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Three score and ten or more

Monday, August 24, 2009

Socialized Medicine

I sat last night and listened to Sean Hannity's program featuring the Medical program that was filled with attack after attack after attack.  I started out with a sense of  approval since, as an active senior with major heath problems in the family I find many feature of what seems to be coming extremely frightening, but as an old teacher of persuasion and logic, I became very frustrated with the half truths, assumptions and faulty trains of logic in the program.  I would like to follow with specific examples but I was lying in bed when the program came on and I didn't get out to get notes, but I have to write for a minute about health care.

Most folks as conservative as I shudder at  the idea of governmentally managed health care.  Indeed governmentally managed "anything" has a bad record in my lifetime.  Most of my conservative friends feel that the only real functions of government are National Defense and Law Enforcement.  Neal Boortz's tirades with standing, I feel that education is a governmental function, though almost every time the National government gets into it, it messes things up.  My deep philosophical feeling is that there is a moral imperative to provide access to health care as well.

I have had only a few experiences with socialized medicine and they all occurred in Finland, and they all had a substantial affirmative affect upon the lives of me and mine.

My first experience was during my term as a Mormon Missionary in Finland.  I had a number of physical problems including a lot of abdominal pain that was diagnosed a chronic inflammation of the gall bladder, a spastic colon, a stomach ulcer, and a few other minor things.  My medical care at that time was quite good, and was paid for by the church, but I did end up  in hospitals a few times and talked to doctors  and could tell that a real socialized medicine program was supported by most of the doctors though it was not really in place.  My experience at that time also included being vaccinated for Tuberculosis (My GP at home denied that any such thing existed, but every time I took a TB skin test thereafter I tested positive (as the Finnish nurse told me I would and everybody accepted the explanation, though I had to show a couple of nurses the vaccination scar --in a place where one has to drop the pants for the demo-- to be convincing_).  I also became a blood donor (I had a two gallon pin from the Red Cross before I went to Finland) and found that, as a blood donor, I didn't just give a pint, but often I would be called and asked to come to the hospital (or clinic) to lie down beside someone and actually watch my blood flowing into the other person.    Weird sensation.  (Actually I say "often" but the combination of giving transfusions directly and giving a pint for the future only added up to about four or five events in three years.)

I went home with my gallbladder in place and with a major set of x-rays rolled up in my suitcase but was otherwise unscathed.

In 1966 I returned to Finland as a Fulbright - Hayes fellow to work on my dissertation which included a translation of a major play by Finland's most famous playwright,  and a lot of research on the way his plays were performed.   When we arrived in Finland (Passport pictures will be seen) my youngest son, who had had medical problems from birth, came down with asthmatic pneumonia.   He ended up in the hospital for over a month.   Nobody asked me how I was going to pay for this, and I was really nervous.  Even with stipends, graduate students with four children do not have much spare money.   It turned out that I was billed the equivalent of about a dollar for each day he was hospitalized.  The medical care was superb, but the doctors, nurses etc. were paid by the government and my son was healthy.

I asked one of the doctors how the program worked, and , if I remember the answer correctly, he said that education, even medical education was paid for by the government, and that when a doctor received his MD, he owed five years of service to the government.  He was just finishing his service, which had also included pediatric training.  He grinned, "We're not slaves, we work long hours but we are well paid".

Partly as a result of my son's hospitalization, within a few months we adopted a little girl through "Save the Children".  She had been given up because her birth father was a gypsy and her mother's new husband was not.  

She was a lovely addition to our family, but about four months later (she was barely walking) she went into the kitchen while my wife was setting the table, got hold of the tablecloth and pulled a pot of hot pea soup over her.  I snatcher her up and put her in a cold shower, and called an ambulance.  She ended up hospitalized in a wonderful burn unit (and having some skin grafts).  When she got out of the hospital we had excellent follow up treatment, and again, we were charged about a buck and a half a day for this treatment.  (In the United States, without insurance, I would have been bankrupted for sure).  Again, Socialized medicine made life liveable at least.

That was not our final episode.  In the spring, my wife contracted either some type of flue or food  poisoning and between diarrhea and vomiting she became dehydrated and was having spasms by the time I got in touch, first with a doctor, then with an ambulance, and she was transported to the hospital where she was on intravenous fluids for a day and was treated for a couple more days.  The cost was more, due to the ambulance, I think, and perhaps because she was not a Finn, but the bill was still less than a hundred dollars.  I returned to the U.S. a firm supporter of some kind of government health care.

Our final experience with Finnish Medicine was very different, though, in some ways, the same.

I have already written about our experience in 2006 when Janet suffered and aortal aneurysm.   When I took her to the Emergency room in Porvoo, no one asked for my insurance or anything else.  They treated her, and after some "feeling around discovered the aneurysm, put her in an ambulance and sent her to Meilahti hospital, the hospital of the University of Helsinki.  By the time I negotiate the fifty kilometer drive, and being lost in Helsinki, when I got to Helsinki she had already been in surgery for over an hour.  The surgeon explained, when we could talk about it, that her ascending aorta had "shredded" and he had replaced about five centimeters of the aorta with a dacron tube.

She spent over two months, one and one half of them unconscious, had a total of three major surgeries and two strokes (suffered when the "paddles" would not stop fibrillation, and the doctor had been forced to manually massage the heart, which led to a bypass to prevent further fibrillation.   The people called her their miracle lady, and the doctors in the U.S. basically stated that almost no-one has survived that sort of surgery.   Her doctor was one of the best in the world (I looked him up on google), and no-one asked any questions about "end of life issues" though before they took her completely out of sleep, the neurologist warned me that her ENG was almost a flat line (meaning no brain activity) and that I should be aware that there was a possibility that she might not remember me, or, for that matter have any conscious mental activity at all.   (She woke up feisty and her first words, shouting at the nurses who were changing her bed and her bandages were "Stop that, you guys are too rough."  It scared the nurses half to death at first)

The financial arrangements were very different from our experience forty years before.   Before the first week was over, the hospital representatives were beginning to ask how I was going to pay for this.  My answer was that I had no clue at all.  I contacted the embassy, the University from which I had retired, and all  the other sources I could think of and still had no clue.  When we were almost ready to return to the states, the doctor came in to reassure us  that they weren't going to make her stay in the hospital till the bill was paid.

It was at that time, that I learned that Medicare stops at the country's borders.  I had a Blue Cross/Blue Shield supplementary insurance but when I became eligible for Medicare the University required that I sign up and change my B C policy to a supplementary one.   I had a bill from the hospital for something in excess of sixty thousand Euros (at about 2.25 bucks to the Euro).  After I got home, after pleas from the embassy, the University and heaven knows who else, Blue Cross sent me a check for some sixty seven thousand dollars, which I sent to the hospital, who wrote me  a note of thanks (actually an Email) and informed me that I still owed them thirty odd thousand Euros.

I discovered that for non Finnish citizens, socialized medicine wasn't as generous as it had been forty years before.   It took some legal advice and a variety of other things before i got out from under that bill, but there was nothing in that country that showed anything but that the very first task was healing and care, and I will be forever grateful to the doctors and staff of Meilahti Hospital.  They performed a miracle.

I spent a lot of time talking to Finns about health care there.  They have well baby health care, care in the schools, excellent care from Doctors and Hospitals.  In 1954 most of the more well off Finns were looking for American trained doctors and paying through the nose for them.  I detected nothing like that  now, and I never spoke to a Finn that had any desire to go elsewhere for medical care.

On the other hand, most Finns pay between forty and fifty percent of their incomes for direct taxes, and there is an additional value-added tax on everything sold in Finland.  Automobiles are tariffed  to the degree that they are almost twice the cost as the same car in the U.S.  The Finns I talked to complain about taxes like everyone else but when I suggested that taxes wouldn't be as high if they didn't have free health care, free education (including University education--up to and including Mediciine), I never heard anyone who would make that trade.

I truly think that there should be some way to provide health care for everyone, though I don't believe for one second that anything that has been proposed this year will do that, at least without rationing.

Some criteria I would think would be necessary for any nationalization would be"

1.  What is good for the goose is good for the gander.  Congressmen, Presidents, soldiers, teachers, and the poor should all be treated alike, and if anyone wants private health care, (and many would) they should have the opportunity to get it, and pay for it 100 percent for themselves.

2. Doctors  (and Nurses) should be very well paid.  (Anyone who has my life in his or her hands should be happy to do the work, and that means adequate pay- - not like the pay that we are now giving teachers-- but I digress here.

3. Personnel who are not providing care (doctors and nurses are providers) should have no right or impulse to dictate the nature or limits of care for patients.i

I have some other criteria, but, I have taught problem solving techniques for most of my life and one of the most important parts of that  process is to clearly identify the problem (which is NOT just that forty some million people don' have insurance).  Then, after a clear identification of the problem, it's causes and results, criteria must be established for the solution that can be shown to directly effect a solution to the problem as identified.  That hasn't begun to happen at all.  Everybody is shouting generalizations at each other and certainly if anyone who is proposing the present program has identified elements of the problem in a clear way, I haven't heard it.

Some problems are complex.  I went for years without dental insurance, and sometimes went without care when I couldn't afford it.  My kids got first dibs.  When the university (in this University town) provided dental insurance it was a blessing, but dentists found that they could charge a lot more, and I now pay, after insurance, about what I paid before insurance.    When the University first made prescription insurance available, I would go to the pharmacy, pick up my prescriptions, pay for them, and the insurance would rebate my share of the cost.  When it was discovered that if a co-pay was set, the pharmacies could charge any darn price they wanted for the drugs (actually the manufacturers more than the pharmacies) and the price of drugs accelerated insanely.   Advertising prescription drugs became legal  (dang liberal Supreme Court) and drug  prices took another jump.  I'm not sure how you work these things into universal medical care.

I know that government can't arbitrarily set costs and prices.  I remember a friend who was a pharmacist who attempted suicide because the state had withheld so much of his income for Medicaid costs that he couldn't pay his supplier and employees.

I think that there should be access to universal care now.  I don't know how in heck we could get it, but the current process isn't hopeful. 

In summation, the British system, with it's death board and limitations is not a good model, neither is the Canadian, and if we wanted to follow a Scandinavian process, we had better check our wallets at the door.

A true problem solving model of problem identification and clear solutions would, I think, be possible, but not with greedy politician and talk show hosts spouting generalizations and calling each other names.  My son who has cirrhosis of the liver, and no funds at all could be aided by some program, there are government programs that are supposed to help in those situations but rationing already exists.  Any one who has studies what goes on the the doctors office knows that rationing by insurance companies is already as real as rationing by government is likely   to be.

I am grateful for a reasonable retirement income, and can hardly imagine my fate without it when drug co payments alone for Janet and myself total over 300 dollars a month.

Janet has disintegrating hips and has been told on several occasions that she needs surgery on her descending aorta which has a dissection (sort of a full length aneurysm) that has killed one of her kidneys.  My oldest son has no functioning liver,  and I am a physical mess with my memory going fast, and my physical abilities about twenty percent of what they were four years ago.As far as the plans that have been proposed so far, (that have almost no research into the real nature of the problem, such as it is), I am terrified that they might be passed into law, and almost as terrified that they might not be.

I should have started this earlier.  As I read it I realize that I am rambling, but, for that matter so is almost everyone else that is "discussing " this issue. 

unsuccessful hypocrite

I am indeed an unsuccessful hypocrite.   I have been very critical of the cash for clunkers program.  I think it is a real strange way to subsidize an industry that is up to its ears in subsidy anyway.  

In spite of my criticism, (and in part because I own three cars that have over 160,000 miles on them. one of which is almost dead and another that is obviously thinking of dying) I decided to go car shopping Friday.

I found a car that both Jan and I loved, that was economical to drive and with a 2000 dollar rebate and 4500 dollars from the cash for clunkers we could (marginally) afford.  We didn't actually take the cars to the dealer, he wanted to check titles first.

Neither of our clunkers qualify.  I had purchased cars that were originally gas savers (not now).  In order to qualify for "cash for clunkers" your "trade in" had to have an original EPA mileage rating of 18 mpg or worse.  Both of my clunkers had original mileage ratings of 20 mpg.

Sigh!!! Hypocrisy is bad enough, unsuccessful hypocrisy is almost unforgivable.

Saturday, August 08, 2009

Its always interesting, at least to me.

I have been working harder (physically) than I have been able to do for some time getting out house ready for the renters.  They are officially moved in, (at least their stuff) but I am still touching things up.

I went in this morning to replace and ground four outlets in one of the bedrooms, since they were the only ones in the house that weren’t repaired earlier.  When I opened the door and turned on the lights, in the house- - - - Nothing.  The power was off.  I was a little concerned that the boys hadn’t made their power arrangements with Ga Power, but hey, I thought, that makes it easy to change out outlets.   I had two of them finished , and another removed when I grabbed a wire to attach it and BZZZZZ.   I let out a yell, dropped the wire, said a quick thank you that I wasn’t touching a solid ground and went to check the power.  Apparently Ga. Power had shut the house off for some reason and had just turned it on in time for me to experience a vital sensation.  I went in and turned off all the breakers (which I should have done even if the power was off) and went about my business.  But it was interesting.  The thought occurred to me that if I was electrocuted while Jan was out of town, she would just about kill me when she came home.  Anyway, a lot of things I should have fixed while we were living here are fixed now.

I read the news, listen to radio and TV. and worry so much that I think I should be posting about the matters of the day.  Patrick at “Redneck” wrote an article yesterday that was so cogent that he made me a little ashamed of filling the pages with fluff, but I still just save my gripes for comments on other blogs.  Analyzing everything that is going on has become too much work.  I really miss Gayles Dragon Lady Republican Blog but she seems to have hit the same block that has hit me.  She is almost to turn three score and ten (or more)

Thursday, August 06, 2009

Silly Stuff

I know that some of you are Wal-Mart haters and that’s fine, but Wally World is a wonderful source of silly.

If you drive through a Wally World parking lot you are sure to see signs that “This Parking Place limited to fifteen minute for Pharmacy customers.  Have you ever purchased a prescription from Wal Mart?  Fifteen Minutes?  No one has EVER purchase a prescription from Wal Mart in fifteen minutes or less (except perhaps the Pharmacist who works there)

Has anyone ever noticed that as the lines grow long in Wal Mart at the end of the day, they close the less than 20 items checkouts.  This is especially true if you are not near the grocery lanes.  It is like a contest to see who can created the longest line at the check out furthest from where you parked the car.

Not being negative for a moment, has anyone noticed that Wal Mart has a whole display near the  checkouts of almost alll the things  (Sham Wow, Green bags, etc., that are advertised on television as “Not available in stores?”

One of my latest televison chuckles is the ad for stuff to apply to your eyes and a brows to make your eyelashes and eyebrows grow.  The add as almost as many warnings as the adds for prescription drugs including a warning that it may permanently color the skin under the eyelash.  Which is another thing:  If everyone carefully listed to the warnings on most prescription drugs, the drug companies would be out of business because we would all stop taking drugs.  The side effects have the potential to be worse than all but the most deadly diseases.

Well, I’m tired and my poison ivy is really getting to me so I’m about to close, but I have to mention my wonderful wife Janet for a moment.

I wrote that when we got home from our Alaska/Washington State/San Juan Islands adventure, Janet turned to me and said sincerely, “I don’t think you will ever get  me on an airplane again.  She was in terrible pain.

Last  week she received an invitation to the wedding of one of her sister’s grandchildren. (Her sister is almost a total invalid, walking almost not at all, and Janet has not been able to see her sister since we got home from Finland in 2006).  She immediately recruited our youngest daughter to accompany her one the plane to Utah (and Idaho).  When I mentioned never getting on a plane again, her answer was “I may never get another chance,  I just feel that I must go”  so, she probably arrived in Salt Lake City a couple of hours ago..  She will see some of our family in that area, but will drive to Idaho Falls  (Iona, actually) for the Saturday wedding, and I miss her already and still hope to be worthy of the love of that lovely lady.  (She will be home Wednesday)  That’s not a silly thing.

Tuesday, August 04, 2009


I hardly know where to start. I really would like to take the first guy who proposed the shrinking toilet as a solution to water shortages. I am not sure whether the next step would be to station him/her in a position where he/she would have to catch toilet effluent from an old toilet and then from a new toilet in buckets and force him to measure (preferably with bare hands) the amount of effluent for a successful flush in each type of toilet or just arrange to seat him/her where the effluent would go on the idiot's head or neck. I am sure that the moronic plumbing mathematician would catch on rather quickly that more water is wasted flushing away the contents of an old toilet in one flush than is wasted in three flushes on the new modern version. The old ones worked better and saved water, but there are now laws in every state prohibiting the new installation of old style toilets. There was even a program on one of the legal television shows about some poor soul who went to Canada, smuggled in an old style toilet from Canada, installed it in his home and got caught. (I don’t remember how he was caught, and probably we don’t want to know since this is a family blog) but he was actually sentenced to prison for the act. (He caught a break though because his judge died,and somebody else received his sentence, but he admitted it was he, and they were merciful—I know, it’s complicated.)

In my old house we had one “new” toilet and one “old” one that had been “grandfathered” in. I salvaged the purity of our sewer lines by using the old one as often as possible and by placing an industrial strength plumber’s friend (sewer plunger) in a convenient relationship to the new one. Life, if not perfect, was, at least functional, and we lived there successfully for almost thirty years.

We then decided it was necessary to “downsize” since our kids were grown and the old house had 2700 square feet of space with four bedrooms and two baths. This was more house than we wanted to take care of . Our decision was helped by the fact that a realtor had found someone who wanted to buy our house, the house next to us and a vacant lot owned by the Salvation Army and build therein a little complex that would have shops downstairs and garden apartments upstairs, and we were offer almost a hundred thousand over the normal price at that time. We hastily downsized and bought a little 1700 square foot house with a pool and and acre of yard.

(We love it, but if you know anyone in the three score and ten or more category who is considering doing the same thing, remind them that someone has to clean and maintain the pool, as well as mow that acre of lawn and trim all that shrubbery, and three score and ten is not a good age to take that responsibility unless one can afford a pool boy and a yard service. Of course, if the sale of the house had gone through, we might have afforded these things.)

The fact that we still own both of these properties is evidence that the sale did not go through. Although this property was originally developed as commercial property, it has been zoned residential and the neighbors protested to the city fathers that this would make their property less valuable. (The value of almost all of it has dropped about thirty percent now, and most of the homes are now student rentals. Oh Well)

Back to toilets. We discovered that both of the toilets in our new house are “new” toilets. They require at least two or three flushes to flush away anything heavier than urine. Even worse, one has to hold on to the “handle” for at least ten seconds before they will flush at all. If one fails to hold on to the handle for the required period of time they just run constantly, thus filling up the septic tank with water. (bad thing). I am pretty handy, and I have replaced the entire guts of both these toilets twice (the second time, in consultation with a friendly plumber type), to no avail.

When Janet fell last December and shattered her femur into about four pieces, she ended up in a wheelchair for about three months and a walker for quite a while (still, occasionally). This required surgery on the bathroom door (so the wheel chair could fit in) and the installation of a raised “potty chair) with arms over the existing toilet.

When several months passed, we decided to replace one of the “johns” with a new sixteen and one half inch sitting place, enabling the removal of the temporary facility. Off I went to Lowes to purchase one of these. I examined the literature, talked to the salesman, and picked one (Made by Jacuzzi, a name that has always done me “good”) that was rated as the best flusher in the lot. (four stars).

I took it home and after removing the miserable toilet that was in place, I installed my new one. I discovered that the new toilet (Lots of people down here use the term commode, but I call a toilet a toilet) doesn’t require one to hold down the handle at all. One small touch and “swoosh” the toilet empties in about a second. BUT it still carries the curse of the new waterless toilet requirement, Though it flushes, any thing in the toilet bigger that four sheets of toilet paper remains in the bowl, looking up expectantly as if to say “HO HO HO”, and we go back to the industrial strength plumber’s friend. It is higher though, and both Janet and I can stand up after use, without a cane or an assistant.

As for the old toilet, I arranged for a charitable organization who builds homes to collect about two FULL rooms of furniture, picture frames, old stereos, etch to sell at their local “RETURN” store. I put old John in the back of the van and carried to to be placed with the other stuff. They got caught in the rain and only took a part of the stuff and couldn’t come back before my new renters were ready to move in, but guess what they left! JOHN himself. It sits there on the lawn of old house, looking lonesome. I am afraid that John’s reputation must have preceded him. I have proposed to my wife that we turn Southern Eclectic and fill the back with potting soil (as well as the seat) an plant begonias in him. I won’t darken these pages with her reply, but I am still looking for a place for him to live. If anyone wants a sturdy “new style” toilet that looks just normal and has to be flushed at least twice, come pick him up. I give directions.