There was a time in America when we used to let our military win wars. Yeah, I know- it’s easy to be an expert sitting in an arm chair. But, it’s a pretty obvious conclusion based on the evidence
World War II ended the string of American Military victories in 1945- the same year the Chicago Cubs last played a World Series game. Since then, we got stalemated in Korea in the early 1950’s, ran away from Viet Nam twenty years later when we lost the guts to do it correctly but did win the battle in Grenada in 1983. I think, though, it was used as a military recruitment training exercise video. Let’s see- in the early 1990’s we moved the battlefront to the Middle East and quit when the politicians yelled that it was time to come in and eat. Conflict was renewed in the past decade in Iraq and Afghanistan with similar results. I think both of those had to do with having a Bush President. Continue reading “Kill or Be Killed”
I have a modest proposal to reshape the health insurance system. It takes away some of the burden from the insurance companies and places it on the individual but also gives the policyholder a saving’s edge. It is based on the idea that the real culprit in all of this are hospitals.
First, here is the plan and then I’ll go into why I believe this is better than the current modus operandi:
How it works
Doctor Visits, Simple Tests, Emergency Room visits
(Self-insurance in a Health Savings Account
Individual uses up to the value of his or her premium for all outpatient visits by paying out of the HSA approved checking account. Once the HSA is exhausted, the Major Medical policy kicks in. The individual is then obligated to spend up to deductible until it is used up and then only pays 20% up to one million for the year.
If during the course of the year, the person does not use any or all of the HSA money, he or she may apply it to the next year, thereby saving them the need to again put aside extra money each year. They are rewarded for being fortunate enough to stay healthy.
Insurance companies lose out but also gain with not having to deal with the paperwork on the majority of medical visits.
Major Medical- Surgery, Expensive Tests, Procedures
2000.00 (paid to an Insurance Company)
Individual is obligated to pay up to the major medical deductible and 20% afterward for all bills up to one million dollar cap for the year. At cap, insurance company pays 100%.
Hospital organizations must also be required to drastically lower billing amounts. It is outrageous and way out of line. They do a lot of unneeded extra testing and then charge an outrageous amount for little time spent taking the tests.
Not too long ago my doctor insisted that I take a CAT scan. Correction- two cat scans, because the area of the body being scanned required two passes. I spent a total of twenty minutes going through the doughnut . The insurance company was billed over six thousand dollars for these twenty minutes of service.
The dye that they made me drink to prep for the test cost five hundred dollars! The insurance company thought that this was fair. Each scan was billed at $2800. The insurance company responded to the bill with, â€œnot so fast! We have a network (translated, a wink and a nod) agreement where you accept our negotiated rate. This brought the price down to $1400 each. Big deal! After using up my $1000 deductible for the year, I was still stuck with paying over one thousand four hundred dollars for an outpatient visit that took less than a half hour.
I called the hospital and asked to get the price reduced. They said that at best they could do was to lower it by ten percent or ask to fill out a financial aid form. I wasn’t about to be insulted by filling out such a form, so I took the discount but then asked for the right to pay it off in three installments. The customer service agent told me that she would not allow it- either pay the full amount in twelve monthly installments, or take the discount. I told her that the hospital already received a more than thousand dollar check from the insurance company on my behalf. It was not as if they were relying only on my payment to make a profit on the deal. I asked to speak to a supervisor. She transferred me into the voice mail for a higher echelon person. He returned my call on the next business day and was equally hesitant to offer compromise. He finally told me he was doing me a great personal favor to allow me to pay the bill off in three installments while also taking the ten percent discount.
There should be only one price for a procedure regardless if a person has insurance or not or whether they are in the insurance network. Period. And the price should be regulated by an impartial group that is not beholden to the hospitals.
I recognize that some of the dollar figures listed above may need to be adjusted for practicality. Paramount, though, is that we need to put intelligence and incentive back into health care decision-making for all parties involved- the patient, doctors, insurance companies and hospitals. Otherwise, we mind as well close down the hospitals and let the healthiest survive to the next generation. It will cut down on the price of gas as there will be less people who own cars.
There is a lot of Profit and Loss record keeping in the business of Life:
Primeval gain- entering this world to experience all that it can offer.
Ultimate loss- when the offer has been permanently voided- Death. There is wishful thinking that we drift into a better place of opportunity from which to profit rather than- shudder the thought- go to that permanent place of torturous punishment
We learned to walk and talk before our memory capabilities were set. No one remembers his first steps or first words. No one can recognize events in pictures in which they appeared that occurred- let’s say- before the age of four.
We are at a loss to recall much of what happened in kindergarten but gained so much from the elementary bits of knowledge and social graces that were taught there. Later on we cluttered our brains with algebraic equations and geometrical patterns but were at a loss to figure why it would ever be necessary to use.
We gained in our youth by building our bodies strong with exercise and the excess energy that came with it but felt the slow loss of motor skills and motivation to move about many years later.
We made new friends on a daily basis in school and saw them disappear out of our life once we graduated. Now and then someone told us, â€œdid you hear so and so passed away?â€ and immediately thought of only the nice things that happened between us.
As time kept ticking away when past our prime, we gained in weight but lost in height, a cruel trick of the symmetry of life.
We gained with new discoveries of modern conveniences but lost in forgetting how do things the old fashioned way.
The greatest irony saw our memories of times past, of things we did so many years earlier come more into focus than what we did four hours earlier.
And we knew who you were but just couldn’t remember your name.
As our liabilities increased to equal our assets, our equity disappeared. Then, one day they said it was time to go and we couldn’t remember any good reason to say no.
Do you still believe in heroes? A kid’s hero is usually an athlete and maybe a movie or television performer. I spent most of my youth in the 1960’s and was always a Chicago Cubs fan. My number one hero was Billy Leo Williams. He batted left handed although he threw with his right hand. Being a lefty myself, I hitched myself to his wagon. For sure, there was also Ernie Banks, who batted righty and was Ma’s hero, so I didn’t want to steal her thunder. The number on the back of Ernie’s uniform was 14 and that became Ma’s lucky number.
Although Ron Santo made up the third part of the fan’s favorite trio during the 60’s decade, I never did cotton to him. He tended to be a hot dog and did not endear himself to the opposition when he would click his heels all the way to the clubhouse after Cubbie victories. Despite compiling enviable statistics, it always seemed as if he hit his home runs late in the game when the score was already lopsided against the Cubs and the cause was hopeless.
Santo also got into a famous fight with the Cubs skipper, Leo â€œThe Lipâ€ Durocher. I felt that he caused friction and division in the dugout and it was a significant reason that the team never made it over the hump despite being loaded with talent. Continue reading “Heroes”
“The Sweetest Sounds, I’ll ever hear are still inside my head” invokes a special memory for me. It was written for a musical play called “No Strings” which debuted in 1962. It is the opening line to just another in a series of many great songs put together by the team of
They say that a grave site is a plot that has no ending. I make an effort to go visit Dad’s when the time permits. The cemetery closes the gates in mid-afternoon to avoid dealing with society’s losers lurking around the area. It is about two miles east on Roosevelt Road in the Western suburbs of Chicago from a client of mine. I try to combine business with sorrow. Continue reading “The Plot Thickens”
â€œAre you or have you ever been a member of the Communist Party?â€ It’s like asking someone “œwhen did you stop beating your wife?” Questions like these more often than not led to no-win situations. If the answer was, “I didn’t”, the interrogator could take it to mean that the person under the spotlight never stopped hitting his spouse or if they were of a less suspicious nature that the person never had hit his wife. As for the political persuasion- even if one had once been a member but had quit five years earlier- it still made them guilty by association. Continue reading “Prisoners of Silence”
In 1980, I signed my first agreement. It was not a real contract per se that had paragraph after paragraph stipulating performance objectives, duration and compensation. It simply stated that I was to receive ten dollars an hour working eight hours a day for three days a week at a company that maintained power regulation equipment. For several weeks I was to receive two hundred and forty dollars per week to write inventory control software on a very early model small business computer. Continue reading “Contractually Speaking”
This is not about old memories but about a song I hate.
In September, 1970, it was time for me to stop being a kid and go off to college. It meant walking three quarters of a mile in all types of weather to the CTA bus turn-around at Devon and Kedzie next to the Thillens Little Leagiue Baseball Stadium. I’d grab a bus to Northeastern Illinois University, located on the far north side of the city of Chicago at Bryn Mawr and St. Louis Avenues. I reversed the process going home so I was not only getting an education but a good physical workout.
In those days the school was still called Northeastern Illinois State College. At some point in my freshman year, it got full accreditation instead of just a factory for turning out teachers. It took great pride in offering a diverse curricula.
I did not go there with the intention of becoming a classroom babysitter, which is what I thought most teachers were. I was also clueless on what major to latch onto. I naturally chose to take as many classes that first trimester that fit into a decent schedule as well as figured to do well in. The class registration system was set up so that upperclassmen were entitled to enroll for the coming trimester first. This left the not so exciting courses as well as odd time schedules for freshmen. Continue reading “Long, Long Ago”
My father was from the old school of salesmen. He had the gift of gab and believed in his product while it seems today as if everyone pushing something is out just to make a buck.
I recently went to a men’s clothier to buy a new suit which had been long overdue. Six months earlier the store used to be across the street from my condo building. They moved away to a more obscure but not too far distant location. At the old place, the entrance was as if going into a speakeasy. One had to drive to the back parking lot that was much in need of repair and enter through a very nondescript and almost unmarked door. Once inside, there were a handful of salesmen eager to grab the next sucker, I mean, prospect entering through the ugly portal. Continue reading “Dearth of The Salesmen”