Socks. A Health Care Story.

It was a pair of socks that turned me against our current health care system.

True Story:
It's fall of 2008. I'm in Prince William County Hospital, Woodbridge, Virginia -- the medical facility that tried to kill me.

I'm there with a chest full of pulmonary embolisms -- a baker's dozen blood clots spread across both lungs. They were a complication from surgery to reattach a torn Achilles tendon.

The hospital room was chilly, and my left foot was still in one of those immobilizing walking boots. Had to be elevated, which made my blanket too short to cover both my feet. The nurse comes in to check on me, and notices my 'good foot' sticking out at the bottom of the covers. She compassionately asks me if I'm cold. I say yes, and she promises to come right back.

She brings me a pair of socks. They are reasonably nice as socks go; cotton, gray, with little patches on the bottom to keep me from sliding around on the floor. I've seen similar socks since, at Wal-Mart. They retail for about eight bucks a pair.

I thank her for her kindness, and she rubs my arm.

I heal enough to go home, and later discover a pretty major insurance SNAFU. The paperwork shuffle sends the wrong documents to the wrong desks, and important deadlines pass. Ultimately I get stuck with the entire bill -- even though I was paying a significant amount to be "covered" before my accident.

Getting stuck with the bill meant I got to see all the charges. Almost $50,000 worth of individual pain-killing pills, Heparin, sleeping pills, meals, fees, and a $74.95 pair of socks.

Huh?

Double-checked it, and yep. It was a real charge.

Line 47.
Socks, Non-Skid: 74.95

Made me a little sick at the stomach. Friends and family had brought me lots of things I needed. I'd forgotten to ask for a pair of thick socks, no big deal. It was an oversight. I would have survived without them for a night or two. And if she'd asked me if I was cold enough to want some fing $75 socks, I would have said "thank you, but no. I'll be ok."

See those socks at the top of the page? I'd pay $75 for those. Hell, Maybe even $100. I don't know if you can see it or not, but they're shiny. Got what looks like hundreds of rhinestones on 'em. Plus .. THOSE socks are famous! Worn by a popular musician in his heyday. If I wore THOSE, everyone would look at them and say "damn, bro. now THOSE are socks. Where'd ya get 'em?"

And I'd prolly blush a little bit, and tell a story that would make me cool. And I'd feel GOOD about paying $75 for a pair of socks.

Instead, the now tattered gray socks with the non-stick tabs make me queasy. And probably will until the day I die. I'm not throwing away $75 socks.

Ever.

I listened to the health care debate for almost two whole years. I read all 2000+ pages of the bill Congress produced, and it makes me queasy too.

It is mysticism -- sort of like when religious people try to explain the plan of Salvation to me. I'm sure THEY understand it, but it's gobbledygook to me.

Here's MY solution, short and sweet enough to cram into ONE blog:

1. Allow everyone to buy a health care plan. Not just businesses buying for groups. Sell them in set amounts of coverage. $1M, $500k, $100k .. with varying deductibles. Allow anyone to sponsor them; businesses, churches, charities, private organizations, social clubs peopled by men named "Bob." Literally, anybody.

Also allow companies to sell term or life policies. Planning to skydive? Play semi-pro football on the weekends sans pads with your buddies? You sir, may need a $10M term policy, good for three years. That's gonna cost 'ya $10k/month ... OR you can gamble that gravity doesn't work, or Joe "wannabe-Brian Urlacher" Smith isn't coming across the middle to break your neck, and take your chances.

Now THAT money, is for catastrophic events. The things that we know will happen to each of us "eventually," that are completely fixable.

Heart attack? Insurance policy.
Rip your achilles playing parking lot pick-up ball when you're too old and fat? Insurance policy.
Having a baby? Insurance policy.

Insurance for all the mid-level stuff that's too big to fix at home, or with an outpatient doctor's office visit, but too small to require a second mortgage.

#2. Take away the mysticism of hospital pricing. One of the beauties that keeps insurance such a murky concept is that no one knows how much anything costs inside the doors of a clinic or hospital. Know why? Because there's no set price. They charge as much for EVERYTHING as an insurance company will pay. That's a recipe for two-way fraud and collusion.

Put up price lists.
Check-up: $20 (or $40, or $100 ... I don't care what an individual hospital charges for an individual thing, I only care that the provider and the patient both know it's cost/value at the beginning of the transaction..)

Cast for broken leg: $200

Allow Doctors to charge an hourly wage just like everybody else. Let me buy their time, and more importantly, their undivided attention.

Then allow them to explain my options with a menu that includes the prices, so I can understand the calculus and weigh the necessary vs. the luxurious. I'm not a moron, and neither are you. The doctor certainly isn't, so why can't we reason together about how far down the rabbit hole we want to go TODAY to figure out if I have indigestion, or esophageal cancer?

Plus, knowing how much something costs is an integral part of competition. Business slow? Let the hospital or doctor run a special; "back to school checkups, 40% off!"

Allow medical outfits to balance their books with supply and demand just like every other business in America. And let them actually get paid by the customer for their services, just like the grocery store, the gas station, and the morgue.

An outpatient procedure should not REQUIRE insurance. It also should not cost $10,000. It doesn't in lots of other countries.

I suspect, that you ... like me, get sick roughly the same number of times every year. You probably have since your 21st birthday. You could probably tell me, right now, within a range of 2 visits how many times you will go to the doctor or hospital in 2012.

That's something you can budget for, just like you budget for gas, and groceries, and new clothes. The most expensive item at the mechanic is only a few thousand dollars. And there's a mechanic on almost every corner in America. I cannot grasp why hospitals are so much different.

And when you have a procedure that WILL cost more money than you should reasonably be expected to have saved up for ... BLAMMO! You whip out that insurance policy, pay your deductible, and let the big boys pay for it... off the price list, not off some imaginary pay chart where gray non-skid socks cost $37.50 each.

Finally, there will be injuries and illnesses that nobody can see coming.

Your heart goes bad, and you need a transplant. Your child is born with a rare congenital condition that requires two years of in-patient care. You contract some off-the-wall virus from the crazy Outbreak monkey and we have to fly in Cuba Gooding Junior and Dustin Hoffman to race to the cure.

That's where I want Uncle Sam to step in. I don't need him to buy me an aspirin. I can handle that, if the price is cost + a reasonable percentage of profit. But if I need a new $20M liver, I don't mind having the rest of you kind tax payers chip in. And quid pro quo. I'll help out with your ten years of chemo if and when you require it.

I also don't mind if the hospital adds a few extra bucks to my bill that helps cover the people who can't afford care. There isn't a system that will cover everybody without it costing an arm and a leg. And as long as prices for the indigent are the same as what everybody else pays, I don't mind pitching in. I may need to tip in to the poor fund now and again, myself. Bad luck happens.

I acknowledge a couple of things. Becoming a physician is a difficult and expensive undertaking. In our system, they deserve to be paid well.

But they could be paid a bit LESS well if THEIR insurance rates weren't so absurdly high. In the current system, doctors get it from both ends. Bring down expense of care, and their malpractice rates plummet. Nothing helps inflate them quite like starting with a $50k patient charge for a hangnail procedure gone bad that ends up in court.

And the space-aged equipment American companies have developed is astronomically expensive. But that's true of a lot of industries. And I'm not so sure those costs aren't also tied to the collusion between insurance companies, big pharma, and big medicine.

I'm not a socialist (most of the time). I'm not a Communist. I'm just a guy who looks out at America and sees an over medicated country with horrible eating and health habits, and a medical system that is simultaneously underfunded, and overwhelmed.

This isn't capitalism. It's slow economic suicide.

That from a guy with ratty $75 socks on my feet.

Peace,

--Stew.

P.S. I don't believe my plan is perfect. I don't think it solves all the problems. I DO believe it's implementable, without creating a new agency, or tacking another $10T onto a debt that's sinking a sunken economy. What would you change? How would you fix it? I already know that you're smarter than Congress. Prove it.

Superhero Negro

We have turned Dr. Martin Luther King into a superhero -- and thrown away the key.

It's worse than prison; because without his unsolicited status he could have flaws, and make mistakes, and even be wrong on occasion.

That's not his lot.

Instead, some of the varnish flakes off when we look too closely. We 'discover' that Coretta wasn't the only object of his sexual affections, and take points away.

We hear his off-pulpit profanity, and try to juxtapose "motherfucker" with "I have a dream."

Its a fool's errand, because the same mind and mouth think and speak both extremes. The same brain and body enjoy the sex in both places. And the same intellect and intuition could see assassination coming, and admire a nice ass walking away.

We should be ashamed of ourselves.

If he were alive today, I wonder if Dr. King would see his role and historic speech at the March on Washington as the highlight of his life. If he were a movie star, I wonder if that wouldn't have been the blockbuster in a career that preferred small independent roles. I have a lot of questions about King. I admire him MORE now that his humanity shines through.

In ninth grade English Lit, Mrs. Mullenberg taught me that every viable hero has a tragic flaw. Growing up, I was never allowed to peek at the dark side of the Good Reverend Doctor.

Wasn't allowed to watch his stress build until he released it into some sexy Southern Belle he wasn't married to.

Couldn't acknowledge his anger spewing out in four-letter tirades among his closest friends. I am confident "the Movement" had its morons, and I wonder how he suffered them.

We have turned Dr. King into the Barbie Doll of civil rights; no genitalia, just a pretty face.

But the orator I have come to respect more is a multi-faceted MAN. A child of the 40s and 50s with warring spirits riding on each shoulder.

I can relate to THAT guy. One of MY angels covers his eyes with his wings about half the time. The other carries a pistol. And he ain't afraid to use it.

My man King is a man who could be distracted by pretty legs escalating into a plaid miniskirt while crafting a message that would change the course of history.

This is MY King. Not the superhero .. the man.

I have my differences with his philosophy. I abhor the use of children in warfare. It was his most effective tactic. I think "turn the other cheek" is a message of subterfuge crafted by men who plan to slap me. He found it a viable and controllable force of the universe, like gravity. I find pacifism degrading. He rode it to a place in history's Pantheon of greatness.

I am glad to live in the pool of promise made possible by his sacrifice.

I don't craft word pictures for the weak at heart. I don't write to make me feel good, or you feel better. I write because sometimes shit's got to be said. And I'm tired enough of the bullshit to say it.

I'm sick of the Superhero King. Tired of rehashing the Lincoln Memorial, and forgetting the Birmingham jail. Bored with fights over the holiday that don't ever reference the dog bites, and water hose bruises. I save my respect for the real guy who probably yelled at planning sessions, and held his own in the political in-fights, even if it meant crushing his opponents.

I like to read between the lines. And when I read the story of this phenomenal life, I see children left at home, fatherless for months at a time, while a bus line was being integrated.

I see a lonely, gorgeous wife -- married to an icon, when she might have preferred a warm body to cuddle up next to sometimes.

I see a church thrust into a harsh international spotlight by their baby-faced pastor when they might have preferred a Reverend who was in town long enough to visit the sick and shut in.

And I admire the, ... the, ... the, the SUCK it must have been to BE Rev. Dr. Martin Luther King.

Many people have asked what Dr. King would think about the 'black community' if he were alive today. Would he recognize it? Would he regret his role in its "progress."

I don't know, and he's not here to tell me. But my question is different..

If Dr. King were alive today, would he recognize himself? Would he smile ... or ... wince, at the Superhero Negro we have created in his image?

Happy Birthday, Dr. King. Can I buy you a beer?






















Peace,
--Stew.

...and your silly death threats...

I had a fascinating exchange with a dear friend last night.
It was short, and cordial .. but important to me.

As I type, U.S. Representative Gabrielle Giffords (D-AZ) lies in a post-operative intensive care room. A gunman put a bullet in her head yesterday morning.

His spree killed six people, including nine-year-old Christina Green and Federal Judge John Roll, 63. This morning's reports say 20 people are injured.

It is tragic to start a Sunday mourning.

But our conversation wasn't about grief. Sadness and anger are a given.

Our discussion was about timing. He has a view I respect, and understand to have some legitimacy, even as I disagree. I bring my point of view here; to my space, because it is on my mind this morning.

At issue was the timing of allusions to Sarah Palin during yesterday's chaotic coverage of the Tuscon violence.

He is a liberal, who despises her rise to prominence. But his perspective was that it is inappropriate to address the possible political undertones of an elected Representative being gunned down at a political event "before the bodies were even cold."

For what it is worth, he may be right. Mine is not a particularly political point of reference. My interest in the question goes to responsibility and how much accountability public figures have for their words.




On March 23rd of last year, Sarah Palin sent a controversial tweet to her 300-thousand plus followers:

Commonsense Conservatives & lovers of America: "Don't Retreat, Instead - RELOAD!" Pls see my Facebook page.

The issue at the time was a Health Care Reform Bill, now law, against which the the former Vice Presidential Candidate and Alaska governor was spearheading opposition.

I want to be up front about two facts:

1. I am not a supporter of Mrs. Palin. Her picture of America doesn't resonate with me. I find her voice shrill and irritating, and her words more often nonsensical than profound on any level.

2. I do not believe Governor Palin's intent with this tweet was to call for the execution of politicians. I believe she was using reload as a metaphor for not backing down from a political point of view; calling instead for re-engagement in the legislative fight.

That said, it was a poor choice of words. And the criticism was fast and furious.

Representative Steve Israel (D-N.Y.); among others, responded via twitter and a series of television interviews. His concern was the imagery:

Reload? @SarahPalinUSA Is your choice of words inciteful or ignorant?

For context, I ask you to recall that at that time there were numerous reports of personal threats to several Democratic lawmakers.

Death threats are common in America. I have always wondered about the people who make them. It seems a rather extreme response to go through all the trouble of promising to kill a person with whom you disagree. But yet, nothing controversial in America happens without allegations of threats to life.

Make a world-series losing error in game 7? Death Threats.

Say the wrong thing to the wrong crowd? Death Threats.

Vote an unpopular way on a legal matter? Death Threats.

Express an unpopular opinion on television or radio? Death Threats.

Run for President as a black guy? Death Threats.

Write a book with a contrarian view? Death Threats.

Dare to draw the Prophet Muhammed (peace be upon him) in a cartoon? Death Threats.

The point of acknowledging these threats isn't that we expect every vow of violence to manifest in a sidewalk assassination. Rather, that collectively "we" have to be aware that these morons with the hair-trigger threat gene walk among us.

And we expect the grown-ups to be cognizant of their existence, because being a public figure in America means that your words tickle millions of hammers, anvils, and stirrups ... and some of those inner canals feed directly into brains where the chemicals aren't balanced just right.

In a nation that prizes free speech, we don't expect you to put out those fires of insanity .. but from your public platform, we do ask you not to fan the flames.

We expect President George W. Bush to stand on his bully pulpit and publicly say to America:

The enemy of America is not our many Muslim friends; it is not our many Arab friends. Our enemy is a radical network of terrorists, and every government that supports them. --20 September 2001

To his eternal credit, he delivered. The non-partisan in each of us knows this paragraph saved lives and prevented lynchings.

Rights and responsibilities are the peanut butter and jelly of American citizenship. One without the other is either too sweet, or makes your gums stick together.

So when Political King and Queenmaker Palin chose to follow her OWN advice .. reloading instead of retreating on the issue, she gets the whole sandwich.

I am not prone to hyperbole, so let's speak of facts. Double click on the image that accompanies these words. Make it bigger. Take off your partisan hat for a moment, and just look at it.

A map of my beloved country, with 20 targets. Not metaphorical targets; actually scope views of specific districts in which it is "time to take a stand."

Then it lists by name, the people to be targeted:
#4: Gabrielle Giffords, AZ - 8

She now of respirators and scars, critically hanging on to life at Tuscon's University Medical Center, thank you to a man with a gun who picked her event as an appropriate target.

If this poster were a CD album cover, pointing out police districts instead of political ones, and our Sunday mourning was for Officers, would there be calls for cooler heads? Calls to slow condemnation of the artist? Same poster, same outcome ..

How about a racial separatist group, from any side of that minefield -- calling for its members to "stand up" against pockets of whites, or blacks, or hispanics? If this were their poster, and we were lighting candles over a Jewish Center, or at an NAACP rally, or Republican headquarters, would we seek to slow down the anger before we called for responsible speech?

I do not blame ex-Governor Palin for the crime. But that's not the standard for behavior we promote. The standard is to not speak words that everyone so easily calls to mind when the idiots among us do something horrendous.

Imagine this: Mrs. Palin could just have easily said "return."

Peace,

--Stew.