying as much care as they possibly can. So the doctors self-limit care to what they think will satisfy the insurance companies, who then set that level of care as the new standard, and try to cut claims even further.
Obamacare is going to be worse, not better. I'm not opposed to providing care for the poor and the disabled; I've just seen what kind of care the government provides. The poor and the disabled get Medicaid. Medicaid treats providers so poorly that it's almost impossible to find a provider who accepts it. Single-payer would have put everyone on Medicaid. "But doctors would have to take it," you may argue, "if it were the only game in town." For anyone with the brains and ambition to become a doctor, medicine is never the only game in town. They keep playing because payments haven't yet been cut to what they could make doing something else, but cut payments enough, and they will begin to retire earlier, go to law school, or go to work for insurance companies and lawyers, cutting claims further, and helping sue the remaining doctors. Medicine will become the province of the dedicated and the incompetent.
Think leaving practice for a second career is too big a move for an established physician? Based on population trends alone, for the next twenty years, we will have more physicians retiring or dying than entering the profession. Cut payments enough, and enrolling in med school begins to sound like a sucker's bet.
So, if we can't cut payments to physicians without cutting the quality of care, wouldn't it be a safer bet to put the government in charge than private insurers? No. If a private insurer cuts claims enough, customers will switch companies. There is at least that check on their power. A company that refuses to listen to its customers will eventually go bankrupt. If you're on a government plan, and they won't pay, what are your options? 1) Go outside the plan, and pay out of pocket, like many Canadians do, coming to the U.S. If you can afford this route, why bother with the government plan? 2) If you can't afford to go off-plan, you can settle for second-rate care. If you've never been on Medicaid, you don't understand how bad government care can be. 3) Lobby for legislation to force the plan to provide preferential coverage for people with your condition. With Boomers reaching retirement age, there simply won't be enough money to treat everyone for everything. Every disease will become a political football. Of course, by the time you have a condition, it is unlikely you can get the law changed in time to help you. You will suffer with poor treatment treatment or none at all, and either get well or die first.
With all the above-mentioned pressures on the medical and insurance systems, isn't it best to keep private insurance, but under close government supervision? No. In that environment, there would be two possible outcomes: 1) the government guarantees the insurance companies the right to make a profit, making them even more powerful, (that's why the insurance and pharmaceutical companies were competing to cast themselves as good guys and each other as bad guys in the healthcare debate) or 2) under heavy regulation, private insurers go out of business one by one, leaving the remaining insurers more powerful and less affordable. If insurance is mandatory, but costs more and more while providing less and less, many of us will be forced to buy some sort of minimum coverage until the government comes to rescue us from the situation it created with some sort of single-payer plan. Eventually, only the very rich and powerful will be able to opt out. The rest of us will be forced, one by one, into some sort of single-payer system, just like Obama wanted in the first place.
There. I vented about several things that were bothering me. I feel a bit better. If you want to leave a comment, feel free, but remember it is my policy to reject all anonymous comments. If you leave an anonymous comment, it will be rejected, not because I disagree, but because it is anonymous. And don't be the moron leaving an anonymous comment objecting to my right to reject anonymous comments.
Labels: Government, Managed Care, Something to Offend Everyone, weather report
Wednesday, June 16, 2010
Laughter in the Rain
It had been threatening rain all morning, and we'd had the occasional sprinkle. That afternoon, the clouds burst and poured rain. "Pitchforks points down" we used to say. That's when GL decided it was time to play outside. I told him to wear his old shoes. I don't remember who suggested the bar of soap, but he liked the idea so much, he ran for his swimsuit.
Read more »
Read more »
Labels: Humor, Photos, weather report
Sunday, June 6, 2010
The Countywide Universal Amalgamated Journal Sentinel Tribune Post Dispatch News-Free Press Sun Chronicle Daily Planet Democrat Observer, continued.
Two sisters had babies on the same day. Made the front page.
Labels: Humor, Paper Trained
Saturday, June 5, 2010
"LETTER" FROM FACEBOOK
"LETTER" FROM FACEBOOK
By Peter Chianca
Dear Facebook member:
It has come to our attention that certain users have raised concerns over our privacy policy. We'd just like you to know that here at Facebook, it's extremely important to us that your information is kept private, to be shared only among your friends, networks, fans, people who "like" the same things you do, and users of applications you don't realize you've signed up for.
It's true that it's in our best interests, for growth and advertising purposes, to make as much of your personal information as possible freely available over the Web. But we make a promise never to share what's on your profile unless you have expressly authorized us to do so by not un-checking an arcane series of hard-to-find boxes, some of which don't exist.
So just to make sure you understand your privacy rights as a Facebook user, we've put together the following easy-to-follow guidelines:
1) Default settings. Just to make things easier, our default settings make your personal information, photos and videos accessible to everyone on the Web, including your mother, your second-grade teacher and the guy who, at this very moment, is photoshopping the heads of strange children onto the bodies of centaurs.
2) Photos. We understand why you might have concerns over who can see photos of you that you've posted, or that are posted by your friends, or by an old boyfriend or girlfriend. But the rumors that embarrassing pictures of you are automatically visible to your boss and your pastor are entirely untrue. Assuming you've checked and/or unchecked the right boxes, they can only be seen by friends, friends of friends, friends of friends of friends and all the other people who play Farmville.
3) Instant Personalization Pilot Program. This is the program that allows other websites, like Yelp and Pandora, to access your profile information. However, you can opt out of this program - at this very moment we have a team of engineers trying to determine how one might go about doing that.
"But Facebook, why would you ever presume that we'd want you to share our information with other websites without our permission?" you might ask. To which we'd respond: "Shut up and play some more Mafia Wars."
4) If you're embarrassed about people seeing your "Like" list, maybe you should stop liking things like Barry Manilow and "Jersey Shore." You know who you are. And so do we.
Finally, we want to remind you that, if you're that concerned about people seeing the information you somehow thought would remain private just because that's what we told you when you signed up, you always have the option of deleting your account.
Good luck figuring out how to do it.
-----------------
Copyright 2010 Peter Chianca. Permission is granted to send this to others, with attribution, but not for commercial purposes.
By Peter Chianca
Dear Facebook member:
It has come to our attention that certain users have raised concerns over our privacy policy. We'd just like you to know that here at Facebook, it's extremely important to us that your information is kept private, to be shared only among your friends, networks, fans, people who "like" the same things you do, and users of applications you don't realize you've signed up for.
It's true that it's in our best interests, for growth and advertising purposes, to make as much of your personal information as possible freely available over the Web. But we make a promise never to share what's on your profile unless you have expressly authorized us to do so by not un-checking an arcane series of hard-to-find boxes, some of which don't exist.
So just to make sure you understand your privacy rights as a Facebook user, we've put together the following easy-to-follow guidelines:
1) Default settings. Just to make things easier, our default settings make your personal information, photos and videos accessible to everyone on the Web, including your mother, your second-grade teacher and the guy who, at this very moment, is photoshopping the heads of strange children onto the bodies of centaurs.
2) Photos. We understand why you might have concerns over who can see photos of you that you've posted, or that are posted by your friends, or by an old boyfriend or girlfriend. But the rumors that embarrassing pictures of you are automatically visible to your boss and your pastor are entirely untrue. Assuming you've checked and/or unchecked the right boxes, they can only be seen by friends, friends of friends, friends of friends of friends and all the other people who play Farmville.
3) Instant Personalization Pilot Program. This is the program that allows other websites, like Yelp and Pandora, to access your profile information. However, you can opt out of this program - at this very moment we have a team of engineers trying to determine how one might go about doing that.
"But Facebook, why would you ever presume that we'd want you to share our information with other websites without our permission?" you might ask. To which we'd respond: "Shut up and play some more Mafia Wars."
4) If you're embarrassed about people seeing your "Like" list, maybe you should stop liking things like Barry Manilow and "Jersey Shore." You know who you are. And so do we.
Finally, we want to remind you that, if you're that concerned about people seeing the information you somehow thought would remain private just because that's what we told you when you signed up, you always have the option of deleting your account.
Good luck figuring out how to do it.
-----------------
Copyright 2010 Peter Chianca. Permission is granted to send this to others, with attribution, but not for commercial purposes.
Thursday, June 3, 2010
I Miss Lake Wobegon
Garison Keillor, who used to be enjoyable to listen to, has turned into a partisan hatemonger and a most unpleasant person.
Labels: News from Lake Wobegon, Something to Offend Everyone
The Countywide Universal Amalgamated Journal Sentinel Tribune Post Dispatch News-Free Press Sun Chronicle Daily Planet Democrat Observer, continued.
We have been getting The Countywide Universal Amalgamated Journal Sentinel Tribune Post Dispatch News-Free Press Sun Chronicle Daily Planet Democrat Observer for a few weeks now. Mama Bear has found a few useful coupons in the Sunday edition, but nowhere near enough to pay for the paper, not even at the ridiculously low introductory rate.
But it's a newspaper, someone will say. You're supposed to get it for the news. Fair enough, but if it didn't happen in this county, they just download and print out yesterday's story from Associated Press. I can do the same thing a day earlier on Yahoo for free. I'm sure that someone will say that it's not really free; both the local paper and Yahoo pay for the service, and hopefully some of that money gets back to the original reporter to compensate him for putting the requisite liberal spin on events to get the story "picked up" by AP, i.e. approved by its censors. Well, Yahoo performs the same service faster, with no subscription fees and fewer ads.
The paper costs more because they cut down all those trees to preach their environmentalist message. I don't consider myself all that Green, but I hate to throw something in a landfill that might be useful somewhere else. For example, anything I print out, once I'm done with it, we use for scratch paper. Once both sides of the paper have been written on, we shred and compost it. I hated to throw all these newspapers in the dumpster, so I started throwing them in the compost bin. They kept blowing out. I tried wetting them down with the hose. After a few hours, the top layer dried out, and the papers started blowing around again. Trying to saturate all those layers would drive my water bill sky-high. I tried separating the pages and running them through the shredder. They blow around a lot less, and after a light sprinkling, they stay put. Problem solved, but I now spend over an hour a week shredding the paper that I didn't want in the first place.
But it's a local paper. What about all the local news you can't get anywhere else? What vital local events would I be missing out on if I didn't get the paper? Well, like the Herald-Star, edited by Harold Starr, it's not so much the news as the index to the news. All the crimes reported this week occurred in the county seat. The police chief in the city at the opposite end of the county is working toward having his department "accredited". Police, fire, and emergency services departments in several jurisdictions are involved in turf disputes. Incumbent re-elected. New restrictions on outdoor burning proposed. A local bar may lose its liquor license. The city won't say why, but they will say why not. Man celebrates 64 years of membership in the local YMCA. High school sports coverage. Fairs, festivals, and fundraisers. If you open a new business anywhere in the county, you can most likely get your picture in the paper.
A bunch of people in various places observed Memorial Day last Monday. Independence Day Parades in most towns in the county will be on July 5 this year because the 4th falls on a Sunday. I'd already read that in the village newsletter. Even if I hadn't, I could have guessed it. That's the day the Post Office is closed. The parade here always starts at 9:30 a.m., and every church in town has a float in the parade. By 11:30, the celebration is over, everyone heads home, some people fire up their grills, and the rest of the day is devoted to eating, drinking, and napping. The nearest fireworks display is in a town ten miles down the road. I love small-town life.
The county seat's local Humane Society has been caught using expired rabies vaccines. They're giving new vaccinations free to the animals that got the expired vaccine. They say, "We're fixing the problem as fast as we can." That's odd, I would have thought "as fast as we can" would have come before giving 600 expired doses over the last six months. According to a professor at the state university school of veterinary medicine, the vaccines are still safe and effective for up to six months beyond their expiration date, "not that you should use them," but the state will not recognize vaccinations if the vaccine was past its expiration. The last case of rabies in a domestic animal in the city was 20 years ago. A local kennel says it will not accept animals without an up-to-date vaccine, but it has checked its records and hasn't found any that got the expired dose. The Humane Society employee who caught the error has been fired. He says he was fired for reporting his employer to the state. Ya think? He's seeking legal counsel. His former employer won't comment.
Prom made the front page Friday, Saturday and Sunday. At age 40, I think that qualifies as news I can't use. And can someone tell me what is so important about Prom, anyway? Some people, and I don't mean just high school kids, take it very seriously. I've even heard of parents considering home schooling for its educational benefits, but rejecting the idea, saying, "There's no way my kid's going to miss Prom! That was the most important night of my life!" Overlooking the possibility that your kid was conceived at Prom, Post-Prom, or Post-Post-Prom, how did you get this old and have such an empty life? I attended a small religious high school that didn't have prom because they didn't believe in dancing. I missed out on a lot of other things, but I don't see what I missed by not going to Prom. I'm not even sure what the purpose of Prom is. According to all the kids I knew who went to Prom, it was the night all the kids of a certain age listened to loud music, danced, got drunk, and had sex. So how is that different from any number of other parties any other weekend? Is it because they dress up? Is it because they spend more money than my wife and I spent on our wedding?
Well, that's the news from Lake Wobegon, where all the women are strong, all the men are good-looking, and all the children are above average.
But it's a newspaper, someone will say. You're supposed to get it for the news. Fair enough, but if it didn't happen in this county, they just download and print out yesterday's story from Associated Press. I can do the same thing a day earlier on Yahoo for free. I'm sure that someone will say that it's not really free; both the local paper and Yahoo pay for the service, and hopefully some of that money gets back to the original reporter to compensate him for putting the requisite liberal spin on events to get the story "picked up" by AP, i.e. approved by its censors. Well, Yahoo performs the same service faster, with no subscription fees and fewer ads.
The paper costs more because they cut down all those trees to preach their environmentalist message. I don't consider myself all that Green, but I hate to throw something in a landfill that might be useful somewhere else. For example, anything I print out, once I'm done with it, we use for scratch paper. Once both sides of the paper have been written on, we shred and compost it. I hated to throw all these newspapers in the dumpster, so I started throwing them in the compost bin. They kept blowing out. I tried wetting them down with the hose. After a few hours, the top layer dried out, and the papers started blowing around again. Trying to saturate all those layers would drive my water bill sky-high. I tried separating the pages and running them through the shredder. They blow around a lot less, and after a light sprinkling, they stay put. Problem solved, but I now spend over an hour a week shredding the paper that I didn't want in the first place.
But it's a local paper. What about all the local news you can't get anywhere else? What vital local events would I be missing out on if I didn't get the paper? Well, like the Herald-Star, edited by Harold Starr, it's not so much the news as the index to the news. All the crimes reported this week occurred in the county seat. The police chief in the city at the opposite end of the county is working toward having his department "accredited". Police, fire, and emergency services departments in several jurisdictions are involved in turf disputes. Incumbent re-elected. New restrictions on outdoor burning proposed. A local bar may lose its liquor license. The city won't say why, but they will say why not. Man celebrates 64 years of membership in the local YMCA. High school sports coverage. Fairs, festivals, and fundraisers. If you open a new business anywhere in the county, you can most likely get your picture in the paper.
A bunch of people in various places observed Memorial Day last Monday. Independence Day Parades in most towns in the county will be on July 5 this year because the 4th falls on a Sunday. I'd already read that in the village newsletter. Even if I hadn't, I could have guessed it. That's the day the Post Office is closed. The parade here always starts at 9:30 a.m., and every church in town has a float in the parade. By 11:30, the celebration is over, everyone heads home, some people fire up their grills, and the rest of the day is devoted to eating, drinking, and napping. The nearest fireworks display is in a town ten miles down the road. I love small-town life.
The county seat's local Humane Society has been caught using expired rabies vaccines. They're giving new vaccinations free to the animals that got the expired vaccine. They say, "We're fixing the problem as fast as we can." That's odd, I would have thought "as fast as we can" would have come before giving 600 expired doses over the last six months. According to a professor at the state university school of veterinary medicine, the vaccines are still safe and effective for up to six months beyond their expiration date, "not that you should use them," but the state will not recognize vaccinations if the vaccine was past its expiration. The last case of rabies in a domestic animal in the city was 20 years ago. A local kennel says it will not accept animals without an up-to-date vaccine, but it has checked its records and hasn't found any that got the expired dose. The Humane Society employee who caught the error has been fired. He says he was fired for reporting his employer to the state. Ya think? He's seeking legal counsel. His former employer won't comment.
Prom made the front page Friday, Saturday and Sunday. At age 40, I think that qualifies as news I can't use. And can someone tell me what is so important about Prom, anyway? Some people, and I don't mean just high school kids, take it very seriously. I've even heard of parents considering home schooling for its educational benefits, but rejecting the idea, saying, "There's no way my kid's going to miss Prom! That was the most important night of my life!" Overlooking the possibility that your kid was conceived at Prom, Post-Prom, or Post-Post-Prom, how did you get this old and have such an empty life? I attended a small religious high school that didn't have prom because they didn't believe in dancing. I missed out on a lot of other things, but I don't see what I missed by not going to Prom. I'm not even sure what the purpose of Prom is. According to all the kids I knew who went to Prom, it was the night all the kids of a certain age listened to loud music, danced, got drunk, and had sex. So how is that different from any number of other parties any other weekend? Is it because they dress up? Is it because they spend more money than my wife and I spent on our wedding?
Well, that's the news from Lake Wobegon, where all the women are strong, all the men are good-looking, and all the children are above average.
Labels: Humor, News from Lake Wobegon, Paper Trained, Something to Offend Everyone
Good News
MB's employer is always trying new ways to get its employees to diet and exercise. That means that they have a lot of fat people working for them. Fat people have more health problems, and that costs her employer money. Late last year, they sponsored a series of on-site Weight Watchers meetings. Her employer paid half the cost up front. Employees who signed up paid half price, and at the end of the session, if they met their individual weight loss goals set by Weight Watchers, they were reimbursed for the half they paid. MB did very well, making her goal in the first session. They had another session the first part of this year. Again she did well, narrowly missing the new goal. MB was jazzed. They wanted to offer a third session, but not enough people signed up. Those who did sign up tried to recruit enough members to have a third session. When pressed, people said, "We want to take the summer off. That's when we go places and do things." In other words, "We want to put the weight back on, and get credit for losing the same weight again in the fall. Assuming they do this again in the fall." That's how fat people think. That's why they're fat.
We couldn't afford the fees for her to join another group. Not at full price. Not on what they pay her. MB was frustrated. She'd lost weight in the past, but it was a slow and arduous process, and she never seemed to keep it off. Now that she'd found something that seemed to work for her, she didn't want to lose her momentum. After scrabbling about for ideas, she decided to continue to follow the plan on her own. But to stick to it, she felt she would need encouragement and moral support from other people on the plan. She got a friend to agree to do "at home weight watchers" with her. I agreed to try it too. We weigh in once a week and report our progress.
I've never been what I would call fat, but I am carrying around more weight than is good for me. I've only lost weight three times in my life. All three were in the summer. One summer, we had a hot spell that seemed like it would never end. We lived in an attic apartment with no a/c and very little insulation. I was working 60 hours a week, doing hard physical labor. We had a baby who didn't sleep much. Another summer, I was experimenting with semi-vegetarianism. On that diet, I could eat meat, and I could eat carbs, just not at the same meal. I got so bored with the food choices, eating became a chore. I usually didn't finish my meals because it didn't seem worth the effort to chew them. The third summer was the summer I spent unloading trucks at Wal-Mart. None of these were things I could keep up long-term, the first physically, the second emotionally, (I got to the point that just looking at a salad made me depressed.) and the third financially. When I returned to normal food and activity levels, the weight returned. Other than these, my weight has either stayed the same or slowly increased.
So I was not optimistic about Weight Watchers, at home or anywhere else. I only agreed to track points and weigh in to support Mama Bear. I didn't think I could stick to the plan, not even in the short run. Well, five weeks in, I've found that I have to plan ahead a bit more, but most days I manage not to go over my allotted points. Even on the days I do go over, I don't go over as far as I expected. I've lost 10 lbs. so far, and I don't even feel like I'm working that hard. One thing that helps is that there are no forbidden foods. I just have to add up the points and decide what's worth it to me. MB hasn't lost any additional weight, but she hasn't put any of the weight she lost back on.
We couldn't afford the fees for her to join another group. Not at full price. Not on what they pay her. MB was frustrated. She'd lost weight in the past, but it was a slow and arduous process, and she never seemed to keep it off. Now that she'd found something that seemed to work for her, she didn't want to lose her momentum. After scrabbling about for ideas, she decided to continue to follow the plan on her own. But to stick to it, she felt she would need encouragement and moral support from other people on the plan. She got a friend to agree to do "at home weight watchers" with her. I agreed to try it too. We weigh in once a week and report our progress.
I've never been what I would call fat, but I am carrying around more weight than is good for me. I've only lost weight three times in my life. All three were in the summer. One summer, we had a hot spell that seemed like it would never end. We lived in an attic apartment with no a/c and very little insulation. I was working 60 hours a week, doing hard physical labor. We had a baby who didn't sleep much. Another summer, I was experimenting with semi-vegetarianism. On that diet, I could eat meat, and I could eat carbs, just not at the same meal. I got so bored with the food choices, eating became a chore. I usually didn't finish my meals because it didn't seem worth the effort to chew them. The third summer was the summer I spent unloading trucks at Wal-Mart. None of these were things I could keep up long-term, the first physically, the second emotionally, (I got to the point that just looking at a salad made me depressed.) and the third financially. When I returned to normal food and activity levels, the weight returned. Other than these, my weight has either stayed the same or slowly increased.
So I was not optimistic about Weight Watchers, at home or anywhere else. I only agreed to track points and weigh in to support Mama Bear. I didn't think I could stick to the plan, not even in the short run. Well, five weeks in, I've found that I have to plan ahead a bit more, but most days I manage not to go over my allotted points. Even on the days I do go over, I don't go over as far as I expected. I've lost 10 lbs. so far, and I don't even feel like I'm working that hard. One thing that helps is that there are no forbidden foods. I just have to add up the points and decide what's worth it to me. MB hasn't lost any additional weight, but she hasn't put any of the weight she lost back on.