In San Francisco for the BlogHer Conference last weekend, I met a young woman who had just arrived from Canada to study medicine at Stanford. Her mother is a physician in Canada and her mother’s associates had encouraged her to study in the US because, "You’ll see a lot of crazy things there.” I thought she meant culturally, but no. Apparently, doctors see many diseases in far more advanced stages here than in Canada where public medicine means lots of preventive care and diseases are often caught early. The US health system provides a clinical laboratory where disease is allowed to wreak its damage on humans unchecked and untreated. People are more afraid of the economic consequences of disease than the physical ones, and so they wait to go to the doctor until they cannot bear it any more.
I remember reading stories from my childhood and teens of American doctors going around to third world countries to help the sick. They described with great pity the advanced stages of diseases they would find in those places. I was shocked that people should suffer long and lingering deaths from diseases we had cured or could cure if caught soon enough. When I traveled in my college days, I was warned off with horror stories from going to doctors or dentists in Europe. The evidence of my friends' actual experiences confirmed that the United States had the best medical treatment in the world and I was grateful for it.
That idea may be fixed in my brain but it is simply no longer true. We rank 37th in the world, right after Costa Rica and just ahead of Slovenia when it comes to the quality of oour health care. When I look at my life and how I use the health care system, I understand. I have health insurance that only covers one checkup a year and then doesn’t kick in again until after I have spent $5000 each benefit year. This is the level of care that I can afford. Chronic or serious illness would not only limit my ability to work and thus reduce my income, my deductible amount would mean that the first $5000 I earned every year would go for doctor bills. I cannot afford to get sick.
Earlier this year I went to a doctor for palpitations. When I asked the cardiologist to discuss how to investigate the problem with an eye to cost because I had such a high deductible, he dismissed my request, saying, “That was your choice.” To him, my lower coverage was a choice to be like the grasshopper and not the ant in the Aesop fable. He must have figured I had fiddled instead of saving, coming as he does from an income bracket with excess income where saving is an option.
It turned out that my problem was no health risk and I would just have to live with thepalpitations. I was upset at having to spend so much money on doctors and tests to find out it was nothing. Yes, I know it is important to know for sure, which is why I went. But now I sit here trying to decide on whether I should have other preventive tests that doctors recommend for women my age: mammogram and colonoscopy. I’m not sure I can afford them. What would be the harm if I waited another year? Or two.
You might ask why taxes should pay for these tests if I am not willing to do it on my own. I am willing to pay several hundred dollars a month for health insurance so that if I find I have a serious problem, I will not find myself in the pitiable place of those childhood third-world ghosts I carry around in my mind. If and when that happens, the insurance will have to pay much, much more if it is discovered later rather than sooner, but the financial calculus for me does not encourage me to discover it earlier. Once I have a serious health problem, I am looking at financial ruin on top of ruined health. So I delay. I tell myself I should go but never get around to scheduling the tests. Time passes.
Yes I have my head in the sand. The cardiologist was wrong. I am not a grasshopper. I am an ostrich. I am an American.
Thursday, July 24, 2008
Our Expensive Third-World-Quality Health Care System
Saturday, July 12, 2008
The Softball Ex-Press
The blogosphere and supporters of Barack Obama have been railing over the mild-mannered treatment John McCain has received from the main stream media. The examples of glossing over his inconsistencies, mistakes and downright lies are so numerous, the voices pointing them out sound like broken records in their call for more balanced reporting. There are several reasons, however, why this gentle treatment makes sense, though none of them are about truth or the interests of the body politic. They are all about the nature of the news in the post-journalism era and the human preference for equally matched opponents.
The MSM is fighting for its life. The advertiser-driven model that pays for news wants eyeballs on the page. The big problem in covering McCain in the news is that nobody really cares about him. Obama is the story. Obama gets the eyeballs glued to the TV so that the advertisers can market their razor blades or deodorant. It has nothing to do with fairness. Obama is a celebrity, and every detail of his day will be picked apart endlessly by a ratings-driven broadcast news system (thanks to Reagan) hosted predominantly by spokesmodels instead of reporters. (Who but a bevy of spokesmodels would think that photoshopping a competitors face would be a legitimate attack against their reporting as was done at Fox News this week?) Since ratings are all, the ‘news’ must find or manufacture controversy and excitement in the subjects of interest to its viewers. And the only political subject of interest is Obama.
But it seems the media are actually bending backward to try and frame McCain’s failings and gaffe’s in a positive light. McCain’s non-joke that exporting cigarettes to Iran would have the benefit of killing our enemies was headlined by the Associated Press as a moment of fun spousal play when Cindy McCain poked hubby in the back for his comment. Or how about the headline that shows McCain leading Obama among the all-important voting bloc of pet-owners. This goes beyond picking apart Obama. It seems the MSM is actually supporting McCain by white-washing his image for him.
The election year ratings are at the core of this artificial 'balancing' of the candidates. If only one candidate is likely to be elected, if there's no real contest, then there's no news. Some semblance of a competition has to be maintained if coverage of the election is going to draw enough viewers and readers to keep news departments afloat. That presidential press corps is expensive. What's the point of spending all that money if the race is over. People will not watch a sport if the outcome is known beforehand. The Yankees playing my office baseball team would not draw much in the way of fans. After the 217th home run by the Yanks in the first inning, who would keep watching. Golf lets people of unequal skill play each other. Think of the MSM bias as being McCain's high handicap score. The media is actually raising McCain and trying to lower Obama so that the American people will be uncertain of the outcome and tune in.
Some argue that this is a betrayal of the protections offered the Fourth Estate. News should be impartial and serve the public interest. And the public needs to know just how awful McCain is. These folks are looking at the McCain campaign as a fair fight and want the blows by each side to be covered evenly. But let's face it; on a human level, it's not a fair match. No one wants to see the shame of an old man brought to face his decrepit and degenerated state. The more awful McCain is, the more I see a pathetic old man. And hitting a weak man when he’s down elicits a reaction against the messenger. The news tries to be a happy place despite the litany of death and destruction, and rubbing grampa’s nose in the mess he’s making smacks of senior abuse. They can’t admit it because he is the presumptive Republican nominee, so they avoid noticing his decline and keep us all focused on the glory that he enjoyed in his prime.
Such is the softball game played by the press with the McCain campaign. It is not a love affair with him and his maverick image. It is a self-serving posture of neutrality with all the trappings of a kangaroo-court where the verdict has been decided beforehand: the two Presidential Candidates are locked in an even battle for the White House. Details at 11.
Sunday, July 06, 2008
Vampire Republicans
Vampires - they suck your blood, infect you with their curse of bloodlust, and have no reflection that is the mark of soullessness. They might be creatures of fantasy in the literal sense, but metaphorically speaking, they are all around us making pronouncements on the television, strolling the halls of power, and debasing their enemies real and perceived in interrogation rooms around the world.
The Los Angeles Times reports that the Republican Party is worried about losing big in the coming Senate races. Sen. John Ensign (R-Nev.), chairman of the National Republican Senatorial Committee, lists a host of problems facing candidates from his party. These are all problems of what teachers would call 'plot' and not 'character.' Bad things have happened to the party. Nowhere is there an examination of whether the party's mindset and values has any responsibility for the disastrous situation.
It is not schadenfreude that makes me want to see them grovel, wear hair shirts, and climb the steps of the Capitol on their knees. Unless they see that they committed the sin of pride, dismissing with contempt their opponents on legislation and political action simply because they held all the reins, they are going to continue to support policies harmful to the body politic. Now that they see their control over the reins slipping, they moan about bipartisanship. Without acknowledgement of their fundamental failure to do the right thing - share the power when they had it all - their bipartisanship is a sham.
Amends need to be made. I know it is an election year, but the Republicans must do for their nation what Hillary has done for her party. She still believes she is the better candidate, that Barack cannot win, and if he does, his policies will sometimes take us in the wrong direction. But she has put on a smile and is supporting him absolutely.
After 9/11 the Democrats did that for the President and his party. Sometimes they held their noses and voted with the majority trusting that the other side also had the nation's best interests at heart. Republicans now trying to blame the President for all the failings of his administration look in the mirror of history and do not see themselves at all. Like vampires, they sucked out much of the wealth and national standing in the world gained during the Clinton years and now are wringing their hands wondering what went wrong. They look in the mirror and do not see their own faces. Like the vampires, they have lost their soul.
If the Republican in the Senate want to salvage some of this next election, they have to make amends to redeem their souls. Not just apologize, but support the Democrats on issues important to them as a way of admitting that the elephant in the room is not always right. The reality of this country right now shows that their policies were often wrong-headed. How can we trust giving them the means to govern again unless they can demonstrate that they have eyes to take a good look at themselves in the mirror in the light of day?
